Miracle-dz/UniFAR-FTUs huggingface dataset:
Impact of self-care programs in Type 2 Diabetes Mellitus population in primary health care. Systematic review and meta-analysis.

AIMS AND OBJECTIVES To evaluate the effectiveness of self-care programs in type 2 diabetes mellitus (T2DM) population in primary health care. BACKGROUND The impact of educational interventions on T2DM has been evaluated in various contexts, but there is uncertainty about their impact in that of primary care. DESIGN Systematic review and meta-analysis. METHODS A search was conducted in PubMed, CINAHL, WOS and Cochrane databases for randomised controlled trials carried out in the period January 2005-December 2017, including studies with at least one face-to-face educational interventions. The quality of the evidence for the primary outcome was evaluated using the GRADE System. A meta-analysis was used to determine the effect achieved although only the results classified as critical or important were taken into consideration. Checklist of Preferred Reporting Items for Systematic Reviews and Meta-analyses has been followed. PROSPERO registration Number: CRD42016038833. RESULTS In total, 21 papers (20 studies) were analysed, representing a population of 12,018 persons with T2DM. For the primary outcome, HbA1 c, the overall reduction obtained was -0.29%, decreasing the effect in long-term follow-up. The quality of the evidence was low/very low due to very serious risk of bias, inconsistency and indirectness of results. Better results were obtained for individual randomized trials versus cluster designs and in those programs in which nurses leaded the interventions. The findings for other cardiovascular risk factors were inconsistent. CONCLUSIONS Educational interventions in primary care addressing T2DM could be effective for metabolic control, but the low quality of the evidence and the lack of measurement of critical results generates uncertainty and highlights the need for high-quality trials. RELEVANCE TO CLINICAL PRACTICE Most of self-care programs for T2DM in primary care are focused on metabolic control, while other cardiovascular profile variables with greater impact on mortality, or patient reported outcomes are less intensely addressed.
Subjective Well-Being, Health and Healthcare Utilization: A Study of Rural Elderly in Odisha

Health and well-being have a significant impact on economic security, level of independence and social interaction among the elderly. As there is a rapid decline in the joint and extended family system in India, the communities no longer protect the rights of the elderly people as they used to do in the past. This makes the elderly largely displaced in the community and they are more vulnerable to isolation, deteriorating health leading to disability, psychological distress, physical/mental abuse and relatively have less satisfaction in life. Socio-economic inequalities in health and healthcare utilization are more rampant among the rural elderly in comparison to their urban counterpart. Moreover, the issues of health inequalities, prevalence of morbidity, disability and psychological distress, physical/mental abuse and overall well-being are neglected especially among the rural population. The objectives of the study are five-fold: first, to assess the prevalence of multi-morbidity and socio-economic inequalities in various chronic health conditions among rural elderly; second, to examine the association of morbidity with disability and psychological distress; third, to analyze the pattern of healthcare utilization and financing among the elderly; forth, to examine the association of elderly abuse with morbidity and disability and finally, to examine the various covariates of life satisfaction among the rural elderly. In this thesis, a cross-sectional survey has been conducted by using multi-stage random sampling procedure among 310 elderly (60+ years) in Bargarh District of Odisha. Different statistical and econometrics tools such as logistic regression, generalized linear regression model and hierarchal regression have been used to address the above objectives. The findings of the study indicate that the most common prevalent diseases among the elderly are arthritis, chronic obstructive pulmonary disease, high blood pressure and cataract. Age, state of economic dependence and life style indicators are the most important measured predictors of multi-morbidity among the rural elderly. Life satisfaction is associated with various socio-economic and demographic factors including physical, cognitive health and social networks. Results also indicate that abused elderly are more prone to disability, morbidity and psychological distress. Consequently, a multidimensional approach is required to address the issues of health inequalities and overall subjective well-being among the rural elderly.
Ankle Exoskeleton Assistance Can Improve Over-Ground Walking Economy in Individuals With Cerebral Palsy

Individuals with neuromuscular impairment from conditions like cerebral palsy face reduced quality of life due to diminishing mobility and independence. Lower-limb exoskeletons have potential to aid mobility, yet few studies have investigated their use during over-ground walking – an exercise that may contribute to our understanding of potential benefit in free-living settings. The goal of this study was to determine the potential for adaptive plantar-flexor assistance from an untethered ankle exoskeleton to improve over-ground walking economy and speed. Six individuals with cerebral palsy completed three consecutive daily over-ground training sessions to acclimate to, and tune, assistance. During a final assessment visit, metabolic cost, walking speed, and soleus electromyography were collected for baseline, unpowered, low, training-tuned, and high assistance conditions. Compared to each participant’s baseline condition, we observed a 3.9 ± 1.9% (p = 0.050) increase in walking speed and a 22.0 ± 4.5% (p = 0.002) reduction in soleus activity with training-tuned assistance; metabolic cost of transport was unchanged (p = 0.130). High assistance resulted in an 8.5 ± 4.0% (p = 0.042) reduction in metabolic cost of transport, a 6.3 ± 2.6% (p = 0.029) increase in walking speed, and a 25.0 ± 4.0% (p < 0.001) reduction in soleus activity. Improvement in exoskeleton-assisted walking economy was related to pre-training baseline walking speed ( $\text{R}^{{2}}={0.94}$ , p = 0.001); the slower and more impaired participants improved the most. Energy cost and preferred walking speed remained generally unchanged for the faster and less impaired participants. These findings demonstrate that powered ankle exoskeletons have the potential to improve mobility-related outcomes for some people with cerebral palsy.
Implementing Autonomous Driving Behaviors Using a Message Driven Petri Net Framework

Most autonomous car control frameworks are based on a middleware layer with several independent modules that are connected by an inter-process communication mechanism. These modules implement basic actions and report events about their state by subscribing and publishing messages. Here, we propose an executive module that coordinates the activity of these modules. This executive module uses hierarchical interpreted binary Petri nets (PNs) to define the behavior expected from the car in different scenarios according to the traffic rules. The module commands actions by sending messages to other modules and evolves its internal state according to the events (messages) received. A programming environment named RoboGraph (RG) is introduced with this architecture. RG includes a graphical interface that allows the edition, execution, tracing, and maintenance of the PNs. For the execution, a dispatcher loads these PNs and executes the different behaviors. The RG monitor that shows the state of all the running nets has proven to be very useful for debugging and tracing purposes. The whole system has been applied to an autonomous car designed for elderly or disabled people.
Semi-Automated evidence synthesis in health psychology: current methods and future prospects

ABSTRACT The evidence base in health psychology is vast and growing rapidly. These factors make it difficult (and sometimes practically impossible) to consider all available evidence when making decisions about the state of knowledge on a given phenomenon (e.g., associations of variables, effects of interventions on particular outcomes). Systematic reviews, meta-analyses, and other rigorous syntheses of the research mitigate this problem by providing concise, actionable summaries of knowledge in a given area of study. Yet, conducting these syntheses has grown increasingly laborious owing to the fast accumulation of new evidence; existing, manual methods for synthesis do not scale well. In this article, we discuss how semi-automation via machine learning and natural language processing methods may help researchers and practitioners to review evidence more efficiently. We outline concrete examples in health psychology, highlighting practical, open-source technologies available now. We indicate the potential of more advanced methods and discuss how to avoid the pitfalls of automated reviews.
Estimating the population size of female sex workers and transgender women in Sri Lanka

We implemented population size estimation of female sex workers (FSW) and transgender women (TGW) in Sri Lanka in 2018 using several approaches (geographical mapping, service and unique object multiplier and a modified Delphi method during the stakeholder consensus meeting). Mapping was done in 49 randomly selected Divisional Secretariats, which provided a basis for extrapolation of size estimates to the national level. Two types of adjustments were applied on the mean (minimum-maximum) population estimate obtained during mapping: (1) an adjustment for mobility to reduce double counting of FSW and TGW frequenting multiple spots, obtained during mapping; (2) an adjustment for “a hidden population”, obtained from surveys among FSW and TGW. For the multiplier method, we used data from services of non-governmental organisations that FSW and TGW were in contact with, and surveys based on respondent-driven sampling. Surveys were carried out in the cities of Colombo (FSW, TGW), Kandy (FSW), Galle (FSW) and Jaffna (TGW). We estimated that there are 30,000 FSWs in Sri Lanka, with a plausible range of 20,000–35,000, which implies a prevalence of FSW of 0.56% (0.37–0.65%) among adult females. This study provided baseline estimates of 2,200 TGW in the country, with a plausible range of 2,000–3,500, which is 0.04% (0.04–0.07%) of adult male population. Our estimates of the proportional contribution of the FSW and TGW populations among the adult population in Sri Lanka are consistent with the The Joint United Nations Programme on HIV/AIDS (UNAIDS) recommended estimates for Asia and the Pacific. The results provide an important point for macro- and micro-level planning of HIV services, allocating programme resources and assessing programme coverage and quality.
The Molecular and Physiological Effects of Protein-Derived Polyamines in the Intestine

Consumption of a high-protein diet increases protein entry into the colon. Colonic microbiota can ferment proteins, which results in the production of protein fermentation end-products, like polyamines. This review describes the effects of polyamines on biochemical, cellular and physiological processes, with a focus on the colon. Polyamines (mainly spermine, spermidine, putrescine and cadaverine) are involved in the regulation of protein translation and gene transcription. In this, the spermidine-derived hypusination modification of EIF5A plays an important role. In addition, polyamines regulate metabolic functions. Through hypusination of EIF5A, polyamines also regulate translation of mitochondrial proteins, thereby increasing their expression. They can also induce mitophagy through various pathways, which helps to remove damaged organelles and improves cell survival. In addition, polyamines increase mitochondrial substrate oxidation by increasing mitochondrial Ca2+-levels. Putrescine can even serve as an energy source for enterocytes in the small intestine. By regulating the formation of the mitochondrial permeability transition pore, polyamines help maintain mitochondrial membrane integrity. However, their catabolism may also reduce metabolic functions by depleting intracellular acetyl-CoA levels, or through production of toxic by-products. Lastly, polyamines support gut physiology, by supporting barrier function, inducing gut maturation and increasing longevity. Polyamines thus play many roles, and their impact is strongly tissue- and dose-dependent. However, whether diet-derived increases in colonic luminal polyamine levels also impact intestinal physiology has not been resolved yet.
Visually Guided Acquisition of Contact Dynamics and Case Study in Data-Driven Haptic Texture Modeling

Data-driven modeling of human hand contact dynamics starts with a tedious process of data collection. The data of contact dynamics consist of an input describing an applied action and response stimuli from the environment. The quality and stability of the model mainly depend on how well data points cover the model space. Thus, in order to build a reliable data-driven model, a user usually collects data dozens of times. In this article, we aim to build an interactive system that assists a user in data collection. We develop an online segmentation framework that partitions a multivariate streaming signal. Real-time segmentation allows for tracking the process of how the model space is being populated. We applied the proposed framework for a haptic texture modeling use-case. In order to guide a user in data collection, we designed a user interface mapping applied input to alternative visual modalities based on the theory of direct perception. A combination of the segmentation framework and user interface implements a human-in-loop system, where the user interface assigns the target combination of input variables and the user tries to acquire them. Experimental results show that the proposed data collection schema considerably increases the approximation quality of the model, whereas the proposed user interface considerably reduces mental workload experienced during data collection.
Suicide

The author has written this book in the hopes of diminishing the amount of suicide. He has been encouraged by the consideration that there are but two books in the English language devoted entirely to this subject. He takes occasion to quote against Forbes Winslow's Anatomy of Suicide an unfavourable criticism from the Athenaeum. About a more recent work on the subject Mr Wynn Westcott observes, "The thoroughly scientific statistical work of H. Morselli, of Turin, has been recently published in
Global reach of ageism on older persons’ health: A systematic review

Objective Although there is anecdotal evidence of ageism occurring at both the structural level (in which societal institutions reinforce systematic bias against older persons) and individual level (in which older persons take in the negative views of aging of their culture), previous systematic reviews have not examined how both levels simultaneously influence health. Thus, the impact of ageism may be underestimated. We hypothesized that a comprehensive systematic review would reveal that these ageism levels adversely impact the health of older persons across geography, health outcomes, and time. Method A literature search was performed using 14 databases with no restrictions on region, language, and publication type. The systematic search yielded 13,691 papers for screening, 638 for full review, and 422 studies for analyses. Sensitivity analyses that adjusted for sample size and study quality were conducted using standardized tools. The study protocol is registered (PROSPERO CRD42018090857). Results Ageism led to significantly worse health outcomes in 95.5% of the studies and 74.0% of the 1,159 ageism-health associations examined. The studies reported ageism effects in all 45 countries, 11 health domains, and 25 years studied, with the prevalence of significant findings increasing over time (p < .0001). A greater prevalence of significant ageism-health findings was found in less-developed countries than more-developed countries (p = .0002). Older persons who were less educated were particularly likely to experience adverse health effects of ageism. Evidence of ageism was found across the age, sex, and race/ethnicity of the targeters (i.e., persons perpetrating ageism). Conclusion The current analysis which included over 7 million participants is the most comprehensive review of health consequences of ageism to date. Considering that the analysis revealed that the detrimental impact of ageism on older persons’ health has been occurring simultaneously at the structural and individual level in five continents, our systematic review demonstrates the pernicious reach of ageism.
Life with Bacterial Mechanosensitive Channels, from Discovery to Physiology to Pharmacological Target

General principles in biology have often been elucidated from the study of bacteria. This is true for the bacterial mechanosensitive channel of large conductance, MscL, the channel highlighted in this review. This channel functions as a last-ditch emergency release valve discharging cytoplasmic solutes upon decreases in osmotic environment. SUMMARY General principles in biology have often been elucidated from the study of bacteria. This is true for the bacterial mechanosensitive channel of large conductance, MscL, the channel highlighted in this review. This channel functions as a last-ditch emergency release valve discharging cytoplasmic solutes upon decreases in osmotic environment. Opening the largest gated pore, MscL passes molecules up to 30 Å in diameter; exaggerated conformational changes yield advantages for study, including in vivo assays. MscL contains structural/functional themes that recur in higher organisms and help elucidate how other, structurally more complex, channels function. These features of MscL include (i) the ability to directly sense, and respond to, biophysical changes in the membrane, (ii) an α helix (“slide helix”) or series of charges (“knot in a rope”) at the cytoplasmic membrane boundary to guide transmembrane movements, and (iii) important subunit interfaces that, when disrupted, appear to cause the channel to gate inappropriately. MscL may also have medical applications: the modality of the MscL channel can be changed, suggesting its use as a triggered nanovalve in nanodevices, including those for drug targeting. In addition, recent studies have shown that the antibiotic streptomycin opens MscL and uses it as one of the primary paths to the cytoplasm. Moreover, the recent identification and study of novel specific agonist compounds demonstrate that the channel is a valid drug target. Such compounds may serve as novel-acting antibiotics and adjuvants, a way of permeabilizing the bacterial cell membrane and, thus, increasing the potency of commonly used antibiotics.
Prospective evaluation of the DSM-5 persistent complex bereavement disorder criteria in adults: dimensional and diagnostic approaches

Abstract Background We examine the performance of the Diagnostic and Statistical Manual of Mental Disorders-fifth edition (DSM-5) persistent complex bereavement-related disorder (PCBD) criteria in bereaved adults to identify prolonged grief cases determined prospectively. Methods Bereaved adults (n = 138) were assessed at 8, 21, 32, 67, and 90 months after the sudden death of a spouse or close relative. We used latent class growth analysis to identify the longitudinal trajectories of grief assessed using the Inventory for Complicated Grief. To validate the trajectory that corresponded to prolonged grief, we examined the baseline predictors of these trajectories and their relationship with functional impairment. Results We found three distinct trajectories of grief reactions. One of these trajectories (13.8%) showed high and sustained grief reactions that persisted for almost 7.5 years after the death. Participants with prolonged grief showed greater functional impairment [relative risk ratio (RRR) = 0.82, 95% confidence interval (CI): 0.70 to −0.97; p = 0.02] and higher self-reported depression (RRR = 1.21, 95% CI 1.09 to 1.96; p = 0.001) than participants whose grief reactions subsided over time. The original PCBD (requiring 6 criterion C symptoms) criteria correctly identified cases (57.9–94.7%) with perfect specificity (100%) but low to high sensitivity (5.6–81.3%); however, its sensitivity increased when revising criterion C to require ⩾3 (45.5–94.1%). The dimensional approach showed high sensitivity (0.50–1) and specificity (0.787–0.97). Conclusions We recommend revisions to the PCBD criteria, which are overly restrictive and may exclude cases with clinically significant grief-related distress and impairment. In the meantime, clinicians need to monitor grief symptoms over time using available dimensional approaches to reduce the burden of grief.
Towards efficient design optimization of a miniaturized thermoelectric generator for electrically active implants via model order reduction and submodeling technique

Thermoelectric generators (TEG) convert the thermal energy into electrical energy and are under investigation as a power supply for medical implants. To improve the performance of TEG, the design optimization process through finite element model simulation is preferred by biomedical engineers. This paper aims to provide an efficient method of speeding up the design optimization process of TEG. A three‐dimensional realistic human torso model incorporating the TEG is investigated, where the internal heat transfer in human tissue is characterized by Pennes bioheat equation. In addition, convection, radiation, and evaporation effects at the skin surface are applied to identify the heat transfer effects between the human body and the environment. To speed up finite element simulation of the large‐scale human torso model, projection‐based model order reduction (MOR) is applied for generation of a compact but highly accurate model. Parametric MOR (pMOR) further enables generating a parameter‐independent compact model. For an efficient design optimization of TEG, this compact human torso model is applied within a thermal submodeling approach. Its temperature distribution results are back‐projected and used as boundary conditions for the TEG submodel. The achieved speed‐up in simulation time, demonstrated in this work, clearly indicates that the design optimization process of TEG is more efficient with the combination of MOR and submodeling techniques.
Long noncoding RNA‐mRNA expression profiles and validation in pancreatic neuroendocrine neoplasms

Pancreatic neuroendocrine neoplasms (pNENs) are a group of endocrine tumours arising in the pancreas and deemed to be the most common neuroendocrine tumours. The pathogenesis of pNENs remains unknown. Long noncoding RNAs (lncRNAs) are aberrantly expressed in cancers. The functional roles of lncRNAs and lncRNA‐mRNA expression profiles in pNENs are undefined. The aim of this study was to identify the lncRNA and mRNA expression profiles and explore the lncRNA‐mRNA co‐expression networks associated with the pNENs carcinogenesis.
General anesthesia in the management of early childhood caries: an overview

Early childhood caries is a global healthcare concern in developing and industrialized countries. If left untreated, it leads to immediate and long-term complications that affect the well-being and quality of life of concerned families. Therefore, many preventive and treatment approaches are available to the healthcare provider to curb this virulent form of caries. After behavioral interventions, general anesthesia is used in specific settings when a young patient presents with extensive teeth damage and exhibits a lack of cooperation that is incompatible with conventional dental office care. However, without proper follow-up, any positive results might be lost over time.