Yoxas/statistical_literacy huggingface dataset:
Carcinogenesis is one of the leading health concerns afflicting presumably every single animal species, including humans. Currently, cancer research expands considerably beyond medicine, becoming a focus in other branches of natural science. Accumulating evidence suggests that a proportional scale of tumor deaths involves domestic and wild animals and poses economical or conservation threats to many species. Therefore, understanding the genetic and physiological mechanisms of cancer initiation and its progression is essential for our future action and contingent prevention. From this perspective, I used an evolutionary-based approach to re-evaluate the baseline for debate around Peto's paradox. First, I review the background of information on which current understanding of Peto's paradox and evolutionary concept of carcinogenesis have been founded. The weak points and limitations of theoretical modeling or indirect reasoning in studies based on intraspecific, comparative studies of carcinogenesis are highlighted. This is then followed by detail discussion of an effect of the body mass in cancer research and the importance of cell size in consideration of body architecture; also, I note to the ambiguity around cell size invariance hypothesis and hard data for variability of cell size across species are provided. Finally, I point to the new research area that is driving concepts to identify exact molecular mechanisms promoting the process of tumorigenesis, which in turn may provide a proximate explanation of Peto's paradox. The novelty of the approach proposed therein lies in intraspecies testing of the effect of differentiation of cell size/number on the probability of carcinogenesis while controlling for the confounding effect of body mass/size.
Carcinogenicity is a crucial endpoint for the safety assessment of chemicals and products. During the last few decades, the development of quantitative structure-activity relationship ((Q)SAR) models has gained importance for regulatory use, in combination with in vitro testing or expert-based reasoning. Several classification models can now predict both human and rat carcinogenicity, but there are few models to quantitatively assess carcinogenicity in humans. To our knowledge, slope factor (SF), a parameter describing carcinogenicity potential used especially for human risk assessment of contaminated sites, has never been modeled for both inhalation and oral exposures. In this study, we developed classification and regression models for inhalation and oral SFs using data from the Risk Assessment Information System (RAIS) and different machine learning approaches. The models performed well in classification, with accuracies for the external set of 0.76 and 0.74 for oral and inhalation exposure, respectively, and r2 values of 0.57 and 0.65 in the regression models for oral and inhalation SFs in external validation. These models might therefore support regulators in (de)prioritizing substances for regulatory action and in weighing evidence in the context of chemical safety assessments. Moreover, these models are implemented on the VEGA platform and are now freely downloadable online.
Cardiac function quantification in cardiovascular magnetic resonance requires precise contouring of the heart chambers. This time-consuming task is increasingly being addressed by a plethora of ever more complex deep learning methods. However, only a small fraction of these have made their way from academia into clinical practice. In the quality assessment and control of medical artificial intelligence, the opaque reasoning and associated distinctive errors of neural networks meet an extraordinarily low tolerance for failure. The aim of this study is a multilevel analysis and comparison of the performance of three popular convolutional neural network (CNN) models for cardiac function quantification. U-Net, FCN, and MultiResUNet were trained for the segmentation of the left and right ventricles on short-axis cine images of 119 patients from clinical routine. The training pipeline and hyperparameters were kept constant to isolate the influence of network architecture. CNN performance was evaluated against expert segmentations for 29 test cases on contour level and in terms of quantitative clinical parameters. Multilevel analysis included breakdown of results by slice position, as well as visualization of segmentation deviations and linkage of volume differences to segmentation metrics via correlation plots for qualitative analysis. All models showed strong correlation to the expert with respect to quantitative clinical parameters (rz' = 0.978, 0.977, 0.978 for U-Net, FCN, MultiResUNet respectively). The MultiResUNet significantly underestimated ventricular volumes and left ventricular myocardial mass. Segmentation difficulties and failures clustered in basal and apical slices for all CNNs, with the largest volume differences in the basal slices (mean absolute error per slice: 4.2 ± 4.5 ml for basal, 0.9 ± 1.3 ml for midventricular, 0.9 ± 0.9 ml for apical slices). Results for the right ventricle had higher variance and more outliers compared to the left ventricle. Intraclass correlation for clinical parameters was excellent (≥0.91) among the CNNs. Modifications to CNN architecture were not critical to the quality of error for our dataset. Despite good overall agreement with the expert, errors accumulated in basal and apical slices for all models.
Cardiac implantable electronic devices (CIED) are a heterogeneous group of medical devices with increasingly sophisticated diagnostic capabilities, which could be exploited in forensic investigations. However, current guidelines are lacking clear recommendations on the topic. The first aim of this systematic review is to provide an updated assessment of the role of postmortem CIED interrogation, and to give practical recommendations, which can be used in daily practice. Secondly, the authors aim to determine the rates of postmortem CIED interrogation and autopsy investigations, the type of final rhythm detected close to death (with a focus on the significance of documented arrhythmias), as well as the role of postmortem CIED interrogation in the determination of final cause/time of death, and any potentially fatal device malfunctions. A systematic search in MEDLINE and Scopus aiming to identify reports concerning postmortem human CIED interrogation was performed, including a systematic screening of reference lists. Case reports, letters to the editors, commentaries, review articles or guidelines were excluded, along with studies related to cardiac devices other than CIED. All data were pooled and analyzed using fixed-effects meta-analysis models, and the I2 statistic was used to assess heterogeneity. A total of 25 articles were included in the systematic review, enrolling 3194 decedent CIED carriers. Ten studies (40%) had a 100% autopsy rate, whereas in further 6 studies autopsy findings were variably reported; CIED interrogation was available from 22 studies (88%), and it was never performed prior to autopsy. The overall rate of successful postmortem CIED interrogation was 89%, with high heterogeneity among studies, mainly due to device deactivation/battery discharge. Twenty-four percent of CIED carriers experienced sudden cardiac death (SCD), whereas non-sudden cardiac and non-cardiac death (NSCD, NCD) were reported in 37% and 30% of decedents, respectively. Ventricular tachyarrhythmias were recorded in 34% of overall successfully interrogated CIED, and in 62% of decedents who experienced a SCD; of all ventricular tachyarrhythmias recorded, 40% was found in NSCD or NCD. A clear interpretation of the etiological role of recorded arrhythmias in the causation of death required integration with autopsy findings. Overall, potentially fatal device malfunctions were detected in 12% of cases. Postmortem CIED interrogation is a valuable tool for the determination of the cause of death, and may complement autopsy. Forensic pathologists need to know the potential utility, pitfalls, and limitations of this diagnostic examination to make this tool as much reliable as possible.
Cardiac rehabilitation (CR) improves patient outcomes and quality of life and can be provided virtually through hybrid CR. However, little is known about CR availability in conjunction with broadband access, a requirement for hybrid CR. This study examined the intersection of CR and broadband availability at the county level, nationwide. Data were gathered and analyzed in 2022 from the 2019 American Community Survey, the Centers for Medicare & Medicaid Services, and the Federal Communications Commission. Spatially adaptive floating catchments were used to calculate county-level percent CR availability among Medicare fee-for-service beneficiaries. Counties were categorized: by CR availability, whether lowest (ie, CR deserts), medium, or highest; and by broadband availability, whether CR deserts with majority-available broadband, or dual deserts. Results were stratified by state. County-level characteristics were examined for statistical significance by CR availability category. Almost half of US adults (n = 116 325 976, 47.2%) lived in CR desert counties (1691 counties). Among adults in CR desert counties, 96.8% were in CR deserts with majority-available broadband (112 626 906). By state, the percentage of the adult population living in CR desert counties ranged from 3.2% (New Hampshire) to 100% (Hawaii and Washington, DC). Statistically significant differences in county CR availability existed by race/ethnicity, education, and income. Almost half of US adults live in CR deserts. Given that up to 97% of adults living in CR deserts may have broadband access, implementation of hybrid CR programs that include a telehealth component could expand CR availability to as many as 113 million US adults.
Cardiac rehabilitation (CR) is a class Ia recommendation by international guidelines. However, the participation remains disappointingly low. Multiple barriers were already identified. Nevertheless, the relationship with psychosocial factors remains unsettled. The aim of this study is to analyse the role of psychosocial factors in CR participation. A prospective study on 165 patients with a percutaneous coronary intervention. The main outcome was participation in a centre-based CR programme. The independent relationship between participation and optimism, type D personality or distressed personality, health literacy, depression, social support and self-efficacy. A total number of 165 patients were included in the study of which 81 (49.1%) participated in a centre-based CR programme. Participants were predominantly male. Solely, patients participating in CR were significantly younger (P = 0.005). Participants of CR had significantly higher levels of social support especially from their significant other (P = 0.020) and family (P = 0.050). Furthermore, the health literacy score was significantly higher in the participants group (P = 0.030). A multiple logistic regression demonstrated that higher age, higher social support, not working, being obese and being able to drive a car were significant statistical predictors for CR participation. This study is one of the first to demonstrate the role of social support and health literacy in the participation of CR. Other well-known barriers for CR participation such as age, transport and scheduling issues were identified as barriers in this study.
Cardinal number knowledge-understanding "two" refers to sets of two entities-is a critical piece of knowledge that predicts later mathematics achievement. Recent studies have shown that domain-general and domain-specific skills can influence children's cardinal number learning. However, there has not yet been research investigating the influence of domain-specific quantifier knowledge on children's cardinal number learning. The present study aimed to investigate the influence of domain-general and domain-specific skills on Mandarin Chinese-speaking children's cardinal number learning after controlling for a number of family background factors. Particular interest was paid to the question whether domain-specific quantifier knowledge was associated with cardinal number development. Specifically, we investigated 2-5-year-old Mandarin Chinese-speaking children's understanding of cardinal number words as well as their general language, intelligence, approximate number system (ANS) acuity, and knowledge of quantifiers. Children's age, gender, parental education, and family income were also assessed and used as covariates. We found that domain-general abilities, including general language and intelligence, did not account for significant additional variance of cardinal number knowledge after controlling for the aforementioned covariates. We also found that domain-specific quantifier knowledge did not account for significant additional variance of cardinal number knowledge, whereas domain-specific ANS acuity accounted for significant additional variance of cardinal number knowledge, after controlling for the aforementioned covariates. In sum, the results suggest that domain-specific numerical skills seem to be more important for children's development of cardinal number words than the more proximal domain-general abilities such as language abilities and intelligence. The results also highlight the significance of ANS acuity on children's cardinal number word development.
Cardiopulmonary resuscitation (CPR) education for schoolchildren is emphasized, as bystander CPR is a vital key to increasing the survival rate of out-of-hospital cardiac arrest (OHCA) victims. This study was conducted to verify the effect of CPR education on knowledge, attitudes, self-efficacy, and confidence of Korean elementary school students in performing CPR. Data were collected through structured questionnaires before and after CPR education and analyzed using descriptive statistics, T-tests, and hierarchical regression. Significant improvements in CPR knowledge, attitudes, self-efficacy, and confidence in performing CPR were found after CPR education, with the greatest increase observed in confidence (p = 0.000). The influencing factors on confidence in performing CPR were school grade, attitude, and self-efficacy. Although a significant increase in schoolchildren's CPR knowledge after education was shown, knowledge did not affect confidence in performing CPR. Therefore, early CPR education which focuses on improving confidence in performing CPR is recommended. CPR education might raise attitude and self-efficacy leading to increased confidence in performing bystander CPR. In conclusion, early and regular CPR education for elementary school students is crucial and should be conducted repeatedly.
Cardiopulmonary resuscitation (CPR) is the most critical procedure in the rescue of patients with sudden cardiac death (SCD). The success rate of CPR remains far below expectations, which made CPR education identified as the top priority for SCD. CPR training using the virtual reality (VR) technique is a feasible training method, with a wider population and lower cost, but its efficacy remains controversial. Thus, we will perform a protocol for a systematic review and meta-analysis to identify the efficacy of the VR technique on CPR quality. We will search PubMed, Web of Science, Cochrane Library, Ovid Medline, Embase, China National Knowledge Infrastructure, Chinese BioMedical Literature, Wanfang and VIP databases from inception to November 2021, to identify randomised controlled trials and the first period in randomised cross-over trials assessing the efficacy of VR techniques versus non-VR techniques for adult participants accepting adult CPR training. No language restrictions will be considered. Data synthesis will be performed using RevMan V.5.4 and Stata/MP V.16.0. Outcome measures will be present as relative risk with 95% CIs for dichotomous data and mean difference with 95% CIs for continuous data. The primary outcome will be the CPR quality defined as chest compression rate and depth. Secondary outcomes will be the overall performance of CPR. Heterogeneity will be assessed by the χ2 test and I2 statistic. Data will be synthesised by either fixed-effects or random-effects models according to the I2 value. Trial sequential analysis and modified Jadad Scale will be used to control the risks of random errors and evaluate the evidence quality. Egger's regression test and funnel plots will be used to assess the publication bias. Ethical approval was not required for this systematic review protocol. The findings will be disseminated through peer-reviewed publications. CRD42021281059.
Cardiopulmonary resuscitation (CPR) training is generally led by instructors in a classroom; thus, conventional teaching materials used in CPR training are often constrained by spatiotemporal factors, limiting learners' interest and sense of achievement in learning and preventing them from effectively applying what they learn in practice. For greater effectiveness and more flexible application, clinical nursing education has increasingly emphasized contextualization, individualization, and interprofessional learning. This study determined the self-assessed emergency care competencies of nurses who received gamified emergency care training and explored the factors associated with those competencies. Quota sampling of nurses working at a certain regional hospital in central Taiwan was conducted, and a structured questionnaire was administered to the recruited nurses. A total of 194 valid responses were collected. The research tool was a scale measuring the participants' emergency care competencies after they received gamified emergency care training. The data were analyzed using descriptive and inferential statistics and multiple regression. Of the recruited participants, 50.52% were ≤ 30 years old; 48.45% worked in the internal medicine department; 54.64% graduated from 2-year university technical programs; 54.12% were N2 registered nurses; 35.57% and 21.13% had ≥ 10 and 1-3 years of work experience, respectively; and 48.45% worked in general wards. User need (r = 0.52, p = 0.000), perceived usefulness (r = 0.54, p = 0.000), perceived ease of use (r = 0.51, p = 0.000), and usage attitude (r = 0.41, p = 0.000) were positively correlated with emergency care competencies. Furthermore, the multiple regression analysis revealed that perceived usefulness was the primary factor associated with the participants' emergency care competencies. The results of this study may serve as a reference for acute care facility authorities in designing advanced nursing competency standards and emergency care training programs for nurses.
Cardiothoracic training continues to evolve and is a completely different teaching environment than prior. Cardiothoracic surgical educators are tasked to ensure that all levels of learners are appropriately trained. To be an effective surgical educator, one must expand their skills beyond being content experts but also acquire knowledge of educational theory and formal training in how to teach effectively. Furthermore, applying a scholarly approach and engaging in scholarship differentiate a cardiothoracic surgical educator from a teacher. Therefore, the surgical educator academic track is different from a surgical scientist track in terms of skills, work performed, documentation, and promotion requirements.
Cardiovascular disease (CVD) is the leading cause of death and illness globally. Influenza, pneumococcal disease and herpes zoster infection may trigger acute cardiovascular events or cause complications among cardiac patients. Vaccination is recommended for adults with CVD. There is a gap in research evidence around determinants and uptake of influenza, pneumococcal and zoster vaccines in adults with CVD. The aim of this study is to examine the rate of the uptake of influenza, zoster and pneumococcal vaccines, factors associated with the uptake of influenza vaccine, and the perceptions of influenza and pneumococcal vaccination among people with CVD in the community. Cross-sectional survey data was analysed from three separate surveys carried out in Australia between October 2019 and September 2020 of 972 adults with CVD. We used descriptive statistics to describe data. Thematic analysis examined the reasons for taking influenza vaccine. Multivariable analysis was used to identify independent predictors of the influenza vaccine uptake and perceptions associated with the uptake of influenza and pneumococcal vaccines. Out of 972 participants, a total of 661 (68 %) people said they had received influenza vaccine in the last 12 months; 361 (37 %) had ever received pneumococcal vaccine; 196 (20 %) had ever received zoster vaccine. Among 661 participants who said they received influenza vaccine within the 12 months prior to the study, 543 (82 %) participants received it from doctors or general practitioners (GPs) offices. Age 65 and older, being born in Australia, being employed or retired and having comorbidity were positive predictors of influenza vaccination. Doctors' recommendations to take the vaccine and awareness of free vaccines positively predicted influenza and pneumococcal vaccine uptake. The uptake of recommended pneumococcal and zoster vaccines is low in people with CVD. Doctors' recommendations, targeted health promotion programs in general practice, and easy access to vaccination may optimise vaccination uptake in patients with CVD.
Cardiovascular disease (CVD) is the leading cause of death worldwide, but prevalence estimates in former professional athletes are limited. HUDDLE (Heart Health: Understanding and Diagnosing Disease by Leveraging Echocardiograms) aimed to raise awareness and estimate the prevalence of CVD and associated risk factors among members of the National Football League (NFL) Alumni Association and their families through education and screening events. HUDDLE was a multicity, cross-sectional study of NFL alumni and family members aged 50 years and older. Subjects reported their health history and participated in CVD education and screening (blood pressure, electrocardiogram, and transthoracic echocardiogram [TTE] assessments). Phone follow-up by investigators occurred 30 days postscreening to review results and recommendations. This analysis focuses on former NFL athletes. Of 498 participants screened, 57.2% (N = 285) were former NFL players, the majority of whom were African American (67.6%). The prevalence of hypertension among NFL alumni was estimated to be 89.8%, though only 37.5% reported a history of hypertension. Of 285 evaluable participants, 61.8% had structural cardiac abnormalities by TTE. Multivariable analysis showed that hypertension was a significant predictor of clinically relevant structural abnormalities on TTE. HUDDLE identified a large discrepancy between participant self-awareness and actual prevalence of CVD and risk factors, highlighting a significant opportunity for population health interventions. Structural cardiac abnormalities were observed in most participants and were independently predicted by hypertension, affirming the role of TTE for CVD screening in this population aged older than 50 years. (Heart Health: Understanding and Diagnosing Disease by Leveraging Echocardiograms [HUDDLE]; NCT05009589).