Miracle-dz/UniFAR-FTUs huggingface dataset:
Targeting obstetric providers in interventions for obesity and gestational weight gain: A systematic review

Background Providers need to be comfortable addressing obesity and gestational weight gain so they may give appropriate care; however, health care providers lack guidelines for the most effective educational strategies to assist in providing optimal care. Objective To identify studies that involved the obstetric provider in interventions for either the perinatal management of obesity and/or gestational weight gain in a systematic review. Search strategy A keyword search of databases was performed up to April 2017. Selection criteria Obstetric providers who participated in an intervention with the aim to change a provider’s clinical practice, knowledge, and/or satisfaction with the intervention in relation to the perinatal management of obesity or gestational weight gain were included. Provider intervention could include training or education, changes in systems or organization of care, or resources to support practice. PROSPERO database #42016038921. Data collection and analysis Bias was assessed according to the validated Mixed Methods Appraisal Tool. The following variables were synthesized: study location and setting, provider and patient characteristics, intervention features, outcomes and efficacy, and strengths and weakness. Main results Of the 6,821 abstracts screened, seven studies (4 quantitative, 3 mixed-methods) with a total of 335 providers met the inclusion criteria; two of which focused on the management of obesity, three focused on gestational weight gain, and two focused on both topics. Interventions that incorporated motivational interviewing skills (n = 2), required additional training for the research study and addressed specific knowledge deficits such as nutrition and exercise (n = 3), and interfaced with the electronic medical record (n = 1) demonstrated the greatest impact on provider outcomes. Provider reported satisfaction scores were generally favorable, but none addressed provider-level efficacy in practice change. Conclusions Given the limited number of studies, varying range of provider participation, and lack of provider-level efficacy, further evaluation of provider training and involvement in interventions for perinatal obesity or gestational weight gain is indicated to determine best practices for provider and patient outcomes.
Peripheral Vestibular Disorders: An Epidemiologic Survey in 70 Million Individuals.

BACKGROUND Dizziness is a common complaint in medicine. Nevertheless, there is a lack of valid data concerning the age and gender distribution of dizziness disorders within a larger population. Therefore, the aim of the present study is to undertake a representative epidemiological survey that examines all age groups of an entire population and describes the age and gender distribution of the most common peripheral vestibular disorders. METHODS A population-based epidemiological survey based on confirmed ICD-10 codes, of an entire national population was performed. The population-based data of 70,315,919 patients were leveraged, as provided by 123 statutory health insurance companies in Germany. Patients of all age groups were analyzed. Outcome measures were age and gender distribution and the prevalence of unspecific vertigo, Meniere's disease, benign paroxysmal positional vertigo, vestibular neuritis, and other peripheral vestibular disorders. RESULTS The prevalence among the recorded diagnoses was 6.5% (6,461/100,000 individuals), with women (N = 2,973,323; 65.4%) being significantly more frequently affected by vertigo than men (N = 1,570,240; 34.6%; p < 0.001). Vertigo is rare in childhood (i.e., up to 10-14 yr of age). Subsequently, the prevalence of the analyzed diseases increases with age, up to a peak between 74 and 94 years. CONCLUSIONS The results demonstrate that peripheral vestibular disorders are common in a developed country, across all age groups and a specific distribution of these disorders can be identified for every age group and gender. The impact of these disorders on the German healthcare system is currently underestimated.
Hydrodynamics of linear acceleration in bluegill sunfish, Lepomis macrochirus

ABSTRACT In their natural habitat, fish rarely swim steadily. Instead they frequently accelerate and decelerate. Relatively little is known about how fish produce extra force for acceleration in routine swimming behavior. In this study, we examined the flow around bluegill sunfish Lepomis macrochirus during steady swimming and during forward acceleration, starting at a range of initial swimming speeds. We found that bluegill produce vortices with higher circulation during acceleration, indicating a higher force per tail beat, but they do not substantially redirect the force. We quantified the flow patterns using high speed video and particle image velocimetry and measured acceleration with small inertial measurement units attached to each fish. Even in steady tail beats, the fish accelerates slightly during each tail beat, and the magnitude of the acceleration varies. In steady tail beats, however, a high acceleration is followed by a lower acceleration or a deceleration, so that the swimming speed is maintained; in unsteady tail beats, the fish maintains the acceleration over several tail beats, so that the swimming speed increases. We can thus compare the wake and kinematics during single steady and unsteady tail beats that have the same peak acceleration. During unsteady tail beats when the fish accelerates forward for several tail beats, the wake vortex forces are much higher than those at the same acceleration during single tail beats in steady swimming. The fish also undulates its body at higher amplitude and frequency during unsteady tail beats. These kinematic changes likely increase the fluid dynamic added mass of the body, increasing the forces required to sustain acceleration over several tail beats. The high amplitude and high frequency movements are also likely required to generate the higher forces needed for acceleration. Thus, it appears that bluegill sunfish face a trade-off during acceleration: the body movements required for acceleration also make it harder to accelerate. Summary: Bluegill sunfish accelerate primarily by increasing the total amount of force produced in each tail beat but not by substantially redirecting forces.
Finite‐Element Syntheses of Callus and Bone Remodeling: Biomechanical Study of Fracture Healing in Long Bones

Computational simulations of fracture healing are a valuable tool to improve fracture treatment and implants. Several finite‐element models have been established to predict callus formation due to mechanobiological rules. This work provides a comprehensive simulation for virtual implantation through the combination of callus simulation and finite‐element structural synthesis (FESS) of (re‐)modeling during and after healing based on Pauwel's theory of histogenesis and Wolff's law. The simulation is based on a linear elastic material model and includes generation of fracture hematoma and initial mesenchymal stem cell concentration out of an unspecified solid, cell proliferation, migration, and differentiation due to mechanical stimuli and time‐dependent axial loading. Three nondisplaced femoral shaft fractures with initial interfragmentary movement of 0.2, 0.6, and 1 mm and one fracture with 4 mm translation are modeled. The predictions of interfragmentary movement during fracture healing, healing success, and healing time agree with observed clinical outcome, animal models, and other numerical models. Initial interfragmentary movement between 0.2 and 1 mm leads to healing success, with the fastest healing occurring at 0.2 mm. The model of the dislocated fractures shows no further bending after remodeling and is loaded with physiological stress of −13 MPa. Ideal load–time graphs may give insight into the bone's ability to withstand loads as healing time progresses, and thus holds potential for applications in rehabilitation planning. Better knowledge of the forces present during fracture healing is needed to deploy simulations for surgical planning and manufacturing of patient individualized implants. Anat Rec, 301:2112–2121, 2018. © 2018 Wiley Periodicals, Inc.
Assessment of Tuberculosis Prevalence in Newly Diagnosed Human Immunodeficiency Virus-Infected Adults Attending Care and Treatment Center in Gujarat, India

Background: Tuberculosis (TB) is first opportunistic infection and leading cause of death among human immunodeficiency virus (HIV)/AIDS. Certainly, the prevalence of TB is expected to differ between general population and HIV-infected persons. This study was conducted to determine the prevalence of TB among newly diagnosed HIV-infected adults attending antiretroviral therapy (ART) center in the state of Gujarat, India. Materials and Methods: Cross-sectional study was carried out among newly diagnosed HIV-infected persons attending ART center from July 2012 to September 2012. Screening of TB symptoms and chest X-ray was done for those who consented. Sputum samples were collected for microscopy with Ziehl–Neelsen method for all presumptive TB cases and those diagnosed as pulmonary TB, culture, and drug susceptibility test was done. Blood samples were collected for CD4+ T-cells count and hemoglobin. Results: Out of 2021 eligible HIV-infected persons, 63.5% were males and 68.2% were in the age group of 26–45 years. The prevalence of TB was 17.8%. Among 360 patients with TB, 102 (28%) had smear positive TB, 86 (24%) had smear-negative TB, and 172 (48%) were diagnosed as extrapulmonary TB. Two hundred and thirty-eight (27%) TB patients with CD4+ T-Cell count below 200 compared to 122 (11%) patients above 200. Conclusion: A high prevalence of TB was found among newly diagnosed HIV-infected adults attending ART center for care and treatment. The prevalence of pulmonary and extrapulmonary TB was almost equal. Chances of TB disease were more with depletion of CD4 counts. The study highlights urgent need of intensive case finding as well as periodic screening of newly diagnosed HIV-infected individuals.
Transatlantic tsunami from Canary to the Caribbean

Tsunamis are among the most deadliest threat of coastal areas and a large number of tropical island are exposed because of their proximity to potential tsunami sources. However, far field sources may represent a threat and thus can not totally be eluded. In the framework of the project C3AF which studies the consequences of climate changes over the French West Indies, we used the numerical model SCHISM (ZHANG et al., 2016) to simulate several potential tsunamis propagation as well as their impacts over the Guadeloupe Island (French West Indies). In this study, we present the simulation of a potential tsunami scenario based on the collapse of the Cumbre Viera volcano, in the Canary Islands (ABADIE et al., 2012) to assess the potential threat of the Guadeloupe archipelago. Several scenario have been simulated and time arrival, wave heights and potential inundation are investigated.
Relationship between the anxiety/depression and care burden of the major caregiver of stroke patients

Abstract To investigate the anxiety/depression of caregivers of stroke patients. This study used a cross-sectional survey design and convenience sampling. Totally, 117 caregivers of stroke patients were enrolled. Data were collected from questionnaires. Hamilton anxiety scale, Hamilton depression scale, and Zarit caregiver burden interview were performed. Multiple linear regression and correlation analysis were used. The anxiety score, depression score and total burden score of 117 stroke caregivers were 16.56 ± 8.02, 18.63 ± 9.39, and 25.88 ± 10.35, respectively. Anxiety symptoms, mild to moderate depressive symptoms, and severe depressive symptoms were found in 43.9%, 26.5%, and 27.4% of the caregivers, respectively. Daily care time and medical payment method were influencing factors for anxiety and depression (P < .05). Both anxiety and depression were positively correlated with total care burden score (P < .01). Anxiety and depression are common in the caregivers of stroke patients and are closely related to care burdens. In this regard, appropriate home care guidance, psychological counseling and social support should be provided to the caregivers to reduce their physical and mental burden.
Ultra-widefield angiography in the diagnosis and management of uveitis

PURPOSE: The aim of this study is to evaluate the clinical use of ultra-widefield angiography (UWFA) in uveitis. MATERIALS AND METHODS: We showed the UWFA and traditional 55° fluorescein angiography (FA) of four cases with Eales' disease, idiopathic retinal vasculitis, aneurysms, and neuroretinitis syndrome, Behçet's disease, and idiopathic panuveitis in a tertiary medical center. Comparison of UWFA with traditional 55°FA in the diagnosis and management of uveitis and review of the literature is also presented. RESULTS: Ultra-widefield FA revealed far-peripheral vascular imaging. This information would not have been easily obtained from traditional FA. With more information of the peripheral retina, it may facilitate appropriate diagnosis and monitoring, and the management may be revised. CONCLUSION: UWFA played an important role to confirm the diagnosis of uveitis and to determine the corresponding treatment.
International neural monitoring study group guideline 2018 part I: Staging bilateral thyroid surgery with monitoring loss of signal

This publication offers modern, state‐of‐the‐art International Neural Monitoring Study Group (INMSG) guidelines based on a detailed review of the recent monitoring literature. The guidelines outline evidence‐based definitions of adverse electrophysiologic events, especially loss of signal, and their incorporation in surgical strategy. These recommendations are designed to reduce technique variations, enhance the quality of neural monitoring, and assist surgeons in the clinical decision‐making process involved in surgical management of recurrent laryngeal nerve. The guidelines are published in conjunction with the INMSG Guidelines Part II, Optimal Recurrent Laryngeal Nerve Management for Invasive Thyroid Cancer–Incorporation of Surgical, Laryngeal, and Neural Electrophysiologic Data.
Reducing dynamin 2 (DNM2) rescues DNM2-related dominant centronuclear myopathy

Significance Centronuclear myopathies are rare and severe congenital muscle diseases. Here we hypothesized that reducing dynamin 2 (DNM2) may rescue the pathophysiology observed in DNM2-related dominant centronuclear myopathy. The total DNM2 expression was reduced in a faithful murine model (Dnm2RW/+ mice) using two different methods targeting both mutated and wild-type Dnm2, adeno-associated virus-shRNA, or antisense oligonucleotides, leading to a restoration of muscle mass, histopathology, and muscle ultrastructural features to wild-type levels. This provides a therapeutic strategy for treating this disease. We also propose that targeting both alleles in dominant diseases due to a mutation in only one of the alleles can successfully rescue the phenotypes. Centronuclear myopathies (CNM) are a group of severe muscle diseases for which no effective therapy is currently available. We have previously shown that reduction of the large GTPase DNM2 in a mouse model of the X-linked form, due to loss of myotubularin phosphatase MTM1, prevents the development of the skeletal muscle pathophysiology. As DNM2 is mutated in autosomal dominant forms, here we tested whether DNM2 reduction can rescue DNM2-related CNM in a knock-in mouse harboring the p.R465W mutation (Dnm2RW/+) and displaying a mild CNM phenotype similar to patients with the same mutation. A single intramuscular injection of adeno-associated virus-shRNA targeting Dnm2 resulted in reduction in protein levels 5 wk post injection, with a corresponding improvement in muscle mass and fiber size distribution, as well as an improvement in histopathological CNM features. To establish a systemic treatment, weekly i.p. injections of antisense oligonucleotides targeting Dnm2 were administered to Dnm2RW/+mice for 5 wk. While muscle mass, histopathology, and muscle ultrastructure were perturbed in Dnm2RW/+mice compared with wild-type mice, these features were indistinguishable from wild-type mice after reducing DNM2. Therefore, DNM2 knockdown via two different strategies can efficiently correct the myopathy due to DNM2 mutations, and it provides a common therapeutic strategy for several forms of centronuclear myopathy. Furthermore, we provide an example of treating a dominant disease by targeting both alleles, suggesting that this strategy may be applied to other dominant diseases.
Using Heatmaps to Identify Opportunities for Optimization of Test Utilization and Care Delivery

Background: When a provider orders a test in a pattern that is substantially different than their peers, it may indicate confusion in the test name or inappropriate use of the test, which can be elucidated by initiating dialog between clinicians and the laboratory. However, the analysis of ordering patterns can be challenging. We propose a utilization index (UI) as a means to quantify utilization patterns for individual providers and demonstrate the use of heatmaps to identify opportunities for improvement. Materials and Methods: Laboratory test orders by all providers were extracted from the laboratory information system. Providers were grouped into cohorts based on the specialty and patient population. A UI was calculated for each provider's use of each test using the following formula: (UI = [provider volume of specific test/provider volume of all tests]/[cohort volume of specific test/cohort volume of all tests]). A heatmap was generated to compare each provider to their cohort. Results: This method identified several hot spots and was helpful in reducing confusion and overutilization. Conclusion: The UI is a useful measure of test ordering behavior, and heatmaps provide a clear visual illustration of the utilization indices. This information can be used to identify areas for improvement and initiate meaningful dialog with providers, which will ultimately bring improvement and reduction in costs. Our method is simple and uses resources that are widely available, making this method effective convenient for many other laboratories.
Systematic Analysis of Transmitter Coexpression Reveals Organizing Principles of Local Interneuron Heterogeneity

Abstract Broad neuronal classes are surprisingly heterogeneous across many parameters, and subclasses often exhibit partially overlapping traits including transmitter coexpression. However, the extent to which transmitter coexpression occurs in predictable, consistent patterns is unknown. Here, we demonstrate that pairwise coexpression of GABA and multiple neuropeptide families by olfactory local interneurons (LNs) of the moth Manduca sexta is highly heterogeneous, with a single LN capable of expressing neuropeptides from at least four peptide families and few instances in which neuropeptides are consistently coexpressed. Using computational modeling, we demonstrate that observed coexpression patterns cannot be explained by independent probabilities of expression of each neuropeptide. Our analyses point to three organizing principles that, once taken into consideration, allow replication of overall coexpression structure: (1) peptidergic neurons are highly likely to coexpress GABA; (2) expression probability of allatotropin depends on myoinhibitory peptide expression; and (3) the all-or-none coexpression patterns of tachykinin neurons with several other neuropeptides. For other peptide pairs, the presence of one peptide was not predictive of the presence of the other, and coexpression probability could be replicated by independent probabilities. The stochastic nature of these coexpression patterns highlights the heterogeneity of transmitter content among LNs and argues against clear-cut definition of subpopulation types based on the presence of single neuropeptides. Furthermore, the receptors for all neuropeptides and GABA were expressed within each population of principal neuron type in the antennal lobe (AL). Thus, activation of any given LN results in a dynamic cocktail of modulators that have the potential to influence every level of olfactory processing within the AL.
A Review of Trend of Nursing Theories related Caregivers in Korea

Background: The prevalence of chronic diseases has been rapidly increased due to population aging. As the duration of care needs increase, the caregivers’ socioeconomic burdens have also increased. Objective: This review examines the attributes of caregiving experience and quality of life of caregivers in Korea with a focus on the application of nursing theory. Method: We reviewed studies on caregivers’ caring for adult patients published till 2016 in 4 bio-medical research portal websites or data bases. A total of 1,939 studies were identified through the keyword search. One hundred forty five studies were selected by a process; of which, 17 studies were theory-applied. Selected studies were analyzed in accordance with the structured analysis format. Results: Quantitative studies accounted for 76.6%, while 22.1% were qualitative studies and 1.3% were triangulation studies. Caregiver-related studies increased after 2000. Most frequently, the caregivers were spouses (28.4%), and most frequently, care was provided to a recipient affected by stroke (22.5%). The 17 theory-based studies described 20 theories (70% psychology theories, 30% nursing theories). The most frequent nursing theory was the theory of stress, appraisal and coping. Conclusion: This study sought to better understand caregiving through the analysis of Korean studies on the caregiving experience and caregivers’ QOL and this finding helped presenting empirical data for nursing by identifying the nursing theories applied to the caregiving experience and caregivers’ QOL. The results suggest that the need for further expansion of nursing theories and their greater utilization in the studies of caregiving.
Effect of gel seat cushion on chronic low back pain in occupational drivers

Background: Low back pain (LBP) is an exceedingly common medical condition that results in significant medical and social burden. Sitting for a long period is a common aggravating factor for LBP. Although seat cushion is known to promote comfort, relieve pressure, and correct posture, its effect on chronic LBP has not yet been investigated. This study aimed to evaluate the clinical effect of gel seat cushion on chronic LBP in occupational drivers. Methods: Occupational drivers with chronic LBP lasting for >6 months were recruited. Subjects were double-blinded, randomly assigned to 2 groups (gel and foam cushion groups), and instructed to use the provided cushions while driving. Pain threshold and tissue hardness were measured at tender points using a digital algometer. Numeric pain intensity scale (NPIS), Roland–Morris Disability Questionnaire (RMDQ), and Oswestry Disability Index (ODI) were used to analyze the primary endpoint, whereas the Beck Depression Inventory and Short Form-6D were used for the secondary endpoint. Results: Of 80 enrolled subjects, 75 (gel cushion group, 40; foam cushion group, 35) were included for analysis. Both groups showed significant improvement in NPIS and ODI scores following cushion use. Results for Beck Depression Inventory and Short Form-6D scores indicated that gel cushion use was significantly helpful. Change in NPIS score was significantly greater in the gel cushion group than in the foam cushion group. Conclusion: Gel cushion use may be effective in relieving LBP in occupational drivers seated for a long period compared with foam cushion use.