Miracle-dz/UniFAR-FTUs huggingface dataset:
Environmental Needs, Barriers, and Facilitators for Optimal Healing in the Postoperative Process: A Qualitative Study of Patients’ Lived Experiences and Perceptions

Objectives: Gaining an understanding of postoperative patients’ environmental needs, barriers, and facilitators for optimal healing. Background: An optimal hospital environment (the “healing environment”) can enhance patients’ postoperative recovery and shorten length of stay. However, insights lack into patients’ lived environmental needs for optimal healing after surgery and how these needs are being met. Method: A qualitative study was conducted between August 2016 and August 2017 with 21 patients who underwent elective major abdominal surgery in a Dutch university hospital. Data were collected through context-mapping exercises and interviews to capture patients’ lived experiences and explore the meaning of these experiences. Data were systematically analyzed according to the principles of thematic content analysis. Results: Three themes were identified. First, participants want a sense of control over their treatment, ambient features, privacy, nutrition, and help requests. Participants described the need for positive distractions: personalizing the room, connecting with the external environment, and the ability to undertake activities. Finally, participants expressed the importance of functional, practical, and emotional support from professionals, peers, and relatives. According to participants, the hospital environment often does not meet their healing needs while being hospitalized. Conclusion: The hospital environment often does not meet patients’ needs. Needs fulfillment can be improved by practical adjustments to the physical and interpersonal environment and considering patient’s individual preferences and changing needs during recovery. Patient narratives, pictures, and drawings are valuable sources for hospital managers in their efforts to design evidence-based environments that anticipate to patient-specific needs for achieving early recovery.
Medical Named Entity Extraction from Chinese Resident Admit Notes Using Character and Word Attention-Enhanced Neural Network

The resident admit notes (RANs) in electronic medical records (EMRs) is first-hand information to study the patient’s condition. Medical entity extraction of RANs is an important task to get disease information for medical decision-making. For Chinese electronic medical records, each medical entity contains not only word information but also rich character information. Effective combination of words and characters is very important for medical entity extraction. We propose a medical entity recognition model based on a character and word attention-enhanced (CWAE) neural network for Chinese RANs. In our model, word embeddings and character-based embeddings are obtained through character-enhanced word embedding (CWE) model and Convolutional Neural Network (CNN) model. Then attention mechanism combines the character-based embeddings and word embeddings together, which significantly improves the expression ability of words. The new word embeddings obtained by the attention mechanism are taken as the input to bidirectional long short-term memory (BI-LSTM) and conditional random field (CRF) to extract entities. We extracted nine types of key medical entities from Chinese RANs and evaluated our model. The proposed method was compared with two traditional machine learning methods CRF, support vector machine (SVM), and the related deep learning models. The result shows that our model has better performance, and the result of our model reaches 94.44% in the F1-score.
Factors Affecting the Discharge Destination of Patients With Spinal Bone Metastases

Objective To investigate the factors affecting the discharge destination of patients with spinal bone metastases. Methods We reviewed the medical records of patients admitted to our institute with a diagnosis of skeletalrelated events secondary to malignant disease. Exclusion criteria comprised decreased cognitive function and hypercalcemia, brain metastasis, peritoneal dissemination, and pleural dissemination. The factors examined included the discharge destination, age, sex, the Barthel Index (BI) at admission and discharge, pain at admission and discharge, number of co-resident household members, length of hospital stay, treatment strategy, spinal instability neoplastic score, vertebral body collapse, spinal level of bone metastases, and motor paralysis. For the discharge destination, patients at discharge were grouped into two categories. The home group included patients discharged to their own homes, and the non-home group included patients discharged to other hospitals. Results Of 140 patients, the home group comprised 120 patients and the non-home group comprised 20 patients. Activities of daily living (ADL) and pain at rest and during motion improved significantly in the home group, whereas only pain at rest and during motion improved significantly in the non-home group. The results indicated that discharge BI and motor paralysis were the best predictors of the discharge destination; a BI cut-off value of 72.5 predicted discharge to home. Conclusion This study showed that the ADL level on discharge and motor paralysis affected the discharge destination of patients with spinal bone metastases. These results are likely to be helpful in predicting the discharge destination of patients with spinal bone metastases.
Escalating infection control response to the rapidly evolving epidemiology of the coronavirus disease 2019 (COVID-19) due to SARS-CoV-2 in Hong Kong

Abstract Objective: To describe the infection control preparedness measures undertaken for coronavirus disease (COVID-19) due to SARS-CoV-2 (previously known as 2019 novel coronavirus) in the first 42 days after announcement of a cluster of pneumonia in China, on December 31, 2019 (day 1) in Hong Kong. Methods: A bundled approach of active and enhanced laboratory surveillance, early airborne infection isolation, rapid molecular diagnostic testing, and contact tracing for healthcare workers (HCWs) with unprotected exposure in the hospitals was implemented. Epidemiological characteristics of confirmed cases, environmental samples, and air samples were collected and analyzed. Results: From day 1 to day 42, 42 of 1,275 patients (3.3%) fulfilling active (n = 29) and enhanced laboratory surveillance (n = 13) were confirmed to have the SARS-CoV-2 infection. The number of locally acquired case significantly increased from 1 of 13 confirmed cases (7.7%, day 22 to day 32) to 27 of 29 confirmed cases (93.1%, day 33 to day 42; P < .001). Among them, 28 patients (66.6%) came from 8 family clusters. Of 413 HCWs caring for these confirmed cases, 11 (2.7%) had unprotected exposure requiring quarantine for 14 days. None of these was infected, and nosocomial transmission of SARS-CoV-2 was not observed. Environmental surveillance was performed in the room of a patient with viral load of 3.3 × 106 copies/mL (pooled nasopharyngeal and throat swabs) and 5.9 × 106 copies/mL (saliva), respectively. SARS-CoV-2 was identified in 1 of 13 environmental samples (7.7%) but not in 8 air samples collected at a distance of 10 cm from the patient’s chin with or without wearing a surgical mask. Conclusion: Appropriate hospital infection control measures was able to prevent nosocomial transmission of SARS-CoV-2.
Fourier-Domain OCT Imaging of the Ocular Surface and Tear Film Dynamics: A Review of the State of the Art and an Integrative Model of the Tear Behavior during the Inter-Blink Period and Visual Fixation

In the last few decades, the ocular surface and the tear film have been noninvasively investigated in vivo, in a three-dimensional, high resolution, and real-time mode, by optical coherence tomography (OCT). Recently, OCT technology has made great strides in improving the acquisition speed and image resolution, thus increasing its impact in daily clinical practice and in the research setting. All these results have been achieved because of a transition from traditional time-domain (TD) to Fourier-domain (FD) technology. FD-OCT devices include a spectrometer in the receiver that analyzes the spectrum of reflected light on the retina or ocular surface and transforms it into information about the depth of the structures according to the Fourier principle. In this review, we summarize and provide the state-of-the-art in FD-OCT imaging of the ocular surface system, addressing specific aspects such as tear film dynamics and epithelial changes under physiologic and pathologic conditions. A theory on the dynamic nature of the tear film has been developed to explain the variations within the individual compartments. Moreover, an integrative model of tear film behavior during the inter-blink period and visual fixation is proposed.
Correlation of hyperpolarized 13C‐MRI data with tissue extract measurements

Hyperpolarized (HP) 13C MRI provides the means to monitor lactate metabolism noninvasively in tumours. Since 13C ‐lactate signal levels obtained from HP 13C imaging depend on multiple factors, such as the rate of 13C substrate delivery via the vasculature, the expression level of monocarboxylate transporters (MCTs) and lactate dehydrogenase (LDH), and the local lactate pool size, the interpretation of HP 13C metabolic images remains challenging. In this study, ex vivo tissue extract measurements (i.e., NMR isotopomer analysis, western blot analysis) derived from an MDA‐MB‐231 xenograft model in nude rats were used to test for correlations between the in vivo 13C data and the ex vivo measures. The lactate‐to‐pyruvate ratio from HP 13C MRI was strongly correlated with [1‐ 13C ]lactate concentration measured from the extracts using NMR (R = 0.69, p < 0.05), as well as negatively correlated with tumour wet weight (R = − 0.60, p < 0.05). In this tumour model, both MCT1 and MCT4 expressions were positively correlated with wet weight ( ρ = 0.78 and 0.93, respectively, p < 0.01). Lactate pool size and the lactate‐to‐pyruvate ratio were not significantly correlated.
Dose–Response Association Between Accelerometer-Assessed Physical Activity and Incidence of Functional Disability in Older Japanese Adults: A 6-Year Prospective Study

Abstract Background It is unknown whether moderate-to-vigorous physical activity (MVPA) in bouts of <10 minutes protects against disability risks or if only 10 minutes bouts of MVPA is critical. Additionally, it is unclear whether light physical activity (LPA) or its accumulation patterns is associated with functional disability. Methods A total of 1,687 adults aged ≥65 years and without functional disability at baseline were followed up for 6 years. Functional disability was identified using the database of Japan’s Long-term Care Insurance System. Physical activity was measured using a tri-axial accelerometer secured to the waist. Results Functional disability was identified in 274 participants (16.2%). When examined as quartiles, higher levels of all MVPA measures were dose-dependently associated with lower risk of functional disability. Associations of MVPA in ≥10 and <10 minutes bouts remained significant in a mutually adjusted model. Neither total LPA nor LPA in bout of ≥10 minutes, but LPA in bouts of <10 minutes was associated with functional disability. Analyses using restricted cubic spline functions showed that associations of all MVPA measures and LPA in bouts of <10 minutes with functional disability were linear (p for nonlinear >.05). The hazard ratios (HRs; 95% confidence interval [CI]) for functional disability per 10 minutes increment of total MVPA and LPA in bout of <10 minutes were 0.86 (0.81–0.92) and 0.96 (0.93–0.99), respectively. Conclusions Higher MVPA, regardless accumulation patterns, or LPA in bouts of <10 minutes was associated with lower risk of functional disability in a linear dose–response manner in older adults.
3,2′-Dihydroxyflavone Improves the Proliferation and Survival of Human Pluripotent Stem Cells and Their Differentiation into Hematopoietic Progenitor Cells

Efficient maintenance of the undifferentiated status of human pluripotent stem cells (hiPSCs) is crucial for producing cells with improved proliferation, survival and differentiation, which can be successfully used for stem cell research and therapy. Here, we generated iPSCs from healthy donor peripheral blood mononuclear cells (PBMCs) and analyzed the proliferation and differentiation capacities of the generated iPSCs using single cell NGS-based 24-chromosome aneuploidy screening and RNA sequencing. In addition, we screened various natural compounds for molecules that could enhance the proliferation and differentiation potential of hiPSCs. Among the tested compounds, 3,2′-dihydroxyflavone (3,2′-DHF) significantly increased cell proliferation and expression of naïve stemness markers and decreased the dissociation-induced apoptosis of hiPSCs. Of note, 3,2′-DHF-treated hiPSCs showed upregulation of intracellular glutathione (GSH) and an increase in the percentage of GSH-high cells in an analysis with a FreSHtracer system. Interestingly, culture of the 3,2′-DHF-treated hiPSCs in differentiation media enhanced their mesodermal differentiation and differentiation into CD34+ CD45+ hematopoietic progenitor cells (HPC) and natural killer cells (NK) cells. Taken together, our results demonstrate that the natural compound 3,2′-DHF can improve the proliferation and differentiation capacities of hiPSCs and increase the efficiency of HPC and NK cell production from hiPSCs.
Suitability of SBR for Wastewater Treatment and Reuse: Pilot-Scale Reactor Operated in Different Anoxic Conditions

The present study investigates the performance of a pilot-scale Sequencing Batch Reactor (SBR) process for the treatment of wastewater quality parameters, including turbidity, total suspended solids (TSS), total solids (TS), nitrogen (ammonia (NH3–N), nitrite (NO2−), and nitrate (NO3−), phosphate (PO43−), the chemical oxygen demand (COD), and the 5-day biological oxygen demand (BOD5), from municipal wastewater. Two scenarios, namely, pre-anoxic denitrification and post-anoxic denitrification, were investigated to examine the performance of a pilot-scale SBR on the wastewater quality parameters, particularly the nitrogen removal. The correlation statistic was applied to explain the effects of operational parameters on the performance of the SBR system. The results revealed that the post-anoxic denitrification scenario was more efficient for higher qualify effluent than the first scenario. The effluent concentrations of the targeted wastewater quality parameters obtained for the proposed SBR system were below those of the local standards, while its performance was better than that of the North Sewage Treatment Plant, Dharan, Eastern province, Kingdom of Saudi Arabia (KSA), in terms of the BOD5, COD, TN, and PO43- treatment efficiencies. These results indicated the suitability of SBR technology for wastewater treatment in remote areas in the KSA, with a high potential of reusability for sustainable wastewater management.
The digital patient journey solution for patients undergoing elective hip and knee arthroplasty: Protocol for a pragmatic randomized controlled trial.

AIM To describe a randomized controlled trial protocol that will evaluate the effectiveness of a digital patient journey solution in improving the outcomes of patients undergoing total hip and knee arthroplasty. BACKGROUND There is an urgent need for novel technologies to ensure sustainability, improve patient experience and empower patients in their own care by providing information, support and control. DESIGN A pragmatic randomized controlled trial with two parallel arms. METHODS The participants randomized assigned to the intervention arm (n = 33) will receive access to the digital patient journey solution. The participants in the control arm (n = 33) will receive conventional care, which is provided face to face by using paper-based methods. The group allocations will be blinded from the study nurse during the recruitment and baseline measures, as well as from the outcome assessors. Patients with total hip arthroplasty will be followed up for 8-12 weeks while patients with total knee arthroplasty will be followed up for 6-8 weeks. The primary outcome is health-related quality of life, measured by the EuroQol EQ-5D-5L scale. Secondary outcomes include functional recovery, pain, patient experience and self-efficacy. The first results are expected to be submitted for publication in 2020. IMPACT This study will provide information on the health effects and cost benefits of using the digital patient journey solution to support a patient's preparation for surgery and post-discharge surgical care. If the digital patient journey solution is found to be effective, its implementation into clinical practice could lead to further improvements in patient outcomes. If the digital patient journey solution is found to be cost-effective for the hospital, it could be used to improve hospital resource efficiency.
The APOB rs693 polymorphism impacts the lipid profile of Brazilian older adults

The apolipoprotein B (APOB) gene contains several polymorphic sites described as risk modifiers for cardiovascular events. The objective of this study was to verify the association of the classic APOB Xba I polymorphism (rs693) with atherosclerotic risk factors in a segment of the Brazilian elderly population considering their usual dietary intake. Clinical and biochemical characteristics as well as total caloric and fat intake data were determined from 644 elderly individuals. Polymorphism analysis was performed by conventional polymerase chain reaction followed by enzyme restriction. Statistical analyses compared measures and proportions according to different APOB genotypic combinations. Statistically significant association was found between Xba I polymorphism and serum LDL, total cholesterol, and total lipid levels, with important elevations among T homozygotes compared to the other genotypes. There was homogeneity in all other parameters analyzed (including intake pattern), with a tendency for reduced levels of circulating apolipoprotein B among TT individuals. Our results pointed out that genetic variation in APOB affected the lipemic profile of elderly individuals in a context not biased by diet, generating a pattern suggestive of secretory disorder of lipoprotein particles, with possible implication in atherosclerotic risk.
Comparative Study on Different Remediation Strategies Applied in Petroleum-Contaminated Soils

Due to the increasing pollution by petroleum hydrocarbons (PHs), it is an important task to develop eco-friendly and highly efficient methods for remediating petroleum-contaminated soils. In this study, bioremediation technology was applied to remediate PHs contaminated soils, and the bacterial community structure and physicochemical characteristics of the soil treated using different bioremediation regimens were analyzed. Compared with the control condition (S0), the PHs removal efficiency of biostimulation (S2) and bioaugmentation (S3) was increased significantly. Combined biostimulation with bioaugmentation (S4) had the highest PHs removal efficiency, up to 60.14 ± 4.12%. Among all the selected remediation strategies (S1–S4, S1: soil moisture content: 25–30%), the bacterial alpha-diversity was higher than in S0. The genera Acinetobacter, Escherichia-Shigella, Bacteroides, Microbacterium, and Parabacteroides were found to greatly contribute to PHs’ degradation. In the group S4, the PH-degraders and soil enzyme activity were higher than in the other remediation regimens, and these indices gradually decreased in the mid-to-later periods of all remediation tests. Additionally, the abundance of alkB and nah genes was increased by improving the environmental condition of the microorganism communities. Redundancy analysis (RDA) revealed that the total nitrogen (TN) and total phosphorus (TP) had a positive correlation with total PHs degradation. This study offers insights into the microbial community response to environmental factors during bioremediation, which shows a promoting effect in enhancing the efficiency of PHs remediation.
Achieving Universal Health Coverage (UHC): Dominance analysis across 183 countries highlights importance of strengthening health workforce

Background Despite increasing political will to achieve Universal Health Coverage (UHC), there is a paucity of empiric data describing what health system indicators are useful surrogates of country-level progress towards UHC. We sought to determine what public health interventions were useful tracers of country-level UHC progress. Methods Across 183 countries we evaluated the extent to which 16 service delivery indicators explained variability in the UHC Service Coverage Index, (UHC SCI) a WHO-validated indicator of country-level health coverage. Dominance analyses, stratifying countries by World Bank income criteria, were used to determine which indicators were most important in in predicting UHC SCI scores. Findings Health workforce density ranked first overall, provision of basic sanitation and access to clean water ranked second, and provision of basic antenatal services ranked third. In analysis stratified by World Bank income criteria, health workforce density ranked first in Lower Middle Income-Countries (LMICs) (n = 45) and third in Upper Middle Income-Countries (UMICs) (n = 51). Conclusions While each country will have a different approach to achieving UHC, strengthening the health workforce will need to be a key priority if they are to be successful in achieving UHC.
Privacy-Preserving Process Mining in Healthcare †

Process mining has been successfully applied in the healthcare domain and has helped to uncover various insights for improving healthcare processes. While the benefits of process mining are widely acknowledged, many people rightfully have concerns about irresponsible uses of personal data. Healthcare information systems contain highly sensitive information and healthcare regulations often require protection of data privacy. The need to comply with strict privacy requirements may result in a decreased data utility for analysis. Until recently, data privacy issues did not get much attention in the process mining community; however, several privacy-preserving data transformation techniques have been proposed in the data mining community. Many similarities between data mining and process mining exist, but there are key differences that make privacy-preserving data mining techniques unsuitable to anonymise process data (without adaptations). In this article, we analyse data privacy and utility requirements for healthcare process data and assess the suitability of privacy-preserving data transformation methods to anonymise healthcare data. We demonstrate how some of these anonymisation methods affect various process mining results using three publicly available healthcare event logs. We describe a framework for privacy-preserving process mining that can support healthcare process mining analyses. We also advocate the recording of privacy metadata to capture information about privacy-preserving transformations performed on an event log.