Miracle-dz/UniFAR-FTUs huggingface dataset:
A Meta-Analysis of Fall Prevention Programs for the Elderly: How Effective Are They?

BackgroundAlthough fall prevention studies for the elderly have been reported, there is a paucity of work summarizing the effectiveness of these interventions. ObjectivesThe research question that guided this study was: “What are the effects of fall prevention programs on the proportion of falls in the elderly? ” MethodMeta-analysis was employed to summarize findings of intervention studies of fall prevention in the elderly involving a comparison group and a quantifiable outcome. Studies were reviewed by two of the authors with the eligibility criteria in mind. Studies were then coded and an inter-rater reliability check was performed. ResultsThe overall mean weighted effect size for the 12 studies included in the meta-analysis was . 0779 (Z = 5.03, p < .001). For fall prevention intervention types, exercise alone had a mean weighted effect size of . 0220 (Z = .5303, p > .5), exercise and risk modification had a mean weighted effect size of . 0687 (Z = 3.41, p < .001), and comprehensive risk assessment intervention studies had an effect size of . 1231 (Z = 3.97, p < .001). The mean weighted effect size size for community-based studies was . 0972 (Z = 5.37, p < .001) and for institution-based studies was . 0237 (Z = .7822, p = .22). Time to outcome measure analyses revealed that the mean weighted effect size for studies measuring proportion of falls at 12 months was . 0905 (Z = 5.43, p < .001), and those measuring at four months or less was −. 0972 (Z = −.005, p > .50). ConclusionsThe results of this meta-analysis indicate that there was a 4% decrease in the rate of falls for individuals who were in the treatment groups receiving various fall prevention interventions. Additional intervention studies need to be conducted in the elderly population with a goal of preventing falls.
Guidelines for Youth Sports Clubs to Develop, Implement, and Assess Health Promotion Within Its Activities

The settings approach to health promotion is a world-known concept concerning settings like city, hospital, school, and workplace. The concept has also been used in some regionally specific settings, such as island, prison, or university. However, there are still many, often noninstitutional, settings that have a lot of potential but have not yet been recognized. One of the newcomers is the youth sports club, which has the potential to reach a lot of children and adolescents and is effective, via its casual educational nature based on voluntary participation. According to research, health is an important aim for most youth sports clubs, but it has not been converted into practical actions. Indeed, the clubs often recognize the importance of healthy lifestyles, but there is a lack of understanding of what to do to reinforce it within one’s activities. That is why, on the basis of the results of the Health Promoting Sports Club survey in Finland, guidelines for clubs to enhance health promotion as a part of their activities were created. The aim of this article is to present the guidelines, theirs rationale, and practical examples.
Understanding strategic bidding in multi‐unit auctions: a case study of the Texas electricity spot market

We examine the bidding behavior of firms in the Texas electricity spot market, where bidders submit hourly supply schedules to sell power. We characterize an equilibrium model of bidding and use detailed firm-level data on bids and marginal costs to compare actual bidding behavior to theoretical benchmarks. Firms with large stakes in the market performed close to the theoretical benchmark of static profit maximization. However, smaller firms utilized excessively steep bid schedules significantly deviating from this benchmark. Further analysis suggests that payoff scale has an important effect on firms' willingness and ability to participate in complex, strategic market environments. Copyright (c)2008, RAND.
Aggregation-Induced Dissociation of HCl(H2O)4 Below 1 K: The Smallest Droplet of Acid

Minimally Acidic Acidity is usually construed in the context of a bulk liquid solvent: billions of trillions of molecules such as HCl, added to hundreds of billions of trillions of water molecules. What happens under sparser conditions, for example, in atmospheric or interstellar environments, when a single HCl molecule might interact with just three or four water molecules? Gutberlet et al. (p. 1545; see the Perspective by Zwier) explored this question using theoretical simulations together with vibrational spectroscopy in ultracold helium droplets that effectively isolated small aqueous HCl clusters. HCl remained intact upon solvation by one, two, or three water molecules. Dissociation into an ion pair, as occurs in bulk water, required the approach of a fourth water molecule and was facilitated by the geometry of the existing (H2O)3 cluster. Just four water molecules are sufficient to dissolve the acid HCl into a charged ion pair of proton and chloride. Acid dissociation and the subsequent solvation of the charged fragments at ultracold temperatures in nanoenvironments, as distinct from ambient bulk water, are relevant to atmospheric and interstellar chemistry but remain poorly understood. Here we report the experimental observation of a nanoscopic aqueous droplet of acid formed within a superfluid helium cluster at 0.37 kelvin. High-resolution mass-selective infrared laser spectroscopy reveals that successive aggregation of the acid HCl with water molecules, HCl(H2O)n, readily results in the formation of hydronium at n = 4. Accompanying ab initio simulations show that undissociated clusters assemble by stepwise water molecule addition in electrostatic steering arrangements up to n = 3. Adding a fourth water molecule to the ringlike undissociated HCl(H2O)3 then spontaneously yields the compact dissociated H3O+(H2O)3Cl− ion pair. This aggregation mechanism bypasses deep local energy minima on the n = 4 potential energy surface and offers a general paradigm for reactivity at ultracold temperatures.
Impact of mutations in Toll-like receptor pathway genes on esophageal carcinogenesis

Esophageal adenocarcinoma (EAC) develops in an inflammatory microenvironment with reduced microbial diversity, but mechanisms for these influences remain poorly characterized. We hypothesized that mutations targeting the Toll-like receptor (TLR) pathway could disrupt innate immune signaling and promote a microenvironment that favors tumorigenesis. Through interrogating whole genome sequencing data from 171 EAC patients, we showed that non-synonymous mutations collectively affect the TLR pathway in 25/171 (14.6%, PathScan p = 8.7x10-5) tumors. TLR mutant cases were associated with more proximal tumors and metastatic disease, indicating possible clinical significance of these mutations. Only rare mutations were identified in adjacent Barrett’s esophagus samples. We validated our findings in an external EAC dataset with non-synonymous TLR pathway mutations in 33/149 (22.1%, PathScan p = 0.05) tumors, and in other solid tumor types exposed to microbiomes in the COSMIC database (10,318 samples), including uterine endometrioid carcinoma (188/320, 58.8%), cutaneous melanoma (377/988, 38.2%), colorectal adenocarcinoma (402/1519, 26.5%), and stomach adenocarcinoma (151/579, 26.1%). TLR4 was the most frequently mutated gene with eleven mutations in 10/171 (5.8%) of EAC tumors. The TLR4 mutants E439G, S570I, F703C and R787H were confirmed to have impaired reactivity to bacterial lipopolysaccharide with marked reductions in signaling by luciferase reporter assays. Overall, our findings show that TLR pathway genes are recurrently mutated in EAC, and TLR4 mutations have decreased responsiveness to bacterial lipopolysaccharide and may play a role in disease pathogenesis in a subset of patients.
Assessment of renal perfusion with contrast-enhanced ultrasound: Preliminary results in early diabetic nephropathies.

OBJECTIVE We performed a prospective study to evaluate the value of contrast-enhanced ultrasound (CEUS) in quantitative evaluation of renal cortex perfusion in patients suspected of early diabetic nephropathies (DN), with the estimated GFR (MDRD equation) as the gold standard. METHODS The study protocol was approved by the hospital review board; each patient gave written informed consent. Our study included 46 cases (21 males and 25 females, mean age 55.6 ± 4.14 years) of clinical confirmed early DN patients. After intravenous bolus injection of 1 ml sulfur hexafluoride microbubbles of ultrasound contrast agent, real time CEUS of renal cortex was performed successively using a 2-5 MHz convex probe. Time-intensity curves (TICs) and quantitative indexes were created with Qlab software. Receiver operating characteristic (ROC) curves were used to predict the diagnostic criteria of CEUS quantitative indexes, and their diagnostic efficiencies were compared with resistance index (RI) and peak systolic velocity (PSV) of renal segmental arteries by chi square test. Our control group included forty-five healthy volunteers. Difference was considered statistically significant with P < 0.05. RESULTS Changes of area under curve (AUC), derived peak intensity (DPI) were statistically significant (P < 0.05). DPI less than 12 and AUC greater than 1400 had high utility in DN, with 71.7% and 67.3% sensitivity, 77.8% and 80.0% specificity. These results were significantly better than those obtained with RI and PSV which had no significant difference in early stage of DN (P > 0.05). CONCLUSIONS CEUS might be helpful to improve early diagnosis of DN by quantitative analyses. AUC and DPI might be valuable quantitative indexes.
Estimation of a premium for milk with a high concentration of unsaturated fatty acids based on farm and processor profit: A simulation study.

The objective of this study was to determine, via simulation, the premium required for dairy farmers supplying milk with a high concentration of unsaturated fatty acids (UFA) to a dairy processor to equal the operating profit ($/ha) of average farms, under New Zealand conditions. Fifty average farms (AVE farms) and fifty farms that fed an oilseed supplement to dairy cows (UFA farms) were simulated. The processing of milk produced by AVE farms and UFA farms into skim-milk powder and butter was also simulated. The physical and financial characteristics of dairy farms and a dairy processor were investigated under two scenarios: 1) no premium for UFA and 2) a premium for UFA which equalled the operating profit ($/ha) of UFA farms to that of AVE farms. UFA farms were not different from AVE farms in yields of milk, milkfat and protein, but their farm expenses were greater (P<0.05) than for AVE farms. A premium of $0.15/kg milkfat (for each 0.1 g UFA/100 g milkfat increase) was necessary for UFA farms to have an operating profit ($/ha) similar to AVE farms. These results may be used to further evaluate the impact of modifying milkfat UFA concentration at the farm level.
Using Mutants to Locate "Unknown" Faults

Many fault localization techniques operate by crosscutting coverage information of passed and failed test executions. Generally, their accuracy depends on the utilized coverage elements and on the selected test cases. This paper proposes a novel fault localization method using mutation and investigates its accuracy when using classical test selection criteria such as mutation, branch and block. A controlled experiment shows that (1) the mutation based approach is quite effective at identifying "unknown" faulty program statements. Additionally, the experimental results reveal (2) that the mutation-based test suites are significantly more effective at supporting fault localization than block or branch-based test suites. Further, (3) evidence in support of facilitating mutation alternatives, such as mutant sampling, in order to diminish mutation overheads is also given.
General practitioners' experiences of the psychological aspects in the care of a dying patient

ABSTRACT Objective: General practitioners (GPs) play an integral role in addressing the psychological needs of palliative care patients and their families. This qualitative study investigated psychosocial issues faced by GPs in the management of patients receiving palliative care and investigated the themes relevant to the psychosocial care of dying patients. Method: Fifteen general practitioners whose patient had been recently referred to the Mt. Olivet Palliative Home Care Services in Brisbane participated in an individual case review discussions guided by key questions within a semistructured format. These interviews focused on the psychosocial aspects of care and management of the referred patient, including aspects of the doctor/patient relationship, experience of delivering diagnosis and prognosis, addressing the psychological concerns of the patients' family, and the doctors' personal experiences, reactions, and responses. Qualitative analysis was conducted on the transcripts of these interviews. Results: The significant themes that emerged related to perceived barriers to exploration of emotional concerns, including spiritual issues, and the discussion of prognosis and dying, the perception of patients' responses/coping styles, and the GP's personal experience of the care (usually expressed in terms of identification with patient). Significance of results: The findings indicate the significant challenges facing clinicians in discussions with patients and families about death, to exploring the patient's emotional responses to terminal illness and spiritual concerns for the patient and family. These qualitative date indicate important tasks in the training and clinical support for doctors providing palliative care.
Molecular Characteristics and Metastasis Predictor Genes of Triple-Negative Breast Cancer: A Clinical Study of Triple-Negative Breast Carcinomas

Background Triple-negative breast cancer is a subtype of breast cancer with aggressive tumor behavior and distinct disease etiology. Due to the lack of an effective targeted medicine, treatment options for triple-negative breast cancer are few and recurrence rates are high. Although various multi-gene prognostic markers have been proposed for the prediction of breast cancer outcome, most of them were proven clinically useful only for estrogen receptor-positive breast cancers. Reliable identification of triple-negative patients with a favorable prognosis is not yet possible. Methodology/Principal Findings Clinicopathological information and microarray data from 157 invasive breast carcinomas were collected at National Taiwan University Hospital from 1995 to 2008. Gene expression data of 51 triple-negative and 106 luminal breast cancers were generated by oligonucleotide microarrays. Hierarchical clustering analysis revealed that the majority (94%) of triple-negative breast cancers were tightly clustered together carrying strong basal-like characteristics. A 45-gene prognostic signature giving 98% predictive accuracy in distant recurrence of our triple-negative patients was determined using the receiver operating characteristic analysis and leave-one-out cross validation. External validation of the prognostic signature in an independent microarray dataset of 59 early-stage triple-negative patients also obtained statistical significance (hazard ratio 2.29, 95% confidence interval (CI) 1.04–5.06, Cox P = 0.04), outperforming five other published breast cancer prognostic signatures. The 45-gene signature identified in this study revealed that TGF-β signaling of immune/inflammatory regulation may play an important role in distant metastatic invasion of triple-negative breast cancer. Conclusions/Significance Gene expression data and recurrence information of triple-negative breast cancer were collected and analyzed in this study. A novel set of 45-gene signature was found to be statistically predictive in disease recurrence of triple-negative breast cancer. The 45-gene signature, if further validated, may be a clinically useful tool in risk assessment of distant recurrence for early-stage triple-negative patients.
Send Orders of Reprints at Reprints@benthamscience.net Correlation from Undiluted Vitreous Cytokines of Untreated Central Retinal Vein Occlusion with Spectral Domain Optical Coherence Tomography

Purpose: To correlate inflammatory and proangiogenic key cytokines from undiluted vitreous of treatment-naïve central retinal vein occlusion (CRVO) patients with SD-OCT parameters. Methods: Thirty-five patients (age 71.1 years, 24 phakic, 30 nonischemic) underwent intravitreal combination therapy, including a single-site 23-gauge core vitrectomy. Twenty-eight samples from patients with idiopathic, non-uveitis floaterectomy served as controls. Interleukin 6 (IL-6), monocyte chemoattractant protein-1 (MCP-1), and vascular endothelial growth factor (VEGF-A) levels were correlated with the visual acuity (logMar), category of CRVO (ischemic or nonischemic) and morphologic parameters, such as central macular thickness-CMT, thickness of neurosensory retina-TNeuro, extent of serous retinal detachment-SRT and disintegrity of the IS/OS and others. All cytokines correlated highly with one another (correlation coefficient r=0.82 for IL-6 and MCP-1; r=0.68 for Il-6 and VEGF-A; r=0.64 for MCP-1 and VEGF-A). IL-6 correlated significantly with CMT, TRT, SRT, dIS/OS, and dELM. MCP-1 correlated significantly with SRT, dIS/OS, and dELM. VEGF-A correlated not with changes in SD-OCT, while it had a trend to be higher in the ischemic versus the nonischemic CRVO group (P=0.09). Conclusions: The inflammatory cytokines were more often correlated with morphologic changes assessed by SD-OCT, whereas VEGF-A did not correlate with CRVO-associated changes in SD-OCT. VEGF inhibition alone may not be sufficient in decreasing the inflammatory response in CRVO therapy.
Reconstruction of Health-Seeking Behaviors

In this article, I explore how health-seeking behaviors of immigrants are reconstructed and shaped during the adaptation process by comparing the experiences of three Asian Pacific immigrant groups in Hawaii: Filipinos, Koreans, and Marshallese. A total of 91 participants (52 new immigrants, 22 ethnic community key informants, and 17 service providers) completed in-depth interviews. All three groups of immigrants experienced significant changes in their health-seeking behaviors, but in different ways. Koreans experienced a dramatic decrease in seeking both primary and preventive health care after immigration, whereas Filipinos and Marshallese increased their health-seeking behaviors. Coupled with the previous health care experiences in their home country and individual characteristics, the social context of the host country, to a great degree, influenced the formation of health-seeking behaviors after immigration. The study findings suggest that tailored interventions should take into account the source of behavioral change and difficulties that each immigrant group experiences.
What mediates the relationship between family meals and adolescent health issues.

OBJECTIVE To determine whether the frequency of family meals in childhood is associated with positive health outcomes in adolescence through the mediating links of increased family cohesion and positive coping skills. DESIGN Data were obtained from the National Heart, Lung, and Blood Institute Growth and Health Study (NGHS), a 10-year longitudinal study of 2,379 black and white girls assessed annually from ages 9-19. The mediational analysis framework of H. C. Kraemer and colleagues (2001) was used to test the hypothesis that the frequency of family meals in childhood (Study Years 1 and 3) would be related to health outcomes (Study Year 10) through the mediating links of family cohesion and coping skills (Study Years 7/8), after adjusting for baseline (Year 1) demographics as well as previous levels of the outcome variables (Years 5/6). MAIN OUTCOME MEASURES Several measures of adolescent health variables were included as outcome measures. These included the Perceived Stress Scale, three Eating Disorders Inventory subscales (drive for thinness, body dissatisfaction, and bulimia), number of days of alcohol and tobacco consumption, and engaging in extreme weight control behaviors (e.g., self-induced vomiting). RESULTS More frequent family meals in the first 3 study years predicted greater family cohesion and problem- and emotion-focused coping in Years 7 and 8. Family cohesion mediated family meals and risk of smoking in Year 10. Problem-focused coping mediated family meals and both stress and disordered eating-related attitudes and behaviors in Year 10. CONCLUSION Eating together as a family during childhood may have multiple benefits in later years.
Serodiagnosis of Japanese encephalitis among Nepalese patients by the particle agglutination assay

Japanese encephalitis (JE) is a serious health problem in the southwestern region of Nepal. Serological diagnostic kits for routine diagnostic use in this region have not been available. This study was performed to examine if the particle agglutination (PA) assay for Japanese encephalitis virus (JEV) IgM could be applicable to the samples collected in Nepal and also to evaluate the accuracy of clinical diagnosis of JE. One hundred and ninety-three blood samples were collected from the patients clinically diagnosed with JE or other infectious diseases in the JE-endemic, southwestern region of Nepal, in 2000. The PA assay was performed on these 193 serum samples and the results were compared with those by IgM-capture ELISA. Eighty-six samples were IgM-positive by the PA assay, and 71 of 86 were also positive by IgM-capture ELISA (sensitivity, 99%; specificity, 88%; positive predictive value, 0·82; negative predictive value, 0·99). These results suggest that the PA assay is a simple, reliable and useful diagnostic test to support clinical diagnosis in rural hospitals of Asia including Nepal.
Sufficient and Necessary Open-Loop Stackelberg Strategy for Two-Player Game With Time Delay

This paper is concerned with both difference and differential leader-follower games with time delay. The problem remains challenging although the leader-follower game for delay-free system has been well studied in the past decades. The main obstacle encountered is the noncausality of strategy design caused by the delay. The key technique developed to overcome the difficulty is the introduction of the new co-states which capture the future information of the control and the new state which contains the past effects. The novel contributions of this paper are as follows. First, the sufficient and necessary solvability condition is given to ensure the existence of a unique open-loop Stackelberg strategy for the difference game. Second, the open-loop strategy is explicitly obtained in terms of decoupled and symmetric Riccati equations. Last but not least, a unique strategy for continuous time systems is also given by applying the techniques developed in this paper.
Fluorescence spectroscopy using indocyanine green for lymph node mapping

The principles of cancer treatment has for years been radical resection of the primary tumor. In the oncologic surgeries where the affected cancer site is close to the lymphatic system, it is as important to detect the draining lymph nodes for metastasis (lymph node mapping). As a replacement for conventional radioactive labeling, indocyanine green (ICG) has shown successful results in lymph node mapping; however, most of the ICG fluorescence detection techniques developed are based on camera imaging. In this work, fluorescence spectroscopy using a fiber-optical probe was evaluated on a tissue-like ICG phantom with ICG concentrations of 6-64 μM and on breast tissue from five patients. Fiber-optical based spectroscopy was able to detect ICG fluorescence at low intensities; therefore, it is expected to increase the detection threshold of the conventional imaging systems when used intraoperatively. The probe allows spectral characterization of the fluorescence and navigation in the tissue as opposed to camera imaging which is limited to the view on the surface of the tissue.