Miracle-dz/UniFAR-FTUs huggingface dataset:
Leisure Time Physical Activity Reduces the Risk for Stroke in Adults: A Reanalysis of a Meta-Analysis Using the Inverse-Heterogeneity Model

Objective Apply more robust and additional analyses to a previous meta-analysis that reported statistically significant associations between leisure time physical activity (LTPA) and stroke. Methods A reanalysis of a previous meta-analysis that included nine prospective cohort studies representing 269,594 men and women 25-84 years of age and in which the association between LTPA and incident stroke was examined. Follow-up periods ranged from 7.7 to 32.0 years. Relative risks (RR) from each study were pooled using the inverse-heterogeneity model. Heterogeneity was examined using the Q statistic, inconsistency using I2, and small-study effects using Doi plots and the LFK index. Influence and cumulative meta-analysis were also conducted. Results Using low LTPA as the reference, moderate LTPA was associated with a statistically significant reduction in the risk for stroke in men (RR = 0.79, 95% CI = 0.65 to 0.95) and a trend in women (RR = 0.88, 95% CI = 0.78 to 1.0). High LTPA was associated with a statistically significant reduction in the risk for stroke in both men (RR = 0.72, 95% CI = 0.60 to 0.86) and women (RR = 0.78, 95% CI = 0.66 to 0.92). No statistically significant heterogeneity was observed and inconsistency was low. However, potential small-study effects were observed. With each study deleted once, results remained statistically significant. Cumulative meta-analysis demonstrated stability in results since at least 2005. Conclusions Leisure time physical activity is associated with a reduced risk of stroke in both men and women. However, the small-study effects observed suggest the possibility that results may be exaggerated.
The Contribution of Marine Protected Areas to Resilience and persistence in Marine Fish Species

Networks of no-take marine protected areas (MPAs, areas in which there is no fishing at all) have been widely recommended for the conservation of marine biodiversity. But for marine populations to gain resiliency and persistency that protect them from external factors which may cause declination of the population, individual MPAs must be simultaneously self-sustaining and adequately connected to other MPAs via larval dispersal. For marine species with a dispersive larval stage, populations within MPAs require either the return of settlement-stage larvae to their natal reserve or connectivity among reserves at the spatial scales at which MPA networks are implemented. Until now, larvae have not been tracked when dispersing from one MPA to the other, and the relative magnitude of local retention and connectivity among MPAs remains unknown. In this review, studies on the panda clownfish, the orange clownfish, the vagabond butterflyfish and weakfish provide the first estimates of connectivity in a marine fish species. The results show that populations are sustained by a significant amount of self-recruitment, but it also largely depends on larval dispersal from and to other populations within or outside the MPA boundaries. More generally, the knowledge from these studies provides new insights in MPA development, and hopefully adds to the resilience and persistence of marine fish species.
Sleep Quality and Blood Lipid Composition Among Patients with Diabetes

Background Recent literature has mentioned that people with sleep disorder, experience insulin sensitivity reduction and accordingly higher levels of blood glucose. Objectives This study aimed to investigate the relationship between sleep quality and blood lipid composition in patients with diabetes referring to Minoodar health center in Qazvin, Iran in 2017. Methods Sleep duration and quality were assessed in 347 patients with diabetes using the Pittsburgh sleep quality index (PSQI). The glycosylated hemoglobin A1c (HbA1c) test was used to measure the glycemic control and total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), and high-density lipoprotein cholesterol (HDL-C) were used to determine blood lipid composition of the patients. Multiple regression analyses were applied to examine the associations between sleep measures and HbA1c and lipid parameters using SPSS version 20. Results The patients in the poor sleep quality group had higher levels of fasting blood sugar (FBS) (146.07 ± 57.06 versus 132.8 ± 53.3 mg/dL, P = 0.02), body mass index (BMI) (29.1 ± 3.9 versus 27.6 ± 4.2 kg/m2, P = 0.005) and total cholesterol (209.9 ± 53.4 versus 193.4 ± 45.8, P = 0.02). Furthermore, the patients with short sleep duration had higher total cholesterol level compared with long sleep and medium sleep duration group (202.3 ± 50.2 versus 196.6 ± 47.7 and 195.7 ± 47.4, respectively, P = 0.05). Among different PSQI measures, subjective sleep quality was associated with lower TC and TG in unadjusted models (β = -0.0.1, P = 0.05). Furthermore, greater sleep disturbance was positively linked with higher levels of TC and TG (β = 0.1, P = 0.01 and β = 0.02, P = 0.05). Conclusions In an Iranian population with diabetes living in Qazvin city, sleep disorder is common and as study findings revealed sleep quality was recognized as an influencing factor on some of the lipid profiles, including TC and TG. Thus sleep assessment of patients with type 2 diabetes to find the early recognition of their sleep disorder should be considered an important part of the patients’ treatment.
Socio-demographic determinants of treatment outcome in multidrug resistant tuberculosis cases registered under Programmatic management of drug resistant tuberculosis services in Amritsar, Punjab

Background: Multidrug resistant tuberculosis (MDR-TB) has become a major public health problem. It is associated with significant morbidity and mortality. The treatment success rate worldwide is around 50%. Methods: This cross-sectional study was conducted on all MDR-TB patients who were registered and being treated under PMDT services in Amritsar district from 1st April 2014 to 31st March 2015. The treatment outcome with their socio-demographic determinants was ascertained. Data management and analysis was done by using Microsoft excel and SPSS.Results: Out of 87 MDR-TB patients, 57 (65.5%) were males and 30 (34.4%) were females. The various treatment outcomes observed were- 30 (34.5%) cured, 19 (21.8%) treatment completed, 18 (20.7%) died, 13 (14.9%) defaulted, 4 (4.6%) shifted to XDR TB regime and 3 (3.4%) failure.Conclusions: On statistical analysis, it was observed that age (p=0.000), marital status (p=0.024), educational status (p=0.011) and occupation (p=0.002) were significantly associated with the treatment outcome. Other factors like sex, type of family and socio-economic status did not affect the treatment outcome.
Laparoscopic-Assisted Transanal Extraction of an Impacted Rectal Foreign Body

A foreign body in the rectum (FBR) is becoming a common presentation in the surgical emergency department. Generally, rectal foreign body removal can be a challenge as regards management due to the wide variety of objects inserted in the rectum. Usually, a rectal foreign body is extracted manually in the emergency department under local anesthesia. In some cases, simple manual extraction of an impacted FBR is unsuccessful. In such cases, general anesthesia with surgical intervention may be required to extract the FBT. We describe the case of a 38-y-old previously healthy male, who presented to the emergency department with rectal bleeding and constant pain in the anal area for approximately three h after inserting a lubricant gel container transanally for autoerotic purposes. Proctoscopy was performed in the emergency department to retrieve the FBR. However, the retrieval attempts were unsuccessful. Laparoscopy-assisted transanal extraction of the object was performed under general anesthesia. The object was pushed (milked) using a laparoscopic bowel clamp down the rectum, and the object was then extracted transanally.
Clinical heterogeneity of elderly melanoma patients in the real-world setting: Potential implications for treatment outcomes following immune based therapy.

e21026 Background: Recent studies have indicated that immune checkpoint inhibitor treatment of metastatic melanoma is effective irrespective of older age. However, in the real world setting, not all older patients (pts.) diagnosed with high-risk cutaneous melanoma have same levels of immune function due to wide variation of older age and aging associated diseases that adversely influence it. Frailty associated with co-morbidities, autoimmunity, cancer, and their treatments are three such conditions that influence treatment outcomes following immune based treatment of melanoma in older subjects. To better understand this interaction between melanoma, aging-associated diseases and potential outcomes following immune checkpoint inhibitor treatment in the real world, we reviewed clinical data of elderly melanoma pts. from the University of Connecticut's Neag Cancer Center following an IRB approval. Methods: We retrospectively reviewed clinical characteristics of elderly pts. diagnosed with high-risk cutaneous melanoma (Stage IIC, III, IV) at the University of Connecticut from 2012-2019. Pts. over the age of 60 years were divided into two main groups: Group I ("Fit elderly") and Group II ("Elderly with immune suppressive conditions"). Group II pts. were further divided into three subgroups: A ("Co-morbidities and frailty"), B ("Autoimmunity and its treatment") and C ("Cancer and its treatment"). Results: From 2012-2019, a total of 56 elderly pts. diagnosed with high-risk cutaneous melanoma were stratified as the following: Group I - 31 pts. (55%) and Group II - 25 pts. (45%); among the Group II pts. , Group A contained 14 pts. (56%), Group B 5 pts. (20%), and Group C 6 pts. (24%). The median age for all 56 elderly pts. was 77 yrs. (range 61 to 99). In Group I, the median age was 73 yrs. (range 61-91). In Group II, the median age was 82 years (range 66-99); A median age 85 yrs (range 66-99), B median age 78 yrs (range 66-86), and C 80.5 yrs. (range 66-86). 9 out of 56 pts. (16%) did not receive immune checkpoint inhibitor treatment, of which 7 pts. (56%) were frail and 2 pts. (22%) were non-frail. Conclusions: Our data indicate that the existence of significant clinical heterogeneity among high-risk elderly melanoma pts. encountered in the community setting reflects a wide spectrum of immune function. Larger studies stratifying elderly subjects by co-morbidities and immune suppressive conditions will help shed accurate light on clinical relevance of immune based treatment of melanoma in older subjects.
State Level Public Policy Choices as Predictors of State Teen Birthrates.

The findings of this study confirm that there is a relationship between US state level policy choices and teen birth rates. The predictors of state teen birth rates--high poverty rates low school completion rates low public welfare expenditures and high unemployment rates--are depictive of opportunity structures devoid of opportunities or reasons for hoping for a better future. This is compounded by low expenditures for both education and public welfare which are directly linked to the low school completion rates and high poverty rates that are so strongly predictive of high teen birth rates. These findings are consistent with those of other studies conducted throughout the world for 25 years or longer that also have shown an association between high birth rates low levels of educational attainment and high rates of poverty and unemployment. The role that state level policy choices play in this configuration is depicted statistically in the present analysis. All of this suggests that family professionals have a very strong advocacy role to play in their respective states and nationally as well in changing attitudes that underlie states spending choices and the federal governments too in terms of the costs that high teen birth rates entail. Counseling family life and sex education family planning services although important are insufficient for addressing the underlying conditions with which high teen birth rates are associated: poverty and low levels of education and aspirations for it. To address such conditions opportunity structures must be created in the states and communities in which poor teenagers live.
Applying language skills to interpretation: Student perspectives from signed and spoken language programs

Interpreter Education Programs (IEPs) frequently encounter a dilemma when attempting to assist students who have completed a second-language learning sequence in their transition to interpreter education. Typically, students exhibit difficulties making this transition when they perceive their language base is inadequate to successfully complete the interpreting sequence in their program. This investigation was designed to (a) explore factors that contribute to or inhibit readiness to apply language skills to interpretation, and (b) identify similarities and differences between students’ perspectives of this transition in the context of signed language and spoken language interpretation programs. The Interpreter Education Program (American Sign Language/English) at the University of Arkansas at Little Rock, USA conducted this study in collaboration with the Institute of Theoretical and Applied Translation Studies at the Karl-Franzens-University of Graz, Austria (which offers eleven languages). Observations from both programs provide insight for interpreter educators as they strive to improve programs and enhance student retention and program completion rates.
Challenges and opportunities for improving N use efficiency for rice production in sub-Saharan Africa

ABSTRACT In sub-Saharan Africa (SSA), rice production from smallholder farms is challenged because of a lack of fertilizer inputs and nutrient-poor soils. Therefore, improving nutrient efficiency is particularly important for increasing both fertilizer use and rice yield. This review discusses how to improve the return from fertilizer input in terms of agronomic N use efficiency (AEN), that is, the increase in grain yield per kg of applied N, for rice production in SSA. The AEN values we summarized here revealed large spatial variations even within small areas and a certain gap between researcher-led trials and smallholder-managed farms. Experimental results suggest AEN can be improved by addressing spatial variations in soil-related factors such as P, S, Zn, and Si deficiencies and Fe toxicity in both irrigated and rainfed production systems. In rainfed production systems, differences in small-scale topography are also important which affects AEN through dynamic changes in hydrology and variations in the contents of soil organic carbon and clay. Although empirical evidence is further needed regarding the relationship between soil properties and responses to fertilizer inputs, recent agricultural advances have generated opportunities for integrating these micro-topographical and soil-related variables into field-specific fertilizer management. These opportunities include UAV (unmanned aerial vehicle) technology to capture microtopography at low cost, database on soil nutrient characteristics at high resolution and more numbers of fertilizer blending facilities across SSA, and interactive decision support tools by use of smartphones on site. Small-dose nursery fertilization can be also alternative approach for improving AEN in adverse field conditions in SSA. ABBREVIATIONS: AEN: agronomic nitrogen use efficiency; FISP: farm input subsidy program; VCR: value cost ratio; SOC: soil organic carbon; SSA: sub-Saharan Africa; UAV: unmanned aerial vehicle Graphical Abstract
Occupational Performance of Persons Who Have Suffered a Stroke: a Follow-up Study

The main purpose of this study was to describe the progress made in terms of occupational performance during a two-year period by persons who had suffered a stroke and had been discharged to their home after their initial hospital stay. The population of the study consisted of 49 persons, 30 men and 19 women, with a mean age of 69 years. The Assessment of Motor and Process Skills (AMPS) was used to assess their occupational performance. Of the whole population at discharge, 66% showed increased effort and 29% showed decreased efficiency and independency. The results also showed that the persons who had decreased the most in their efficiency dropped out from the study. Twenty-nine persons participated in the study for 2 years. The best ADL ability was seen in the population at 3 months after discharge. A decrease was seen at 18 months after discharge in AMPS ADL process ability and at 24 months in AMPS ADL motor ability. The results suggest that persons who have suffered a stroke and live in their homes maintain their AMPS ADL ability performance for 1.5 to 2 years. A low AMPS ADL process ability measure in persons who have suffered a stroke signifies a reduced possibility of living at home.
Views of second year nursing students on impediments to safety in the clinical setting: Q-methodology

Background: Little is known about novice students’ perspectives of safety in clinical learning. This gap prevents a comprehensive understanding of their efforts to demonstrate clinical competence while securing safety for stakeholders in increasing complex practice environments. The purpose of this study was to describe impediments to safe clinical learning as perceived by second year students enrolled in a baccalaureate nursing program. Methods: Q-methodology was used to systematically elicit multiple viewpoints about unsafe clinical learning circum- stances. Across two program sites in northern Ontario, Canada, 73 second year students sorted 43 theoretical statement cards identifying unsafe clinical practices and situations. Centroid factor analysis and varimax rotation yielded correlations between participants who held similar and different viewpoints about impediments to safety in clinical learning. Results: Three discrete perspectives and one consensus perspective constituted second year students’ description of unsafe clinical circumstances. The discrete viewpoints were unprepared for role enactment, unsupported learning, and breached standards. There was consensus that a failure to demonstrate patient protection compromised clinical safety. The findings characterized unsafe clinical milieus as a combination of student, educator and programmatic accountability issues. Conclusions: The shared perspectives of novice learners call attention to student preparedness, learning support and adherence to disciplinary standards. Educators and clinicians are compelled to address these issues for the development of conscientious novices within a culture of safety.
Germination and Seedling Development of Common Milkweed and Other Species

Common milkweed (Asclepias syriaca L.) seed did not survive storage in water for 1, 2, and 12 months at 40, 30, and 5 C, respectively; but under dry storage seed viability was destroyed only at 40 C for 5 months. Stratifying common milkweed seed in water at 5 C was more effective in breaking dormancy than at 22 C. Mechanical scarification also caused a significant increase in germination. Exogenous 6-furfurylamino purine (kinetin) and gibberellic acid-3 (GA) increased germination while indole-3-acetic acid (IAA) had no effect. The optimum germination temperature scheme for common milkweed was an alternating 20 to 30 C, the maximum between 35 and 40 C, and the minimum between 15 and 20 C. Common milkweed seedlings were more susceptible to moisture stress than kochia [Kochia scoparia (L.) Schrad. ] but less susceptible than hemp dogbane (Apocynum cannabinum L.) and sunflower (Helianthus annuus L.). In a greenhouse study common milkweed was less drought tolerant than eight other weed species. Common milkweed seedlings tolerated wider pH ranges than honeyvine milkweed [Ampelamus albidus (Nutt.) Britt. ], kochia, and sunflower. Common milkweed seedlings were less tolerant to salt solutions than four other species. Common milkweed emerged from 6-cm depths in Sharpsburg silty clay loam (sicl) at 20 or 30 C but only from the 3-cm depth at an alternating 20 to 30 C. Results from root box studies showed that common and honeyvine milkweed produced less shoot and root weight than kochia and sunflower and had a lower growth rate index of roots than sunflower. Common milkweed seedlings resprouted 21 days after planting when clipped at ground level. As days from planting to clipping increased, sprouting activity increased.
Efficient Optimization of Carry Select Adder

In this brief, the logic operations involved in conventional carry select adder (CSLA) and binary to excess-1 converter (BEC)-based CSLA are analysed to study the data dependence and to identify redundant logic operations. We have eliminated all the redundant logic operations present in the conventional CSLA and proposed a new logic formulation for CSLA. In the proposed scheme, the carry select (CS) operation is scheduled before the calculation of final-sum, which is different from the conventional approach. Bit patterns of two anticipating carry words (corresponding to cin =0and1) and fixed in bits are used for logic optimization of CS and generation units. An efficient CSLA design is obtained using optimized logic units. The proposed CSLA design involves significantly less area and delay than the recently proposed BEC-based CSLA. Due to the small carry-output delay, the proposed CSLA design is a good candidate for square-root (SQRT) CSLA.
Critical Analysis of the Healthcare Response to Burn-Pit-Related Illnesses for Post-9/11 Iraq and Afghanistan Veterans

A serious concern among post-9/11 Iraq and Afghanistan veterans (IAV) are health conditions from military and environmental exposure while serving. Many veterans are becoming suddenly ill and experiencing symptoms that have been associated with exposure to burning trash or “burn pits” set up to destroy waste produced by the military. IAVs are exhibiting respiratory conditions and other numerous health issues from exposure to burn pits during deployments. From the US military operations to the Middle East, 70% of the military personnel reported respiratory illnesses, with 17% experiencing symptoms serious enough to require medical care. Despite growing concerns, little research has been conducted on the health conditions of returning veterans. Many veterans have difficulty gaining appropriate access to care, unable to travel long distances to Veterans health facility, or have to deal with long wait times to see a provider. As a result, many veterans utilize civilian emergency rooms and healthcare facilities. Most healthcare facilities are not familiar with military-related health conditions. To address and prevent delays in care, it is helpful to have a veteran-specific screener questionnaire at the point of healthcare access. Getting a better understanding of the background and history of veterans can aid in accurately triaging this community and lead to better health care outcomes. Collecting and maintaining data regarding health issues that can arise from burn pit exposures can help direct the care of this specific community of veterans. In seeking to improve the understanding of IAV health issues from exposure to burn pits, the aim of this article is to help educate and raise awareness, and assist health care professionals to better triage and direct the care or resources necessary to help this underserved and at-risk community of our veterans.