Miracle-dz/UniFAR-FTUs huggingface dataset:
The process of harmonizing competency-based curricula for medicine and nursing degree programmes: A Multi-institutional and multi-professional experience from Tanzania

Abstract In many low- and middle-income countries, there seems to be a mismatch between graduate skills and healthcare industry requirements due to variability in curricula. With the current increased global demand for competent health profession graduates, harmonizing competency-based curricula (CBC) is necessary to address this mismatch. This paper describes how three health professions training universities in Tanzania and their two long-standing United States partners embarked on developing harmonized CBC for undergraduate medicine and nursing degrees. The main goal of the activity was to develop templates to harmonize curricula that would support graduates to acquire mandatory national Graduate Minimum Essential Competencies (GMEC) irrespective of the institution of their training. The paper describes the processes of engaging multiple institutions, the professions of medicine and nursing and various stakeholders to develop mandatory curricula generic competencies, creating milestones for assessing competencies, training faculty at each of the three partnering institutions in curriculum delivery and assessments, resulting in the adoption of the curricula by the University leadership at each institution. Ultimately the Tanzania Commission for Universities (TCU) a regulatory body required all schools of medicine and nursing in the country to adopt the curricula, thus creating a harmonized national standard for teaching medicine and nursing beginning October 2022.
Multi-Modal Multi-Task Deep Learning For Speaker And Emotion Recognition Of TV-Series Data

Since paralinguistic aspects must be considered to understand speech, we construct a deep learning framework that utilizes multi-modal features to simultaneously recognize both speakers and emotions. There are three kinds of feature modalities: acoustic, lexical, and facial. To fuse the features from multiple modalities, we experimented on three methods: majority voting, concatenation, and hierarchical fusion. The recognition was done from TV-series dataset that simulate actual conversations.
Server-Side Lookup Optimization of A Web Service

A surge of web requests is common phenomena for a web server that handles popular contents. If the server has limited resources (I/O bandwidth, memory, CPU utilization, network bandwidth, etc.), the server may suffer a scalability problem. Optimization on the application side is the only option. This paper compares two techniques dealing on access scalability of a web service that handles popular contents, such as student admission results. This paper explains method how the PHP-FPM worker handle a lookup query between data array stored in a single file and data array split into multiple files. The empirical test results on a web server with 2 GB of RAM and 2 CPU cores show that the lookup process on multiple files can handle more than 63.3% requests, compares to 8.41% requests on a single file. The lookup query of data array split into multiple files outperforms the lookup query of data array stored in a single file.
Mechanisms of paracellular transport of magnesium in intestinal and renal epithelia

Magnesium is the fourth most abundant cation in the body. It plays a critical role in many biological processes, including the process of energy release. Paracellular transport of magnesium is mandatory for magnesium homeostasis. In addition to intestinal absorption that occurs in part across the paracellular pathway, magnesium is reabsorbed by the kidney tubule. The bulk of magnesium is reabsorbed through the paracellular pathway in the proximal tubule and the thick ascending limb of the loop of Henle. The finding that rare genetic diseases due to pathogenic variants in genes encoding specific claudins (CLDNs), proteins located at the tight junction that determine the selectivity and the permeability of the paracellular pathway, led to an awareness of their importance in magnesium homeostasis. Familial hypomagnesemia with hypercalciuria and nephrocalcinosis is caused by a loss of function of CLDN16 or CLDN19. Pathogenic CLDN10 variants cause HELIX syndrome, which is associated with a severe renal loss of sodium chloride and hypermagnesemia. The present review summarizes the current knowledge of the mechanisms and factors involved in paracellular magnesium permeability. The review also highlights some of the unresolved questions that need to be addressed.
Prevalence, measurement, and implications of frailty in stroke survivors: An analysis of three global aging cohorts

Background: Our understanding of the relationship between frailty and stroke, beyond the acute phase of stroke, is limited. We aimed to estimate the prevalence of frailty in stroke survivors using differing methods of assessment and describe relationships with stroke outcomes. Methods: We used data from three international population surveys (American Health and Retirement Survey/English Longitudinal Study of Ageing/Survey for Health and Retirement in Europe) of aging. Frailty status was assessed using the Fried frailty phenotype, a 40-item frailty index (FI) and the clinical frailty scale (CFS). We created estimates of frailty prevalence and assessed association of frailty with outcomes of mortality/hospital admission/recurrent stroke at 2 years follow-up using logistic regression models adjusted for age/sex. Additional analyses explored effects of adding cognitive measures to frailty assessments and of missing grip strength data. Findings: Across 9617 stroke survivors, using the frailty phenotype, 23.8% (n = 2094) identified as frail; with CFS, 30.1% (n = 2906) were moderately or severely frail; using FI, 22.7% (n = 2147) had moderate frailty and 31.9% (n = 3021) had severe frailty. Frailty was associated with increased risk of mortality/hospitalization/recurrent stroke using all three measures. Adding cognitive variables to the FI produced minimal difference in prevalence of frailty. People with physical frailty (phenotype or CFS) plus cognitive impairment had a greater risk of mortality than people with an equivalent level of frailty but no cognitive impairment. Excluding people unable to provide grip strength underestimated frailty prevalence. Interpretation: Frailty is common in stroke and associated with poor outcomes, regardless of measure used. Adding cognitive variables to frailty phenotype/CFS measures identified those at greater risk of poor outcomes. Physical and cognitive impairments in stroke survivors do not preclude frailty assessment.
Application of wireless thoracoscopy in thoracic surgery

Abstract To explore the safety and feasibility of wireless thoracoscope in thoracic surgery. A retrospective analysis was made of all the clinical data of 90 patients with thoracoscope lung resection, from April to August 2021, Shanghai changzheng hospital thoracic minimally invasive center. Compared the thoracoscope preparation time, picture resolution, picture delay, surgeon comfort level, assistant comfort level between the wireless thoracoscope group and wired thoracoscope group. The thoracoscopic preparation time of the wireless thoracoscope group was significantly shorter than that of the wired group (26.66 ± 6.04 vs 62.14 ± 10.07, p < 0.0001). Comfort level of the surgeon (4.64 ± 0.48 vs 3.77 ± 0.42, p < 0.001) and the comfort level of the assistant (4.85 ± 0.36 vs 3.88 ± 0.32, p < 0.001) of the wireless thoracoscope group were higher than that of the wired thoracoscope group. There were no statistically significant differences in video sharpness (4.64 ± 0.48 vs 4.74 ± 0.44, p = 0.31). Although there was one case picture delay in wireless group, it was caused by low power which could be dealt with by a good charge before surgery. The wireless thoracoscope has the advantages of short preparation time, high comfort for the surgeon and the assistant, no less than the wired thoracoscope in picture resolution and picture delay. Wireless connection is more convenient and portability, which is worthy of further application in clinical practice.
Paracetamol versus paracetamol/tramadol in postoperative intertrochanteric fracture: A noninferiority, randomized, controlled, double-blind study

Background One of the most common osteoporotic fractures among the elderly is hip fracture with tramadol frequently being prescribed for these patients. To decrease the risk of falling from tramadol, this study aimed to ascertain the effectiveness of paracetamol compared to paracetamol/tramadol for pain control following hip fixation surgery. Method This was a noninferiority, double-blind, randomized, controlled trial at a tertiary care hospital. All patients were recruited between February 2020 and March 2022. Patients were randomly assigned to paracetamol alone (Group A) or paracetamol/tramadol (Group B). All patients in both groups followed the same protocol for the first two days after surgery. To ascertain differences in pain control between the two groups, different regimens were followed from postoperative days 3–5. Pain scores were assessed by a visual analog scale (VAS). All patients were asked to complete a satisfaction questionnaire on day 5. Result A total of 30 patients were randomly allocated into Group A (paracetamol alone) and 30 into Group B (paracetamol + tramadol). The mean pain score for Group A was 5.85 ± 0.52 and 5.35 ± 0.74 for Group B. Mean cumulative doses in Group A were 4.50 ± 1.33 and 4.06 ± 1.18 in Group B. Although the mean satisfaction with pain management was higher in Group B, this was not statistically significant. Conclusion VAS scores from Group A were slightly higher than Group B. Based on a 2.0-point noninferiority margin of pain, paracetamol alone was not inferior to paracetamol/tramadol in postoperative intertrochanteric fracture.
Pulmonary diffusing capacity to nitric oxide and carbon monoxide during exercise and in the supine position: a test–retest reliability study

What is the central question in this study? How reliable is the combined measurement of the pulmonary diffusing capacity to carbon monoxide and nitric oxide (DLCO/NO) during exercise and in the resting supine position, respectively? What is the main finding and its importance? The DLCO/NO technique is reliable with a very low day‐to‐day variability both during exercise and in the resting supine position, and may thus provide a useful physiological outcome that reflects the alveolar–capillary reserve in humans.
Testing the Order of a Finite Mixture

The order is an important parameter in applications of finite mixture models. Yet designing a valid and easy-to-use statistical test for the order is challenging. To date, most results on hypothesis tests have focused on homogeneity, a special case where the null model has order 1. In this work, we designed an EM test for the general problem of testing the null hypothesis of order m0 versus an alternative hypothesis of order larger than m0. For any positive integer m0, the null limiting distribution of the EM test is a mixture of χ2 distributions. The weights in this mixture-limiting distribution can be conveniently computed. Compared with related results, the new result is obtained under much less strict requirements on the component distribution and the parameter space. Extensive simulation studies show that the limiting distributions closely match the finite sample distributions of the EM test. When m0 = 2, the new EM test has more accurate type I errors and matches the power of the modified likelihood ratio test. When m0 = 3, there is a clear indication that the test has good power properties. Supplementary materials for this article are available online.
Bringing the patient’s perspectives forward in drug development and health-care evaluation

ABSTRACT Introduction For many years, psychologists and other social scientists have been pushing for the individual patient’s perspective – priorities, needs, feelings, and functioning – to be incorporated into drug development. This is usually achieved through the use of patient-reported outcome measures (PROMs) in clinical trials. Areas covered This paper discusses some key issues in the use of PROM data as the sole method of generating information about the patient’s perspective and outlines the relevance of narrative evidence to enhance understanding and interpretation of PROM data. Expert opinion The development and use of PROMs situates them at the vertex of two very different trends in medicine: patient-centered care and standardization. Indeed, the application of PROMs – which pull in the direction of standardization – results in a narrow conception of evidence by overriding the subjectivity of individual experiences, beliefs, and judgments. Without additional context, PROM data cannot easily support individual patient-level care. When collected systematically and with an interpretive phenomenological approach, narrative data can contain valuable information about the patient experience that numerical ratings from PRO measures do not capture.
Structural systems biology approach delineate the functional implications of SNPs in exon junction complex interaction network

Abstract In eukaryotes, transcripts that carry premature termination codons (PTC) leading to truncated proteins are degraded by the Nonsense Mediated Decay (NMD) machinery. Missense and nonsense Single Nucleotide Polymorphisms (SNPs) in proteins belonging to Exon junction complex (EJC) and up-frameshift protein (UPF) will compromise NMD leading to the accumulation of truncated proteins in various diseases. The EJC and UPF which are involved in NMD is a good model system to study the effect of SNPs at a system level. Despite the availability of crystal structures, computational tools, and data on mutational and deletion studies, with functional implications, an integrated effort to understand the impact of SNPs at the systems level is lacking. To study the functional consequences of missense SNPs, sequence-based techniques like SIFT and PolyPhen which classify SNPs as deleterious or non-deleterious and structure-based methods like FoldX which calculate the Delta Delta G, (ddGs, ∆∆G) are used. Using FoldX, the ddG for mutations with experimentally validated functional effects is calculated and compared with those calculated for SNPs in the same protein–protein interaction interface. Further, a model is conceived to explain the functional implications of SNPs based on the effects observed for known mutants. The results are visualized in a network format. The effects of nonsense mutations are discerned by comparing with deletion mutation studies and loss of interaction in the crystal structure. The present work not only integrates genomics, proteomics, and classical genetics with ‘Structural Biology’ but also helps to integrate it into a ‘systems-level functional network’. Communicated by Ramaswamy H. Sarma
A Novel Algorithm to Improve PrEP Adherence Monitoring Using Dried Blood Spots

Tenofovir diphosphate (TFVdp; an active metabolite of oral HIV pre‐exposure prophylaxis (PrEP)) is measured in dried blood spots (DBS) to estimate adherence. However, TFVdp's long half‐life in whole blood may lead to misclassification following a recent change in adherence. PrEP's other metabolite, emtricitabine triphosphate (FTCtp), has a shorter half‐life in whole blood but adherence thresholds are undefined. We characterized DBS TFVdp and FTCtp concentrations across many dosing scenarios. Population pharmacokinetic models were fit to TFVdp and FTCtp DBS concentrations from a directly observed therapy study (NCT03218592). Concentrations were simulated for 90 days of daily dosing followed by 90 days of 1 to 7 doses/week and for event‐driven PrEP (edPrEP) scenarios. Thresholds of 1,000 and 200 fmol/punch, for TFVdp and FTCtp, respectively, were reflective of taking 4 doses/week (a minimum target for effective PrEP in men). TFVdp was < 1,000 fmol/punch for 17 days after initiating daily PrEP and > 1,000 fmol/punch for 62 days after decreasing to 3 doses/week. Respectively, FTCtp was < 200 fmol/punch for 4 days and > 200 fmol/punch for 6 days. Accuracy of edPrEP adherence classification depended on duration between last sex act and DBS sampling for both measures with misclassification ranging from 9–100%. These data demonstrate adherence misclassification by DBS TFVdp for 2 months following a decline in adherence, elucidating the need for FTCtp to estimate recent adherence. We provide proof of principle that individualized interpretation is needed to support edPrEP adherence monitoring. Our collective approach facilitates clinicians' ability to interpret DBS results and administer patient‐centric interventions.
Levels of orientation bias differ across digital content categories: Implications for visual perception

With the continued growth of digital device use, a greater portion of the visual world experienced daily by many people has shifted towards digital environments. The “oblique effect” denotes a bias for horizontal and vertical (canonical) contours over oblique contours, which is derived from a disproportionate exposure to canonical content. Carpentered environments have been shown to possess proportionally more canonical than oblique contours, leading to perceptual bias in those who live in “built” environments. Likewise, there is potential for orientation sensitivity to be shaped by frequent exposure to digital content. The potential influence of digital content on the oblique effect was investigated by measuring the degree of orientation anisotropy from a range of digital scenes using Fourier analysis. Content from popular cartoons, video games, and social communication websites was compared to real-life nature, suburban, and urban scenes. Findings suggest that digital content varies widely in orientation anisotropy, but pixelated video games and social communication websites were found to exhibit a degree of orientation anisotropy substantially exceeding that observed in all measured categories of real-world environments. Therefore, the potential may exist for digital content to induce an even greater shift in orientation bias than has been observed in previous research. This potential, and implications of such a shift, is discussed.
LncRNA IGFL2-AS1 as a ceRNA Promotes HCT116 Cell Malignant Proliferation via the miR-433-3p/PAK4 Axis

Background: Colorectal cancer is a common gastrointestinal malignancy worldwide. Many studies have proved that long noncoding RNA alterations participate in colorectal cancer development. This study sought to probe the regulatory mechanism of lncRNA IGF-like family member 2 antisense RNA 1 (IGFL2-AS1) in colorectal cancer cell malignant proliferation. Methods: LncRNA IGFL2-AS1 expression in colorectal cancer and para-cancerous tissues and colorectal cancer cell lines was detected via quantitative real-time polymerase chain reaction. HCT116 cells were transfected with si-IGFL2-AS1, microRNA (miR)-433-3p inhibitor or p21 (RAC1)-activated kinase 4, PAK4 and IGFL2-AS1 overexpression vector, followed by assessment of cell proliferation and clone formation using 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide assay and colony formation assay. The subcellular localization of lncRNA IGFL2-AS1 was predicted and testified via the nuclear/cytosol fractionation assay. The downstream miRNA of lncRNA IGFL2-AS1 and downstream target of miRNA were predicted, and their binding relationships were testified using dual-luciferase assay and RNA immunoprediction experiment. Results: LncRNA IGFL2-AS1 was abundantly expressed in colorectal cancer tissues and cells. Silencing lncRNA IGFL2-AS1 discouraged HCT116 cell malignant proliferation, while lncRNA IGFL2-AS1 overexpression played an opposite role. LncRNA IGFL2-AS1 was mainly expressed in the cytoplasm of HCT116 cells. LncRNA IGFL2-AS1 bound to miR-433-3p and inhibited its expression. miR-433-3p targeted PAK4. Silencing lncRNA IGFL2-AS1 facilitated miR-433-3p to suppress PAK4 transcription. miR-433-3p inhibition or PAK4 overexpression partly reversed the inhibition of silencing lncRNA IGFL2-AS1 on HCT116 cell malignant proliferation. Conclusion: LncRNA IGFL2-AS1 was abundantly expressed in colorectal cancer tissues and cells, and comparatively bound to miR-433-3p to facilitate PAK4 transcription, thus promoting HCT116 cell malignant proliferation.
The influence of anxiety and depression on headache in adolescent migraineurs: a case-control study

ABSTRACT Background Migraine is commonly linked to a range of psychiatric comorbidities, primarily anxiety and depression. The present study compared the frequency of anxiety and depression disorders in migraine and non-migraine adolescents and evaluated the relation of depression and anxiety to migraine characteristics. Methods In this case-control study, 234 adolescents (112 migraineurs and 122 non-migraine adolescents) aged 13–18 years were evaluated. A headache questionnaire as well as the Beck Anxiety Inventory and Children’s Depression Inventory were completed to investigate the prevalence of headache, anxiety, and depression. Results The average age of participants was 15.77±2 years in the case group and 15.39±1.79 years in the control group. We found significantly higher levels of mild, moderate, and severe anxiety (38.4%, 23.2%and 23.2% respectively) in the migraine group compared to the control group (24.2%, 5.8%and 10.0% respectively) (p<0.001). Significantly more children in the control group (29.6%) than in the case group (10.1%) had a non-depressive CDI score (p=0.005). There was a significant difference between patients with moderate and severe anxiety in terms of attack frequency and duration. Depressed migraineurs recorded higher attack severities and frequencies than migraineurs without depression. Conclusion Anxiety and depression are common in adolescents with migraine and can be associated with more burdensome attacks.
Using Movement Disorder Society Unified Parkinson's Disease Rating Scale Parts 2 and 3 Simultaneously: Combining the Patient Voice with Clinician Ratings

Regulatory recommendations favor outcomes combining objective and patient input. The Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS‐UPDRS), the most commonly used scale in Parkinson's disease (PD), includes patient and investigator ratings in distinct parts, but original clinimetric analyses failed to confirm the validity of combining parts by simple summing.
Production and annealing of electron irradiation damage in ZnO

High-energy (>1.6 MeV) electrons create acceptors and donors in single-crystal ZnO. Greater damage is observed for irradiation in the [0001] direction (Zn face) than in the [0001] direction (O face). The major annealing stage occurs at about 300–325 °C, and is much sharper for defects produced by Zn-face irradiation, than for those resulting from O-face irradiation. The defects appear to have a chain character, rather than being simple, near-neighbor vacancy/interstitial Frenkel pairs. These experiments suggest that ZnO is significantly more “radiation hard” than Si, GaAs, or GaN, and should be useful for applications in high-irradiation environments, such as electronics in space satellites.