Miracle-dz/UniFAR-FTUs huggingface dataset:
Distributed leadership, team working and service improvement in healthcare.

PURPOSE The purpose of this paper is to analyse the introduction of distributed leadership and team working in a therapy department in a healthcare organisation and to explore the factors that enabled the introduction to be successful. DESIGN/METHODOLOGY/APPROACH This paper used a case study methodology. Qualitative and quantitative information was gathered from one physiotherapy department over a period of 24 months. FINDINGS Distributed leadership and team working were central to a number of system changes that were initiated by the department, which led to improvements in patient waiting times for therapy. The paper identifies six factors that appear to have influenced the successful introduction of distributed learning and team working in this case. RESEARCH LIMITATIONS/IMPLICATIONS This is a single case study. It would be interesting to explore whether these factors are found in other cases where distributed leadership is introduced in healthcare organisations. PRACTICAL IMPLICATIONS The paper provides an example of successful introduction of distributed leadership, which has had a positive impact on services to patients. Other therapy teams may consider how the approach may be adopted or adapted to their own circumstances. ORIGINALITY/VALUE Although distributed leadership is thought to be important in healthcare, particularly when organisational change is needed, there are very few studies of the practicalities of how it can be introduced.
Muramyl tripeptide (mifamurtide) for the treatment of osteosarcoma

Osteosarcoma is an ultraorphan disease. There are approximately 1000 new patients diagnosed with osteosarcoma each year in the USA and Europe. Current treatment for osteosarcoma utilizes multiagent chemotherapy and surgical resection of all clinically detectable disease. Current treatments for osteosarcoma achieve 60–70% event-free survival (EFS) for patients with localized disease and approximately 20% EFS for patients who present with metastasis. These results have been stable for two decades. The addition of muramyl tripeptide (mifamurtide) to chemotherapy resulted in a trend towards improved EFS and a one-third reduction in the risk of death from osteosarcoma. Mifamurtide has been approved in Europe for the treatment of newly diagnosed osteosarcoma in combination with chemotherapy.
Lung cancer: histology, staging, treatment and survival.

OBJECTIVE To analyze principal histological types of lung cancer, as well as the staging, treatment and survival of lung cancer patients. METHODS This was a retrospective study based on the analysis of medical charts of patients treated at the Botucatu School of Medicine Hospital das Clínicas over a six-year period. RESULTS From January of 2000 to January of 2006, 240 patients with lung cancer, most (64%) of whom were male, were treated. The most common histological type was squamous cell carcinoma (37.5%), followed by adenocarcinoma (30%), neuroendocrine carcinoma (19.6%) and large cell carcinoma (6.6%). Only 131 patients (54.6%) were treated. Of those, 52 patients (39.7%) received only chemotherapy, 32 (24.4%) were treated with chemotherapy combined with radiotherapy, and 47 (35.9%) were submitted to surgery alone or surgery accompanied by chemotherapy, with or without radiotherapy. Only 27 patients (20.6%) were submitted to surgery alone. Concerning staging, 34.4% presented stage IV at the time of diagnosis, 20.6% presented stage IIIB, 16.8% presented stage IIIA, and the remaining 28.2% were classified as stage I or II. Five-year survival was 65% for those in stage I and 25% for those in the remaining stages. CONCLUSIONS Of the various histological types, the most common was squamous cell carcinoma and the least common was large cell carcinoma. Most cases presented advanced stages at the moment of diagnosis, and less than 30% of the cases presented early stages. This accounts for the low survival rate and the small number of patients submitted to surgical treatment alone, the majority being submitted to chemotherapy alone.
An Investigation of the Relationship among Tunneling, Asymmetric Information and Discount of Private Placement: Evidence from China

The paper develops a model of private placement, then explores the discount of private placement under the control of controlling shareholder and how to influence company's value. We find that private placement is used to a mechanism for tunneling, Whether and how much to tunnel may depend on the discount and the percentage of private placement which purchased by the controlling shareholder. At the same time, asymmetric information has an important influence on the discount of private placement, and the discount is larger when it exists more asymmetric information.
Night-shift work and breast cancer--a systematic review and meta-analysis.

OBJECTIVE The aim of this review was to synthesize the evidence on the potential relationship between nightshift work and breast cancer. METHODS We searched multiple databases for studies comparing women in shift work to those with no-shift work reporting incidence of breast cancer. We calculated incremental risk ratios (RR) per five years of night-shift work and per 300 night shift increases in exposure and combined these in a random effects dose-response meta-analysis. We assessed study quality in ten domains of bias. RESULTS We identified 16 studies: 12 case-control and 4 cohort studies. There was a 9% risk increase per five years of night-shift work exposure in case-control studies [RR 1.09, 95% confidence interval (95% CI) 1.02-1.20; I (2) = 37%, 9 studies], but not in cohort studies (RR 1.01, 95% CI 0.97-1.05; I (2) = 53%, 3 studies). Heterogeneity was significant overall (I (2) = 55%, 12 studies). Results for 300 night shifts were similar (RR 1.04, 95% CI 1.00-1.10; I (2) = 58%, 8 studies). Sensitivity analysis using exposure transformations such as cubic splines, a fixed-effect model, or including only better quality studies did not change the results. None of the 16 studies had a low risk of bias, and 6 studies had a moderate risk. CONCLUSIONS Based on the low quality of exposure data and the difference in effect by study design, our findings indicate insufficient evidence for a link between night-shift work and breast cancer. Objective prospective exposure measurement is needed in future studies.
Delineation of lateral tentorial sinus with contrast-enhanced MR imaging and its surgical implications.

BACKGROUND AND PURPOSE The lateral tentorial sinus (LTS) has not been well described in the imaging literature. The aim of this study was to investigate the value of MR imaging in assessing the LTS, which may provide guidance for preoperative planning. METHODS Fifty-five adult patients underwent MR imaging of the brain. Four neuroradiologists evaluated the studies for delineation of the LTS and its branches. Presence of arachnoid granulation and dominance of the venous drainage also were reported. RESULTS An LTS was detected in 104 of 110 lobes. The LTS in each lobe was classified as type I (candelabra) in 30 (28.8%), type II (independent veins) in 22 (21.1%), and type III (venous lakes) in 37 (35.5%); in 15 (14.4%) of the lobes, the LTS was indeterminate. LTS branches were inconsistently detected, with the exception of the vein of Labbé (VL). Five of eight branches were seen in approximately half of the cases. The VL was identified in 94 (85.4%) lobes. Among these, 53 (56.4%) were draining into the LTS and 22 (23.4%) into the transverse sinus; in 19 (20.2%) cases, the terminal portion was not visualized. The right transverse sinus was dominant in 19 (34.5%) patients and the left in 18 (32.7%); codomination was present in 18 (32.7%) cases. At least one arachnoid granulation was seen in the transverse sinus in 27 (49.1%) patients. CONCLUSION In many instances, the LTS and VL drainage patterns were well delineated on routine MR images. For selected cases, this information may be crucial during lateral skull base surgery to avoid venous infarct.
Familial tumoral calcinosis is characterized by ectopic calcifications and hyperphosphatemia due to inactivating mutations in FGF 23 or UDP-N-acetyl-α-D-galactosamine : polypeptide

1Department of Medicine and 2Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA. 3Division of Endocrinology, Children’s Memorial Hospital, Chicago, Illinois, USA. 4Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA. 5Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, USA. 6Department of Pharmacology, New York University School of Medicine, New York, New York, USA.
Older Women’s Response to Residential Relocation: Description of Transition Styles

Older women relocating to institutional facilities are at risk for negative outcomes such as poorer health, decreased self-esteem, increased sense of social isolation and loneliness, loss of social support, and depression. However, little is known about relocation to congregate living facilities (CLF), the relocation transition process, or factors that contribute to outcomes. The perspectives of 31 women on their relocation experiences to CLF were elicited using a naturalistic approach. The Schumacher & Meleis nursing model of transitions was used to focus the study. Three distinct relocation transition styles emerged: Full Integration (45%), Partial Integration (42%), and Minimal Integration (13%). By understanding the characteristics and risk factors of relocation, unhealthy outcomes can be minimized and healthy outcomes promoted.
Prediction of improvement in left ventricular function with iodine-123-IPPA after coronary revascularization.

UNLABELLED Iodine-123-phenylpentadecanoic acid (IPPA) is a synthetic fatty acid suitable for myocardial imaging. This study is the result of a Phase I/II trial to evaluate IPPA's ability to predict functional recovery in patients undergoing coronary revascularization. METHODS Twenty-three patients with documented coronary disease underwent sequential SPECT imaging with IPPA before and radionuclide ventriculography both before and 8 wk after revascularization. Software was developed to evaluate myocardial IPPA metabolism and to determine the fraction of the left ventricle with intermediate metabolism. RESULTS There was a significant correlation between initial IPPA uptake and final LVEF. The fractional area of the left ventricle demonstrating IPPA metabolism in the intermediate metabolic range was significantly higher in patients who demonstrated a 5% or greater increase in EF after revascularization (0.90 +/- 0.08 versus 0.78 +/- 0.17, p = 0.04). When only the patients who received complete revascularization were evaluated, there was a more significant difference (improved 0.92 +/- 0.05 versus 0.74 +/- 0.17, p = 0.011). Taking a lower limit of 1 s.d. from the mean, (87%) the six patients who had > or = 5% increase in LVEF after revascularization had more than 87% of the left ventricle in the intermediate metabolic range, whereas seven of ten patients whose change in LVEF was < 5% had less than 87% in the intermediate metabolic range (p = 0.011). CONCLUSION In this initial experience, the amount of myocardium in the intermediate metabolic range is associated with improvement in LVEF after revascularization, especially in patients receiving complete revascularization.
Trajectory-Based Tissue Engineering for Cartilage Repair : Impact of Maturation State and Rate on Integration Potential

Introduction Given the limitations of current surgical approaches to treat articular cartilage injuries, tissue engineering (TE) approaches have been aggressively pursued over the past two decades. Critical biochemical and biomechanical properties on the order of native tissue have been achieved in a variety of TE contexts. However, several in-vitro and in-vivo studies indicate that increased tissue maturity may limit the ability of engineered constructs to remodel and integrate with surrounding cartilage, although results from individual studies are highly variable. We recently introduced the concept of “trajectorybased” tissue engineering (TB-TE), which is based on the general hypothesis that time-dependent increases in construct maturation in-vitro prior to implantation (i.e. positive rates) may provide a better predictor of in-vivo success rather than “static” measures of construct maturation state. As a first step toward evaluating this concept, we hypothesized that time-dependent increases in the biochemical and biomechanical properties of TE constructs (a metric of growth) would correlate with their ability to integrate to cartilage. To test this hypothesis, the current objective was to determine and model the time course of maturation of TE constructs during in-vitro culture and to assess their ability to integrate to cartilage at various points during maturation.
N-acetylcysteine improves morphologic and functional aspects of ovarian grafts in rats.

PURPOSE To evaluate morphological and functional aspects of the ovarian graft in transplanted rats treated with NAC. METHODS Female Wistar rats, virgin, 3 to 4 months old, weighing 200-250 grams were used in experiments. The rats have been kept in proper sanitary conditions, receiving food and water ad libitum. Five groups (n=10, each) were constituted: 4 groups treated subcutaneously with NAC, at doses of 150, 300, 600 and 1200 mg/kg (NAC150, NAC300, NAC600 and NAC1200, respectively), one hour of before the ovarian transplantation and control group (GTx) - treated with physiological solution and submitted to ovarian transplantation. The rats were anesthetized and submitted to autologous left ovarian transplantation, without anastomosis in retroperitoneum, and contralateral oophorectomy. During follow-up of 4 or 15 days, the estrous cycle was evaluated by vaginal smears to determine cycle regularity. At the end of 4th or 15th days, rats were re-anesthetized and blood and graft were obtained to estradiol analysis and morphological assessment. Data were analysed by One Way Analysis of Variance (ANOVA) or ANOVA on ranks complemented by Student-Newman-Keuls test. RESULTS At 4th day, viable follicles in the graft did not altered by NAC treatments. The NAC300 and NAC600 groups showed increasing in follicle atresia (p=0.012) compared to GTx and NAC1200 group. At 15th day, 50% of GTx, NAC150, and NAC300 rats showed regular oestrous cycle; 83% of NAC600 and 100% of NAC1200 rats returned to regular cycle. NAC1200 group showed increasing in primordial follicle compared to GTx, NAC150 or NAC300 (p=0.011). NAC did not interfere in estradiol levels after 4 or 15 days of transplantation. CONCLUSION In autologous ovarian transplantation, high dose of NAC promotes graft viability with recovery of estrous cycle.
Loss of CD20 and Bound CD20 Antibody from Opsonized B Cells Occurs More Rapidly Because of Trogocytosis Mediated by Fc Receptor-Expressing Effector Cells Than Direct Internalization by the B Cells

We previously reported that 1 h after infusion of CD20 mAb rituximab in patients with chronic lymphocytic leukemia (CLL), >80% of CD20 was removed from circulating B cells, and we replicated this finding, based on in vitro models. This reaction occurs via an endocytic process called shaving/trogocytosis, mediated by FcγR on acceptor cells including monocytes/macrophages, which remove and internalize rituximab–CD20 immune complexes from B cells. Beers et al. reported that CD20 mAb-induced antigenic modulation occurs as a result of internalization of B cell-bound mAb–CD20 complexes by the B cells themselves, with internalization of ∼40% observed after 2 h at 37°C. These findings raise fundamental questions regarding the relative importance of shaving versus internalization in promoting CD20 loss and have substantial implications for the design of mAb-based cancer therapies. Therefore, we performed direct comparisons, based on flow cytometry, to determine the relative rates and extent of shaving versus internalization. B cells, from cell lines, from patients with CLL, and from normal donors, were opsonized with CD20 mAbs rituximab or ofatumumab and incubated for varying times and then reacted with acceptor THP-1 monocytes to promote shaving. We find that shaving induces considerably greater loss of CD20 and bound mAb from opsonized B cells in much shorter time periods (75–90% in <45 min) than is observed for internalization. Both shaving/trogocytosis and internalization could contribute to CD20 loss when CLL patients receive rituximab therapy, but shaving should occur more rapidly and is most likely to be the key mechanism of CD20 loss.
Pulmonary Vein Antrum Isolation:

Several techniques are used for AF ablation, but no general consensus exists as to which technique is the most effective. At our center, we have developed a technique for isolating the pulmonary veins (PVs) at their antrum. The technique is guided by intracardiac echocardiography (ICE) and mapping with a circular (Lasso) catheter. Our technique was developed based on four crucial principles:
Cost-effectiveness of primarily human papillomavirus–based cervical cancer screening in settings with currently established Pap screening: A systematic review commissioned by the German Federal Ministry of Health

Objectives: The aim of this study was to summarize the current evidence for the cost-effectiveness of primarily human papillomavirus (HPV) -based cervical cancer screening in settings with already established Papanicolaou test (Pap) programs. Emphasis was placed on the German situation with annual Pap screening. Methods: Medical, economic, and health technology assessment (HTA) databases were systematically searched for cost-effectiveness studies comparing HPV to Pap screening. Study data were extracted, standardized, and summarized in cost-effectiveness plots contrasting HPV strategies to Pap screening with 1-, 2-, 3-, and 5-years interval. For each Pap setting, the likelihood of cost-effective HPV screening was assessed depending on willingness-to-pay. Results: We reviewed twelve decision-analytic cost-effectiveness models. Study results showed wide variation due to methodical heterogeneity. Data synthesis revealed that the cost-effectiveness of HPV screening depends on the interval of the established Pap screening strategy. In comparison with Pap screening every 2 years, only 25 percent of the HPV-based screening strategies were cost-effective. However, in comparison with Pap screening every 1, 3, or 5 years, 83 percent, 55 percent, and 92 percent of HPV screening strategies were cost-effective, respectively. Results for settings with annual Pap screening are based on models assuming 100 percent screening coverage. Conclusions: The introduction of HPV-based screening programs is cost-effective if the screening interval of the established Pap program exceeds 2 years. In settings with biennial Pap screening, introduction of HPV-based screening is unlikely to be cost-effective. Results also suggest cost-effectiveness of HPV-based screening in settings with annual Pap screening; however, this finding should be confirmed under realistic screening adherence assumptions.
A Wideband LNA for Wireless Multistandard Receiver in l30nm CMOS SOI Process

This paper presents a wide-band multi-standard CMOS SOI LNA architecture for wireless applications, such as GSM, DCS, WCDMA, Bluetooth and 802.11b,g WLAN. The target frequency band extends from 900 MHz to 2.5 GHz. The LNA, integrated in a 130nm CMOS SOI process, exhibits a simulated power gain of 17 dB with an input return loss of 10 dB over the band, a minimum noise figure of 2.2dB at 900 MHz, 1.9dB at 1800 MHz, 2dB at 2.1 GHz, 2.3dB at 2.5 GHz respectively, an IIP3 in band of -5dBm. The core circuit consumes 13 mA from a 1.2V supply voltage
EXTRACTION AND ANALYSIS OF CONDENSED TANNINS IN CASTANEA SATIVA MILL.

Proanthocyanidins, also known as condensed tannins are widespread in woody plants, but are also found in certain forages. Castanea sativa Mill. are exploited for various purposes, but a little is known about potential of this species and possible application in diet and therapy. The parts of chestnut such as: seed, peeled seed, brown seed shell, red internal seed shell, leaves, catkin, spiny bur, as well as the new and old chestnut bark were extracted with 50% ethanol as an extragents. Contents of total phenolics and total flavonoids were measured by application of the standard colorimetric assay. The total condensed tannins content estimated was highest in red internal seed shell 15.29%CE (vanillin assay) and 3.12%CT (acid butanol assay). Also high content of total phenolic compounds and condensed tannins had extracts of catkin, brown seed shell of chestnut and new chestnut bark. Extracts of C. sativa Mill. can be a potential resource of natural tannins with possible application in diet and therapy.
Assessment of hematological parameters of neonatal cord blood in anemic and non-anemic mothers -

Anemia during pregnancy is associated with high rate of mortality and morbidity among mothers and neonates. The aim of this study was to evaluate hematological parameters of cord blood of neonates born to anemic and non-anemic mothers. This is a cross-sectional comparative study which was carried out in Khartoum state maternity hospitals, 208 anemic pregnant women of hemoglobin levels less than 11.0gm/dl and 292 non anemic pregnant women of hemoglobin levels above 11.0gm/dl were enrolled. Cord blood samples were collected from umbilical cord and drained into K2EDTA containers to estimate complete blood counts using hematological analyzer Sysmex 21, manual reticulocytes count was performed, and venous K2EDTA blood samples were collected from each mother to estimate hemoglobin level. Obtained data were compared by SPSS program version 11.5 using student t-test, and significant level considered as ≤ 0.05. The study revealed that high significant levels of reticulocyte counts (P ≤ 0.05) in cord blood of neonates born to anemic mothers when compared to non-anemic. In other parameters no significant result was recognized. We conclude that anemia during pregnancy has significant effect on reticulocyte counts in neonates been born to anemic mothers in comparison with those were born to non-anemic.
The Visual Discrimination of Bending

The sensitivity of observers to nonrigid bending was evaluated in two experiments. In both experiments, observers were required to discriminate on any given trial which of two bending rods was more elastic. In experiment 1, both rods bent within the same oriented plane, and bent either in a frontoparallel plane or bent in depth. In experiment 2, the two rods within any given trial bent in different, randomly chosen orientations in depth. The results of both experiments revealed that human observers are sensitive to, and can reliably detect, relatively small differences in bending (the average Weber fraction across experiments 1 and 2 was 9.0%). The performance of the human observers was compared to that of models that based their elasticity judgments upon either static projected curvature or mean and maximal projected speed. Despite the fact that all of the observers reported compelling 3-D perceptions of bending in depth, their judgments were both qualitatively and quantitatively consistent with the performance of the models. This similarity suggests that relatively straightforward information about the elasticity of simple bending objects is available in projected retinal images.