Miracle-dz/UniFAR-FTUs huggingface dataset:
Short-term mortality in older medical emergency patients can be predicted using clinical intuition: A prospective study

Background Older emergency department (ED) patients are at risk for adverse outcomes, however, it is hard to predict these. We aimed to assess the discriminatory value of clinical intuition, operationalized as disease perception, self-rated health and first clinical impression, including the 30-day surprise question (SQ: “Would I be surprised if this patient died in the next 30 days” of patients, nurses and physicians. Endpoints used to evaluate the discriminatory value of clinical intuition were short-term (30-day) mortality and other adverse outcomes (intensive/medium care admission, prolonged length of hospital stay, loss of independent living or 30-day readmission). Methods In this prospective, multicentre cohort study, older medical patients (≥65 years), nurses and physicians filled in scores regarding severity of illness and their concerns (i.e. disease perception and clinical impression scores) immediately after arrival of the patient in the ED. In addition, patients filled in a self-rated health score and nurses and physicians answered the SQ. Area under the curves (AUCs) of receiver operating characteristics (ROCs) were calculated. Results The median age of the 602 included patients was 79 years and 86.7% were community dwelling. Within 30 days, 66 (11.0%) patients died and 263 (43.7%) patients met the composite endpoint. The severity of concern score of both nurses and physicians yielded the highest AUCs for 30-day mortality (for both 0.75; 95%CI 0.68–0.81). AUCs for the severity of illness score and SQ of nurses and physicians ranged from 0.71 to 0.74 while those for the disease perception and self-rated health of patients ranged from 0.64 to 0.69. The discriminatory value of the scores for the composite endpoint was lower (AUCs ranging from 0.60 to 0.67). We used scores that have not been previously validated which could influence their generalisability. Conclusion Clinical intuition,—disease perception, self-rated health and first clinical impression—documented at an early stage after arrival in the ED, is a useful clinical tool to predict mortality and other adverse outcomes in older ED patients. Highest discriminatory values were found for the nurses’ and physicians’ severity of concern score. Intuition may be helpful for the implementation of personalised medical care in the future.
Clinical analysis of neck node metastasis in oral cavity cancer

Objectives The purpose of this study was to evaluate the neck node metastasis pattern and related clinical factors in oral cavity cancer patients. Materials and Methods In total, 76 patients (47 males, 29 females) with oral squamous cell carcinoma (OSCC) who had no previous malignancies and were not undergoing neoadjuvant concomitant chemoradiotherapy or radiotherapy were selected for analysis. Results Occult metastases were found in 8 of 52 patients with clinically negative nodes (cN0, 15.4%). Neck node metastases were found in 17 patients (22.4%). There was a statistically significant relationship between neck node metastasis and T stage (P=0.014) and between neck node metastasis and distant metastasis (Fisher's exact test, P=0.019). Conclusion Neck node metastasis was significantly related to tumor size and distant metastasis during follow-up.
Sequential effects of reappraisal and rumination on anger during recall of an anger-provoking event

In everyday life, people often combine strategies to regulate their emotions. However, to date, most research has investigated emotion regulation strategies as if they occur independently from one another. The current study aims to better understand the sequential interplay between strategies by investigating how reappraisal and rumination interact to affect anger experience. After participants (N = 156) recalled a recent anger-provoking event, they were instructed to either a) reappraise the event twice, b) reappraise the event, and then ruminate about the event, c) ruminate about the event, and then reappraise the event, or d) ruminate twice about the event. The effects of the first strategy used replicated a large body of research: reappraisal was associated with a decrease in anger, but rumination was associated with no change in anger. There was a small interactive effect of the combination of the two strategies, such that those who ruminated and then reappraised showed a larger decrease in anger than those who reappraised and then ruminated. There were no other differences between groups. This suggests that the second strategy does have an effect over and beyond the first strategy, but this effect is small in size, highlighting the importance of the initial emotion regulation strategy used.
Non-Coding RNAs to Aid in Neurological Prognosis after Cardiac Arrest

Cardiovascular disease in general, and sudden cardiac death in particular, have an enormous socio-economic burden worldwide. Despite significant efforts to improve cardiopulmonary resuscitation, survival rates remain low. Moreover, patients who survive to hospital discharge have a high risk of developing severe physical or neurological symptoms. Being able to predict outcomes after resuscitation from cardiac arrest would make it possible to tailor healthcare approaches, thereby maximising efforts for those who would mostly benefit from aggressive therapy. However, the identification of patients at risk of poor recovery after cardiac arrest is still a challenging task which could be facilitated by novel biomarkers. Recent investigations have recognised the potential of non-coding RNAs to aid in outcome prediction after cardiac arrest. In this review, we summarize recent discoveries and propose a handful of novel perspectives for the use of non-coding RNAs to predict outcome after cardiac arrest, discussing their use for precision medicine.
Balance between BDNF and Semaphorins gates the innervation of the mammary gland

The innervation of the mammary gland is controlled by brain-derived neurotrophic factor (BDNF), and sexually dimorphic sequestering of BDNF by the truncated form of TrkB (TrkB.T1) directs male-specific axonal pruning in mice. It is unknown whether other cues modulate these processes. We detected specific, non-dimorphic, expression of Semaphorin family members in the mouse mammary gland, which signal through PlexinA4. PlexinA4 deletion in both female and male embryos caused developmental hyperinnervation of the gland, which could be reduced by genetic co-reduction of BDNF. Moreover, in males, PlexinA4 ablation delayed axonal pruning, independently of the initial levels of innervation. In support of this, in vitro reduction of BDNF induced axonal hypersensitivity to PlexinA4 signaling. Overall, our study shows that precise sensory innervation of the mammary gland is regulated by the balance between trophic and repulsive signaling. Upon inhibition of trophic signaling, these repulsive factors may promote axonal pruning.
Development and validation of a scale to measure the quality of patient medication counseling using Rasch model

Objective: The purpose of this study is to develop and validate the psychometric properties of a scale for measuring the quality of patient medication counseling by using the Rasch model. Methods: In this study, the scale was developed based on the literature review. It consisted of 31 items across five subscales: introduction, problem identification, content, behavior, and conclusion. A convenient sample of community pharmacists was recruited from four major cities in Vietnam: Hanoi, Da Nang, Ho Chi Minh, and Can Tho. Data collection was conducted from June 10 to October 30, 2017. A Rasch analysis for polytomous data was performed to assess the suitability of the item and the reliability of the scale. Results: The research results showed that all items had a positive point-measure correlation coefficient between 0.47 and 0.77. All items had infit and outfit values in the optimal range between 0.5 and 1.5 except for D5, but its value was within acceptable range. Differential item function analysis indicated that all items had no DIF, except for items B4 and E4 containing moderate magnitude of DIF. Response category statistics found that there was a gradual increase in difficulty level from category 1 to 5 and no presence of reversal. Infit and outfit statistics of these categories were also considered good, with their values close to 1. The test result of the item characteristic curve and the person-item map showed that there were some overlapping items. Their appearance, however, might play an important role in measuring different aspects of construct. The overall scale reliability index (0.97) was high and the overall scale separation index (6.11) was good. Conclusions: The developed scale satisfied the requirements of the Rasch model. The scale is a useful tool that could be used to measure the quality of patient medication counseling among community pharmacists.
The FLUENT study design: investigating immune cell subset and neurofilament changes in patients with relapsing multiple sclerosis treated with fingolimod

Background Fingolimod is a sphingosine 1-phosphate receptor modulator for the treatment of patients with relapsing forms of multiple sclerosis (RMS). Fingolimod sequesters lymphocytes within lymphoid tissue thereby reducing the counts of circulating lymphocytes. However, fingolimod’s effects on the innate and adaptive components of the immune system are incompletely understood. Objective The FLUENT study will investigate temporal changes in circulating immune cell subsets in patients with RMS treated with fingolimod. Secondary objectives include examining the association between anti-John Cunningham virus (JCV) antibody status/index and phenotypic changes in innate and T and B cell subsets in patients on fingolimod therapy, and the association between serum neurofilament levels and clinical outcomes. Methods FLUENT is a prospective, multicenter, two-cohort, nonrandomized, open-label Phase IV study. Cohort 1 will include fingolimod-naïve patients and Cohort 2 will include patients who have received fingolimod 0.5 mg/day continuously for ≥2 years. Changes in the cellular components of the innate and adaptive immune system will be characterized over 12 months. Results The study is ongoing. Conclusion FLUENT may provide evidence for the use of immunologic profiling in predicting efficacy and risk of infection in patients with RMS treated with fingolimod.
Gender, age, and pharmacists’ job satisfaction

A comprehensive literature review was conducted on the concept of job satisfaction in the pharmacist workforce field and the facets it comprises, as well as its measurement, aiming to (i) review the nature, mechanisms, and importance of job satisfaction in the context of the pharmacist workforce, (ii) survey some of the most salient facets that configure job satisfaction, and (iii) discuss validity and measurement issues pertaining to it. Although female pharmacists generally hold less appealing jobs, earn lower wages and salaries, and are promoted less frequently than their male counterparts, they report higher levels of job satisfaction. Age has a U-shape effect on job satisfaction, with middle-age pharmacists less satisfied than both younger and older practitioners. Workload, stress, advancement opportunities, job security, autonomy, fairness in the workplace, supervisors, coworkers, flexibility, and job atmosphere are facets contributing to pharmacists’ job satisfaction. Finally, discrepancy exists among researchers in measuring job satisfaction as a single global indicator or as a composite measure derived from indices of satisfaction with key aspects of a job. Understanding the mechanisms that affect pharmacists’ job satisfaction is important to employers in their pursuit to respond to practitioners’ needs, decrease turnover, and increase productivity. As pharmacists’ response to work-related conditions and experiences depends on gender and age, a unique set of rewards and incentives may not be universally effective. Additional research into the dynamics of the forces shaping pharmacists’ perceptions, opinions, and attitudes is needed in order to design and implement policies that allocate human resources more efficiently within the various pharmacy settings.
A comparative study on the various monolithic low noise amplifier circuit topologies for RF and microwave applications

This paper critically compares the various monolithic low noise amplifier (LNA) circuit topologies using BiCMOS or MESFET technologies for RF and microwave applications, in addition to the conventional techniques, five newly proposed schemes for the simultaneous noise and input power matching are extensively compared with each other at microwave frequencies. At L-band, the best scheme is found to be the proposed cascode inductive series feedback (CCSF) or common-source inductive series feedback (CSSL)+common-gate inductive parallel feedback (CGPF) when 0.5 /spl mu/m GaAs MESFET is used, while it is cascode resistive parallel feedback (CCPF) when n-p-n BJT is used. At C- and X-bands, the proposed CGPF exhibits the best performance. Other than CGPF, the CSSL+CGPF seems to he the best at 6 GHz, and both CCPF+CGPF and CSSL+CGPF are recommended at 12 GHz. Finally, to verify the feasibility of this approach, a CCPF has been fabricated with 0.5 /spl mu/m GaAs MMIC technology, of which measured results agree well with the simulated ones.
Same same but different – A qualitative study on the development and maintenance of personal networks among German and international medical students

Introduction: In addition to linguistic and cultural difficulties, problems with social integration are frequently found among international medical students. In contrast, the social interaction among German medical students is considered as non-problematic. Personal networks are considered as positively influencing factors for the learning environment of students as well as their academic performance and personal wellbeing. However, while general findings on the development and maintenance of personal networks among medical students are available, there is insufficient data on students with different nationality or cultural backgrounds. Therefore, we compared the perception of international and German medical students on the development and maintenance of personal networks and examined possible influencing factors. Methodology: Following the principles of theoretical sampling in qualitative research, we recruited 17 international and 10 German preclinical medical students. The survey was conducted with semi-structured interviews, which focused on the participants’ experiences with the development and maintenance of personal networks in medical school. The coding and analysis of the interview transcripts was based on the principles of grounded theory. Results: We show that German participants rated the network development in medical school much more positively than the international participants. This difference was influenced by: a different perception of affiliation to the group of medical students, a low academic benefit from contacts with international students, the socio-cultural framework of medical school as well as the individual strategies of international medical students in dealing with integration. Conclusion: Our study extends existing insights into the development and maintenance of the social environment in medical school by understanding the perception of a subgroup of medical students. A better understanding of these social processes enables an effective evaluation of support and teaching for the subgroup of international medical students in Germany.
Draft Genome Sequence of Azole-Resistant Aspergillus thermomutatus (Neosartorya pseudofischeri) Strain HMR-AF-39, Isolated from a Human Nasal Septum Abscess Aspirate

Here, we present the draft genome sequence of Aspergillus thermomutatus (formerly known as Neosartorya pseudofischeri; strain HMR-AF-39/LSPQ-01276), a cryptic species of Aspergillus section Fumigati. This species is intrinsically resistant to antifungal azoles and is recognized as an agent of invasive aspergillosis among immunocompromised hosts. ABSTRACT Here, we present the draft genome sequence of Aspergillus thermomutatus (formerly known as Neosartorya pseudofischeri; strain HMR-AF-39/LSPQ-01276), a cryptic species of Aspergillus section Fumigati. This species is intrinsically resistant to antifungal azoles and is recognized as an agent of invasive aspergillosis among immunocompromised hosts.
Antiplatelet Therapy in Acute Mild-Moderate Ischemic Stroke (ATAMIS): a parallel, randomised, open-label, multicentre, prospective study

Background A recent study shows that dual antiplatelet therapy with clopidogrel plus aspirin is superior to aspirin monotherapy for minor stroke, which is defined as a National Institutes of Health Stroke Scale (NIHSS)score of ≤3. However, acute mild-moderate ischaemic stroke (4≤NIHSS≤10) still needs aggressive antiplatelet intervention to prevent deterioration and recurrence of stroke. The efficacy and safety of dual antiplatelet therapy versus aspirin monotherapy in the population are not clear. A multicentre clinical trial is designed to evaluate the efficacy and safety of clopidogrel plus aspirin therapy versus aspirin monotherapy within 48 hours of symptom onset of mild-moderate ischaemic stroke. Methods/Design The study is a randomised, open-label, multicentre, prospective trial with a target enrolment of 2700 patients from 60 centres in Northeast China. A treatment allocation identification number to each enrolled patient will be provided by a random number generator. The follow-up time for the clopidogrel plus aspirin and aspirin monotherapy groups is 90 days. The primary efficacy endpoint is a stroke progression event, which is defined as ≥4 point increase in the NIHSS score in 48 hours. The second efficacy endpoints include new ischaemic stroke within 90 days, change in the NIHSS score within 14 days, modified Rankin Scale score on day 90 and other vascular or death events within 90 days. The safety endpoints include mucocutaneous haemorrhage, organ haemorrhage and intracranial haemorrhage, adverse events and severe adverse events. χ2 test, t-test (or Mann-Whitney test), survival analysis and Cox proportional hazards models will be conducted. The findings of the study may provide an important evidence for clinical practice for these patients. Discussion The trial will be conducted under a rational design and will provide valuable evidence on the appropriate treatment for this population. Ethics and dissemination The study was reviewed and approved by the Ethics Committee of the General Hospital of Shen-Yang Military Region (no K(2016) 6). Trial registration number NCT02869009; Pre-results.
Evaluation of Validity and Reliability of Inertial Measurement Unit-Based Gait Analysis Systems

Objective To replace camera-based three-dimensional motion analyzers which are widely used to analyze body movements and gait but are also costly and require a large dedicated space, this study evaluates the validity and reliability of inertial measurement unit (IMU)-based systems by analyzing their spatio-temporal and kinematic measurement parameters. Methods The investigation was conducted in three separate hospitals with three healthy participants. IMUs were attached to the abdomen as well as the thigh, shank, and foot of both legs of each participant. Each participant then completed a 10-m gait course 10 times. During each gait cycle, the hips, knees, and ankle joints were observed from the sagittal, frontal, and transverse planes. The experiments were conducted with both a camerabased system and an IMU-based system. The measured gait analysis data were evaluated for validity and reliability using root mean square error (RMSE) and intraclass correlation coefficient (ICC) analyses. Results The differences between the RMSE values of the two systems determined through kinematic parameters ranged from a minimum of 1.83 to a maximum of 3.98 with a tolerance close to 1%. The results of this study also confirmed the reliability of the IMU-based system, and all of the variables showed a statistically high ICC. Conclusion These results confirmed that IMU-based systems can reliably replace camera-based systems for clinical body motion and gait analyses.
Influence of self-efficacy management on adherence to self-care activities and treatment outcome among diabetes mellitus type 2

Background: High level of self-efficacy and adherence to self-care activities have a positive impact on the achievement of glycemic goal among diabetic patients. In Sudan, there is a gap in knowledge related to self-efficacy management and its influence on adherence to self-care activities and overall disease control. Objective: To identify the influence of management self-efficacy on adherence to self-care activities and treatment outcome among Sudanese patients with type 2 diabetes mellitus. Methods: A cross-sectional study was conducted at two health care facilities in Sudan from April to May 2016. Patients with type 2 diabetes mellitus were included. Convenience sampling method was adopted. Diabetes Management Self-Efficacy Scale and the Revised Summary of Diabetes Self-care Activities were used to collect data through a face-to-face interview. Logistic regression analysis was performed. A p value <0.05 was considered to be significant. Data were processed using the software SPPS v 21.0. Results: A total of 392 patients were included. Respondents classified with high level of self- efficacy across all domains were 191 (48.7%). Moreover, high level of education [adjusted OR 0.5 (0.3-0.7), (p=0.001)] and formal health education on diabetes [adjusted OR 2.4 (1.6-3.7), (p<0.001)], were found to be significantly associated with high level of diabetes management self-efficacy. Patients who had high level of self-efficacy to manage nutrition, physical exercise activity and medication were found more adherent to general diet, exercise activity, and medication taking, respectively. Patients with controlled disease were 87(22.2%). The only predictor of diabetes control was diabetes management self-efficacy [OR 2.1(1.3- 3.5), (p=0.002)]. Conclusions: Diabetes management self-efficacy was associated with high level of education and receiving health education. Self-efficacy was significantly associated with adherence to self-care activities and glycemic control. Substantial efforts are still needed to empower the patients with self-efficacy and improving adherence to self-care activities through appropriate interventions.
Hadoop Scheduler with Deadline Constraint

A popular program ming model for running data intensive applications on the cloud is map reduce. In the Hadoop usually, jobs are scheduled in FIFO order by default. There are many map reduce applications which require strict deadline. In Hadoop framework, scheduler w i t h deadline c o n s t r a i n t s has not been implemented. Existing schedulers d o not guarantee that the job will be completed by a specific deadline. Some schedulers address the issue of deadlines but focus more on improving s y s t e m utilization. We have proposed an algorithm which facilitates the user to specify a jobs deadline and evaluates whether the job can be finished before the deadline. Scheduler with deadlines for Hadoop, which ensures that only jobs, whose deadlines c an be met are scheduled f o r execution. If the job submitted does not satisfy the specified deadline, physical or virtual nodes can be added dynamically to complete the job within deadline(8).