Miracle-dz/UniFAR-FTUs huggingface dataset:
Patient safety and incident reporting: survey of Italian healthcare workers

Background Incident-reporting systems (IRS) are tools that allow front-line healthcare workers to voluntary report adverse events and near misses. The WHO has released guidelines that outline the basic principles on how to design and implement successful IRS in healthcare organisations. Methods A written survey was administered with an assisted self-assessment technique to a representative sample of healthcare workers in Italian hospitals with and without IRS. Data were collected using two different 16-item questionnaires. The questionnaires targeted two issues: (1) workers' experience of patient safety incidents and (2) their expectations on incident reporting. Results 70% of respondents confirmed involvement in a patient safety incident, but only 40% utilised an IRS to formally report the event. The data indicate that information regarding patient safety incidents is not communicated throughout the entire organisation. Conclusions Research findings are consistent with the available evidence on healthcare workers' experience of patient safety incidents.
Neuronal and vascular biomarkers in syringomyelia: investigations using longitudinal MRI.

AIMS Syringomyelia is a formation of fluid-filled cavities in the spinal cord, caused by a number of situations including trauma. To understand the origin and progression of syringomyelia, animal models were developed to mimick the condition and computer models were implemented for performing numerical analysis. This article characterizes the neuropathological stages of a contused spinal cord before and after the syringomyelia formation using longitudinal in vivo MRI. MATERIALS & METHODS Rat was subject to a contusion-type spinal cord injury (SCI) at the T12 level. MRI data were gathered on post-injury days 3, 14, 28, 72, 94 and 404 using a 9.4 T scanner. In addition, neurobehavioral tests were performed prior to the scans on these days. RESULTS Pathological consequences of SCI included significant edema and, to a lesser degree, hemorrhage in the acute phase, followed by neuronal loss, tissue alterations and vascular changes in the late stages. The images from the post-injury day 14 indicated shrinkage of the injured tissue and occlusion of the central canal. Subsequently, syringomyelia was initiated cranial to the occlusion and the fluid-filled cavities enlarged with time. The neurologic deficits of the injured rat also worsened over time. CONCLUSION The inflammatory, but not the hemostatic, component seems to be a prerequisite for syringomyelia proceeding contusive SCI and abnormal flow of the cerebrospinal fluid (CSF) is likely the main factor. Bioimaging markers from high-resolution MRI sensitized to inflammation and CSF flow may be used for early detection of syringomyelia and assessing its prognosis.
LONGITUDINAL STUDIES OF INTELLECTUAL AND BEHAVIORAL DEVELOPMENT IN CHILDREN WITH CONGENITAL HEART DISEASE

This is the final paper in a series (5, 6, 9) which reports the results of a five year developmental study comparing the intelligence and adjustment of children with cyanotic congenital heart disease, those children with acyanotic cardiac disease and normal children. Previous papers have not dealt with changes during the five year study period. Possible effects of intervening cardiac operation upon the development of children with congenital heart disease are of primary interest. More than 40% of the children in the cardiac group underwent operation during the course of the investigation, and so we were able to compare the developmen; of operated and nonoperated children. We studied changes in physical capacity, intelligence and adjustment of the child and also changes in the mother's attitude toward her child, the extent of her anxiety and her need to protect and pamper him.
A 2‐year follow‐up study of cigarette smoking and risk of dementia

The report focused on investigating the relationship between cigarette smoking and dementia in elderly people through prospective studies. We did a 2‐year follow‐up study of elderly people. A total of 2820 participants aged 60 years old and over from six communities of Chongqing agreed to take part. Dementia was diagnosed with MMSE (Mini‐Mental State Examination) and DSM‐III‐R (Diagnostic and Statistical Manual of Mental Disorders). Participants were classified as never smokers, past smokers, and current smokers. During follow‐up, we recorded incident cases of dementia. The association of smoking and dementia was investigated using proportional hazards regression analysis. A total of 121 incident cases of dementia were detected, of which 84 (69%) were Alzheimer's disease, 17 (14%) were vascular dementia, and 21(17%) were other dementia. Compared with never smokers, current smokers had an increased risk of Alzheimer's disease (RR = 2.72; 95% CI = 1.63–5.42) and vascular dementia (RR = 1.98; 95% CI = 1.53–3.12) adjusting for age, sex, education, blood pressure, and alcohol intake. Compared with light smokers, the adjusted risk of Alzheimer's disease was significantly increased among smokers with a medium level of exposure (RR = 2.56; 95% CI = 1.65–5.52), with an even higher risk of Alzheimer's disease in the heavy smoking group (RR = 3.03; 95% CI = 1.25–4.02). Smoking was associated with the risk of dementia. This study suggests that both smoking status and amount is associated with dementia.
The long and winding road: influences of intracellular metabolite diffusion on cellular organization and metabolism in skeletal muscle

SUMMARY A fundamental principle of physiology is that cells are small in order to minimize diffusion distances for O2 and intracellular metabolites. In skeletal muscle, it has long been recognized that aerobic fibers that are used for steady state locomotion tend to be smaller than anaerobic fibers that are used for burst movements. This tendency reflects the interaction between diffusion distances and aerobic ATP turnover rates, since maximal intracellular diffusion distances are ultimately limited by fiber size. The effect of diffusion distance on O2 flux in muscle has been the subject of quantitative analyses for a century, but the influence of ATP diffusion from mitochondria to cellular ATPases on aerobic metabolism has received much less attention. The application of reaction–diffusion mathematical models to experimental measurements of aerobic metabolic processes has revealed that the extreme diffusion distances between mitochondria found in some muscle fibers do not necessarily limit the rates of aerobic processes per se, as long as the metabolic process is sufficiently slow. However, skeletal muscle fibers from a variety of animals appear to have intracellular diffusion distances and/or fiber sizes that put them on the brink of diffusion limitation. Thus, intracellular metabolite diffusion likely influences the evolution of muscle design and places limits on muscle function.
Identification of Mycobacteria in Solid-Culture Media by Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry

ABSTRACT Matrix-assisted laser desorption ionization–time of flight mass spectrometry (MALDI-TOF MS) has recently been introduced into the clinical microbiology laboratory as a rapid and accurate method to identify bacteria and yeasts. In this paper we describe our work on the use of MALDI-TOF MS for the identification of mycobacterial isolates. We developed a protocol for protein extraction from mycobacteria and utilized it to construct a database containing 42 clinically relevant type and reference strains of mycobacteria. The database was used to identify 104 clinical isolates of mycobacteria. All members of the Mycobacterium tuberculosis complex were identified accurately at the complex level but could not be separated at the species level. All other organisms were identified at the species level, with the exception of one strain of M. kansasii (accurately identified but with a low spectral score) and three pairs of closely related strains: M. abscessus and M. massiliense, M. mucogenicum and M. phocaicum, and M. chimaera and M. intracellulare. These pairs of organisms can currently be identified only by multilocus gene sequence analysis. We conclude that MALDI-TOF MS analysis can be incorporated into the work flow of the microbiology laboratory for rapid and accurate identification of most strains of mycobacteria isolated from solid growth media.
An Algorithm for Maxillectomy Defect Reconstruction

A maxillectomy defect creates a communication from oral cavity to nasal cavity that may extend to the orbit. Functional deglutition and speech problems with a significant soft tissue deficit ensue. This paper defines the reconstruction options for the spectrum of inferior partial maxillectomy defects to midfaceorbital exonerations. Treatment protocols from maxillectomy patients treated in January 1991 to February 1996 at a major tertiary care institution were reviewed(n = 108). An ascension of care from dental obturator, nonvascularized graft, local flap, regional flap, and free tissue grafts (n = 28) is described. These data and experience were organized to provide a treatment algorithm to assist in presurgical planning for maxillectomy reconstruction.
Using Contextual Information for Machine Translation Evaluation

Automatic evaluation of Machine Translation (MT) is typically approached by measuring similarity between the candidate MT and a human reference translation. An important limitation of existing evaluation systems is that they are unable to distinguish candidate-reference differences that arise due to acceptable linguistic variation from the differences induced by MT errors. In this paper we present a new metric, UPF-Cobalt, that addresses this issue by taking into consideration the syntactic contexts of candidate and reference words. The metric applies a penalty when the words are similar but the contexts in which they occur are not equivalent. In this way, Machine Translations (MTs) that are different from the human translation but still essentially correct are distinguished from those that share high number of words with the reference but alter the meaning of the sentence due to translation errors. The results show that the method proposed is indeed beneficial for automatic MT evaluation. We report experiments based on two different evaluation tasks with various types of manual quality assessment. The metric significantly outperforms state-of-the-art evaluation systems in varying evaluation settings.
Women attending hospital in Malawi for miscarriage: a qualitative study of perceptions of miscarriage.

Aims: To investigate women’s perceptions of miscarriage and its complications. Study Design: A qualitative design was used with data collected through semistructured interviews. Place and Duration of Study: Gynaecology ward of the Queen Elizabeth Central Hospital, Blantyre, Malawi, during February and March 2012. Methodology: Sample: We included 30 patients (aged between 18 and 39) admitted to the gynaecology ward for surgery following miscarriage. Inclusion criteria were: (a) Original Research Article British Journal of Medicine & Medical Research, 4(2): 699-710, 2014 700 diagnosis of miscarriage (b) aged over 18. Semi-structured interviews were conducted through a translator and lasted an average of 30 minutes (range 14 – 46minutes). Results: 14 of the women interviewed knew what a miscarriage was. Perceived causes included contraceptives, prohibited medicines, hard labour, stress, HIV, malaria, witchcraft, traditional medicines, lack of child spacing and abuse by their male partners. Women obtained knowledge from their own experience of miscarriage and through the shared experiences of female family members and friends. Women were found to have concerns about death from miscarriage; facing stigmatising attitudes of community and health workers; and the treatment they would receive in hospital, particularly the surgical procedure. Conclusions: The women had poor knowledge of the causes and symptoms of miscarriage. They were concerned about the treatment that they would receive in the hospital and how their miscarriage would be perceived by both the hospital staff and within their communities. Women who have miscarriages should be encouraged to discuss this with female friends and relatives to improve knowledge on miscarriage and help dispel the stigma surrounding it. Providing information on the treatment they would receive whilst in hospital may help to allay women’s concerns. Incorporating education about miscarriage into the school syllabus may help to improve women’s awareness and understanding.
MicroRNA-34b promoter hypermethylation induces CREB overexpression and contributes to myeloid transformation

MicroRNA-34b down-regulation in acute myeloid leukemia was previously shown to induce CREB overexpression, thereby causing leukemia proliferation in vitro and in vivo. The role of microRNA-34b and CREB in patients with myeloid malignancies has never been evaluated. We examined microRNA-34b expression and the methylation status of its promoter in cells from patients diagnosed with myeloid malignancies. We used gene expression profiling to identify signatures of myeloid transformation. We established that microRNA-34b has suppressor ability and that CREB has oncogenic potential in primary bone marrow cell cultures and in vivo. MicroRNA-34b was found to be up-regulated in pediatric patients with juvenile myelomonocytic leukemia (n=17) and myelodysplastic syndromes (n=28), but was down-regulated in acute myeloid leukemia patients at diagnosis (n=112). Our results showed that hypermethylation of the microRNA-34b promoter occurred in 66% of cases of acute myeloid leukemia explaining the low microRNA-34b levels and CREB overexpression, whereas preleukemic myelodysplastic syndromes and juvenile myelomonocytic leukemia were not associated with hypermethylation or CREB overexpression. In paired samples taken from the same patients when they had myelodysplastic syndrome and again during the subsequent acute myeloid leukemia, we confirmed microRNA-34b promoter hypermethylation at leukemia onset, with 103 CREB target genes differentially expressed between the two disease stages. This subset of CREB targets was confirmed to associate with high-risk myelodysplastic syndromes in a separate cohort of patients (n=20). Seventy-eight of these 103 CREB targets were also differentially expressed between healthy samples (n=11) and de novo acute myeloid leukemia (n=72). Further, low microRNA-34b and high CREB expression levels induced aberrant myelopoiesis through CREB-dependent pathways in vitro and in vivo. In conclusion, we suggest that microRNA-34b controls CREB expression and contributes to myeloid transformation from both healthy bone marrow and myelodysplastic syndromes. We identified a subset of CREB target genes that represents a novel transcriptional network that may control myeloid transformation.
Short-term follow-up of palpable breast lesions with benign imaging features: evaluation of 375 lesions in 320 women.

OBJECTIVE The purpose of this study was to evaluate the feasibility of short-term follow-up of palpable masses that have benign imaging features. MATERIALS AND METHODS The cases of all women with round, oval, or lobular palpable masses with circumscribed margins and homogeneous ultrasound echotexture for which short-term follow-up was recommended from July 1997 through December 2003 were retrospectively identified. Evaluation was by ultrasound and/or mammography and focused clinical examination. Outcome was assessed with imaging or clinical follow-up lasting at least 12 months. The cancer incidence for palpable lesions was compared with that for nonpalpable lesions recommended for short-term follow-up. RESULTS In 379 women, 443 palpable masses with benign features for which short-term follow-up was recommended were identified. Outcome data were available on 375 masses in 320 women. Lesions were evaluated with mammography and ultrasound (n = 186) or ultrasound alone (n = 189). Masses were typically identified only with ultrasound (n = 258, 68.8%); were oval (n = 275, 73.3%), of equal density to normal breast tissue on mammograms (n = 95 on 117 mammograms, 81.2%), and hypoechoic (n = 336 in 372 ultrasound examinations, 90.3%); and were prospectively believed to be fibroadenoma (n = 304, 81.1%). Eighty-five lesions (22.7%) were biopsied soon after evaluation, and one 1.5-mm ductal carcinoma in situ was diagnosed. At follow-up (mean, 2.7 years), 26 lesions (6.9%) had grown. Twenty-four of the 26 lesions were biopsied, and no cancer was diagnosed. The overall cancer prevalence was similar for palpable (0.3%) and nonpalpable (1.6%) masses. The cost of short-term follow-up was less than that of biopsy. CONCLUSION Short-term follow-up is a reasonable alternative to biopsy of palpable breast lesions with benign imaging features, particularly for young women with probable fibroadenoma.
Disease and Health Inequalities Attributable to Air Pollutant Exposure in Detroit, Michigan

The environmental burden of disease is the mortality and morbidity attributable to exposures of air pollution and other stressors. The inequality metrics used in cumulative impact and environmental justice studies can be incorporated into environmental burden studies to better understand the health disparities of ambient air pollutant exposures. This study examines the diseases and health disparities attributable to air pollutants for the Detroit urban area. We apportion this burden to various groups of emission sources and pollutants, and show how the burden is distributed among demographic and socioeconomic subgroups. The analysis uses spatially-resolved estimates of exposures, baseline health rates, age-stratified populations, and demographic characteristics that serve as proxies for increased vulnerability, e.g., race/ethnicity and income. Based on current levels, exposures to fine particulate matter (PM2.5), ozone (O3), sulfur dioxide (SO2), and nitrogen dioxide (NO2) are responsible for more than 10,000 disability-adjusted life years (DALYs) per year, causing an annual monetized health impact of $6.5 billion. This burden is mainly driven by PM2.5 and O3 exposures, which cause 660 premature deaths each year among the 945,000 individuals in the study area. NO2 exposures, largely from traffic, are important for respiratory outcomes among older adults and children with asthma, e.g., 46% of air-pollution related asthma hospitalizations are due to NO2 exposures. Based on quantitative inequality metrics, the greatest inequality of health burdens results from industrial and traffic emissions. These metrics also show disproportionate burdens among Hispanic/Latino populations due to industrial emissions, and among low income populations due to traffic emissions. Attributable health burdens are a function of exposures, susceptibility and vulnerability (e.g., baseline incidence rates), and population density. Because of these dependencies, inequality metrics should be calculated using the attributable health burden when feasible to avoid potentially underestimating inequality. Quantitative health impact and inequality analyses can inform health and environmental justice evaluations, providing important information to decision makers for prioritizing strategies to address exposures at the local level.
The Assimilation of E-business in Manufacturing SMEs: Determinants and Effects on Growth and Internationalization

In order to become ‘world‐class’ enterprises, manufacturing SMEs have made sizable investments in Internet‐related technologies as the infrastructure for e‐business applications. To the extent that e‐business is assimilated by the SME, it can significantly affect the firm's key business processes and relationships such as servicing customers and collaborating with business partners. In this regard, an empirical study of 108 Canadian firms sought to answer the following questions: For what purposes are the Internet and the Web presently used, i.e., to what extent are e‐business functions assimilated in manufacturing SMEs? What characteristics of the SMEs' environmental, strategic, managerial, operational and technological context determine e‐business assimilation? And ultimately, to what extent does e‐business assimilation contribute to the growth and internationalization of manufacturing SMEs?
Adaptive ECG biometric recognition: a study on re-enrollment methods for QRS signals

The diffusion of wearable and mobile devices for the acquisition and analysis of cardiac signals drastically increased the possible applicative scenarios of biometric systems based on electrocardiography (ECG). Moreover, such devices allow for comfortable and unconstrained acquisitions of ECG signals for relevant time spans of tens of hours, thus making these physiological signals particularly attractive biometric traits for continuous authentication applications. In this context, recent studies showed that the QRS complex is the most stable component of the ECG signal, but the accuracy of the authentication degrades over time, due to significant variations in the patterns for each individual. Adaptive techniques for automatic template update can therefore become enabling technologies for continuous authentication systems based on ECG characteristics.
Neurocognitive functioning in early‐onset and late‐onset older patients with euthymic bipolar disorder

Most neurocognitive studies have not taken into account the fact that older patients with bipolar disorder (BD) are a heterogeneous population. The main goal of this study was to compare neurocognitive performance and extrapyramidal symptoms in older patients with early‐onset BD (EO‐BD) and late‐onset BD (LO‐BD).
Circulating Ceramides Predict Cardiovascular Outcomes in the Population-Based FINRISK 2002 Cohort

Objective—Ceramides are molecular lipids implicated in apoptosis, inflammation, obesity, and insulin resistance. An earlier study reported that ceramides were associated with fatal outcome among patients with coronary heart disease. Here, we examined whether ceramides are associated with major adverse cardiovascular events (MACEs) among apparently healthy individuals. Approach and Results—FINRISK 2002 is a population-based risk factor survey, which recruited men and women aged 25 to 74 years. The cohort was followed up until the end of 2014. We quantified 4 circulating ceramides, Cer(d18:1/16:0), Cer(d18:1/18:0), Cer(d18:1/24:0), and Cer(d18:1/24:1), in 8101 serum samples by a targeted liquid chromatography–tandem mass spectrometry assay. Primary outcome of interest was incident MACE (n=813). Secondary analyses were performed for MACE death (n=116) without previous nonfatal MACE and for recurrent MACE (n=226) among survivors of a previous incident MACE. We used Cox proportional hazard models adjusted for the Framingham covariates to determine the association of ceramides with the outcomes. Of the ceramide species, Cer(d18:1/18:0) had the strongest association with incident MACE and the highest unadjusted hazard ratio of 1.31 (95% confidence interval, 1.21–1.41), which remained significant at 1.21 (95% confidence interval, 1.11–1.33) after Framingham risk factor adjustments. The hazard ratios were generally stronger for recurrent and fatal events than for first events. Clinical net reclassification improvement was 7.5% (P=6.9×10−5) for Cer(d18:1/18:0). Conclusions—Distinct serum ceramides are associated with the risk of incident MACE in apparently healthy individuals. These results should encourage more detailed analyses of ceramides in cardiovascular pathobiology and suggest new biomarkers of MACE risk.