Miracle-dz/UniFAR-FTUs huggingface dataset:
New kid on the block? Community nurses' experiences of caring for sick children at home.

AIMS AND OBJECTIVES To investigate the experiences of Swedish community nurses in caring for sick children at home, as this is a growing population of patients in community care. BACKGROUND There is international consensus that sick children should receive care in their homes as far as possible. Home health care allows the family to stay together while the child is undergoing treatment and thus reduces strain on the family. However, it can also be demanding for parents to take on increased responsibilities for their sick child. Children as a patient group is a relatively new phenomenon in community home health care in Sweden and represents a small part of the community nurse responsibilities, making it difficult to accumulate experience. DESIGN A qualitative descriptive design. METHODS In-depth interviews with twelve nurses in community health care. Qualitative content analysis was used. RESULTS 'Feeling confident in order to instil confidence' was key in nurses' experiences. Two main themes emerged: 'Building a trusting relationship with the family' and 'Feeling confident in the role as caregiver'. Nurses aimed at creating a trusting nursing relationship and working closely with parents. The nurses' feeling of confidence in their role as caregivers depended on the support they received and the knowledge they had. CONCLUSION Many community nurses felt unconfident about caring for children at home but experienced it as manageable when peer support and a distinct collaboration with the paediatric clinic/hospital were present. The ongoing shift from hospital to home care urges paediatric clinics/hospitals and community health care to develop formal policies of transmural collaboration to train and support home nurses to deliver adequate care to sick children and their families at home and safeguard good outcomes. RELEVANCE TO CLINICAL PRACTICE The implication of the study may contribute to efforts being made to extend and improve cooperation between paediatric clinics/hospitals and community health care.
An Algebraic Approach to Physical-Layer Network Coding

The problem of designing physical-layer network coding (PNC) schemes via nested lattices is considered. Building on the compute-and-forward (C&F) relaying strategy of Nazer and Gastpar, who demonstrated its asymptotic gain using information-theoretic tools, an algebraic approach is taken to show its potential in practical, nonasymptotic, settings. A general framework is developed for studying nested-lattice-based PNC schemes-called lattice network coding (LNC) schemes for short-by making a direct connection between C&F and module theory. In particular, a generic LNC scheme is presented that makes no assumptions on the underlying nested lattice code. C&F is reinterpreted in this framework, and several generalized constructions of LNC schemes are given. The generic LNC scheme naturally leads to a linear network coding channel over modules, based on which noncoherent network coding can be achieved. Next, performance/complexity tradeoffs of LNC schemes are studied, with a particular focus on hypercube-shaped LNC schemes. The error probability of this class of LNC schemes is largely determined by the minimum intercoset distances of the underlying nested lattice code. Several illustrative hypercube-shaped LNC schemes are designed based on Constructions A and D, showing that nominal coding gains of 3 to 7.5 dB can be obtained with reasonable decoding complexity. Finally, the possibility of decoding multiple linear combinations is considered and related to the shortest independent vectors problem. A notion of dominant solutions is developed together with a suitable lattice-reduction-based algorithm.
Stimulation of the sphenopalatine ganglion in intractable cluster headache: Expert consensus on patient selection and standards of care

Context and overview Chronic cluster headache (CCH) is a debilitating headache disorder with a significant impairment of the patients' lives. Within the past decade, various invasive neuromodulatory approaches have been proposed for the treatment of CCH refractory to standard preventive drug, but only very few randomized controlled studies exist in the field of neuromodulation for the treatment of drug-refractory headaches. Based on the prominent role of the cranial parasympathetic system in acute cluster headache attacks, high-frequency sphenopalatine ganglion (SPG) stimulation has been shown to abort ongoing attacks in some patients in a first small study. As preventive effects of SPG-stimulation have been suggested and the rate of long-term side effects was moderate, SPG stimulation appears to be a promising new treatment strategy. Aims and conclusion As SPG stimulation is effective in some patients and the first commercially available CE-marked SPG neurostimulator system has been introduced for cluster headache, patient selection and care should be standardized to ensure maximal efficacy and safety. As only limited data have been published on SPG stimulation, standards of care based on expert consensus are proposed to ensure homogeneous patient selection and treatment across international headache centres. Given that SPG stimulation is still a novel approach, all expert-based consensus on patient selection and standards of care should be re-reviewed when more long-term data are available.
CFD Investigation into Diesel PCCI Combustion with Optimized Fuel Injection

A multi-pulse injection strategy for premixed charge compression ignition (PCCI) combustion was investigated in a four-valve, direct-injection diesel engine by a computational fluid dynamics (CFD) simulation using KIVA-3V code coupled with detailed chemistry. The effects of fuel splitting proportion, injection timing, spray angles, and injection velocity were examined. The mixing process and formation of soot and nitrogen oxide (NOx) emissions were investigated as the focus of the research. The results show that the fuel splitting proportion and the injection timing impacted the combustion and emissions significantly due to the considerable changes of the mixing process and fuel distribution in the cylinder. While the spray, inclusion angle and injection velocity at the injector exit, can be adjusted to improve mixing, combustion and emissions, appropriate injection timing and fuel splitting proportion must be jointly considered for optimum combustion performance.
Arterial Stiffness and Cardiovascular Events: The Framingham Heart Study

Background— Various measures of arterial stiffness and wave reflection have been proposed as cardiovascular risk markers. Prior studies have not assessed relations of a comprehensive panel of stiffness measures to prognosis in the community. Methods and Results— We used proportional hazards models to analyze first-onset major cardiovascular disease events (myocardial infarction, unstable angina, heart failure, or stroke) in relation to arterial stiffness (pulse wave velocity [PWV]), wave reflection (augmentation index, carotid-brachial pressure amplification), and central pulse pressure in 2232 participants (mean age, 63 years; 58% women) in the Framingham Heart Study. During median follow-up of 7.8 (range, 0.2 to 8.9) years, 151 of 2232 participants (6.8%) experienced an event. In multivariable models adjusted for age, sex, systolic blood pressure, use of antihypertensive therapy, total and high-density lipoprotein cholesterol concentrations, smoking, and presence of diabetes mellitus, higher aortic PWV was associated with a 48% increase in cardiovascular disease risk (95% confidence interval, 1.16 to 1.91 per SD; P=0.002). After PWV was added to a standard risk factor model, integrated discrimination improvement was 0.7% (95% confidence interval, 0.05% to 1.3%; P<0.05). In contrast, augmentation index, central pulse pressure, and pulse pressure amplification were not related to cardiovascular disease outcomes in multivariable models. Conclusions— Higher aortic stiffness assessed by PWV is associated with increased risk for a first cardiovascular event. Aortic PWV improves risk prediction when added to standard risk factors and may represent a valuable biomarker of cardiovascular disease risk in the community.
Teleophthalmology in Diabetic Retinopathy

Over the past decade, there have been rapid strides in progress in the fields of telecommunication and medical imaging. There is growing evidence regarding use of teleophthalmology for screening of diabetic retinopathy. This article highlights some pertinent questions regarding use of telescreening for diabetic retinopathy. It deals with evidence regarding accuracy of diagnosis, patients satisfaction and cost-effectiveness. The American Telemedicine Association have given certain guidelines for teleheath practices for diabetic retinopathy. The article discusses regarding these guidelines. Finally, a working model for diabetic retinopathy screening through teleophthalmology has been described. Telescreening for diabetic retinopathy seems to be a cost-effective, accurate, and reliable method for screening for diabetic retinopathy. The American Telemedicine Association has set up guidelines for telescreening that should be adhered to provide quality screening services to people with diabetes.
Improving the Prevention, Early Recognition, and Treatment of Pediatric Obesity by Primary Care Physicians

To determine if participation in a learning collaborative (LC) would improve care processes for prevention, early recognition, and treatment of childhood obesity by primary care physicians (PCP), the authors conducted pre-post evaluations of the use of obesity related care processes by 18 primary care practices following participation in a 9-month LC based on the Model for Improvement. Prior to the LC, chart audits revealed that 55% of patients had a BMI recorded; this rose to 97% of patients at its conclusion. Following the LC, 11 practices had implemented systematic prevention advice to parents of infants compared with 3 prior to the LC. All practices developed plans for evaluation and management of children with an elevated BMI. Participation in an LC increased the number of primary care practices that provided anticipatory guidance regarding obesity prevention and that identified and treated overweight or obese children.
“Then It Will Be Good”

Youths (N = 57; mean age = 13.83 years) residing near Tororo, Uganda, were interviewed to obtain quantitative and qualitative data pertaining to negative life events, adjustment problems, coping, social support, self-worth, and hope. On average, they experienced nearly half of the 22 negative life events assessed. The experience of negative life events related positively to internalizing problems and negatively to social support and self-worth. Coping strategies (problem-focused, positive reframing, avoidance, and support-seeking) were positively associated with hope. Problem-focused coping was negatively related to externalizing problems. Furthermore, social support was positively associated with coping strategies, self-worth, and hope and was negatively related to adjustment problems. The qualitative data shed light on the difficult events the youths endured and what types of coping strategies they used. Ultimately, interviews suggested that youths experienced many negative events, but they remained optimistic.
Crescimento e produtividade de soja após cultivo solteiro e coquetel de plantas de cobertura

A adequação da cobertura vegetal à cultura agrícola e ao manejo de solo é importante para obtenção de melhorias do sistema e, consequentemente, de maior produtividade. Nesse contexto, este estudo analisou a interferência de restos vegetais de aveia preta (Avena strigosa Schreb) (AP) e coquetel de aveia preta, nabo forrageiro ( Raphanus sativus L.) e ervilhaca-comum ( Vicia sativa L.) (CO) no índice de velocidade de emer gência (IVE), velocidade de emergência (VE) de plântulas, altura de plantas e produtividade da cultura da soja em intervalos diferenciados entre dessecação da cobertura vegetal com glifosato 480 (3L ha ) e semeadura da cultivar BRS 232. Parcelas de 5 m x 2,5 m, com 1 m de bordadura, receberam quatro tratamentos com cobertura AP, quatro para CO e uma testemunha para cada cobertura, ao acaso, com cinco repetições. A dessecação foi nos intervalos de 1, 10, 20 e 30 dias anteriores à semeadura da soja. A colheita foi manual e a produtividade, ajustada para 13% de teor de água. O delineamento experimental foi inteiramente casualizado, em esquema de parcelas subdivididas, teste de Scott e Knott a 5% de probabilidade. Pelos resultados obtidos pode-se recomendar a utilização do coquetel de coberturas na cultura da soja a fim de proporcionar emergência de plântulas mais vigorosas. A emeadura da soja é recomendada a partir de 10 dias após a dessecação da cobertura vegetal.
Frequency Analysis of Ventricular Fibrillation in Swine Ventricles

It has been suggested from frequency analysis that cardiac fibrillation is driven by stable intramural reentry, with wavebreak occurring due to failure of 1:1 propagation. We tested this hypothesis with a combined experimental and theoretical approach. Optical mapping was performed on epicardial, endocardial, and transmural cut surfaces of fibrillating swine ventricles. Wavelets were characterized, the frequency content of optical signals analyzed, and space-time plots (STPs) constructed to detect Wenckebach-like conduction. The findings were compared with simulations in 2D and 3D cardiac tissue using the Luo-Rudy action potential model. The incidence of reentry in the cut transmural surface (11.8% in right ventricle, 14.3% in left ventricle) was similar to that on the endocardial surface (13.1%, P =NS) but greater than on the epicardial surface (7.7%, P <0.01). Frequency spectra of optically recorded membrane voltage were organized into spatial domains with the same dominant frequency, but these domains were nonstationary. In STPs, pseudo-2:1 conduction block was caused by double potentials arising when reentry occurred on the recording site rather than true Wenckebach conduction. The latter was observed in 11 of 166 STPs but did not occur at borders of high-to-low frequency domains. In simulations, similar findings were obtained when action potential duration (APD) restitution slope was steep. Stationary dominant frequency domains with Wenckebach conduction patterns were observed only in the presence of shallow APD restitution slope and marked nonuniform tissue heterogeneity. In conclusion, stable intramural reentry as the engine of fibrillation was not observed. Our findings support the idea that dynamic wavebreak plays a fundamental role in the generation and maintenance of ventricular fibrillation.
Parent-child relationship and behavior problems in children with ADHD

Objectives: Previous studies have examined the effect of parent–child relationships on conduct problems, but rarely are the mother–child and father–child relationships studied independently. The current study examined parent–child relationships and their connection to comorbid behaviors in children with Attention-Deficit/Hyperactivity Disorder (ADHD). More specifically, this study explored the mother–child and father–child relationship in children with ADHD, with an explicit focus on the aspects of the parent–child relationship that are related to more positive behavioral outcomes. Methods: A sample of 74 children with ADHD (aged 8–11 years) and their mothers (n = 74) and fathers (n = 37) participated in the current study and completed a variety of parenting and behavioral measures. A number of relationship factors, including parent- and child-reported levels of attachment were examined in connection to parental ratings of behavioral outcomes such as defiance, aggression, and conduct problems. Results: Results indicated that different aspects of the parent–child relationship for mothers and fathers were related to ratings of behavioral problems. Relational frustration was found to be a consistent predictor of negative ratings of behavior for both parents, while involvement was a predictor of more positive ratings of behavior for fathers only. Conclusions: A better understanding of the specific aspects of the mother–child and father–child relationship may play a role in helping to understand the link between parent–child relationships and behavioral concerns in children with ADHD. Implications for practice are highlighted with a particular emphasis on strengthening the parent–child bond in families with children with ADHD.
Clinical and epidemiologic investigation of two Legionella-Rickettsia co-infections.

BACKGROUND We treated two patients diagnosed with legionellosis and simultaneous Rickettsia conorii co-infection. OBJECTIVES To report the clinical and laboratory characteristics of this unusual combination, and to describe the execution and results of our environmental and epidemiologic investigations. METHODS Serial serologic testing was conducted 1, 4 and 7 weeks after initial presentation. Water samples from the patients' residence were cultured for Legionella. Follow-up cultures were taken from identical points at 2 weeks and at 3 months after the initial survey. RESULTS Both patients initially expressed a non-specific rise in anti-Legionella immunoglobulin M titers to multiple serotypes. By week 4 a definite pattern of specifically elevated IgG titers became apparent, with patient 1 demonstrating a rise in specific anti-L. pneumophila 12 IgG titer and patient 2 an identical response to L. jordanis. At 4 weeks both patients were positive for both IgM and IgG anti-R. conorii antibodies at a titer > or = 1:100. Heavy growth of Legionella was found in water sampled from the shower heads in the rooms of both patients. Indirect immunofluorescence of water cultures was positive for L. pneumophila 12 and for L. jordanis. CONCLUSIONS Although most cases of community-acquired Legionella pneumonia in our region appear simultaneously with at least one other causative agent, co-infection with R. conorii is unusual and has not been reported to date. This report illustrates the importance of cooperation between clinicians and public health practitioners.
Hemispheric dominance and language proficiency levels in the four macro skills of Western Mindanao State university college students

This study was conducted to determine the relationship between the hemispheric dominance (HD) and the English proficiency (EP) scores in the four macro skills of the Western Mindanao State University college students. It hypothesized that students’ HD would have a significant correlation a) with their EP scores in listening, speaking, reading and writing, b) with their global EP score, c) with both the macro and global scores when respondents would be grouped according to age, gender and area of specialization. In this study, there were 240 respondents selected through purposive, stratified, and random sampling techniques from the 5,096 students of the Colleges of Arts and Sciences, Engineering and Education. Using the standardized HD Test, the standardized Listening and Reading Comprehension Tests, the researcher-made Speaking and Writing Skill Tests and Cloze Test and employing mainly the Pearson r for the statistical analysis, the study concluded: 1) that most of the students of the Colleges of Arts and Sciences, Engineering and Education of Western Mindanao State University were left-brained (74.6%); 2) that the students were “good” in speaking, “fair” in listening and writing skills but “ poor” in reading and in global English; 3) that there was no significant relationship between the students’ hemisphericity and their EP scores in listening, speaking, reading, writing and global proficiency tests; and 4) that a significant relationship was shown between HD and EP scores when respondents were grouped according to age and area of specialization only.
Sub-diffuse optical biomarkers characterize localized microstructure and function of cortex and malignant tumor.

This study uses a sub-diffusive light transport model to analyze fiber-optic measurements of reflectance spectra to recover endogenous tissue biomarkers and to correct raw fluorescence emissions for distortions from background optical properties. Measurements in tissue-simulating phantoms validated accurate recovery of the reduced scattering coefficient [(0.3-3.4 mm-1), error 10%], blood volume fraction [(1-3 vol%), error 7%], and a dimensionless metric of anisotropic scattering, γ, that is sensitive to submillimeter tissue ultrastructure [(1.29-2.06), error 11%]. In vivo sub-diffusive optical data acquired during clinical neurosurgeries characterize differences in microstructure (γ), perfusion (blood volume), and metabolism (PpIX fluorescence) between normal cortex and malignant tumor.
Cardioprotective Activity of Pongamia pinnata in Streptozotocin-Nicotinamide Induced Diabetic Rats

Pongamia pinnata (L.) Pierre has been used in traditional medicine for the treatment for diabetes and metabolic disorder. The aim of this study was to investigate the effect of petroleum ether extract of the stem bark of P. pinnata (known as PPSB-PEE) on cardiomyopathy in diabetic rats. Diabetes was induced in overnight fasted Sprague-Dawley rats by using injection of streptozotocin (55 mg/kg, i.p.). Nicotinamide (100 mg/kg, i.p.) was administered 20 min before administration of streptozotocin. Rats were divided into group I: nondiabetic, group II: diabetic control (tween 80, 2%; 10 mL/kg, p.o.) as vehicle, and group III: PPSB-PEE (100 mg/kg, p.o.). The blood glucose level, ECG, hemodynamic parameters, cardiotoxic and antioxidant biomarkers, and histology of heart were carried out after 4 months after STZ with nicotinamide injection. PPSB-PEE treatment improved the electrocardiographic, hemodynamic changes; LV contractile function; biological markers; oxidative stress parameters; and histological changes in STZ induced diabetic rats. PPSB-PEE (100 mg/kg, p.o.) decreased blood glucose level, improved electrocardiographic parameters (QRS, QT, and QTc intervals) and hemodynamic parameters (SBP, DBP, EDP, max dP/dt, contractility index, and heart rate), controlled levels of cardiac biomarkers (CK-MB, LDH, and AST), and improved oxidative stress (SOD, MDA, and GSH) in diabetic rats. PPSB-PEE is a promising remedy against cardiomyopathy in diabetic rats.
Trends in thoracic aortic aneurysms and dissection: out of the shadows and into the light.

In this issue of Circulation , Sidloff and colleagues1 have presented their findings that, among 18 World Health Organization member states over a period of 16 years (1994–2010), there has been a reduction in the age-standardized mortality from both thoracic aortic aneurysm and dissection. If one considers the United States, the United Kingdom, and Sweden, 3 countries that have published extensively on the prevalence and mortality of thoracic aortic disease, the trends are quite favorable: Mortality from thoracic aortic aneurysm has declined by ≈5% to 10% among men and 3% to 6% among women, and mortality from aortic dissection has declined by ≈2% to 3% among men and 1% to 2% among women. However, and not surprisingly, the investigators discovered heterogeneity among mortality trends by country. For example, for men with thoracic aortic aneurysms, although there was a statistically significant reduction in mortality over time in 13 of the 18 countries, in 3 countries, there was instead an increase in mortality. Similarly, for men suffering from aortic dissection, although there was again a statistically significant reduction in mortality over time in 13 of the 18 countries, in 1 country, there was a significant rise in mortality. Japan and Romania were the 2 countries with the most consistent increases in mortality. Article see p 2287 The investigators then considered the impact of changing prevalence of risk factors on the changing mortality from thoracic aortic disease. In all of the countries studied, there was a decline in systolic blood pressure of up to 6% over time, and there was a linear relationship between systolic blood …