Miracle-dz/UniFAR-FTUs huggingface dataset:
When mental health and medicine collide: Maintaining safety in the emergency department

Mental health patients seeking care through emergency departments (ED) create different challenges for nurses than their medical counterparts. Understanding the special needs of psychiatric populations requires nurses to identify recurring characteristics, subgroups, and demographics. Psychiatric patients share similar traits that hinder their access to health care despite the distribution of mental illness across age, race, gender, and ethnic barriers. Similarities among psychiatric patients include impaired thought processes, tendency to withdraw from social interaction, and shame related to the stigma of mental illness. Psychiatric patients using emergency departments for primary care compound their vulnerable status by circumventing patient-provider relationships that develop when establishing routine practice and familiarity with a primary care physician. This article illustrates how nurses in the American health care system, specifically those in emergency specialties, can respond to environmental challenges while caring for mental health patients. Strategic planning allows ED teams to prepare for an influx of mental health patients and maintain safety as they serve this vulnerable population.
An application of zero-inflated Poisson regression for software fault prediction

Poisson regression model is widely used in software quality modeling. When the response variable of a data set includes a large number of zeros, Poisson regression model will underestimate the probability of zeros. A zero-inflated model changes the mean structure of the pure Poisson model. The predictive quality is therefore improved. In this paper, we examine a full-scale industrial software system and develop two models, Poisson regression and zero-inflated Poisson regression. To our knowledge, this is the first study that introduces the zero-inflated Poisson regression model in software reliability. Comparing the predictive qualities of the two competing models, we conclude that for this system, the zero-inflated Poisson regression model is more appropriate in theory and practice.
Relationships between motor impairments and activity limitations in patients with neuromuscular disorders

Aim: The strength and nature of the relationships between motor impairments and activity limitations assessed by the ACTIVLIM questionnaire were investigated in 245 patients with neuromuscular disorders. Methods: Measures of motor impairments consisted of: (1) a grip strength test using a Jamar dynamometer, (2) a Manual Muscle Testing bilaterally performed in 18 muscle groups and (3) a gait speed spontaneously adopted by the patients using the 10 m timed walking test. Results: Activity limitations were poorly correlated with grip strength in both hands (r = 0.3 and 0.36) and moderately correlated with gait speed (r = 0.53). Spearman’s coefficients of correlation between the manual muscle testing and activity limitations were moderate to very poor (ρ = 0.5 to 0.17). Conclusion: The relationships between motor impairments and activity limitations are not straightforward in patients with neuromuscular disorders, indicating that the activity limitations should be separately assessed and cannot be simply inferred from motor impairment measures.
CSF oligoclonal band status informs prognosis in multiple sclerosis: a case control study of 100 patients

Objective: Oligoclonal band (OCB) negative multiple sclerosis (MS) is well recognised but uncommon, studied in only a few usually small case series. These reached differing conclusions on whether its clinical features or course differ from OCB positive disease. The study hypothesis was that a definitive study would not only be of clinical and prognostic value but also potentially offer information about the possible role of CSF oligoclonal immunoglobulins in MS disease processes. Methods: A collaborative cohort of well documented patients in southwest England and south Wales was used to identify and analyse a large group of patients with OCB negative MS and make comparisons with age and sex matched OCB positive controls. Results: An approximate minimum 3% of patients with MS were OCB negative. They were significantly more likely to exhibit neurological or systemic clinical features atypical of MS (headaches, neuropsychiatric features and skin changes). Non-specific MRI, blood and (other) CSF abnormalities were also more common, emphasising the need for continued diagnostic vigilance, although the incautious application of McDonald diagnostic criteria in OCB negative cases renders categorisation as “definite” MS more likely. Studying the uniformly assessed Cardiff group (69 patients), we found the prognosis for neurological disability was significantly better for OCB negative cases. The age adjusted hazard ratio for OCB negative and OCB positive subjects to reach Disability Scale Status (DSS) 4 and DSS 6 was, respectively, 0.60 (95% CI 0.39 to 0.93; p = 0.02) and 0.51 (95% CI 0.27 to 0.94; p = 0.03). Conclusion: There are clear clinical differences between OCB negative and OCB positive MS, in particular a better prognosis for disability. This is consistent with a secondary but nonetheless contributory role in disease process for intrathecally synthesised immunoglobulins.
Chemokine receptors in allergic diseases

Under homeostatic conditions, as well as in various diseases, leukocyte migration is a crucial issue for the immune system that is mainly organized through the activation of bone marrow‐derived cells in various tissues. Immune cell trafficking is orchestrated by a family of small proteins called chemokines. Leukocytes express cell‐surface receptors that bind to chemokines and trigger transendothelial migration. Most allergic diseases, such as asthma, rhinitis, food allergies, and atopic dermatitis, are generally classified by the tissue rather than the type of inflammation, making the chemokine/chemokine receptor system a key point of the immune response. Moreover, because small antagonists can easily block such receptors, various molecules have been developed to suppress the recruitment of immune cells during allergic reactions, representing potential new drugs for allergies. We review the chemokines and chemokine receptors that are important in asthma, food allergies, and atopic dermatitis and their respectively developed antagonists.
Frequent Subgraph Based Familial Classification of Android Malware

The rapid growth of Android malware poses great challenges to anti-malware systems because the sheer number of malware samples overwhelm malware analysis systems. A promising approach for speeding up malware analysis is to classify malware samples into families so that the common features in malwares belonging to the same family can be exploited for malware detection and inspection. However, the accuracy of existing classification solutions is limited because of two reasons. First, since the majority of Android malware is constructed by inserting malicious components into popular apps, the malware's legitimate part may misguide the classification algorithms. Second, the polymorphic variants of Android malware could evade the detection by employing transformation attacks. In this paper, we propose a novel approach that constructs frequent subgraph (fregraph) to represent the common behaviors of malwares in the same family for familial classification of Android malware. Moreover, we propose and develop FalDroid, an automatic system for classifying Android malware according to fregraph, and apply it to 6,565 malware samples from 30 families. The experimental results show that FalDroid can correctly classify 94.5% malwares into their families using around 4.4s per app.
Novel approaches and perspectives in allergen immunotherapy

In this review, we report on relevant current topics in allergen immunotherapy (AIT) which were broadly discussed during the first Aarhus Immunotherapy Symposium (Aarhus, Denmark) in December 2015 by leading clinicians, scientists and industry representatives in the field. The aim of this symposium was to highlight AIT‐related aspects of public health, clinical efficacy evaluation, mechanisms, development of new biomarkers and an overview of novel therapeutic approaches. Allergy is a public health issue of high socioeconomic relevance, and development of evidence‐based action plans to address allergy as a public health issue ought to be on national and regional agendas. The underlying mechanisms are in the focus of current research that lays the ground for innovative therapies. Standardization and harmonization of clinical endpoints in AIT trials as well as current knowledge about potential biomarkers have substantiated proof of effectiveness of this disease‐modifying therapeutic option. Novel treatments such as peptide immunotherapy, intralymphatic immunotherapy and use of recombinant allergens herald a new age in which AIT may address treatment of allergy as a public health issue by reaching a large fraction of patients.
Nonlesional atopic dermatitis skin shares similar T‐cell clones with lesional tissues

Atopic dermatitis (AD) is characterized by robust immune activation. Various T‐cell subsets, including Th2/Th22 cells, are increased in lesional and nonlesional skin. However, there is conflicting literature on the diversity of the T‐cell receptor (TCR) repertoire in lesional AD, and its relation to nonlesional skin remains unclear.
The potential of anti‐infectives and immunomodulators as therapies for asthma and asthma exacerbations

Asthma is responsible for approximately 25,000 deaths annually in Europe despite available medicines that maintain asthma control and reduce asthma exacerbations. Better treatments are urgently needed for the control of chronic asthma and reduction in asthma exacerbations, the major cause of asthma mortality. Much research spanning >20 years shows a strong association between microorganisms including pathogens in asthma onset, severity and exacerbation, yet with the exception of antibiotics, few treatments are available that specifically target the offending pathogens. Recent insights into the microbiome suggest that modulating commensal organisms within the gut or lung may also be a possible way to treat/prevent asthma. The European Academy of Allergy & Clinical Immunology Task Force on Anti‐infectives in Asthma was initiated to investigate the potential of anti‐infectives and immunomodulators in asthma. This review provides a concise summary of the current literature and aimed to identify and address key questions that concern the use of anti‐infectives and both microbe‐ and host‐based immunomodulators and their feasibility for use in asthma.
The Importance of the Social Environment in Dementia Care

To manage the care of residents with dementia, many long-term care facilities have created special care units designed to meet the unique needs of this group. This article describes results of the qualitative component of a larger research project examining environment-behavior relationships in dementia care settings. The study includes 18 in-depth interviews that were conducted with 9 staff and 9 family members of special care unit (SCU) residents. Thematic analysis was conducted using grounded theory techniques. Although participants described residents 'needs in relation to both the physical and social environments, the latter was perceived to have more impact on quality of life andfunctional ability. This article focuses on five areas of need, identified by participants, in relation to the social environment: stimulation and meaningful activity, human contact, safety and supervision, individualized care, andflexibility.
Drug repurposing to treat asthma and allergic disorders: Progress and prospects

Allergy and atopic asthma have continued to become more prevalent in modern society despite the advent of new treatments, representing a major global health problem. Common medications such as antihistamines and steroids can have undesirable long‐term side‐effects and lack efficacy in some resistant patients. Biologic medications are increasingly given to treatment‐resistant patients, but they can represent high costs, complex dosing and management, and are not widely available around the world. The field needs new, cheap, and convenient treatment options in order to bring better symptom relief to patients. Beyond continued research and development of new drugs, a focus on drug repurposing could alleviate this problem by repositioning effective and safe small‐molecule drugs from other fields of medicine and applying them toward the treatment for asthma and allergy. Herein, preclinical models, case reports, and clinical trials of drug repurposing efficacy in allergic disease are reviewed. Novel drugs are also proposed for repositioning based on their mechanism of action to treat asthma and allergy. Overall, drug repurposing could become increasingly important as a way of advancing allergy and atopic asthma therapy, filling a need in treatment of patients today.
The safety and efficacy of IFN-β products for the treatment of multiple sclerosis

Multiple sclerosis, a chronic demyelinating disease of the CNS, is now a treatable disease. Phase III clinical trials of three recombinant IFN-β products conducted in relapsing-remitting multiple sclerosis have shown, albeit modest, significant effects on relapses and short-term progression of disability, and a more substantial effect on MRI parameters. However, these effects do not correlate well with clinical disease activity or long-term disability. Overall, IFN-β is safe and generally well tolerated, and reported adverse events were comparable between preparations. Systemic side effects can be effectively managed by dose escalation, use of an auto-injector and careful clinical monitoring.
Early‐life antibiotic exposure increases the risk of developing allergic symptoms later in life: A meta‐analysis

This study systematically reviewed and quantified the relationship between exposure to antibiotics during the first 2 years of life and the risk of allergies/atopies including hay fever, eczema, food allergy, positive skin prick testing (SPT), or elevated allergen‐specific serum/plasma immunoglobulin (Ig) E levels later in life. PubMed and Web of Science databases were searched for observational studies published from January 1966 through November 11, 2015. Overall pooled estimates of the odds ratios (ORs) were obtained using fixed or random‐effects models. Early‐life exposure to antibiotics appears to be related to an increased risk of allergic symptoms of hay fever, eczema, and food allergy later in life. The summary OR for the risk of hay fever (22 studies) was 1.23, 95% confidence interval (CI):1.13‐1.34; I2: 77.0%. The summary OR for the risk of eczema (22 studies) was 1.26, 95% CI: 1.15‐1.37; I2: 74.2%, and the summary OR for food allergy (3 studies) was 1.42, 95% CI: 1.08‐1.87; I2: 80.8%. However, no association was found for antibiotics exposure early in life and objective atopy measurements including positive SPT or elevated allergen‐specific serum/plasma IgE levels.
Potential of Evoked Otoacoustic Emissions for Infant Hearing Screening

Reprint requests: Dr. Martin, Department of Otorhinolaryngology & Communicative Sciences, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030 A considerable body of experimental and theoretical work indicates that the cochlea actively produces energy at the frequencies of stimulating sounds as part of the normal-hearing process. Some of this energy escapes from the active site of energy production in the organ of Corti and travels, in a retrograde fashion, to the stapes footplate, through the middle ear, and into the external ear canal where it is detected as sound. It is this diverted energy that is recorded as an otoacoustic emission (OAE). The normal propagation of the traveling wave and the direction of the reemission of acoustic energy into the ear canal are represented diagrammatically in Figure 1. OAEs represent a relatively new class of cochlear response, since their existence has been known for little more than 10 years. The findings of a number of experimental investigations of emissions and their relations to behavioral hearing indicate that OAEs represent one aspect of the cochlear mechanism responsible for the high sensitivity and sharp frequency selectivity exhibited by the human ear. " Basic studies in animals have provided evidence suggesting that OAEs are generated by the outer hair cell system. This hypothesis is supported further by recent in vitro studies demonstrating that outer hair cells demonstrate motile responses when stimulated. A number of investigators have proposed that OAEs can serve as a unique test of cochlear function because of their specificity for outer hair cells along with their objectivity and noninvasiveness. Furthermore, since most OAEs appear to be present in all normal hearing ears of both adults and infants, it has been proposed that these emissions may form the basis of a hearing screening test that would be particularly useful for the early detection of hearing loss, especially in infants and young children.
Increased serum insulin-like growth factor 1 in early idiopathic Parkinson's disease

Objective Insulin-like growth factor 1 (IGF-1) provides protection against loss of dopaminergic neurons in animal models of Parkinson's disease (PD). The aim of this study was to measure serum IGF-1 in patients with PD and assess its correlation with the clinical presentation. Methods Serum IGF-1 and growth hormone (GH) levels were measured in 12 patients with idiopathic PD and 12 matched healthy controls, three times over a period of 6 months after overnight fasting. Based on the results, serum IGF-1 was measured in six additional, yet untreated, PD patients. Results IGF-1 values were stable over the whole period (r=0.83–0.93) in patients and controls. IGF-1 was significantly higher in treated PD patients than in controls at all time points (all p<0.001). There were no significant differences in serum GH levels between patients and controls. Receiver operating characteristics showed a cut-off at 114 ng/ml for differentiation of treated patients and controls (area under the curve=0.90). In the patient group, higher serum IGF-1 levels were correlated with shorter disease duration (r=−0.56, p=0.001). In the healthy control group, higher IGF-1 was correlated with slightly impaired motor performance, as measured by the Unified Parkinson's Disease Rating Scale motor score (r=0.46, p=0.005). In the untreated patient group, serum IGF-1 levels were significantly higher than in healthy controls (p<0.001). Applying the cut-off value of 114 ng/ml, all untreated patients were correctly classified as PD patients. Conclusion Increased IGF-1 might be an interesting serum marker for early PD and potentially for subclinical dopaminergic dysfunction.
Cosensitization to profilin is associated with less severe reactions to foods in nsLTPs and storage proteins reactors and with less severe respiratory allergy

Control and Prevention, Beijing, China Department of Environmental Health Sciences, Yale University School of Public Health, New Haven, CT, USA Department of Immunobiology, Yale University School of Medicine, New Haven, CT, USA Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA Howard Hughes Medical Institute, Yale University, New Haven, CT, USA Email: leyao.wang@wustl.edu
Hyper‐IgE in the allergy clinic––when is it primary immunodeficiency?

The 2017 International Union of Immunological Societies (IUIS) classification recognizes 3 hyper‐IgE syndromes (HIES), including the prototypic Job's syndrome (autosomal dominant STAT3‐loss of function) and autosomal recessive PGM3 and SPINK5 syndromes. Early diagnosis of PID can direct life‐saving or transformational interventions; however, it remains challenging owing to the rarity of these conditions. This can result in diagnostic delay and worsen prognosis. Within increasing access to “clinical‐exome” testing, clinicians need to be aware of the implication and rationale for genetic testing, including the benefits and limitations of current therapies. Extreme elevation of serum IgE has been associated with a growing number of PID syndromes including the novel CARD11 and ZNF341 deficiencies. Variable elevations in IgE are associated with defects in innate, humoral, cellular and combined immunodeficiency syndromes. Barrier compromise can closely phenocopy these conditions. The aim of this article was to update readers on recent developments at this important interface between allergy and immunodeficiency, highlighting key clinical scenarios which should draw attention to possible immunodeficiency associated with extreme elevation of IgE, and outline initial laboratory assessment and management.
Mortality after traumatic spinal cord injury: 50 years of follow-up

Objective To study mortality and causes of death in an unselected geographically defined cohort of patients with traumatic spinal cord injury (TSCI), 1952–2001. Methods Patients were identified from hospital records. The date of death was obtained from the National Population Register, and causes of death recorded by linkage to the Norwegian Cause of Death Registry. Patient mortality was compared with mortality in the Norwegian population using standardised mortality ratios (SMR) adjusted for age and gender. Results 401 patients (70 women and 331 men) were identified. By 31 August 2008, 173 were dead. Median survival time in deceased patients was 7.4 years; 6.9 years for patients with cervical injuries and 8.2 years for patients with thoracolumbosacral injuries (TLS). TSCI patients had an increased mortality (SMR 1.85) compared with the Norwegian population. SMR did not change during the observation period. SMR was significantly higher for women than for men (2.88 vs 1.72), and higher in patients with complete TSCI compared with patients with incomplete TSCI (4.23 vs 1.25). SMR was 6.70 for patients with complete cervical injuries and 3.07 for patients with complete TLS injuries. Cause specific SMR were 1.96 for respiratory disease, and for suicide including accidental poisoning 3.70 for men and 37.59 for women. Conclusions Patients with a TSCI, and especially women, have an increased mortality despite modern treatment and care. Special attention should be paid to respiratory dysfunction and pulmonary infections, and to prevent suicide and accidental poisoning.
The Evolution and Eradication of Infectious Diseases

ABSTRACT Dr. Cockburn is well trained and has had impressive experience with infectious diseases around the world. He describes his book as "a bird's-eye view of the relationships between host, parasite, and environment" and states that a specialist "is likely to find errors and omissions within his special knowledge. "The first chapter, "The Role of Speculation in Research," notes common distrust of "speculation," as, for example, the prejudice (based partly on negative experiments) of malariologists against considering simian malaria important in human disease until the recent demonstration of mosquito transmissibility to humans of Plasmodium vivax-like simian parasites.In chapters on "Evolutionary Background," "Paleoepidemiology," "The Evolution of Infectious Diseases," and "The Species Concept in Microbiology," the author applies principles of evolution and genetics in speculating on the development of pathogenic organisms from originally "free living forms. " He cites the recent discovery of Treponema zuelzerae (which contains "Reiter antigen") as an example