Miracle-dz/UniFAR-FTUs huggingface dataset:
Clinical and Ultrasound Assessment of Enthesis in Psoriatic Arthritis in a Romanian Cohort

Introduction: Spondyloarthritis (SpA) is a group of chronic inflammatory disorders which includes ankylosing spondylitis (SA), psoriatic arthritis (PsA), reactive arthritis (ReA), arthritis associated with inflammatory bowel disease (IBD) and undifferentiated spondyloarthritis (uSpA). The enthesis, the area of insertion of the tendon, ligament or joint capsule onto the bone, can be characterized as a central feature in PsA. Material and methods: The study included a number of 28 patients, 18 females and 10 males, with PsA hospitalized during 2016-2018 in the Department of Rheumatology of the Emergency County Hospital of Craiova. All the patients were diagnosed with psoriatic arthritis according to CASPAR criteria and had a history of entheseal pain, mandatory criteria for inclusion in the study. All patients underwent clinical examination, laboratory tests and musculoskeletal ultrasonography (MSUS). Results: The Belgrade Ultrasound Enthesitis Score (BUSES) was not significantly associated either with ESR (p=0.536) or CRP (p=0.965) values. Furthermore, the clinical evaluation through the LEEDS enthesitis index (LEI) showed no significant association with ESR (p=0.067) or CRP (p=0.206). Despite MSUS and clinical findings, there was no significant correlation between disease activity in psoriatic arthritis (DAPSA) and BUSES (p=0,549) or LEI (p=0,197). However, clinical and echographic scores (BUSES and LEI) were significantly associated (p=0.001). Conclusions: Our study proved a significant correlation between LEI and BUSES, although in literature the evidence is contrasting. This is probably due to the fact that the majority of the patients had high disease activity which made the clinical assessment similar to the US. Further studies on more numerous groups of patients have to be conducted in order to debate the inconsistencies related to clinical and US examinations in patients with PsA.
Health literacy and women's health: challenges and opportunities.

INTRODUCTION This article describes the impact of health literacy on women's health and provides strategies for addressing this public health issue. METHODS A comprehensive literature review was conducted of peer-reviewed journals. Multiple electronic databases were used, including CINAHL, MEDLINE, PubMed, and Google Scholar. Key words were used to identify articles and were combined to include health literacy, health behavior, women's health, patient education, and professional role. Additional articles were identified as a result of reviewing reference lists found during the electronic search. RESULTS Health literacy is a complex issue that affects many women and can adversely affect women's knowledge, ability to adhere to clinical plans of care, and health outcomes for women and their children. It is estimated that 36% of adults in the United States possess limited health literacy skills. Effective strategies can be used by health care providers to address this serious problem, including clear and effective communication, development of health education materials, professional education, and development of community partnerships. DISCUSSION Health literacy is a serious problem. Effective approaches can be employed to blunt the adverse effect on women's health. Health care providers are well positioned to demonstrate leadership within the health care system regarding health literacy.
Targeted Simulation-based Leadership Training for Trauma Team Leaders

Introduction Effective team leadership is linked to better teamwork, which in turn is believed to improve patient care. Simulation-based training provides a mechanism to develop effective leadership behaviors. Traditionally, healthcare curricula have included leadership as a small component of broader teamwork training, with very few examples of leadership-focused curricula. The objective of this work is to describe a novel simulation-based team leadership curriculum that easily adapts to individual learners. Methods We created a simulation-based team leadership training for trauma team leaders in graduate medical education. Participants included second- and third-year emergency medicine and surgery residents. Training consisted of a single, four-hour session and included facilitated discussion of trauma leadership skills, a brief didactic session integrating leadership behaviors into Advanced Trauma Life Support®, and a series of simulations and debriefing sessions. The simulations contained adaptable components that facilitated individualized learning while delivering set curricular content. A survey evaluation was administered 7–24 months following the training to assess self-reported implementation of trained material. Results A total of 36 residents participated in the training and 23 (64%) responded to the survey. The majority of respondents (n = 22, 96%) felt the training was a valuable component of their residency education and all respondents reported ongoing use of at least one behavior learned during the training. The most commonly cited skills for ongoing use included the pre-arrival brief (n = 21, 91%) and prioritization (n = 21, 91%). Conclusion We delivered a leadership-focused, simulation-based training that 1) adapted to learners’ individual needs, and 2) was perceived to impact practice up to 24 months post-training. More work is needed to understand the impact of this training on learner knowledge and behavior, as well as patient outcomes.
The Human Capital Study 2002–04: Tracking, data Collection, Coverage, and Attrition

Between 2002 and 2004, the Institute of Nutrition of Central America and Panama (INCAP), in collaboration with Emory University, the International Food Policy Research Institute (IFPRI), and the University of Pennsylvania, re-surveyed young Guatemalan adults who had, as children, been participants in a nutrition supplementation trial conducted by INCAP between 1969 and 1977. This “Human Capital Study 2002–04” complements and extends data obtained in previous studies by collecting new information on measures of physical health and well-being, schooling and cognitive ability, wealth, consumption and economic productivity, and marriage and fertility histories. This paper describes the study domains and data collection procedures. Among 2,393 members of the original sample, 1,856 (77%) were targets for enrollment. Response rates varied by gender, current place of residence, and domain of data collection, with 80% of males and 89% of females completing at least one data collection instrument. Attrition was not random and appears to be associated with a number of initial characteristics of individuals and their households that should be controlled for in future analyses. We conclude that data collection was successful and data quality is high, facilitating the successful undertaking of our planned investigation of important study hypotheses.
Design-Space Exploration of Energy-Delay-Area Efficient Coarse-Grain Reconfigurable Datapath

This paper presents the VLSI design of a high data throughput, energy and area efficient data path targeted for DSP and multimedia applications. Three different implementations of the reconfigurable data path using static, dynamic domino and D3L logic styles are presented to serve as low power, high speed, and speed-energy optimized variants of the architecture. When implemented using ST Microelectronics 90nm 1V CMOS technology, the proposed data path leads to a maximum supported clock frequency ranging from 917 MHz to 1.2 GHz with a dynamic power consumption @ 500 MHz ranging from 788 µW to 1.02 mW.
Long-term seizure outcome following surgery for dysembryoplastic neuroepithelial tumor.

OBJECT Resection of dysembryoplastic neuroepithelial tumor (DNET) is thought to result in favorable seizure outcome, but long-term follow-up data are scarce. The authors present a review of 18 patients who underwent surgical removal of a DNET: 12 via temporal lobectomy and six via lesionectomy. METHODS The mean long-term follow up was 10.8 years (median 10.4 years, range 7.8 to 14.8 years), and results obtained during this time period were compared with previously reported short-term (mean 2.7 years) seizure outcome data. In the current study, 66.7% patients had an Engel Class I outcome and 55.6% had an Engel Class IA outcome compared with 77.8% and 55.6%, respectively. Temporal lobectomy (Engel Class I, 83.3%; Engel Class IA, 66.7%) led to a better seizure outcome than lesionectomy (Engel Classes I and IA, 33.3%). Two patients (11.1%) required repeated operation and both had an incomplete lesionectomy initially. CONCLUSIONS Results indicated that complete resection of a DNET leads to a favorable seizure outcome, with epilepsy cure in those who had experienced early postoperative seizure relief. Long-term seizure outcome after surgery is predictable based on the result of short-term follow up.
Post-mortem Characterisation of a Case With an ACTG1 Variant, Agenesis of the Corpus Callosum and Neuronal Heterotopia

Cytoplasmic Actin Gamma 1 (ACTG1) gene variant are autosomal dominant and can cause CNS anomalies (Baraitser Winter Malformation Syndrome; BWMS). ACTG1 anomalies in offspring include agenesis of the corpus callosum (ACC) and neuronal heterotopia which are ectopic nodules of nerve cells that failed to migrate appropriately. Subcortical and periventricular neuronal heterotopia have been described previously in association with ACC. In this case report, we investigated a neonatal brain with an ACTG1 gene variant and a phenotype of ACC, and neuronal heterotopia (ACC-H) which was diagnosed on antenatal MR imaging and was consistent with band heterotopia seen on post-mortem brain images. Histologically clusters of neurons were seen in both the subcortical and periventricular white matter (PVWM) brain region that coincided with impaired abnormalities in glial formation. Immunohistochemistry was performed on paraffin-embedded brain tissue blocks from this case with ACTG1 variant and an age-matched control. Using tissue sections from the frontal lobe, we examined the distribution of neuronal cells (HuC/HuD, calretinin, and parvalbumin), growth cone (drebrin), and synaptic proteins (synaptophysin and SNAP-25). Additionally, we investigated how the ACTG1 variant altered astroglia (nestin, GFAP, vimentin); oligodendroglia (OLIG2) and microglia (Iba-1) in the corpus callosum, cortex, caudal ganglionic eminence, and PVWM. As predicted in the ACTG1 variant case, we found a lack of midline radial glia and glutamatergic fibers. We also found disturbances in the cortical region, in glial cells and a lack of extracellular matrix components in the ACTG1 variant. The caudal ganglionic eminence and the PVWM regions in the ACTG1 variant lacked several cellular components that were identified in a control case. Within the neuronal heterotopia, we found evidence of glutamatergic and GABAergic neurons with apparent synaptic connections. The data presented from this case study with BWMS with variants in the ACTG1 gene provides insight as to the composition of neuronal heterotopia, and how disturbances of important migratory signals may dramatically affect ongoing brain development.
[Incidence of risk factors and vascular complications in patients with newly diagnosed type 2 diabetes mellitus].

UNLABELLED The objective of the investigation was early detection of risk factors of diabetes and/or atherosclerosis and the prevalence of vascular complications of diabetes in newly diagnosed patients with type 2 diabetes in the Slovak Republic. PATIENTS AND METHODS In the Slovak detection programme of vascular complications participated 40 diabetological out-patient departments. In the course of one year (from the beginning of June 1999 to the end of May 2000) in a total of 3424 newly diagnosed patients with type 2 diabetes, aged under 70 years the case-history was recorded, focused on risk factors of diabetes and atherosclerosis, on the patients' lifestyle, on vascular complications of diabetes and their treatment. Moreover a detailed clinical and laboratory examination was made. The authors made in addition to assessment of the blood sugar level also biochemical examinations focused on indicators of the lipid metabolism and microalbuminuria. All patients had an ophthalmological examination, and the electrocardiogram was recorded. RESULTS As to risk factors of diabetes as many as 3259 patients (95.2%) reported a low physical activity (exercise lasting less than the minimum of 3 x 30 minutes per week) and 3001 (87.6%) had an elevated body weight, whereby 43.9% patients had a BMI of 25 to 30 kg/m2 and 43.8% were obese (BMI > 30 kg/m2). Diabetes mellitus in a first grade relative was reported by 1521 patients (44.7%). As to risk factors of atherosclerosis, the most frequent finding was hyprcholesterolaemia (values > 5.2 mmol/l) in 2262 patients (67.3%), and hypertriglyceridaemia (values > 1.7 mmol/l) in 2194 patients (66.5%). Arterial hypertension (values of systolic and/or diastolic pressure > 140/90 Hg) were recorded in 2326 (67.9%) patients. The most frequent microvascular complication of diabetes was microalbuminuria was in 20.5% patients. Ischaemic heart disease was recorded in 22.80 diabetics. Risk factors of atherosclerosis and vascular complications in newly diagnosed type 2 diabetics are closely related to the patients' body weight. CONCLUSION The authors provided evidence of a high incidence of risk factors of diabetes and atheroscleosis in newly diagnosed patients with type 2 diabetes mellitus, and in practically every fifth patient the presence of ischaemic heart disease. Obesity is a significant adverse metabolic and vascular factor.
Factors Affecting the Implementation of Clinical Pharmacy Services in China

New policies in China have recently led to the implementation of clinical pharmacy services in hospitals. We explored the views of hospital administrators, pharmacy directors, clinical pharmacists, and dispensing pharmacists about the factors affecting clinical pharmacy services in China, using the framework approach and organizational theory. We conducted 30 interviews with 130 participants at 29 hospitals (both secondary and tertiary) in Beijing, Zhengzhou, Luoyang, and Shanghai. We found that the barriers to and facilitators of implementation of clinical pharmacy services slotted into the environment and participant dimensions of Scott’s adapted version of Leavitt’s organizational model. External support from government was perceived as crucial to promoting pharmacy services. It is proposed that the internationally recognized Basel Statements of the International Pharmaceutical Federation also provide a strong foundation for guiding China in implementing clinical pharmacy services.
Sensitivity of Ablation Targets Prediction to Electrophysiological Parameter Variability in Image-Based Computational Models of Ventricular Tachycardia in Post-infarction Patients

Ventricular tachycardia (VT), which could lead to sudden cardiac death, occurs frequently in patients with myocardial infarction. Computational modeling has emerged as a powerful platform for the non-invasive investigation of lethal heart rhythm disorders in post-infarction patients and for guiding patient VT ablation. However, it remains unclear how VT dynamics and predicted ablation targets are influenced by inter-patient variability in action potential duration (APD) and conduction velocity (CV). The goal of this study was to systematically assess the effect of changes in the electrophysiological parameters on the induced VTs and predicted ablation targets in personalized models of post-infarction hearts. Simulations were conducted in 5 patient-specific left ventricular models reconstructed from late gadolinium-enhanced magnetic resonance imaging scans. We comprehensively characterized all possible pre-ablation and post-ablation VTs in simulations conducted with either an “average human VT”-based electrophysiological representation (i.e., EPavg) or with ±10% APD or CV (i.e., EPvar); additional simulations were also executed in some models for an extended range of these parameters. The results showed that: (1) a subset of reentries (76.2–100%, depending on EP parameter set) conducted with ±10% APD/CV was observed in approximately the same locations as reentries observed in EPavg cases; (2) emergent VTs could be induced sometimes after ablation in EPavg models, and these emergent VTs often corresponded to the pre-ablation reentries in simulations with EPvar parameter sets. These findings demonstrate that the VT ablation target uncertainty in patient-specific ventricular models with an average representation of VT-remodeled electrophysiology is relatively low and the ablation targets stable, as the localization of the induced VTs was primarily driven by the remodeled structural substrate. Thus, personalized ventricular modeling with an average representation of infarct-remodeled electrophysiology may uncover most targets for VT ablation.
Computational Neural Modeling of Auditory Cortical Receptive Fields

Previous studies have shown that the auditory cortex can enhance the perception of behaviorally important sounds in the presence of background noise, but the mechanisms by which it does this are not yet elucidated. Rapid plasticity of spectrotemporal receptive fields (STRFs) in the primary (A1) cortical neurons is observed during behavioral tasks that require discrimination of particular sounds. This rapid task-related change is believed to be one of the processing strategies utilized by the auditory cortex to selectively attend to one stream of sound in the presence of mixed sounds. However, the mechanism by which the brain evokes this rapid plasticity in the auditory cortex remains unclear. This paper uses a neural network model to investigate how synaptic transmission within the cortical neuron network can change the receptive fields of individual neurons. A sound signal was used as input to a model of the cochlea and auditory periphery, which activated or inhibited integrate-and-fire neuron models to represent networks in the primary auditory cortex. Each neuron in the network was tuned to a different frequency. All neurons were interconnected with excitatory or inhibitory synapses of varying strengths. Action potentials in one of the model neurons were used to calculate the receptive field using reverse correlation. The results were directly compared to previously recorded electrophysiological data from ferrets performing behavioral tasks that require discrimination of particular sounds. The neural network model could reproduce complex STRFs observed experimentally through optimizing the synaptic weights in the model. The model predicts that altering synaptic drive between cortical neurons and/or bottom-up synaptic drive from the cochlear model to the cortical neurons can account for rapid task-related changes observed experimentally in A1 neurons. By identifying changes in the synaptic drive during behavioral tasks, the model provides insights into the neural mechanisms utilized by the auditory cortex to enhance the perception of behaviorally salient sounds.
Managing Agroecosystems for Soil Microbial Carbon Use Efficiency: Ecological Unknowns, Potential Outcomes, and a Path Forward

Agricultural systems are increasingly managed for improving soil carbon (C) accumulation. However, there are limits to C returns in agricultural systems that constrain soil C accumulation capacity. Increasing the efficiency of how soil microbes process C is gaining interest as an important management strategy for increasing soil C and is a key feature of soil C dynamics in many new microbial-explicit models. A higher microbial C use efficiency (CUE) may increase C storage while reducing C system losses and is a fundamental trait affecting community assembly dynamics and nutrient cycling. However, the numerous ecological unknowns influencing CUE limit our ability to effectively manage CUE in agricultural soils for greater soil C storage. In this perspective, we consider three complex drivers of agroecosystem CUE that need to be resolved to develop effective C sequestration management practices in the future: (1) the environment as an individual trait moderator versus a filter, (2) microbial community competitive and faciliatory interactions, and (3) spatiotemporal dynamics through the soil profile and across the microbial lifecycle. We highlight ways that amendments, crop rotations, and tillage practices might affect microbial CUE conditions and the variable outcomes of these practices. We argue that to resolve some of the unknowns of CUE dynamics, we need to include more mechanistic, trait-based approaches that capitalize on advanced methods and innovative field research designs within an agroecosystem-specific context. By identifying the management-level determinants of CUE expression, we will be better positioned to optimize CUE to increase soil C storage in agricultural systems.
The Impact of Workplace Harassment on Health in a Working Cohort

Background: Workplace abuse, including sexual harassment, is frequently experienced worldwide and is related to adverse mental health outcomes, and injuries. Flight attendants are an understudied occupational group and are susceptible to harassment due to working in a feminized, client-facing occupation with few protections or sanctioned responses against aggressive behaviors. Objective: We investigated the relationship between workplace abuse and health in a cohort of cabin crew. We also aimed to characterize perpetrator profiles. Methods: We conducted our study among 4,459U.S. and Canada-based participants from the Harvard Flight Attendant Health Study using multivariate logistic regression. Our exposures of interest were episodes of workplace abuse in the past year. We evaluated several mental and physical health outcomes, including depression, fatigue, musculoskeletal injuries, and general workplace injuries. Results: We report that exposures to verbal abuse, sexual harassment, and sexual assault are common among cabin crew, with 63, 26, and 2% of respondents, respectively, reporting harassment in the past year alone. Workplace abuse was associated with depression, sleep disturbances, and musculoskeletal injuries among male and female crew, with a trend toward increasing odds ratios (ORs) given a higher frequency of events. For example, sexual harassment was related to an increased odds for depression (OR = 1.91, 95% confidence interval [CI]: 1.51–2.30), which increased in a dose response-like manner among women reporting harassment once (OR = 1.44, 95% CI: 0.93–1.95), 2–3 times (OR = 1.83, 95% CI: 1.29–2.38), and 4 or more times (OR = 4.12, 95% CI: 3.18–5.06). We found that passengers were the primary perpetrators of abuse. Conclusions: Our study is the first to comprehensively characterize workplace abuse and harassment and its relation to health in a largely female customer-facing workforce. The strong associations with health outcomes observed in our study highlights the question of how workplace policies can be altered to mitigate prevalent abuses. Clinicians could also consider how jobs with high emotional labor demands may predispose people to adverse health outcomes, educate patients regarding their psychological/physical responses and coping strategies, and be aware of signs of distress in patients working in such occupations in order to direct them to the appropriate treatments and therapies.