Miracle-dz/UniFAR-FTUs huggingface dataset:
Nursing judgement and decision‐making using the Sedation Withdrawal Score (SWS) in children

AIMS The aim of the study was to evaluate registered children's nurses' approaches to the assessment and management of withdrawal syndrome in children. BACKGROUND Assessment of withdrawal syndrome is undertaken following critical illness when the child's condition may be unstable with competing differential diagnoses. Assessment tools aim to standardize and improve recognition of withdrawal syndrome. Making the right decisions in complex clinical situations requires a degree of mental effort and it is not known how nurses make decisions when undertaking withdrawal assessments. DESIGN Cognitive interviews with clinical vignettes. METHODS Interviews were undertaken with 12 nurses to explore the cognitive processes they used when assessing children using the Sedation Withdrawal Score (SWS) tool. Interviews took place in Autumn 2013. FINDINGS Each stage of decision-making-noticing, interpreting and responding-presented cognitive challenges for nurses. When defining withdrawal behaviours nurses tended to blur the boundaries between Sedation Withdrawal Score signs. Challenges in interpreting behaviours arose from not knowing if the patient's behaviour was a result of withdrawal or other co-morbidities. Nurses gave a range of diagnoses when interpreting the vignettes, despite being provided with identical information. Treatment responses corresponded to definite withdrawal diagnoses, but varied when nurses were unsure of the diagnosis. CONCLUSION Cognitive interviews with vignettes provided insight into nurses' judgement and decision-making. The SWS does not standardize the assessment of withdrawal due to the complexity of the context where assessments take place and the difficulties of determining the cause of equivocal behaviours in children recovering from critical illness.
Ostdeutsche Arbeitskräfte in Westdeutschland

Die Untersuchung zeigt neben einigen Strukturmerkmalen der 1,2 Mio. ostdeutschen Arbeitskrafte in Westdeutschland deren regionale Verteilung nach Arbeitsamtsbezirken, ihre Verteilung auf die wichtigsten Branchen sowie auf Betriebe nach Betriebsgrosenklassen. Hierzu wurden Daten der Beschaftigtenstatistik der Bundesanstalt fur Arbeit und des Zentralen Einwohnermelderegisters von Berlin (ZER) verwendet. Es wird festgestellt, das die hochsten Zahlen ostdeutscher Abwanderer und Pendler in den Grosstadtbezirken Berlin, Nurnberg, Munchen und Stuttgart sowie an der ehemaligen DDR-Grenze zu finden sind. Eine Kombination der (relativen) Zustrome mit der in der Region beobachteten Entwicklung von Beschaftigung und Arbeitslosigkeit last jene Gebiete erkennen, in denen ostdeutsche Arbeitskrafte vorwiegend zur Beseitigung der Arbeitskrafteknappheit beitrugen, ohne einen besonderen Angebotsdruck zu verursachen. Andererseits lassen sich aber auch jene Gebiete identifizieren, in denen eine Ausweitung der Beschaftigung bei hohen Zustromzahlen mit einem Anstieg der Arbeitslosigkeit verbunden ist. Ahnliche Effekte findet man in den aufnehmenden Wirtschaftszweigen: Hier gibt es welche (z.B. das Friseur- und Korperpflegegewerbe), die bei schrumpfender Gesamtbeschaftigung eine grose Zahl ostdeutscher Arbeitskrafte eingestellt haben, und andere (z.B. Kreditinstitute und Versicherungsgewerbe), wo die Ausweitung der Beschaftigung um ein Vielfaches uber den Einstellungen Ostdeutscher liegt. Das Arbeitskraftemangel primar ein Problem von Klein- und Mittelbetrieben ist, wird durch die Verteilung der einpendelnden und zugewanderten ostdeutschen Arbeitskrafte uberwiegend auf diese Betriebe bestatigt. Dieses Ergebnis weist auf ein uberdurchschnittlich hohes Arbeitsplatzrisiko ostdeutscher Arbeitskrafte hin; denn Klein- und Mittelbetriebe reagieren deutlich schneller und starker auf konjunkturelle Schwankungen. (IAB2)
Product Portfolio and Mobile Apps Success: Evidence from App Store Market

This research empirically analyzes seller’s product portfolio strategy in the mobile application (apps) market. We use crosssectional data on the most downloaded application rankings in the Apple App Store to examine the impact of app portfolio strategy on sales performance. We find that app portfolio diversification is positively correlated with sales performance. We also find that sellers who offer a combination of free and paid apps have higher sales performance than those who deliver paid apps only. Furthermore, the results show that sellers with scale advantages compete differently from sellers in the long tail. These findings have implications for theorizing about product portfolio management in the emerging mobile app store markets.
Energy expenditure of soldiers in a warm humid climate

1. Energy expenditure determinations have been made on thirty-two soldiers newly arrived in the warm humid climate of southern Malaya. Ergometer cycling was investigated as well as everyday activities such as lying, sitting, riding in a trunck, abultions, buildings a jungle camp and walking with loads over four different routes. 2. The inter-individual variation in the gross energy expenditure (kcal/min and kJ/min) of each activity has been compared with the variation in energy expenditure standardized for body-weight, surface area and lean body mass. Standardization for body size did not consistently or effectively reduce the coefficients of variation of energy expenditure. 3. The gross energy expenditure of most activities was significantly correlated with bodyweight, surface area or lean body mass but the correlation coefficients were not of a high order, suggesting that less than 41% of the inter-individual variation in energy expenditure was accounted for by variation in body size. 4. The energy expenditure of walking at various speeds over both firm and uneven terrain was related to the square of the walking speed and the total weight of the man and his equipment (correlation coefficients 0.89–0.92, P < 0.001).
Root nodulation of Sesbania rostrata

The tropical legume Sesbania rostrata can be nodulated by Azorhizobium caulinodans on both its stem and its root system. Here we investigate in detail the process of root nodulation and show that nodules develop exclusively at the base of secondary roots. Intercellular infection leads to the formation of infection pockets, which then give rise to infection threads. Concomitantly with infection, cortical cells of the secondary roots dedifferentiate, forming a meristem which has an "open-basket" configuration and which surrounds the initial infection site. Bacteria are released from the tips of infection threads into plant cells via "infection droplets," each containing several bacteria. Initially, nodule differentiation is comparable to that of indeterminate nodules, with the youngest meristematic cells being located at the periphery and the nitrogen-fixing cells being located at the nodule center. Because of the peculiar form of the meristem, Sesbania root nodules develop uniformly around a central axis. Nitrogen fixation is detected as early as 3 days following inoculation, while the nodule meristem is still active. Two weeks after inoculation, meristematic activity ceases, and nodules then show the typical histology of determinate nodules. Thus, root nodule organogenesis in S. rostrata appears to be intermediate between indeterminate and determinate types.
Variation of Soil Microbial Population in Different Soil Horizons

Large diversity of micro flora and fauna are found in soil horizons. Microbial population in soil are determined by various factor such as soil depth, organic matter, porosity, oxygen and carbon dioxide concentration, soil PH, etc. Factors that influence microorganism role in nutrient building and cycling in soil and organic matter decomposition are of unique interest. Microorganisms decompose organic matter, detoxifying the toxic substance, fixing the nitrogen, transformation of nitrogen, phosphorous, potassium and other secondary & micro nutrients are the major biochemical activities performed by microbes in soil. Low population of microorganism is found in the compact soil, soil with low organic matter percentage and on deeper strata of soil. So, this paper was reviewed to explore major factors that influence soil microbial population and its role in soil productivity. This was already established fact but main aim of this paper is to collect related information and conclude the future research prospects to strengthen the microorganism role in soil productivity and factor that influence growth of microorganism.
Diabetes Mellitus After Kidney Transplantation in the United States

I read with interest the report by Kasiske et al. concerning an analysis of new-onset diabetes mellitus, based on data from the United Renal Data System (1). The authors’ analysis of risk factors for new-onset diabetes and its clinical implications provides valuable evidence on this important issue, and highlights the need for management strategies that minimize risk of diabetes developing after transplantation. Their results concerning the incidence of new-onset diabetes and the increased relative risk of diabetes associated with tacrolimus-based immunosuppression are broadly in line with our own findings (2).
Hepatic lipid accumulation in healthy subjects: A comparative study using spectral fat‐selective MRI and volume‐localized 1H‐MR spectroscopy

Fat‐selective MRI was applied to assess the amount and spatial distribution of hepatic lipids (HL) in healthy subjects. The results were compared with those obtained by localized 1H‐MR spectroscopy (MRS). Ninety subjects (23–63 years old) underwent single‐slice fat‐selective MRI with spatial‐spectral excitation and volume‐localized spectroscopy at 1.5 T. HLs were analyzed in ventral and dorsal regions of interest (ROIs) of the liver in fat‐selective images. Spectra were evaluated using the integral signal of methylene and methyl signals. The fat‐selective images showed smooth and homogeneous distribution of HL over the entire cross section of the liver. There was, however, a marked interindividual variability in the amount of HL. MRS revealed a lipid signal fraction between 0.5% and 39.3%. The fat content in the ROIs in images correlated well with the spectroscopic results (r ≥ 0.95). Both techniques provide sufficient sensitivity for a reliable and quantitative assessment of liver steatosis in subjects without liver disease. 1H‐MRS has a higher sensitivity compared to MRI, especially for small amounts of HL, which may be of interest for metabolic interventions. Fat‐selective images provide more spatial information about fat distribution, which makes this technique suitable for clinical imaging of patients with liver disease. Magn Reson Med, 2006. © 2006 Wiley‐Liss, Inc.
The SF-36 Health Status Questionnaire in Assessing Patients with Epistaxis Secondary to Hereditary Hemorrhagic Telangiectasia

Background This study assesses the ability of the short form 36 (SF-36), a validated health status survey, to measure the health of patients with epistaxis due to hereditary hemorrhagic telangiectasia (HHT). Methods Thirty-eight patients completed the SF-36 and symptom-specific questionnaires. They were asked to rate their epistaxis as severe, moderate, or mild. The SF-36 data are compared with a reference population and analyzed with respect to the subgroups. Results The scores for each dimension of health were significantly reduced (p < 0.05) when compared with the reference population for all dimensions except pain. When compared with the patients’ ratings of severity, a significant correlation was detected in five dimensions (p < 0.05). Conclusion The SF-36 reflects the reduced health status of patients with epistaxis due to HHT. Changes in the SF-36 score could be used as an outcome measure in assessing efficacy of treatment of this condition.
Experimental parasite community ecology: intraspecific variation in a large tapeworm affects community assembly.

Non-random species associations occur in naturally sampled parasite communities. The processes resulting in predictable community structure (e.g. particular host behaviours, cross-immunity, interspecific competition) could be affected by traits that vary within a parasite species, like growth or antigenicity. We experimentally infected three-spined sticklebacks with a large tapeworm (Schistocephalus solidus) that impacts the energy needs, foraging behaviour and immune reactions of its host. The tapeworms came from two populations, characterized by high or low growth in sticklebacks. Our goal was to evaluate how this parasite, and variation in its growth, affects the acquisition of other parasites. Fish infected with S. solidus were placed into cages in a lake to expose them to the natural parasite community. We also performed a laboratory experiment in which infected fish were exposed to a fixed dose of a common trematode parasite. In the field experiment, infection with S. solidus affected the abundance of four parasite species, relative to controls. For two of the four species, changes occurred only in fish harbouring the high-growth S. solidus; one species increased in abundance and the other decreased. These changes did not appear to be directly linked to S. solidus growth though. The parasite exhibiting elevated abundance was the same trematode used in the laboratory infection. In that experiment, we found a similar infection pattern, suggesting that S. solidus affects the physiological susceptibility of fish to this trematode. Associations between S. solidus and other parasites occur and vary in direction. However, some of these associations were contingent on the S. solidus population, suggesting that intraspecific variability can affect the assembly of parasite communities.
Asymmetrical spondylolysis.

The objective of this study was to examine examples of spondylolysis in which the pattern of separation was clearly asymmetrical, in order to learn more about the process of bone separation that produces this condition. Although the primary focus was on unilateral complete separation, examples of asymmetry represented by incomplete separation and by complete bilateral separation where the separation sites are in different locations on the two sides were included. Two collections were used, one consisting of Canadian Inuit skeletons curated at the Canadian Museum of Civilization, and the other of 48 individual examples of asymmetrical spondylolysis from sites in a variety of localities curated by several different institutions. The first collection was studied primarily to observe early manifestations of spondylolysis, particularly incomplete separation, while various patterns of asymmetrical complete separation were the focus of the second. The results indicate that asymmetry is part of the earliest osteological picture of spondylolysis, with right-sidedness predominating, a condition perhaps related in some way to handedness. The right-side predominance appears to decrease with age. The ratio of unilateral to bilateral separation ranges from 3-33% in different studies, and a significant number of the unilateral separations have spina bifida occurring in the same vertebra. Overall, the specimens examined here, considered along with clinical cases, nicely illustrate a progression of spondylolysis. A unilateral separation may heal, it may progress to bilateral separation, or it may remain as a permanent condition, producing a pattern of degenerative changes that can include spondylolisthesis. A unilateral healing of bilateral complete separation is likely a rare phenomenon, at least after the separations have reached a certain level of maturity.
Risk of treatment-related mortality with sorafenib in patients with cancer.

BACKGROUND Fatal adverse events (FAEs) have been reported with sorafenib, a vascular endothelial growth factor receptor kinase inhibitor (VEGFR TKI). We here performed an up-to-date and detailed meta-analysis to determine the overall risk of FAEs associated with sorafenib. METHODS Databases, including PubMed, Embase and Web of Science, and abstracts presented at the American Society of Clinical Oncology annual meetings were searched to identify relevant studies. Eligible studies included randomized controlled trials evaluating sorafenib effects in patients with all malignancies. Summary incidence rates, relative risks (RRs), and 95% confidence intervals (CIs) were calculated for FAEs. In addition, subgroup analyses were performed according to tumor type and therapy regimen. RESULTS 13 trials recruiting 5,546 patients were included in our analysis. The overall incidence of FAEs with sorafenib was 1.99% (95%CI, 0.98-4.02%). Patients treated with sorafenib had a significantly increased risk of FAEs compared with patients treated with control medication, with an RR of 1.77 (95%CI 1.25-2.52, P=0.001). Risk varied with tumour type, but appeared independent of therapy regimen. A significantly increased risk of FAEs was observed in patients with lung cancer (RR 2.26; 95% CI 1.03-4.99; P= 0.043) and renal cancer (RR 1.84; 95% CI 1.15-2.94; P= 0.011). The most common causes of FAEs were hemorrhage (8.6%) and thrombus or embolism (4.9%). CONCLUSIONS It is important for health care practitioners to be aware of the risks of FAEs associated with sorafenib, especially in patients with renal and lung cancer.
Transient expression in Nicotiana benthamiana for rapid functional analysis of genes involved in non‐photochemical quenching and carotenoid biosynthesis

Summary Plants must switch rapidly between light harvesting and photoprotection in response to environmental fluctuations in light intensity. This switch can lead to losses in absorbed energy usage, as photoprotective energy dissipation mechanisms can take minutes to hours to fully relax. One possible way to improve photosynthesis is to engineer these energy dissipation mechanisms (measured as non‐photochemical quenching of chlorophyll a fluorescence, NPQ) to induce and relax more quickly, resulting in smaller losses under dynamic light conditions. Previous studies aimed at understanding the enzymes involved in the regulation of NPQ have relied primarily on labor‐intensive and time‐consuming generation of stable transgenic lines and mutant populations – approaches limited to organisms amenable to genetic manipulation and mapping. To enable rapid functional testing of NPQ‐related genes from diverse organisms, we performed Agrobacterium tumefaciens‐mediated transient expression assays in Nicotiana benthamiana to test if NPQ kinetics could be modified in fully expanded leaves. By expressing Arabidopsis thaliana genes known to be involved in NPQ, we confirmed the viability of this method for studying dynamic photosynthetic processes. Subsequently, we used naturally occurring variation in photosystem II subunit S, a modulator of NPQ in plants, to explore how differences in amino acid sequence affect NPQ capacity and kinetics. Finally, we functionally characterized four predicted carotenoid biosynthesis genes from the marine algae Nannochloropsis oceanica and Thalassiosira pseudonana and examined the effect of their expression on NPQ in N. benthamiana. This method offers a powerful alternative to traditional gene characterization methods by providing a fast and easy platform for assessing gene function in planta.
Tiny giants of gene regulation: experimental strategies for microRNA functional studies

The discovery over two decades ago of short regulatory microRNAs (miRNAs) has led to the inception of a vast biomedical research field dedicated to understanding these powerful orchestrators of gene expression. Here we aim to provide a comprehensive overview of the methods and techniques underpinning the experimental pipeline employed for exploratory miRNA studies in animals. Some of the greatest challenges in this field have been uncovering the identity of miRNA–target interactions and deciphering their significance with regard to particular physiological or pathological processes. These endeavors relied almost exclusively on the development of powerful research tools encompassing novel bioinformatics pipelines, high‐throughput target identification platforms, and functional target validation methodologies. Thus, in an unparalleled manner, the biomedical technology revolution unceasingly enhanced and refined our ability to dissect miRNA regulatory networks and understand their roles in vivo in the context of cells and organisms. Recurring motifs of target recognition have led to the creation of a large number of multifactorial bioinformatics analysis platforms, which have proved instrumental in guiding experimental miRNA studies. Subsequently, the need for discovery of miRNA–target binding events in vivo drove the emergence of a slew of high‐throughput multiplex strategies, which now provide a viable prospect for elucidating genome‐wide miRNA–target binding maps in a variety of cell types and tissues. Finally, deciphering the functional relevance of miRNA post‐transcriptional gene silencing under physiological conditions, prompted the evolution of a host of technologies enabling systemic manipulation of miRNA homeostasis as well as high‐precision interference with their direct, endogenous targets. WIREs Dev Biol 2016, 5:311–362. doi: 10.1002/wdev.223
The frequency and nature of sleep disorders in a community‐based population of patients with Parkinson’s disease

Sleep disturbances in Parkinson’s disease (PD) are a common problem. The aim of this study was to detail the frequency and nature of sleep disorders in a representative population of PD patients. A recently identified prevalent population, consisting of 161 PD patients were used as a representative population. Twenty‐seven of 122 (22%) patients were identified as having marked sleep disorders, with sleep fragmentation and nocturia being the most commonly reported problems. Sleep scores worsened with higher Hoehn and Yahr stages. Sleep disturbances are a relatively common complication of PD and worsen with increasing Hoehn and Yahr stage.
Serum‐induced monocyte differentiation and monocyte chemotaxis are regulated by the p38 MAP kinase signal transduction pathway

Regulation by the p38 mitogen‐activated protein (MAP) kinase signaling pathway of monocytic inflammatory functions was evaluated using L‐790,070, a potent and selective inhibitor of p38 MAP kinase. Three major functions of monocytes were investigated: differentiation, chemotaxis, and phagocytosis. L‐790,070 inhibited serum‐induced monocyte differentiation with an IC50 of 0.5 nM. Monocyte chemotaxis induced by RANTES, macrophage inflammatory protein‐1α (MIP‐1α), monocyte chemotactic protein‐1 (MCP‐1), and fMLP were all sensitive to L‐790,070. When titrated, L‐790,070 inhibited MCP‐1‐induced chemotaxis in a concentration‐dependent manner with an IC50 of 0.3 nM. However, the ability of serum‐derived macrophages to phagocytose apoptotic neutrophils was unaffected by L‐790,070. The concentration with which L‐790,070 inhibited both differentiation and chemotaxis was similar to that necessary to inhibit p38 MAP kinase activation of MAPKAP kinase (0.3 nM) in response to stimulation by lipopolysaccharide. Therefore, the data in this report suggest that the mechanism by which L‐790,070 blocked monocyte differentiation and prevented chemotaxis was by inhibiting p38 MAP kinase activity. J. Leukoc. Biol. 67: 869–875; 2000.