Miracle-dz/UniFAR-FTUs huggingface dataset:
Value-Added Care: A New Way of Assessing Nursing Staffing Ratios and Workload Variability

Objective: To thoroughly understand the implications of California regulatory staffing ratios on nursing units, the present study examines the relative amounts of time allocated to workload activities among registered nurses. Background: Nursing is a synergistic, intuitive process and may not be capable of being translated into minimum patient-to-nurse ratios that work across an entire region or state. A fundamental step in evaluating the appropriateness of prescribed ratios lies in assessing how registered nurses spend their time while caring for patients. Once workload intensity is assessed, additional factors can be identified to design mandated staffing levels for acute care settings. Methods: Variability in workload intensity was assessed using the Robert Woods Johnson Foundation "Transforming Care at the Bedside" work flow methodology approach in evaluating value-added care and assessing the amount of time nurses spent on direct care and other categorical activities. Results: The results revealed a marked variation in the medical-surgical unit compared with the 2 telemetry units regarding the amount of time spent by registered nurses on value-added, necessary, and non-value-added activities, as well as variability in the amount of time that registered nurses spent on direct care, indirect care, documentation, waste, and other activities. Conclusion: By evaluating patient quality of care in acute care settings, we can return to a basic aspect of how nurses spend their time caring for patients-the activities that not only involve direct care but also benefit the patient.
Nucleotide sequences of the pbpX genes encoding the penicillin‐binding proteins 2x from Streptococcus pneumoniae R6 and a cefotaxime‐resistant mutant, C506

Development of penicillin resistance in Streptococcus pneumoniae is due to successive mutations in penicillin‐binding proteins (PBPs) which reduce their affinity for β‐lactam antibiotics. PBP2x is one of the high‐Mr PBPs which appears to be altered both in resistant clinical isolates, and in cefotaxime‐resistant laboratory mutants. In this study, we have sequenced a 2564 base‐pair chromosomal fragment from the penicillin‐sensitive S. pneumoniae strain R6, which contains the PBP2x gene. Within this fragment, a 2250 base‐pair open reading frame was found which coded for a protein having an Mr of 82.35 kD, a value which is in good agreement with the Mr of 80–85kD measured by SDS‐gel electrophoresis of the PBP2x protein itself. The N‐terminal region resembled an unprocessed signal peptide and was followed by a hydrophobic sequence that may be responsible for membrane attachment of PBP2x. The corresponding nucleotide sequence of the PBP2x gene from C504, a cefotaxime‐resistant laboratory mutant obtained after five selection steps, contained three nucleotide substitutions, causing three amino acid alterations within the β‐lactam binding domain of the PBP2x protein. Alterations affecting similar regions of Escherichia coli PBP3 and Neisseria gonorrhoeae PBP2 from β‐lactam‐resistant strains are known. The penicillin‐binding domain of PBP2x shows highest homology with these two PBPs and S. pneumoniae PBP2b. In contrast, the N‐terminal extension of PBP2x has the highest homology with E. coli PBP2 and methicillin‐resistant Staphylococcus aureus PBP2′. No significant homology was detected with PBP1a or PBP1b of Escherichia coli, or with the low‐Mr PBPs.
Inquiry-based learning in science and mathematics

This paper sets out strong arguments in favour of inquiry-based education in science and mathematics in terms of benefits to individuals and to society. It draws on research and other sources, such as the publications of the Fibonacci project, to define inquiry and model the development of understanding through inquiry. The rather sparse evidence of the effectiveness of inquiry-based approaches is cited, noting the need for valid means of assessing the outcomes of inquiry. The final section considers the role that student assessment can take both in supporting and in reporting learning through inquiry and changes in current assessment practices that are needed.
Treatment of Inflammatory Facial Acne with 1,450‐nm Diode Laser in Type IV to V Asian Skin Using an Optimal Combination of Laser Parameters

BACKGROUND The 1,450‐nm diode laser is effective for the treatment of inflammatory acne, but there is a significant risk of postinflammatory hyperpigmentation (PIH) in Asian skin. OBJECTIVE To determine whether lower fluence and shorter cooling duration of the 1,450‐nm diode laser improve acne effectively with minimal PIH in darker skin. MATERIALS AND METHODS Twenty‐six subjects (skin phototypes IV–V) with inflammatory facial acne received four treatments using the 1,450‐nm diode laser with 6‐mm spot size 3 to 4 weeks apart. We used three passes with a fluence of 8 J/cm2 with dynamic cooling of 25 ms to minimize PIH. Serial blinded assessment of acne lesion counts and sebum measurement were evaluated before and up to 6 months after treatment. RESULTS Four weeks and 6 months after the last treatment, reduction of mean acne lesions was 29% (p<.01) and 40% (p<.03), respectively, from baseline in the group with moderate acne. Significant improvements of sebum production were noted. Four episodes of temporary PIH (3.8%) were observed out of all treatment sessions. CONCLUSION Use of multiple passes of a 1,450‐nm diode laser with lower fluence and shorter dynamic cooling device retains its therapeutic efficacy with substantial reduction of PIH for moderate acne. The nonablative 1,450‐nm diode laser was loaned for this study by Candela, Corp., Wayland, Massachusetts.
Société d'origine et logiques migratoires. Les Dogon de Sangha.

Petit (Veronique). - Sociedad de origen y logicas migratorias : los Dogon de Sangha (Mali) El sistema migratorio de los Dogon de Sangha (Mali) se descompone en tres modali- dades diferentes: una migracion hacia tierras agricolas en la planicie del Seno Gondo, una migracion interna y una migracion internacional, ambas urbanas. El primer tipo de movi- miento, de colonizacion, debe analizarse desde una perspectiva socio-antropologica que ten- ga en cuenta la organizacion de la familia extensa y del clan. Los intercambios economicos, religiosos y sociales entre las comunidades de origen y las de la planicie son muy intensos. Las migraciones urbanas, internas о internacionales, responden a un patron mas indivualis- ta. No obstante, no deben interpretarse en terminos puramente economicos. Aunque estan motivadas por un deseo de enriquecimiento personal, tambien son una consecuencia del cuestionamiento por parte de los jovenes del sistema social tradicional, que otorga todo el poder a los hombres y a las personas mayores en detrimento de las mujeres y de los jovenes. En la conclusion se comenta el valor heuristico de la migracion como reveladora del funcionamiento social.
High-ef fi ciency on-line haemodia fi ltration improves conduit artery endothelial function compared with high-fl ux haemodialysis in end-stage renal disease patients

Background. Middle molecular weight uraemic toxins are considered to play an important role in vascular dysfunction and cardiovascular outcomes in end-stage renal disease (ESRD) patients. Recent dialysis techniques based on convection, specifically high-efficiency on-line haemodiafiltration (HDF), enhance the removal of middle molecular weight toxins and reduce all-cause mortality in haemodialysis (HD) patients. However, the mechanisms of these improved outcomes remain to be established. Methods. This prospective study randomly assigned 42 ESRD patients to switch from high-flux HD to high-efficiency online HDF (n = 22) or to continue HD (n = 20). Brachial artery endothelium-dependent flow-mediated dilatation, central pulse pressure, carotid artery intima-media thickness (IMT), internal diastolic diameter and distensibility and circulating markers of uraemia, inflammation and oxidative stress were blindly assessed before and after a 4-month follow-up. Results. Brachial flow-mediated dilatation and carotid artery distensibility increased significantly in the HDF group compared with HD, while carotid IMT and diameter remained similar. HDF decreased predialysis levels of the uraemic toxins β2-microglobulin, phosphate and blood TNFα mRNA expression. Oxidative stress markers were not different between the HD and HDF groups. Blood mRNA expression of protein kinase C β2, an endothelial NO-synthase (eNOS) inhibitor, decreased significantly with HDF. Conclusions. High-efficiency on-line HDF prevents the endothelial dysfunction and stiffening of the conduit arteries in ESRD patients compared with high-flux HD. HDF decreases uraemic toxins, vascular inflammation, and is associated with subsequent improvement in eNOS functionality. These results suggest that reduced endothelial dysfunction may be an intermediate mechanism explaining the beneficial outcomes associated with HDF.
A Multicenter Trial Defining a Serum Protein Signature Associated with Pancreatic Ductal Adenocarcinoma

Background. Pancreatic ductal adenocarcinoma (PDAC) is an aggressive disease with rapid tumor progression and poor prognosis. This study was motivated by the lack of sensitive and specific PDAC biomarkers and aimed to identify a diagnostic, serum protein signature for PDAC. Methods. To mimic a real life test situation, a multicenter trial comprising a serum sample cohort, including 338 patients with either PDAC or other pancreatic diseases (OPD) and controls with nonpancreatic conditions (NPC), was analyzed on 293-plex recombinant antibody microarrays targeting immunoregulatory and cancer-associated antigens. Results. Serum samples collected from different hospitals were analyzed and showed that (i) sampling from five different hospitals could not be identified as a preanalytical variable and (ii) a multiplexed biomarker signature could be identified, utilizing up to 10 serum markers that could discriminate PDAC from controls, with sensitivities and specificities in the 91–100% range. The first protein profiles associated with the location of the primary tumor in the pancreas could also be identified. Conclusions. The results demonstrate that robust enough serum signatures could be identified in a multicenter trial, potentially contributing to the development of a multiplexed biomarker immunoassay for improved PDAC diagnosis.
Very high upper critical fields in MgB2 produced by selective tuning of impurity scattering

We report a significant enhancement of the upper critical field Hc2 of different MgB2 samples alloyed with nonmagnetic impurities. By studying films and bulk polycrystals with different resistivities ρ ,w e sho wac lear trend of a ni ncrease in Hc2 as ρ increases. One particular high resistivity film had a zero-temperature Hc2(0) well above the Hc2 values of competing non-cuprate superconductors such as Nb3Sn and Nb–Ti. Our high-field transport measurements give record values H ⊥ c2 (0) ≈ 34 T and H || c2 (0) ≈ 49 T for high resistivity films and Hc2(0) ≈ 29 T for untextured bulk polycrystals. The highest Hc2 film also exhibits a significant upward curvature of Hc2(T ) and a temperature dependence of the anisotropy parameter γ( T ) = H || c2 /H ⊥ c2 opposite to that of single crystals: γ( T ) decreases as the temperature decreases, from γ( Tc) ≈ 2t o γ( 0) ≈ 1.5. This remarkable Hc2 enhancement and its anomalous temperature dependence are a consequence of the two-gap superconductivity in MgB2 ,w hich offers special opportunities for further Hc2 increases by tuning of the impurity scattering by selective alloying on Mg and B sites. Our experimental results can be explained by a theory of two-gap superconductivity in the dirty limit. The very high values of Hc2(T ) observed suggest that MgB2 can be made into a versatile, competitive high-field superconductor.
A technique for extracting physiological parameters and the required input function simultaneously from PET image measurements: theory and simulation study

Positron emission tomography (PET) is an important tool for enabling quantification of human brain function. However, quantitative studies using tracer kinetic modeling require the measurement of the tracer time-activity curve in plasma (PTAC) as the model input function. It is widely believed that the insertion of arterial lines and the subsequent collection and processing of the biomedical signal sampled from the arterial blood are not compatible with the practice of clinical PET, as it is invasive and exposes personnel to the risks associated with the handling of patient blood and radiation dose. Therefore, it is of interest to develop practical noninvasive measurement techniques for tracer kinetic modeling with PET. In this paper, a technique is proposed to extract the input function together with the physiological parameters from the brain dynamic images alone. The identifiability of this method is tested rigorously by using Monte Carlo simulation. The results show that the proposed method is able to quantify all the required parameters by using the information obtained from two or more regions of interest (ROIs) with very different dynamics in the PET dynamic images. There is no significant improvement in parameter estimation for the local cerebral metabolic rate of glucose (LCMRGlc) if there are more than three ROIs. The proposed method can provide very reliable estimation of LCMRGlc, which is our primary interest in this study.
Protein interactions within Saccharomyces cerevisiae Elongator, a complex essential for Kluyveromyces lactis zymocicity

mTn3‐tagging identified Kluyveromyces lactis zymocin target genes from Saccharomyces cerevisiae as TOT1–3/ELP1–3 coding for the RNA polymerase II (pol II) Elongator histone acetyltransferase (HAT) complex. tot phenotypes resulting from mTn3 tagging were similar to totΔ null alleles, suggesting loss of Elongator's integrity. Consistently, the Tot1–3/Elp1–3 proteins expressed from the mTn3‐tagged genes were all predicted to be C‐terminally truncated, lacking ≈ 80% of Tot1p, five WD40 Tot2p repeats and two HAT motifs of Tot3p. Besides its role as a HAT, Tot3p assists subunit communication within Elongator by mediating Tot2–Tot4, Tot2–Tot5, Tot2–Tot1 and Tot4–Tot5 protein–protein interactions. TOT1 and TOT2 are essential for Tot4–Tot2 and Tot4–Tot3 interactions respectively. The latter was lost with a C‐terminal Tot2p truncation; the former was affected by progressively truncating TOT1. Despite being dispensable for Tot4–Tot2 interaction, the extreme C‐terminus of Tot1p may play a role in TOT/Elongator function, as its truncation confers zymocin resistance. Tot4p/Kti12p, an Elongator‐associated factor, also interacted with pol II and could be immunoprecipitated while being bound to the ADH1 promoter. Two‐hybrid analysis showed that Tot4p also interacts with Cdc19p, suggesting that Tot4p plays an additional role in concert with Cdc19p, perhaps co‐ordinating cell growth with carbon source metabolism.
Kinetics of adsorption of methylene blue onto activated carbon prepared from palm kernel shell

The kinetics of adsorption of methylene blue from aqueous solution onto activated carbon prepared from palm kernel shell has been investigated. The time dependent studies showed a rapid adsorption in the first ten minute. A batch sorption model based on the assumption of the pseudo first and second order mechanism, were applied to predict the rate constants. The adsorption process follows the pseudo-second order kinetic, having a correlation coefficient in the range between 0.98 and 1. The pseudo second order rate constant k2 was found to generally decrease from 1.79 to 4.5 x 10-2 as the initial concentration increased from 5 to 25 ppm but increased from 4.9 x 10-2 to 2.3 x 10-1 with increased temperature, suggesting that the adsorption process is endothermic. Intra-particle diffusion was confirmed as one of the rate determining steps; as such the adsorption mechanism is controlled by particle diffusion rather than film diffusion.
Anterior migration of lateral plate mesodermal cells during embryogenesis of the pufferfish Takifugu niphobles: insight into the rostral positioning of pelvic fins

In vertebrates, paired appendages (limbs and fins) are derived from the somatic mesoderm subsequent to the separation of the lateral plate mesoderm into somatic and splanchnic layers. This is less clear for teleosts, however, because the developmental processes of separation into two layers and of extension over the yolk have rarely been studied. During teleost evolution, the position of pelvic fins has generally shifted rostrally (Rosen; Nelson, 1982, 1994), although at the early embryonic stage the presumptive pelvic fin cells are initially located near the future anus region – the anterior border of hoxc10a expression in the spinal cord – regardless of their final destination. Our previous studies in zebrafish (abdominal pelvic fins) and Nile tilapia (thoracic pelvic fins) showed that the presumptive pelvic fin cells shift their position with respect to the body trunk after its protrusion from the yolk surface. Furthermore, in Nile tilapia, presumptive pelvic fin cells migrate anteriorly on the yolk surface. Here, we examined the embryonic development of the lateral plate mesoderm at histological levels in the pufferfish Takifugu niphobles, which belongs to the highly derived teleost order Tetraodontiformes, and lacks pelvic fins. Our results show that, in T. niphobles, the lateral plate mesoderm bulges out as two separate layers of cells alongside the body trunk prior to its further extension to cover the yolk sphere. Once the lateral plate mesoderm extends laterally, it rapidly covers the surface of the yolk. Furthermore, cells located near the anterior border of hoxc10a expression in the spinal cord reach the anterior‐most region of the yolk surface. In light of our previous and current studies, we propose that anterior migration of presumptive pelvic fin cells might be required for them to reach the thoracic or more anterior positions as is seen in other highly derived teleost groups.
C-Jun Activation-Dependent Tumorigenic Transformation Induced Paradoxically by Overexpression or Block of S-Adenosylmethionine Decarboxylase

All mammalian cells absolutely require polyamines (putrescine, spermidine, and spermine) for growth. Here we show that the overexpression of cDNA for S-adenosylmethionine decarboxylase (AdoMetDC), the main regulatory enzyme in the biosynthesis of higher polyamines, induces transformation of rodent fibroblasts when expressed in the sense or the antisense orientation. Both transformants were able to induce invasive tumors in nude mice. Neither transformation was associated with activation of the mitogen-activated protein kinases Erk1 and Erk2. Instead, the AdoMet DC sense, but not antisense, transformants displayed constitutive activation of the c-Jun NH2-terminal kinase (JNK) pathway. However, both transformations converged on persistent phosphorylation of endogenous c-Jun at Ser73. The phenotype of the AdoMetDC sense transformants was reversed by expression of dominant-negative mutants of SEK1 (MKK4), JNK1, and c-Jun (TAM-67), which were also found to impair cytokinesis. Similarly, TAM-67 reverted the morphology of the AdoMetDC-antisense expressors. This report is the first demonstration of a protein whose overexpression or block of synthesis can induce cell transformation. In addition, we show that the polyamine biosynthetic enzymes require c-Jun activation for eliciting their biological effects.
Rehabilitation of Aphasia: More Is Better

Abstract Although the most effective means of treating aphasia post stroke has not been determined, several areas of aphasia therapy have proven to be more effective than others. A recent study had determined that intense aphasia therapy over a short period of time has greater impact on recovery than less intense therapy over a longer period of time. Building upon the idea that more is better, this article examines other spects of aphasia therapy that may be combined to facilitate recovery.
Analysis of switched quantizer based on the quadratic spline functions

ABSTRACT In this paper, an approximation of the optimal compressor function using the quadratic spline functions with 2L = 8 segments is described. Since the quadratic spline with 2L = 8 segments provides better approximation of the optimal compression function than quadratic spline with 2L = 4 segments, capitalizing on the benefits of the obtained spline approximation, quantizer designing process is firstly performed for the so assumed number of segments and the Laplacian source of a unit variance. Then, to enhance the usability of the proposed model, the switched quantization technique is applied and a beneficial analysis is derived, providing insight in the robustness of the proposed quantizer performances with respect to the mismatch in designed for and applied to variances. Reached quality has been compared to another model from the literature, and it has been shown that the proposed model outperforms the previous model by almost 1.3 dB.
Renal function and risk of myocardial infarction in an elderly population: the Rotterdam Study.

BACKGROUND Renal insufficiency is a risk factor for cardiovascular disease in patients with renal disease or coronary heart disease; however, it is unknown whether renal function is an independent predictor of cardiovascular disease in the general population. METHODS We investigated whether the level of renal function, estimated by glomerular filtration rate, was associated with the risk of incident myocardial infarction among 4484 apparently healthy subjects in the Rotterdam Study (mean age, 69.6 years). We estimated the glomerular filtration rate by Cockcroft-Gault and abbreviated modification of diet in renal disease equations and used Cox regression analysis to estimate hazard ratios adjusted for cardiovascular risk factors, atherosclerosis, and medication use. RESULTS During the follow-up period (mean, 8.6 years), 218 subjects (4.9%) had a myocardial infarction. A 10 mL/min per 1.73 m(2) decrease in glomerular filtration rate was associated with a 32% increased risk of myocardial infarction (P<.001). Compared with subjects in the fourth quartile, the multivariate-adjusted hazard ratios for the risk of myocardial infarction increased from 1.64 (95% confidence interval [CI], 1.03-2.59) in the third quartile to 1.94 (95% CI, 1.21-3.10) in the second quartile and 3.06 (95% CI, 1.80-5.19) in the quartile with the lowest glomerular filtration rate estimated by the Cockcroft-Gault equation. Using the abbreviated modification of diet in renal disease equation, the risk estimates for the third to first quartiles were 1.34 (95% CI, 0.89-2.01), 1.66 (95% CI, 1.14-2.49), and 1.90 (95% CI, 1.25-2.90), respectively. CONCLUSIONS The present study shows that renal function is a graded and independent predictor of the development of myocardial infarction in an elderly population. Early detection of decreased renal function may identify subjects who are at heightened risk of coronary heart disease.
Performance of rate 0.96 (68254, 65536) EG-LDPC code for NAND Flash memory error correction

As the process technology scales down and the number of bits per cell increases, NAND Flash memory is more prone to bit errors. In this paper, we employ a rate-0.96 (68254, 65536) Euclidean geometry (EG) low-density parity-check (LDPC) code for NAND Flash memory error correction, and evaluate the performance under binary input (BI) additive white Gaussian noise (AWGN) and NAND Flash memory channels. The performance effect of output signal quantization is also studied. We show the strategies for determining the optimum quantization boundaries and computing the quantized log-likelihood ratio (LLR) for the NAND Flash channel model that is approximated as a mixture of Gaussian distributions. Simulation results show that the error performance with the NAND Flash memory channel is much different from that with the BI-AWGN channel. Since the distribution of NAND Flash memory output signal is not stationary, it is important to accurately assess the stochastic distribution of the signal for optimum sensing.