Miracle-dz/UniFAR-FTUs huggingface dataset:
Falls prevention revisited: a call for a new approach.

BACKGROUND Patient falls constitute a major threat to health services' ability to provide care. Previous studies confirm that nurses can identify patients at risk and that a preventative programme can reduce the rate of falls but few studies have been evaluated over time. AIMS AND OBJECTIVES A study was undertaken to test a Falls Prevention Programme in an acute medical area that was re-evaluated 5 years later to determine if the effects were sustainable. DESIGN The design included two groups of patients admitted before and after the programme. Variables such as staffing, equipment, environment and routines were controlled. However, because of ethical approval constraints, some variables such as age, mental status, mobility and gender were not. METHODS The programme included a risk assessment tool, a choice of interventions, a graphic that alerted others to 'at risk patients' and simple patient and staff education. Data were collected using incident forms and a formula was used to calculate a rate of falls. A non-paired t-test compared rates and anova examined the relationship of age, gender, mobility and mental status on the incidence of falls. Control graphs determined the stability of the process. RESULTS The falls rate was significantly reduced. Control graphs demonstrate that the process achieved greater control with less variation. In the next 5 years the falls rate increased to preprogramme levels and control graphs demonstrated that the process was no longer controlled. Compliance with the programme had deteriorated. CONCLUSIONS The practice review considered skill mix, patient activity and acuity but provided no definitive answers to explain non-compliance. The implications to nursing are discussed. RELEVANCE TO CLINICAL PRACTICE Clinicians are called to conduct more rigorous research into falls prevention but it may be more useful to direct research towards examining nursing work and increasing nurse autonomy in falls prevention.
Protective effect of quercetin on liver damage induced by chronic toluene exposure in rats

The aim of this study was to evaluate the possible protective effects of quercetin (QE) on liver injury caused by chronic toluene exposure in rats. The rats were randomly allotted into one of three experimental groups: control, toluene treated and toluene treated with QE; each group contained 10 animals. The control group received 1 ml physiologic serum, and toluene treatment was performed by inhalation of 3000 ppm toluene, for 8 h/day and 6 days/week for 12 weeks. The rats in the QE-treated groups were given QE (15 mg/kg, intraperitoneal) once a day for 12 weeks starting just after toluene exposure. Tissue samples were obtained for histopathological investigation. To date, no histopathological changes in the liver of rats after chronic toluene exposure by QE treatment have been reported. Light microscopic evaluation of liver tissue samples of toluene-exposed rats revealed enlarged sinusoids filled with blood. In addition, some of the hepatocytes showed loss of cytoplasm, and some had a hyperchromatic nucleus. QE treatment attenuated alterations in liver histology. The alpha smooth muscle actin, transforming growth factor beta-positive cells and the activity of terminal deoxynucleotidyl transferase dUTP nick end labeling in the toluene-treated group were observed to be reduced with QE treatment. The data indicate that QE attenuates toluene-induced liver injury, but further investigation is still absolutely necessary.
Gender differences in autoimmune demyelination in the mouse: Implications for multiple sclerosis

Gender‐related differences in experimental allergic encephalomyelitis (EAE) were examined in the SJL mouse with the purpose of characterizing an animal model ideal for the study of gender‐related differences in multiple sclerosis (MS). For the model to allow for study of the induction and the effector phase of disease, the adoptive EAE model was characterized. First, the SJL strain was shown to be nonresponsive with regard to the development of antisyngeneic HY‐specific responses in females, thereby permitting intergender adoptive transfers of T lymphocytes during EAE induction. Then, when myelin basic protein (MBP)‐specific T cells derived from females were adoptively transferred into female and male recipients, female recipients demonstrated a more rapid onset of disease (p = 0.01), greater maximal acutephase clinical scores (p < 0.0001) and greater mean clinical scores (p < 0.0001) compared with male recipients. When MBP‐specific T cells derived from males were adoptively transferred, female recipients again tended to be more severely affected. Histopathologic analysis revealed quantitative differences between genders that paralleled clinical expression. These results document a clear gender‐related difference in adoptive EAE in the SJL, with clinical and histopathologic disease greater in females compared with males. This model will be a useful tool for addressing autoimmune mechanisms underlying gender‐related differences in MS.
Migration and differentiation of neural progenitor cells from two different regions of embryonic central nervous system after transplantation into the intact spinal cord

Transplantation of in vitro‐expanded neural stem cells (NSCs) is a potentially powerful tool to repair functions of the injured spinal cord. A prerequisite for the successful transplantation therapy is identification of optimized experimental parameters that can promote maximal survival, extensive migration and selective differentiation of the transplanted NSC population in the spinal cord. To this end, we evaluated the basic characteristics of NSC‐like cells from two different donor sources, the embryonic hippocampus and spinal cord, after transplantation into the neonatal spinal cord. Proliferation and differentiation phenotypes of both NSC‐like cells can be controlled by the concentration of fibroblast growth factor‐2 (FGF‐2) in vitro. Both NSC‐like cells can survive within the environment of the intact neonatal spinal cord and showed extensive migratory behaviour shortly after transplantation. However, quantitative analysis revealed preferential migration of hippocampus‐derived cells in the dorsal white matter. Both NSC‐like cells showed restricted phenotype toward the oligodendroglial lineage after transplantation. Transplantation of the mixture of two cell types revealed selective survival of hippocampus‐derived NSC‐like cells. This study indicates the possibility of transplanting hippocampus‐derived NSCs to supply the cell source for immature oligodendrocytes, which are thought to be essential for both the myelination and trophic support of regenerating axons in the dorsal white matter of the spinal cord.
Integration of deep bottleneck features for audio-visual speech recognition

Recent interest in “deep learning”, which can be deﬁned as the use of algorithms to model high-level abstractions in data, us-ing models composed of multiple non-linear transformations, has resulted in an increase in the number of studies investigating the use of deep learning with automatic speech recognition (ASR) systems. Some of these studies have found that bottleneck features extracted from deep neural networks (DNNs), sometimes called “deep bottleneck features” (DBNFs), can reduce the word error rates of ASR systems. However, there has been little research on audio-visual speech recognition (AVSR) systems using DBNFs. In this paper, we propose a method of integrating DBNFs using multi-stream HMMs in order to improve the performance of AVSRs under both clean and noisy conditions. We evaluate our method using a continuously spoken, Japanese digit recognition task under matched and mis-matched conditions. Relative word error reduction rates of roughly 68.7%, 47.4%, and 51.9% were achieved, compared with an audio-only ASR system and two feature-fusion models, which employed DBNFs and single-stream HMMs, respectively.
Goblet Cell Population in the Pathological Middle Ear and Eustachian Tube of Children and Adults

On 64 temporal bones from slightly abnormal and pathological prematures and newborn infants, children, and adults, 35,000–40,000 counts of goblet cells were done in different parts of the Eustachian tube and middle ear. The goblet cells were present in all Eustachian tubes and middle ear areas. In ears previously exposed to infection the density was slightly increased in the tubal orifice and in most parts of the middle ear. In subacute and acute pathological actions, especially tubal occlusion, and in chronic diseases, such as active chronic otitis and in secretory otitis media, the goblet-cell density is appreciably increased.
Formation of platelet microaggregates correlates with adverse clinical outcome in patients with coronary artery disease

Summary Platelet activation plays a pivotal role in the pathogenesis of acute coronary syndromes. Laser-light scattering in a platelet aggregometer was used to evaluate aggregate size and number quantitatively. Small platelet aggregates ultimately develop into medium and then large platelet aggregates. Thus the measurement of small platelet aggregates is important in the evaluation of thrombus formation. We examined the relationship between small platelet aggregates and the occurrence of subsequent cardiovascular events. We followed-up 204 patients (149 men and 55 women, mean age 68 ± 9 years) with coronary artery disease (CAD) for 48 months. Blood sampling to determine platelet aggregation was performed on the day of hospital discharge. The degree of small platelet aggregates [relative risk 4.34, 95% confidence interval (1.62-11.7), p = 0.004] and low left-ventricular ejection fraction [relative risk 2.88, 95% confidence interval (1.23-6.73), p = 0.015] were independent predictors of the occurrence of cardiovascular events in multivariate Cox hazard analysis. In Kaplan-Meier analysis, the degree of small platelet aggregates correlated with the probability of cardiovascular event occurrence. In patients with CAD, an increase in small platelet aggregates is closely correlated with the future occurrence of cardiovascular events
2017 ISHNE‐HRS expert consensus statement on ambulatory ECG and external cardiac monitoring/telemetry

Ambulatory ECG (AECG) is very commonly employed in a variety of clinical contexts to detect cardiac arrhythmias and/or arrhythmia patterns which are not readily obtained from the standard ECG. Accurate and timely characterization of arrhythmias is crucial to direct therapies that can have an important impact on diagnosis, prognosis or patient symptom status. The rhythm information derived from the large variety of AECG recording systems can often lead to appropriate and patient‐specific medical and interventional management. The details in this document provide background and framework from which to apply AECG techniques in clinical practice, as well as clinical research.
Lipid peroxidation and antioxidant enzyme activities in erythrocytes of type I and II alcoholics

Reduced and oxidized glutathione (GSH and GSSG), protein‐bound glutathione, lipid peroxidation and antioxidant enzyme activities were determined in the erythrocyte lysates and membranes of type I and II alcoholics in order to clarify the effect of age‐of‐onset and the duration of the alcohol consumption on erythrocyte oxidant and antioxidant status. The osmotic fragility and susceptibility of the erythrocytes to haemolysis were also determined. Erythrocyte lipid peroxidation was significantly increased but, GSH and protein‐bound GSH, GSH/GSSG ratio and antioxidant enzyme activities were markedly decreased in the erythrocytes of the alcoholic subgroups. Erythrocyte count and haemoglobin content in the blood of alcoholics were found to be decreased in accordance with the finding that erythrocytes were more fragile and less resistant to haemolysis particularly in type II alcoholics. The present study showed that ethanol‐induced oxidative stress in erythrocytes can lead to haemolysis and membrane‐specific injuries in erythrocytes of the alcoholic subtypes. Copyright © 2004 John Wiley & Sons, Ltd.
Validation of a System to Predict Recanalization After Endovascular Treatment of Intracranial Aneurysms.

BACKGROUND With increasing use of endovascular techniques in the treatment of ruptured and unruptured aneurysms, the issue of obliteration efficacy has become increasingly important. We have previously reported the Aneurysm Recanalization Stratification Scale, which uses accessible predictors including aneurysm-specific factors (size, rupture, and intraluminal thrombosis) and treatment-related features (treatment modality and immediate angiographic result) to predict retreatment risk after endovascular therapy. OBJECTIVE To assess the external validity of the Aneurysm Recanalization Stratification Scale. METHODS External validity was assessed in independent cohorts from 4 centers in the United States and Canada where endovascular and open neurovascular procedures are performed, and in a multicenter cohort of 1543 patients. Probability of retreatment stratified by risk score was derived for each center and the combined multicenter cohort. RESULTS Despite moderate variability in retreatment rate among centers (29.5%, 9.9%, 9.6%, 26.3%, 19.7%, and 18.3%), the Aneurysm Recanalization Stratification Scale demonstrated good predictive value with C-statistics of 0.799, 0.943, 0.780, 0.695, 0.755, and 0.719 for each center and the combined cohort, respectively. Probability of retreatment stratified by risk score for the combined cohort is as follows: -2, 4.9%; -1, 5.7%; 0, 5.8%; 1, 13.1%; 2, 19.2%; 3, 34.9%; 4, 32.7%; 5, 73.2%; 6, 89.5%; and 7, 100.0%. CONCLUSION Surgical decision-making and patient-centered informed consent require comprehensive and accessible information on treatment efficacy. The Aneurysm Recanalization Stratification Scale is a valid prognostic index. This is the first comprehensive model that has been developed to quantitatively predict retreatment risk following endovascular therapy.
Rhamnolipid Surfactants: An Update on the General Aspects of These Remarkable Biomolecules

Pseudomonas strains are able to biosynthesize rhamnose‐containing surfactants also known as rhamnolipids. These surface‐active compounds are reviewed with respect to chemical structure, properties, biosynthesis, and physiological role, focusing on their production and the use of low‐cost substrates such as wastes from food industries as alternative carbon sources. The use of inexpensive raw materials such as agroindustrial wastes is an attractive strategy to reduce the production costs associated with biosurfactant production and, at same time, contribute to the reduction of environmental impact generated by the discard of residues, and the treatment costs. Carbohydrate‐rich substrates generated low rhamnolipid levels, whereas oils and lipid‐rich wastes have shown excellent potential as alternative carbon sources.
Learning in practice

# Competency based medical training: review {#article-title-2} The competency approach has become prominent at most stages of undergraduate and postgraduate medical training in many countries. In the United Kingdom, for example, it forms part of the performance procedures of the General Medical Council (GMC),1 underpins objectively structured clinical examinations (OSCEs) and records of in-training assessment (RITA), and has been advocated for the selection of registrars in general practice and interviews. 2 3 It has become central to the professional lives of all doctors and is treated as if it were a panacea—but there is little consensus among trainees, trainers, and committees on what this approach entails. I aim to explore the origins and development of the competency approach, evaluate its current role in medical training, and discuss its strengths and limitations. #### Summary points The competency approach did not result directly from recent scandals of incompetent doctors. It originated from parallel developments in vocational training in many countries, such as the national qualifications framework in New Zealand, the national training board in Australia, the national skills standards initiative in the United States, and the national vocational qualifications (NVQs) in the United Kingdom.4 This movement was driven largely by the political perceived need to make the national workforce more competitive in the …
Fair Value and the Missing Correspondence between Accounting and Auditing

Resumen. Se pretende argumentar que la relacion perdida entre contabilidad y auditoria se ha producido porque los supuestos filosoficos basicos de la auditoria no se han desarrollado tanto como sus correspon-dientes en el campo de la contabilidad. En tanto que la contabilidad de valor razonable representa una realidad socialmente construida, la auditoria parece siempre estar fundada en la tradicion positivista de la teoria de la evidencia (Cf. Mautz y Sharaf, 1961; AAA, 1973; Flint, 1988). El resto del trabajo se focaliza en el analisis del problema de la relacion perdida entre contabilidad y auditoria, problema que se ha planteado en la seccion primera. En primer lugar, la siguiente seccion describira brevemente la metodologia utilizada para el analisis. En la tercera seccion se dara una breve descripcion del cambio historico del paradigma principal de la contabilidad, que pasa de informar la verdad a informar en coherencia con los principios de contabilidad generalmente aceptados (PCGA) y los cambios correspondientes en el paradigma principal de la auditoria, desde los tiempos antiguos hasta la auditoria moderna en el siglo XIX, que culmino con la promulgacion de ASOBAC. En la cuarta seccion, se analizan los avances de la ultima o dos
Insider Trading.

Insider Trading is the trading of a company's (A Listed Company in this case) stock or other securities by individuals with potential access to non-public information about the company. Simply put, Insider Trading means buying or selling stocks, bonds or other securities based on significant information that's not available to the general public. Besides creating an uneven playing field that disadvantages regular investors, Insider Trading by corporate officials also violates their responsibility to operate in the best interests of shareholders.
Leisure-time Physical Activity and All-cause Mortality in an Elderly Cohort

Background: Physical activity is one of the mainstays of secondary prevention in people with heart disease. It is not well understood, however, how the presence of heart disease or a history of habitual exercise prior to the study modify any mortality-sparing effects of leisure-time physical activity. Methods: We analyzed data from a well-described cohort of subjects aged 54 years and older at intake (median age, 70 years) from Sonoma, CA, studied between 1993 and 2001 with mortality follow-up until 2003. A history-adjusted marginal structural model was used to obtain counterfactual excess risk estimates that were pooled across the different time points. Additive interaction was examined by comparing these excess risk estimates across strata of age, heart disease, and precohort physical activity. Results: Estimates of the excess risk for 2-year all-cause mortality comparing Centers for Disease Control and Prevention–recommended levels of current physical activity to lower levels of activity ranged from −0.7% to −4.9% among subjects younger than 75 years of age and from −7.8% to −14.8% among older subjects. Heart disease or precohort physical activity were not found to modify the effect of leisure-time physical activity. Conclusions: Our data are consistent with the view that the mortality-sparing effect of recent physical activity is independent of the presence or absence of underlying cardiac disease and the pattern of past physical activity.
Two‐step cell patterning on planar and complex curved surfaces by precision spraying of polymers

Controlling adhesion of living animal cells plays a key role in biosensor fabrication, drug‐testing technologies, basic biological research, and tissue engineering applications. Current techniques for cell patterning have two primary limitations: (1) they require photolithography, and (2) they are limited to patterning of planar surfaces. Here we demonstrate a simple, precision spraying method for both positive and negative patterning of planar and curved surfaces to achieve cell patterns rapidly and reproducibly. In this method, which we call precision spraying (PS), a polymer solution is aerosolized, focused with sheath airflow through an orifice, and deposited on the substrate using a deposition head to create ∼25 µm sized features. In positive patterning, adhesive molecules, such as laminin or polyethylenimine (PEI) were patterned on polydimethylsiloxane (PDMS) substrates in a single spraying operation. A variety of animal cell types were found to adhere to the adhesive regions, and avoid the non‐adhesive (bare PDMS) regions. In negative patterning, hydrophobic materials, such as polytetrafluoroethylene (PTFE) and PDMS, were patterned on glass substrates. Cells then formed patterns on the exposed glass regions and avoided the hydrophobic regions. Cellular patterns were maintained for up to 2 weeks in the presence of serum, which normally fouls non‐adhesive regions. Additionally, we found that precision spraying enabled micropatterning of complex‐curved surfaces. Our results show that precision spraying followed by cell plating enables rapid and flexible cellular micropatterning in two simple steps. © 2005 Wiley Periodicals, Inc.
250 CTG repeats in DMPK is a threshold for correlation of expansion size and age at onset of juvenile–adult DM1

Myotonic dystrophy type 1 (DM1) is associated with an expansion of CTG repeats in the 3′UTR of the DMPK gene. It is accepted, as in other trinucleotide diseases, that the number of the repeats is correlated with age at onset and severity of the disease. However, assessment of genotype–phenotype correlation in DM1 is complicated with the expansion‐biased somatic instability of mutant alleles over time and difficulties in precise assessment of the number of repeats by standard Southern blot hybridization. In order to clarify this issue we defined DM1 expansion size in lymphocytes by three parameters: size of progenitor, average, and largest allele, using a more precise small‐pool/long‐range PCR technique. We found a negative linear correlation of age at onset and average expansion size in juvenile‐adult DM1 patients (35 out of 46) whose progenitor allele is less than 245 repeats long. Our result favors the hypothesis of the existence of a threshold in the progenitor allele size beyond which number of CTG repeats does not influence age at onset. Potential clinical significance is that the average allele size could be a useful indicator for the age at onset in juvenile–adult DM1 patients with relatively short progenitor allele. To test whether somatic instability of mutant alleles influences the progression of DM1, patients were divided in three phenotypic classes according to the severity of neuromuscular symptoms. We showed that the largest expansion in each DM1 phenotypic class reflects somatic instability of mutant allele over time independently of progenitor allele size and patient’s age at sampling. The mean of the largest expansion was significantly different between phenotypic classes, implying the possible association between expansion‐biased somatic instability of mutant alleles over time and progression of neuromuscular symptoms. Hum Mutat 19:131–139, 2002. © 2002 Wiley‐Liss, Inc.