Miracle-dz/UniFAR-FTUs huggingface dataset:
Potentially inappropriate prescribing andthe risk of adverse drug reactions in critically ill older adults

Background: Potentially inappropriate medication (PIM) use in the elderly is associated with increased risk of adverse drug reactions (ADRs), but there is limited information regarding PIM use in the intensive care unit (ICU) setting. Objective: The aim of the study is to describe the prevalence and factors associated with the use of PIM and the occurrence of PIM-related adverse reactions in the critically ill elderly. Methods: This study enrolled all critically ill older adults (60 years or more) admitted to medical or cardiovascular ICUs between January and December 2013, in a large tertiary teaching hospital. For all patients, clinical pharmacists listed the medications given during the ICU stay and data on drugs were analyzed using 2012 Beers Criteria, to identify the prevalence of PIM. For each identified PIM the medical records were analyzed to evaluate factors associated with its use. The frequency of ADRs and, the causal relationship between PIM and the ADRs identified were also evaluated through review of medical records. Results: According to 2012 Beers Criteria, 98.2% of elderly patients used at least one PIM (n=599), of which 24.8% were newly started in the ICUs. In 29.6% of PIMs, there was a clinical circumstance that justified their prescription. The number of PIMs was associated with ICU length of stay and total number of medications. There was at least one ADR identified in 17.8% of patients; more than 40% were attributed to PIM, but there was no statistical association. Conclusions: There is a high prevalence of PIM used in acutely ill older people, but they do not seem to be the major cause of adverse drug reactions in this population. Although many PIMs had a clinical circumstance that led to their prescription during the course of ICU hospitalization, many were still present upon hospital discharge. Therefore, prescription of PIMs should be minimized to improve the safety of elderly patients.
Calculation of the control signal in MIMO NN-based ANARX models: Analytical approach

In this paper, an application of Neural Networks based Additive Nonlinear AutoRegressive eXogenous (NN-ANARX) structure is investigated for modeling and control of nonlinear multi-input-multi-output (MIMO) systems. A novel analytical technique for calculation of control signal is proposed. After that the ANARX-based dynamic output feedback linearization control algorithm is applied for control of nonlinear MIMO systems. The effectiveness of the proposed technique is demonstrated on numerical examples.
Using Point-of-View Video Modeling to Teach Play to Preschoolers With Autism

This study evaluated the effectiveness of point-of-view video modeling in teaching selected toy-play skills to two preschoolers with autism. This type of modeling involved the experimenters carrying or holding the video camera at eye level (from the child's perspective) and without recording models (persons]) to show the environment as a child would see it when he or she was performing the targeted skills. The researchers used a multiple-probe design across two children and two behaviors to evaluate the effect of the point-of-view modeling on the children's acquisition and maintenance of play actions. They used generalization probes to assess the degree to which the participants used the new skills across novel toys and during classroom activities. The results indicated that point-of-view modeling was an effective tool for teaching toy-play actions to preschoolers with autism. The authors discuss the extension of current video modeling research and implications for home and school interventions.
Bonding pathways of high-pressure chemical transformations

A three-stage bonding pathway towards high-pressure chemical transformations from molecular precursors or intermediate states has been identified by first-principles simulations. With the evolution of principal stress tensor components in the response of chemical bonding to compressive loading, the three stages can be defined as the van der Waals bonding destruction, a bond breaking and forming reaction, and equilibrium of new bonds. The three-stage bonding pathway leads to the establishment of a fundamental principle of chemical bonding under compression. It reveals that during high-pressure chemical transformation, electrons moving away from functional groups follow anti-addition, collision-free paths to form new bonds in counteracting the local stress confinement. In applying this principle, a large number of molecular precursors were identified for high-pressure chemical transformations, resulting in new materials.
Prevalence of Helicobacter pylori infection in a cohort of Italian military students

In 1990, to study regional prevalences and risk factors of Helicobacter pylori infection in healthy young adult males, sera were collected from a nationwide sample of 1659 males (mean age 20·7 years) at introduction into the Air Force School for military students in Caserta, Italy. An enzyme-linked immunosorbent assay was used to detect H. pylori specific immunoglobulin G antibodies. The observed overall seropositivity rate was 17·5% (95% CI 15·7–19·4). Prevalence was higher in southern Italy and in the Italian islands as compared with northern Italy and central Italy (21·3% vs. 9·5%). Multiple logistic regression analysis showed that residence in southern areas and islands was the strongest predictor of the likelihood of H. pylori seropositivity; number of siblings in the household was marginally associated; years of father's schooling was not a significant predictor. H. pylori positive subjects were more likely positive for antibodies to hepatitis A virus infection (anti-HAV) than those H. pylori negative (35·4% vs. 24·9%; Odds Ratio 1·7, 95% CI 1·3–2·2). Adjustment for the confounding effect of sociodemographic variables weakened this association (OR 1·3, 95% CI 1·0–1·7). These findings suggest that differences in environmental conditions rather than in socioeconomic status may have played the major role in the different spread of H. pylori infection across the country.
Whence the red panda?

The evolutionary history of the red panda (Ailurus fulgens) plays a pivotal role in the higher-level phylogeny of the "bear-like" arctoid carnivoran mammals. Characters from morphology and molecules have provided inconsistent evidence for placement of the red panda. Whereas it certainly is an arctoid, there has been major controversy about whether it should be placed with the bears (ursids), ursids plus pinnipeds (seals, sea lions, walrus), raccoons (procyonids), musteloids (raccoons plus weasels, skunks, otters, and badgers [mustelids]), or as a monotypic lineage of uncertain phylogenetic affinities. Nucleotide sequence data from three mitochondrial genes and one nuclear intron were analyzed, with more complete taxonomic sampling of relevant taxa (arctoids) than previously available in analyses of primary molecular data, to clarify the phylogenetic relationships of the red panda to other arctoid carnivorans. This study provides detailed phylogenetic analyses (both parsimony and maximum-likelihood) of primary character data for arctoid carnivorans, including bootstrap and decay indices for all arctoid nodes, and three statistical tests of alternative phylogenetic hypotheses for the placement of the red panda. Combined phylogenetic analyses reject the hypotheses that the red panda is most closely related to the bears (ursids) or to the raccoons (procyonids). Rather, evidence from nucleotide sequences strongly support placement of the red panda within a broad Musteloidea (sensu lato) clade, including three major lineages (the red panda, the skunks [mephitids], and a clearly monophyletic clade of procyonids plus mustelids [sensu stricto, excluding skunks]). Within the Musteloidea, interrelationships of the three major lineages are unclear and probably are best considered an unresolved trichotomy. These data provide compelling evidence for the relationships of the red panda and demonstrate that small taxonomic sample sizes can result in misleading or possibly erroneous (based on prior modeling, as well as conflict between the results of our analyses of less and more complete data sets) conclusions about phylogenetic relationships and taxonomy.
Role of Silicon in Diatom Metabolism : Cyclic Nucleotide Levels, Nucleotide Cyclase, and Phosphodiesterase Activities during Synchronized Growth of Cylindrotheca fusiformis.

Adenylate cyclase, guanylate cyclase, and the cyclic nucleotide phosphodiesterases of Cylindrotheca fusiformis were characterized in crude and partially purified preparations. Both cyclases were membrane-bound and required Mn(2+) for activity, though Mg(2+) gave 50% activity with adenylate cyclase. Properties of adenylate cyclase were similar to those of higher eukaryotic cyclases in some respects, and in other respects were like lower eukaryotic cyclases. Guanylate cyclase was typical of other lower eukaryotic enzymes.Two phosphodiesterase activities were found, one selective for cyclic AMP, the other for cyclic GMP. The 5'-nucleoside monophosphate was the major product of both activities and each of the enzymes had distinctive divalent cation requirements, pH optima, and kinetic parameters. Both phosphodiesterases were similar to those of other lower eukaryotes with one notable difference: the cyclic AMP enzyme was inhibited by calcium.Changes in the cyclic nucleotide levels were quantitated in light-dark and silicon-starvation synchronized cultures using a more sensitive radioimmunoassay than used in a previously published study (Borowitzka and Volcani 1977 Arch Microbiol 112: 147-152). Contrary to the previous report, the cyclic GMP level did not change significantly in either synchrony. The cyclic AMP level increased dramatically very early in the period of DNA replication with the peak cyclic AMP accumulation substantially preceding that of DNA synthesis in both synchronies. There was no significant change in the activity of either cyclase or either phosphodiesterase during either synchrony. Thus, the mechanism for the rise in cAMP level remains unclear.
Learner Support in the Open Distance Learning and E-Learning Context Using the Community of Inquiry Model

The recent global growth and popularity of Open Distance Learning (ODL) have been attributed to its advantages, such as flexibility for students who wish to study while working. Moreover, ODL is an effective tool in extending participation to students from less privileged social groups who are unreachable due to geographic location or who cannot access higher education due to diverse factors, such as financial constraints or domestic arrangements. In the light of this, this study investigated learner support in the Department of Adult Basic Education and Training (ABET) at the University of South Africa (Unisa), the largest, dedicated ODL institution in South Africa. A literature study identified the Community of Inquiry (CoI) model proposed by Garrison, Anderson and Archer (2000) as useful in this context, and the model will be used as a conceptual framework for the empirical inquiry. The researcher drew a random sample of 400 students (n = 400) from a total number of 1 808 students enrolled for the Higher Diploma in Adult Basic Education and Training. A quantitative research approach was employed to investigate the research questions. The CoI framework proposes that successful learning takes place when there are three presences in a class, namely social, teaching and cognitive presences (Garrison et al. 2000). The study will focus on the social presence aspect of the model. The CoI theoretical framework represents a process of creating a deep and meaningful (collaborative–constructivist) learning experience. According to Engelbrecht (2003:39), e-learning models provide valuable frameworks for understanding the integration of technology and pedagogy, and may help to identify key disparities between the current and desired situation. Given the access and communication facilities of the Internet, an e-learning environment has distinct advantages as a means of providing support for communities of inquiry in order to promote higher-order learning. The majority of the students (66, 1%) feel comfortable talking to one another during teaching and learning. The students use myUnisa to talk about the teaching and learning activities. The findings here are that students use myUnisa to communicate comfortably among themselves. There is student-to-student interaction and this promotes learner-centredness. DOI: 10.5901/mjss.2014. v5n20p1251
Middle-period curative effect of posterior lumbar intervertebral fusion (PLIF) and interspinous dynamic fixation (Wallis) for treatment of L45 degenerative disease and its influence on adjacent segment degeneration.

OBJECTIVE To study middle period curative effect of posterior lumbar intervertebral fusion (PLIF) and interspinous dynamic fixation (Wallis) in the treatment of L45 degenerative disease and its influence on adjacent segment degeneration. PATIENTS AND METHODS 66 patients with lumbar L45 degenerative diseases were selected for study. The patients were randomly divided into PLIF operation group and Wallis operation group with 33 cases in each group. The patients were analyzed for T1ρ value, functional score and UCLA classification of L3/4 and L5/S1 segment in different periods of two groups of patients. RESULTS The level of T1ρ for L3/4 and L5/S1 segment in two groups between preoperative period and last follow-up showed a decreasing trend, while level of T1ρ value of L3/4 segment in PLIF operation group was significantly lower than Wallis group. Within group comparison, the level of T1ρ for L3/4 segment in PLIF operation group until the last follow-up was significantly lower than that before operation. While comparing two groups, ODI scores after operation for PLIF group and Wallis group was significantly lower than those before operation and JOA score was significantly higher than that before operation. The UCLA grade of L3/4 and L5/S1 segment of the two groups was significantly improved compared with that at the time of the last follow-up. CONCLUSIONS Both PLIF and Wallis methods are effective for the treatment of lumbar degenerative disease of L45. Wallis operation has slight advantage in slowing down the speed of intervertebral disc degeneration in the upper adjacent segment of the patient.
Employees' Perception of the Learning Organization

This article is about employees' perception of the Learning Organization, and it confirms our theoretical model claiming that employees see causality between frames for learning and a learning environment. This indicates that to some extent it is possible to design and manage a learning organization by working with the frames for learning. The model furthermore shows that the reward system as a learning frame has a high effect on the learning environment according to the employees. We base our theoretical model on a theory of the Learning Organization where the Learning Organization is described by 11 characteristics, and we test the model on data from four Danish service firms by using the technique of structural equation modelling (LISREL).
Are national policies and programs for prevention and management of postpartum hemorrhage and preeclampsia adequate? A key informant survey in 37 countries

Most surveyed countries have many supportive policies and program elements, but issues remain that impede maternal health efforts, including: inconsistent availability of essential commodities, particularly misoprostol; limitations on midwives' scope of practice; incomplete or out-of-date service delivery guidelines; and weak reporting systems. Most surveyed countries have many supportive policies and program elements, but issues remain that impede maternal health efforts, including: inconsistent availability of essential commodities, particularly misoprostol; limitations on midwives' scope of practice; incomplete or out-of-date service delivery guidelines; and weak reporting systems. ABSTRACT Introduction: Although maternal mortality has declined substantially in recent years, efforts to address postpartum hemorrhage (PPH) and preeclampsia/eclampsia (PE/E) must be systematically scaled up in order for further reduction to take place. In 2012, a key informant survey was conducted to identify both national and global gaps in PPH and PE/E program priorities and to highlight focus areas for future national and global programming. Methods: Between January and March 2012, national program teams in 37 countries completed a 44-item survey, consisting mostly of dichotomous yes/no responses and addressing 6 core programmatic areas: policy, training, medication distribution and logistics, national reporting of key indicators, programming, and challenges to and opportunities for scale up. An in-country focal person led the process to gather the necessary information from key local stakeholders. Some countries also provided national essential medicines lists and service delivery guidelines for comparison and further analysis. Results: Most surveyed countries have many elements in place to address PPH and PE/E, but notable gaps remain in both policy and practice. Oxytocin and magnesium sulfate were reported to be regularly available in facilities in 89% and 76% of countries, respectively. Only 27% of countries, however, noted regular availability of misoprostol in health facilities. Midwife scope of practice regarding PPH and PE/E is inconsistent with global norms in a number of countries: 22% of countries do not allow midwives to administer magnesium sulfate and 30% do not allow them to perform manual removal of the placenta. Conclusions: Most countries surveyed have many of the essential policies and program elements to prevent/manage PPH and PE/E, but absence of commodities (especially misoprostol), limitations in scope of practice for midwives, and gaps in inclusion of maternal health indicators in the national data systems have impeded efforts to scale up programs nationally.
The product of the lexC gene of Escherichia coli is single-stranded DNA-binding protein

Extracts from lexC113 cells could not support phage G4 DNA-dependent replication unless supplemented with single-stranded DNA-binding protein. Purified lexC113 binding protein supported synthesis in a reconstituted replication assay, using purified proteins at 30 but not at 42 degrees C, indicating that the product of the lexC113 gene is an altered single-stranded DNA-binding protein.
A new mutation of the lamin A/C gene leading to autosomal dominant axonal neuropathy, muscular dystrophy, cardiac disease, and leuconychia

The LMNA gene encodes two nuclear envelope proteins, lamins A and C, derived from alternative splicing. First identified in autosomal dominant Emery-Dreifuss muscular dystrophy (AD-EDMD),1 mutations in this gene are implicated in up to seven diseases including autosomal recessive EDMD (AR-EDMD),2 limb-girdle muscular dystrophy type 1B (LGMD1B),3 dilated cardiomyopathy with conduction defects (DCM-CD),4,5 autosomal dominant partial lipodystrophy of Dunnigan type,6 autosomal recessive axonal Charcot-Marie-Tooth disease (AR-CMT2),7 mandibuloacral dysplasia,8 and Hutchinson-Gilford progeria syndrome.9,10 In addition, some patients appear to have a combination of these different phenotypes11,12 or a clinical variant including skin abnormalities.13 To extend the clinical spectrum of laminopathies, we report a previously undescribed dominant missense mutation, E33D, identified in LMNA and clinically characterised by the combination of axonal neuropathy with myopathic features, cardiac disease including dilated cardiomyopathy, conduction disturbances and arrhythmia, and leuconychia. The LMNA gene is therefore the first gene implicated in both autosomal dominant and recessive forms of CMT2. The pedigree of a white family originating from the south west of France is shown in fig 1. The index case (II-5) and his affected daughter (III-13) were neurologically and cardiologically assessed by one of our team; only partial information was available for other affected members through questioning of patient III-13. The clinical features of all the affected members are shown in table 1. The results of nerve electrophysiological examination of patients II-5 and III-13 are shown in table 2. A muscle CT scan performed for patient II-5 showed wasting and marked fatty infiltration predominating in paraspinal, vasti, hamstring, and gastrocnemius muscles (fig 2). Fig 3 shows the fingernails of patients II-5 and III-13, exhibiting leuconychia. View this table: Table 1 Clinical features of the affected family members View this table: Table 2 Electrophysiological study of patients II-5 and III-13 Figure 1 Pedigree of the family. Arrow …
Elementary Teachers Negotiating Discourses in Writing Instruction

Using Ivanic’s (2004) framework, the study of 20 elementary teachers examines the relationships among teachers’ beliefs about writing, their instructional practices, and contextual factors. While the district-adopted curriculum reflected specific discourses, teachers’ beliefs and practices reflected a combination of discourses. The nature of the professional development tended to reinforce particular discourses, but occasionally offered an alternative. The three cases revealed how teachers negotiated the tensions among various discourses. Beth exemplified a skills discourse, but demonstrated beliefs about writing as communication; however, she did not articulate tensions between the discourses and followed the district, skillsinfused curriculum. Amber borrowed from skills, traits, process, and genre discourses without resolving potential contradictions, resulting in instructional practices that had little coherence. Jackson, who brought in his own writing as a hip-hop artist, illustrated the social practices discourse as well as creativity and genre discourses to create an enhanced version of a district-adopted curriculum. Implications for practice include raising teacher’s awareness of the contradictory discourses that surround them.
Conceptualizing the creative tourist class: technology, mobility and tourism experiences

Increasing mobilities and an ever greater amount of technologies that support creativity have led to the emergence of a so-called Creative Class in our postmodern society. Creative Class members have distinctive experiences that blur the boundaries between everyday and touristic life. These experiences challenge conventional typologies of the tourist experience and have tremendous implications for tourism research and practice. In this article we discuss first what the Creative Class is, what experiences it has, and how it uses emerging technologies to create, mediate, and reconstruct these experiences. A special emphasis is placed on the relationship the Creative Class has with technology, in particular consumer-generated media. The discussion draws on literature from different fields, stressing the need for an interdisciplinary perspective to analyze and understand the phenomenon. Next, the article proposes that there is indeed an emergence of a creative tourist class with distinct tourism experiences. We then argue that these insights call for a new conceptualization of tourism experiences in general. A tourism experience sphere is presented and described that seeks to overcome some of the limitations of our current conceptualization and understanding of tourists' experiences. The sphere represents a multidimensional space enabling combinations of experience aspects and dimensions (these are illustrative items and not meant to be an exhaustive categorization). The article closes with an agenda for future research regarding tourism experiences, creative tourists, tourism product development, and tourism marketing.