Miracle-dz/UniFAR-FTUs huggingface dataset:
Features of primary health care teams associated with successful quality improvement of diabetes care: a qualitative study.

BACKGROUND In quality improvement activities such as audit, some general practices succeed in improving care and some do not. With audit of care likely to be one of the major tools in clinical governance, it would be helpful to establish what features of primary health care teams are associated with successful audit in general practice. OBJECTIVE The aim of the present study was to identify those features of primary health care teams that were associated with successful quality improvement during systematic audit of diabetes care. METHOD Semi-structured tape-recorded interviews were carried out with lead GPs and practice nurses in 18 general practices in Leicestershire that had the opportunity to improve their care and had completed two data collections in a multipractice audit of diabetes care. The interviewees were asked to describe their practice's approach to audit and the transcripts were coded for common features and judged for strength of feeling by blinded independent raters. Features common to practices that had, and those that had not, managed to improve diabetes care were identified. RESULTS Six features were identified reliably in the transcripts by blinded independent raters. Four were significantly associated with the successful improvement of care. Success was more likely in teams in which: the GP or nurse felt personally involved in the audit; they perceived their teamwork as good; they had recognized the need for systematic plans to address obstacles to quality improvement; and their teams had a positive attitude to continued monitoring of care. A positive attitude to audit and a personal interest in the disease were not associated with improvement in care. CONCLUSIONS Success in improving diabetes care is associated with certain organizational features of primary health care teams. Experimental studies are required to determine whether the development of teamwork enables practice teams to identify and overcome systematically the obstacles to improved quality of patient care that face them.
Effect of Rhinovirus Challenge on Antioxidant Enzymes in Respiratory Epithelial Cells

The host inflammatory response appears to be an important contributor to the pathogenesis of human viral respiratory illness. Virus-induced oxidative stress appears to mediate an early phase of elaboration of the proinflammatory cytokine interleukin-8 by respiratory epithelial cells. The purpose of these studies was to determine if virus-induced alterations in either the expression or function of antioxidant enzymes contributes to the cellular oxidative stress following rhinovirus challenge. The activities of Mn superoxide dismutase (MnSOD), catalase and glutathione peroxidase (GPX) were not significantly changed by rhinovirus challenge. CuZn superoxide dismutase (CuZnSOD) activity six hours after challenge was 2.55 - 0.56 U/mg protein in rhinovirus-challenged cells compared to 1.16 - 0.54 U/mg protein in control cells ( p =0.029). This increased activity was associated with a concomitant increase in CuZnSOD mRNA and protein concentration. These data suggest that rhinovirus-induced changes in the host cell redox state that result in the early elaboration of interleukin-8 are not mediated by inhibition of either the expression or function of these antioxidant enzymes.
Eye gaze interaction with expanding targets

Recent evidence on the performance benefits of expanding targets during manual pointing raises a provocative question: Can a similar effect be expected for eye gaze interaction? We present two experiments to examine the benefits of target expansion during an eye-controlled selection task. The second experiment also tested the efficiency of a "grab-and-hold algorithm" to counteract inherent eye jitter. Results confirm the benefits of target expansion both in pointing speed and accuracy. Additionally, the grab-and-hold algorithm affords a dramatic 57% reduction in error rates overall. The reduction is as much as 68% for targets subtending 0.35 degrees of visual angle. However, there is a cost which surfaces as a slight increase in movement time (10%). These findings indicate that target expansion coupled with additional measures to accommodate eye jitter has the potential to make eye gaze a more suitable input modality.
Process gatekeepers and compliance with enterprise processes

– Process gatekeepers, individuals responsible for strictly enforcing data completeness at critical points within a process, are often used to encourage compliance with processes associated with enterprise systems. The purpose of this paper is to explore the relationship between process gatekeepers and process compliance. , – Through a mixed‐method approach of both qualitative and quantitative analyses of one firm's sales processes, the paper identifies and measures four key drivers of compliance with the work process: ease of use, perceived value, urgency, and gatekeeper flexibility. , – The paper finds that process context‐specific, gatekeeper‐related factors directly affect an individual's willingness to work within the bounds of prescribed processes. In particular, the paper finds evidence that gatekeeper flexibility appears to encourage process compliance. , – These findings are limited in generalizability to a single organization, by potential instrument‐related biases, and by typical caveats associated with models derived from exploratory research. , – Implications include the motivation of the need for overall process compliance in realizing the benefits of an enterprise information system, as well as the counterintuitive notion that gatekeeper flexibility may be positively related to process compliance. , – This paper introduces the notion of process gatekeeper, devises a context‐specific measure of gatekeeper flexibility, and relates this notion to an overall model associated with process compliance in an enterprise system context.
Refractory iron-deficiency anemia and gluten intolerance - Response to gluten-free diet.

INTRODUCTION refractory iron-deficiency anemia has a multifactorial origin related to various gastrointestinal conditions, with celiac disease plus malabsorption and IBD together with isolated gluten intolerance being most common. OBJECTIVES to determine the prevalence of serum, genetic, and histological markers for gluten intolerance, and to analyze the response to gluten withdrawal from the diet in these patients. METHODS a number of patients with refractory anemia were prospectively and consecutively enrolled. A protocol to measure serum (TGt-2), genetic (HLA-DQ2/DQ8), and histological markers for celiac disease was applied. All followed a gluten-free diet for a median 3.6 years. Sustained remission of anemia during follow-up was interpreted as positive response. RESULTS ninety-eight patients (84% females) with a mean age of 54 years were studied. Anti-TGt2 antibodies were positive in 5% of cases. A total of 67 cases (68%) were haplotype HLA-DQ2 or -DQ8 (+). We found villous atrophy (Marsh III) in 13% of patients, and an inflammatory pattern (Marsh I or II) in 13%. All remaining 72 patients (74%) had no histological duodenal changes.Age, anemia duration, number of transfusions, number of parenteral iron doses, and time on a gluten-free diet were all compared according to the presence or absence of villous atrophy and HLA-DQ2/8 positivity, and no significant differences were found for any of the analyzed variables. Response was positive in 92% of subjects. CONCLUSIONS celiac disease with villous atrophy is rarely a cause of refractory anemia. Gluten intolerance with no histological lesions is seen in almost 75% of patients, and therefore plays a relevant role in its development.
Bursts and Heavy Tails in Temporal and Sequential Dynamics of Foraging Decisions

A fundamental understanding of behavior requires predicting when and what an individual will choose. However, the actual temporal and sequential dynamics of successive choices made among multiple alternatives remain unclear. In the current study, we tested the hypothesis that there is a general bursting property in both the timing and sequential patterns of foraging decisions. We conducted a foraging experiment in which rats chose among four different foods over a continuous two-week time period. Regarding when choices were made, we found bursts of rapidly occurring actions, separated by time-varying inactive periods, partially based on a circadian rhythm. Regarding what was chosen, we found sequential dynamics in affective choices characterized by two key features: (a) a highly biased choice distribution; and (b) preferential attachment, in which the animals were more likely to choose what they had previously chosen. To capture the temporal dynamics, we propose a dual-state model consisting of active and inactive states. We also introduce a satiation-attainment process for bursty activity, and a non-homogeneous Poisson process for longer inactivity between bursts. For the sequential dynamics, we propose a dual-control model consisting of goal-directed and habit systems, based on outcome valuation and choice history, respectively. This study provides insights into how the bursty nature of behavior emerges from the interaction of different underlying systems, leading to heavy tails in the distribution of behavior over time and choices.
Wave-induced liquefaction of the seabed around a single pile considering pile–soil interaction

ABSTRACT The analysis of wave-induced liquefaction of seabeds is of profound importance for offshore structures such as wind turbines and oil platforms. The seabed around pile foundations is subjected to two effects, vertical wave loads and the lateral pile–soil interactions induced by the rocking of super structures. This paper numerically studies the excess pore pressure responses of the seabed around a pile when both effects are considered. Numerical analysis is conducted using an in-house developed, effective stress-based, three-dimensional finite element code. The mechanical behaviors of the seabed are simulated by a kinematic hardening constitutive model that can describe the cyclic mobility of soils. Comparing the results of the seabed around a pile and the seabed with no pile foundation shows that the excess pore pressures accumulate faster when both of the effects are considered. Water depth plays an essential role in determining whether the effect of pile–soil interaction on excess pore pressures can be neglected. In deep waters, the excess pore pressure response mainly derives from the effect of the pile rocking, while the influence of vertical wave pressure on the seabed is relatively small. However, in shallow waters, both of the effects are significant.
Fine-structure analysis of the processing and polyadenylation region of the herpes simplex virus type 1 thymidine kinase gene by using linker scanning, internal deletion, and insertion mutations

Most eucaryotic mRNAs are polyadenylated. In higher eucaryotes, the sequence AATAAA is located 7 to 30 base pairs (bp) upstream from the site of processing and polyadenylation and is a critical part of the signal for processing and polyadenylation. Efficient cleavage and polyadenylation also require sequences downstream of polyadenylation sites. The herpes simplex virus type 1 thymidine kinase (tk) gene contains two copies of the AATAAA hexanucleotide and a GT box (18 of 19 consecutive residues are G or T) previously shown to be required for efficient processing and polyadenylation of tk mRNA (C. N. Cole and T. P. Stacy, Mol. Cell. Biol., 5:2104-2113). To define further the sequence requirements for efficient polyadenylation, we prepared linker scanning, internal deletion, and small insertion mutations in the polyadenylation region of the tk gene. These mutations were analyzed by S1 nuclease protection analysis of cytoplasmic RNA isolated from transfected Cos-1 monkey kidney cells. When the proximal AATAAA was deleted, no tk mRNA polyadenylated in the normal region was detected, whereas replacement of the second AATAAA with an XbaI linker had no effect on polyadenylation. When various portions of the GT box were replaced with linker, the amount of tk mRNA produced was reduced to 23 to 82% of the normal amount, but polyadenylation in the normal region was never abolished. Thus, no single portion of the GT box was absolutely required. In some cases, extended transcripts, polyadenylated at a cryptic site within pBR322, were detected. A spacing of 6 bp between AATAAA and the GT box was too short for efficient processing and polyadenylation. A spacing of 30 bp appeared to work almost as efficiently as did the wild-type spacing of 18 bp. Taken together, these results indicate that efficient polyadenylation requires both AATAAA and downstream GT-rich sequences. In addition, processing and polyadenylation are affected both qualitatively and quantitatively by sequences at polyadenylation sites and at more distant locations.
Biochemical profile of idiopathic uric acid nephrolithiasis.

BACKGROUND The objective of this study was to elucidate a biochemical profile of patients with idiopathic uric acid nephrolithiasis, without secondary causes (such as dehydration or diarrhea). Study subjects comprised 56 patients with idiopathic uric acid nephrolithiasis (UA stone group) who underwent a full outpatient evaluation. The control group was composed of 54 with absorptive hypercalciuria and 2 normal subjects, matched with the UA stone group according to age, body mass index, and gender. METHODS Urinary pH and ammonium and serum and urinary uric acid were measured. The fractional excretion of urate was calculated. RESULTS Compared with the control group, the UA stone group had a significantly higher serum uric acid and significantly lower urinary uric acid, pH (5.34 +/- 0.23 vs. 6.17 +/- 0.36, P < 0.001), and fractional excretion of urate (0.052 +/- 0.028 vs. 0.080 +/- 0.029, P < 0.001), but individual values overlapped considerably between the two groups. Discriminant analysis of the relationship between urinary pH and fractional excretion of urate yielded a "discriminant score," which provided a much better separation between the two groups, with a correct classification in 95.5% of subjects. In contrast, urinary ammonium, citrate, sulfate, and potassium did not differ between two groups. CONCLUSIONS In idiopathic uric acid nephrolithiasis, urinary pH and fractional excretion of urate are significantly lower than in control subjects, suggestive of defects in urinary acidification and urate excretion. Since these impairments are believed to be associated with primary gout, the underlying disturbance in idiopathic uric acid nephrolithiasis may be primary gout.
Effector Functions of Natural Killer Cell Subsets in the Control of Hematological Malignancies

Treatment of hematological malignant disorders has been improved over the last years, but high relapse rate mainly attributable to the presence of minimal residual disease still persists. Therefore, it is of great interest to explore novel therapeutic strategies to obtain long-term remission. Immune effector cells, and especially natural killer (NK) cells, play a crucial role in the control of hematological malignancies. In this regard, the efficiency of allogeneic stem cell transplantation clearly depends on the immune-mediated graft versus leukemia effect without the risk of inducing graft versus host disease. Alloreactive donor NK cells generated following hematopoietic stem cell transplantation ameliorate the outcome of leukemia patients; in addition, in vivo transfer of in vitro expanded NK cells represents a crucial tool for leukemia treatment. To improve NK cell effector functions against resistant leukemia cells, novel immunotherapeutic strategies are oriented to the identification, isolation, expansion, and administration of particular NK cell subsets endowed with multifunctional anti-tumor potential and tropism toward tumor sites. Moreover, the relationship between the emergence and persistence of distinct NK cell subsets during post-graft reconstitution and the maintenance of a remission state is still rather unclear.
Identifying a migrating stress front using apparent stress for an unplanned rock mass cave

Throughout a mining environment, variations in geotechnical and stress conditions can lead to unplanned rock mass failure. For operations with microseismic monitoring capabilities, seismic event locations and source parameters can often provide significant insight into rock mass failure processes. This paper presents observed variations in the seismic source parameter, apparent stress, during an unplanned rock mass cave in a deep Canadian mine. Over the course of six months, the rock mass cave propagates upwards more than 75 m, at more than 1,000 m depth below surface. Emphasis is placed on identifying zones of relatively high rock mass stress as the cave propagates upwards over time.
On why the iron K-shell absorption in AGN is not a signature of the local warm/hot intergalactic medium

We present a comparison between the 2001 XMM–Newton and 2005 Suzaku observations of the quasar, PG 1211+143, at z= 0.0809. Variability is observed in the 7 keV iron K-shell absorption line (at 7.6 keV in the quasar frame), which is significantly weaker in 2005 than during the 2001 XMM–Newton observation. From a recombination time-scale of 4 × 103 cm−3, while the absorber column is 5 × 1022 < NH < 1 × 1024 cm−2. Thus, the size scale of the absorber is too compact (pc scale) and the surface brightness of the dense gas too high (by 9–10 orders of magnitude) to arise from local hot gas, such as the local bubble, group or warm/hot intergalactic medium (WHIM), as suggested by McKernan, Yaqoob & Reynolds. Instead, the iron K-shell absorption must be associated with an active galactic nucleus (AGN) outflow with mildly relativistic velocities. Finally, we show that the association of the absorption in PG 1211+143 with local hot gas is simply a coincidence, and the comparison between the recession and iron K absorber outflow velocities in other AGN does not reveal a one-to-one kinematic correlation.
Synthesis of novel poly(dG)–poly(dG)–poly(dC) triplex structure by Klenow exo− fragment of DNA polymerase I

The extension of the G-strand of long (700 bp) poly(dG)–poly(dC) by the Klenow exo− fragment of DNA polymerase I yields a complete triplex structure of the H-DNA type. High-performance liquid chromatography analysis demonstrates that the length of the G-strand is doubled during the polymerase synthesis. Fluorescence resonance energy transfer analysis shows that the 5′ ends of the G- and the C-strands, labeled with fluorescein and TAMRA, respectively, are positioned close to each other in the product of the synthesis. Atomic force microscopy morphology imaging shows that the synthesized structures lack single-stranded fragments and have approximately the same length as the parent 700 bp poly(dG)–poly(dC). CD spectrum of the polymer has a large negative peak at 278 nm, which is characteristic of the poly(dG)–poly(dG)–poly(dC) triplex. The polymer is resistant to DNase and interacts much more weakly with ethidium bromide as compared with the double-stranded DNA.
The 5-HTTLPR polymorphism, early and recent life stress, and cognitive endophenotypes of depression

Studies associating interactions of 5-HTTLPR and life adversities with depression have yielded equivocal results. Studying endophenotypes may constitute a more powerful approach. In the current study, it was assessed whether interactions of 5-HTTLPR with childhood emotional abuse (CEA) and recent negative life events (RNLE) affect possible cognitive endophenotypes of depression, namely, attention-allocation bias and the ability to recognise others' mind states in 215 young adults of North-West European descent. The ability to classify others' negative mind states was found to be increased with increasing RNLE in carriers of low-expressing Serotonin Transporter Linked Polymorphic Region (5-HTTLPR) alleles. Carriers of two low-expressing alleles also preferentially oriented attention towards negative information. Gene-environment interactions were not observed for attention allocation bias. No effects involving CEA were observed. These results suggest that low-expressing 5-HTTLPR alleles may confer increased risk for depression through enhanced recognition of negative facial expressions following RNLE.
CD44 mobilization in allogeneic dendritic cell–T cell immunological synapse plays a key role in T cell activation

CD44 is involved in several biological processes owing to its dual role as a cell adhesion and signaling molecule. In an allogeneic dendritic cell (DC)–T cell interaction model, we show here that CD44 gets clustered at the contact between T cells with mature but not immature DCs. Also, CD44 colocalized with lipid rafts at the immunological synapse (IS). Using DCs or T cells derived from CD44‐deficient mice, we observed that the presence of CD44 on DCs and T cells is important for the formation of DC–T cell tight conjugates. However, deficiency of CD44 on DCs but not T cells affected the functional IS, as indicated by decreased phosphotyrosine and protein kinase C‐θ enrichment at the synapse. Also, CD44‐deficient DCs induced significantly decreased proliferation as well as IL‐2 and IFN‐γ production from allogeneic T cells. The polarization of CD44 at the synapse was also noted in an antigen (OVA)‐specific, syngeneic DC–T cell interaction using OVA‐specific T cells derived from OT‐II mice. It was believed that large molecules such as CD44 were excluded from the IS. Results presented here show for the first time that CD44 is recruited to the IS during allogeneic DC and T cell interactions and plays an important role in subsequent T cell activation.
Modelling desiccation crack geometry evolution in clayey soils by analytical and numerical approaches

In the present work, the development and geometry of desiccation cracks are studied by using a finite element code including cohesive joints elements. The numerical results show that cracking occurs sequentially to form different crack families. The propagation of each crack at the onset suddenly reaches an ultimate depth. The cracks in each family appear simultaneously and reach an identical ultimate depth. From the numerical results and additional analytical analysis, empirical correlations are proposed to predict the spacing and crack depth as a function of suction applied on the top surface, the soil parameters, and the desiccation rate. The proposed model shows that higher suction is required to initiate cracks at a higher value of soil tensile strength. In addition, there is a general trend of larger spacing and deeper cracks for a slower desiccation rate. Finally, empirical relations are evaluated by comparing them with in situ experimental observations published previously.