Miracle-dz/UniFAR-FTUs huggingface dataset:
From peer-based to peer-led: redefining the role of peers across the hepatitis C care pathway: HepCare Europe

Abstract Background HCV infection disproportionately affects underserved populations such as homeless individuals, people who inject drugs and prison populations. Peer advocacy can enable active engagement with healthcare services and increase the likelihood of favourable treatment outcomes. Objectives This observational study aims to assess the burden of disease in these underserved populations and describe the role of peer support in linking these individuals to specialist treatment services. Methods Services were identified if they had a high proportion of individuals with risk factors for HCV, such as injecting drug use or homelessness. Individuals were screened for HCV using point-of-care tests and a portable FibroScan. All positive cases received peer support for linkage to specialist care. Information was gathered on risk factors, demographics and follow-up information regarding linkage to care and treatment outcomes. Results A total of 461 individuals were screened, of which 197 (42.7%) were chronically infected with HCV. Referral was made to secondary care for 176 (89.3%) and all received peer support, with 104 (52.8%) individuals engaged with treatment centres. Of these, 89 (85.6%) started treatment and 76 (85.4%) had a favourable outcome. Factors associated with not being approved for treatment were recent homelessness, younger age and current crack cocaine injecting. Conclusions Highly trained peer support workers working as part of a specialist outreach clinical team help to identify a high proportion of individuals exposed to HCV, achieve high rates of engagement with treatment services and maintain high rates of treatment success amongst a population with complex needs.
KNOWLEDGE AND PRACTICES OF RESIDENT DOCTORS AND NURSES IN BREAST FEEDING IN OBSTETRIC AND PAEDIATRICS DEPARTMENTS OF JINNAH HOSPITAL, LAHORE

Breastfeeding is fundamental to the health and development of children and important for the health of their mothers. The promotion and support of breastfeeding is a global priority and an important child – survival intervention and the World Health Organization advocates exclusive breastfeeding for six months. The purpose of this study was to assess the knowledge and practices among the resident doctors and nurses of Obstetric and Paediatrics departments regarding breastfeeding. It was a descriptive cross sectional study. It was carried out at the Obstetric and Paediatrics departments of Jinnah Hospital, Lahore from March – October 2009. Patients and Methods: Using non-probability purposive sampling, resident doctors and nurses of the obstetrics and pediatrics departments fulfilling the inclusion criteria and who gave their verbal consent were included in the study. Their knowledge and practices regarding breastfeeding were assessed by a pre-tested questionnaire. Results: In a total of 133 respondents, 78 (59%) doctors and nurses were interviewed from the Obstetric department and 55 (41%) doctors and nurses were interviewed from the Paediatrics department. Regarding training for breastfeeding promotion, 98 (74%) of the respondents did not receive any training. The knowledge of the 77 (99%) respondents of the obstetric department and 55 (100%) of paediatrics departments was less than 50%. Regarding practices related to breastfeeding promotion, 58 (74%) and 48(89%) out of 133respondents of obstetric and Paediatrics department had poor practices (< 50%). Conclusion: There is poor knowledge and practices regarding breastfeeding among the health care workers of the tertiary level hospital as they had not received any proper in – service training while working in their respective departments.
EXCISION OF THE LUNATE BONE IN KIENBÖCK'S DISEASE

1. Twenty-four cases of excision of the lunate bone in Kienbock9s disease have been reviewed. 2. In general, the results have been favourable, with 88 per cent excellent or good and 12 per cent fair or poor. 3. Abnormal contact between the triquetrum and the styloid process of the ulna appeared in many cases, but this contact did not appear to prejudice the results. 4. Excision after prolonged symptoms of the disease gave disappointing results.
Autophagy induction in the treatment of Alzheimer's disease

A growing body of evidence indicates that autophagy, an intracellular degradation pathway, profoundly affects Alzheimer's disease (AD) pathogenesis. Autophagy mediates the degradation of neurotoxic material and damaged organelles, allowing their clearance by glial and neuronal cells, while impaired autophagy may account for the accumulation of protein aggregates. Accordingly, dysfunctional autophagy is one of AD hallmarks; it occurs early in the disease development, which makes it an attractive therapeutic intervention target. Therefore, in recent years, the potential of autophagy induction as a treatment for AD has been studied extensively using various autophagy inducers, most of which are already in clinical practice for other medical conditions. Albeit promising results, including in AD clinical trials, this therapeutic strategy still requires careful consideration in order to fully understand the role of autophagy in AD pathogenesis and to further improve the outcomes. This review summarizes the current findings in this field and raises open questions and new prospects.
Matrix Decompositions and Sparse Graph Regularity

We introduce and study a matrix decomposition that is a common generalization of the singular value decomposition (SVD), cut decomposition, CUR decomposition, and others. For any given set of pairs $P \subseteq \mathbb{R}^m \times \mathbb{R}^n$ and matrix $A \in \mathbb{R}^{m \times n}$, we write $A$ as a weighted sum of rank one matrices formed by some pairs in $P$. The resulting projection value decomposition (PVD) inherits several useful properties of the SVD; for example, the decomposition can be obtained by greedily peeling off rank one matrices, and the norm of the coefficients of the decomposition is the Frobenius norm of the matrix. Perhaps most interesting is that, in analogy with low-rank approximation from SVD, truncating the decomposition gives matrix approximations of small error. When applied to the adjacency matrices of graphs, the PVD lets us derive the weak regularity lemma of Frieze and Kannan as well as Szemeredi's strong regularity lemma. Whereas these regularity lemmas in their usual forms are nontrivial only for dense graphs on $\Omega(n^2)$ edges, our generalization implies extensions to a new class of sparse graphs which we call cut pseudorandom, which are roughly those with small leading coefficients in the appropriate PVD. It turns out that cut pseudorandomness unifies several important pseudorandomness concepts in prior work: we show that $L_p$ upper regularity and a version of low threshold rank are both special cases, thus implying weak and strong regularity lemmas for these graph classes where only weak ones were previously known.
MUSIC PERFORMANCE AS A THERAPY FOR MANAGING STRESS AMONGST THE ACADEMICS IN NIGERIAN FEDERAL UNIVERSITIES

The serious breakdown in health of the academics in Nigerian Federal Universities which placed them in chronic dependency on drugs has necessitated this study. The study adopted a descriptive survey approach which ascertained that music performance as therapy would be a vital tool for managing stress amongst the academic staff of the Nigerian Federal Universities. The population comprised all the lecturers from the faculties of Education and Humanities in the two Federal
La imagen radiológica de la tuberculosis pulmonar en pacientes con farmaco-resistencia. Estudio comparativo

Introduction: Pulmonary tuberculosis is an important cause of morbility and mortality in developing countries, and the possibility of infections with drug-resistant strains has increased. Tuberculous lesions are usually located in the upper lung field, but there is scanty information about the radiological presentation in patients with drug-resistant tuberculosis. Objective: To compare the radiological presentation of multidrug-resistant (MDR) tuberculosis with the observed in other drug-resistances (non-MDR) Methods: The chest X-rays of patients with drug-resistant pulmonary tuberculosis attending a tuberculosis clinic between 1994 and 1995 were reviewed. Lesions were classified according to their location in the upper, lower or multilobar lung fields, and presence of cavitations was assessed. Results: We included 50 patients, in whom multilobar were the most frequent lesions (58.8%). MDR tuberculosis was present in 34 (68%) of patients. When we compared MDR and non-MDR tuberculous patients, there was no difference in the location of pulmonary lesions or in the frequency of cavitations. When adjusted by gender, a difference in the frequency of bilateral multilobar lesions (p = 0.004) and cavities (p = 0.02) in male patients with MDR tuberculosis was observed. Conclusions: Radiological images in MDR tuberculosis were very similar to those observed in other resistances and, in general, whichever the drug-resistance could be, their images seem to be similar to those found in tubercu- losis due to sensitive strains.
Response by Kim, Son, and Nam

We thank the commentators for giving us very thoughtful comments. As the commentators pointed out, health care professionals have become aware of ever-increasing health disparities in tobacco control and are now challenged with an urgent need for smoking prevention and cessation interventions in underserved populations (Fagan et al., 2004). Although the rate of smoking prevalence for Korean male immigrants has been high, there are almost no culturally tailored smoking cessation programs available to them. To be effective, cessation interventions must be sensitive to the needs of an ethnic group in mind. This study was conducted to provide the groundwork for future cessation interventions in Korean American men, and findings highlighted the need for culturally tailored cessation interventions. We concur with the commentators’ perspectives that the interviewer plays an instrumental role in qualitative research. Qualifications of the moderator leading focus groups are quite critical for scientific integrity of the findings. The moderator is the second author of this study and a mastersprepared social worker with ample experience as a small group leader and therapist. The principal investigator and first author of this study worked closely with the social worker to ensure the rigor of the qualitative methods used for the study. For example, she provided feedback immediately after each group meeting on the use of moderating skills. Of the five themes—culture, gender, addiction, health, and age—the focus of this article is on the first two themes, and findings pertaining to the other themes have been reported elsewhere (Kim, Son, & Nam, 2005). The second article using the same data set described in detail Korean American men’s personal experiences with smoking and quitting. The clinical implications of the findings and suggestions for future studies are made specifically in relation to some cessation strategies used by Korean male smokers in the study. We recommend that readers also read this article. A combination of pharmacotherapy and cognitive behavioral therapy at an individual or group level is currently the leading treatment modality as outlined in the Clinical Practice Guideline (U.S. Department of Health and Human Service, 2000). The effectiveness of these treatments has been validated mainly with Whites, and the number of Asian Americans who
Operating theatre nurses’ experiences of teamwork for safe surgery

The aim of this study was to describe operating theatre nurses’ experiences of teamwork within the surgical team in regard to achieving patient safety. Safe surgery for patients is based on teamwork in a safe modus between the members in the surgical team. Operating theatre nurses contribute to safe surgery by professional perioperative nursing activities and by participation in teamwork in the surgical team. A qualitative descriptive design using narrative interviews with 16 operating theatre nurses in Sweden was chosen for increased understanding of their experiences of teamwork in regard to achieving patient safety. The findings are presented in three themes, illustrating teamwork in regard to achieving patient safety between the operating theatre nurses’ and other professionals in everyday situations. From the operating theatre nurses’ narrated experiences of teamwork, person-centred nursing care, interdependent collaboration and familiarity of the professionals’ skills contributed to safe surgery. A brief meeting, unfamiliarity of professionals’ skills, uncontrolled tantrums and experiences of exclusion were experienced as counteractive to patient safety. The operating theatre nurses managed demanding situations by diverse strategies to restore patient safety.
The effect of 12 weeks regular physical activity and vitamin E in the treatment of non-alcoholic steatohepatitis: A pilot study

Background: Despite the prevalence of Non-Alcoholic Fatty Liver Disease (NAFLD) and Non-Alcoholic Steatohepatitis (NASH), no treatment has been proven to be effective in these common diseases. Although many studies have shown that lifestyle modifications such as increasing physical activities and exercise could be effective in the treatment of these common diseases, the optimal strategy is still not determined. According to the beneficial effects of antioxidant agents in the treatment of NASH, vitamin E has been used for this purpose by some clinicians. We designed this study for assessing beneficial effects of regular physical activity on the biochemical and imaging responses in patients with NASH and comparing this with vitamin E as an accepted treatment for NASH. Materials and Methods: Randomized and single-blind clinical trials were carried out in Gonbad-e Kavus through which a total of 30 consecutive patients with the ultra sonographic diagnosis of non-alcoholic steatohepatitis (NASH) were enrolled and randomized to one of the three arms: Vitamin E 800 mg/day, regular physical activity, or both. Results: Significant improvement in liver transaminases level and ultrasonographic grading of fatty liver occurred in all groups after 3 months of treatment although there was no considerable difference between the treatment groups in these responses (ANOVA: P>0.5). Conclusion: There were no significant differences between exercise and vitamin E alone or in combination regarding the reduction in the level of liver enzymes and sonographic evidences of fatty liver although both resulted in significant improvements in biochemical endpoints. This implies that physical activity could be considered as effective as vitamin E in the improvement of biochemical and ultrasonographic presentations of NASH and the addition of Vitamin E does not offer any benefits. According to the findings of this pilot study a full-powered study with a control group should be designed.
Ganglioneurocytoma (central neurocytoma with diffuse ganglionicdifferentiation) with neuraxis dissemination. Case report and review of the literature

We report the case of a 46-year-old man with ganglioneurocytoma, initially managed by subtotal resection. The location of the tumour was typical for central neurocytoma, but there was a rapid local progression (in 3 months) mimicking malignant tumour with simultaneous dissemination in the brain as evidenced by magnetic resonance imaging (MRI). The histological appearance of this tumour lacked features of malignancy and showed two neoplastic cells types – a predominance of neurocytes with some ganglion cells scattered singly and in clusters in all parts of the tumour. An immunostain for synaptophysin was typical for neuronal tumours. The proliferative potential of the tumour was low, as indicated by an MIB1 immunostain. The disease was managed at progression with radiotherapy delivered to the whole brain (42 Gy in 15 fractions) and with a boost to the primary site (2 fractions of 2 Gy). Four months after radiotherapy the neurological status of the patient had improved and he no longer required steroid administration. MRI revealed tumour stabilisation. We conclude that neuronal tumours like ganglioneurocytoma or central neurocytoma with diffuse ganglionic differentiation may not be as benign as previously thought and discuss other data reporting malignant behaviour of such tumours. Aggressive tumour behaviour can occur in the absence of the described histopathological signs of poor prognosis, making clinical predictions from the pathological data uncertain. The predictive value of the proliferative index, reported by some authors, is not always a reliable predictor of aggressive behaviour, as exemplified by the case now reported.
Doctoral-level qualifications outside of universities: A comparison of forms and practices

The breadth of doctoral forms available in universities has expanded considerably over the last twenty years to include a wide range of professional and practice-based doctorates in addition to the well-established PhD and older academic doctorates such as the DSc and DLitt. However, the essential properties of the doctorate – that it consists of original research or scholarly contribution, and that it represents a substantial piece or collection of work equivalent to at least three years’ full-time study – remain the hallmark of qualifications at this level. Outside of higher education there are a small number of qualifications that while not doctorates are considered to be broadly at doctoral level. The forms and practices represented by these awards are somewhat more diverse than those of university doctorates. Three contrasting awards made by professional institutes and general awarding bodies are taken as examples and their claims to doctoral level discussed. Using them as a mirror to current university practice opens up questions about whether there is scope for greater diversity at the topmost academic level, for instance through smaller awards that support professional leadership and accredit small-scale but original contributions to practice. It also asks questions about the kind of work that can contribute to doctoral level (relevant to the modular component of some professional doctorates), as well as the boundaries between awards representing rigorous assessment of professional contributions and those that are more honorary in nature.
The Effects of Vitamin C on Bone Development in Children and Adolescents

Background Numerous studies have focused on the contribution of calcium and vitamin D to bone growth and mass accumulation, but not many focused on other nutrients such as vitamin for promoting bone growth and mineralization. Objectives 1) To determine whether dietary intakes of Vitamin C positively supports bone growth and increases the bone mineral density in both boys and girls. 2) To determine the effectiveness of fruits and vegetables for improving bone mineral density in adolescents. Search Methods The search strategies included a search on PubMed.gov for studies from year 2000 to present that focused on the correlation between the vitamin C or fruits and vegetable intakes and the bone development. Key terms: vitamin C, bone mineral density, bone mineral content, fruit, vegetable, dietary intake, adolescence, bine development, Dual energy x-ray absorptiometry (DXA), peripheral quantitative computed tomography (pQCT), and diet questionnaire.
Inclusion of disabled students in Higher education in Zimbabwe

Inclusion of disabled students in higher education has been gathering momentum in various countries, although until recently, it has not been under the spotlight. This study was born because of the absence of research on personal experiences of disabled students in higher education in Zimbabwe. The study's major object was to investigate the current provision for disabled students in higher education in Zimbabwe. Narrative research and ethnography are the methodologies that informed this study. Fifteen University of Zimbabwe disabled students were the main informants of this study. Inevitably, the study took into cognisance, the researcher's vast personal and professional experience, and diverse views from other scholars through a comprehensive literature review. The study established that attitudes and disability awareness could be either catalysts or obstacles to inclusion. Institutional barriers that incorporate physical access, inappropriate application and admission procedures, inappropriate teaching methods, inadequate support services and resources, and most importantly - absence of legislation and political will, hampered participation of disabled students in higher education in Zimbabwe. Lack of coordinated disability activism among disabled people's organisations was also reported in this study. It was from these research outcomes that the researcher constructed the social ecosystem framework, which embodied the theoretical resources, namely, postcolonial theory, globalisation, disability studies and inclusive education. Critical determinants in the applicability and effective use of the social ecosystem framework in promoting the inclusion of disabled students in higher education in Zimbabwe and beyond were identified. These include enabling socio-cultural beliefs, genuine family and community support, stable political and economic climate, appropriate legislation and political will, appropriate/accessible information and technology, self-belief, proactive disability activism, and sustainable partnerships. Conclusions drawn and practical recommendations were made to various stakeholders in the education of disabled students in higher education. Finally, the research study also signposted areas for further research.