Miracle-dz/UniFAR-FTUs huggingface dataset:
Interprofessional Collaboration to Improve Discharge from Skilled Nursing Facility to Home: Preliminary Data on Postdischarge Hospitalizations and Emergency Department Visits

An interprofessional collaborative practice model was established at Hennepin County Medical Center to improve discharge management from the transitional care unit of the skilled nursing facility (SNF) to home. The practice model involves a geriatrician, nurse practitioner, and pharmacist who care for individuals at a community‐based SNF. Before SNF discharge, the pharmacist conducts a chart and in‐person medication review and collaborates with the nurse practitioner to determine the discharge medication regimen. The pharmacist's review focuses on assessing the indication, safety, effectiveness, and convenience of medications. The pharmacist provides follow‐up in‐home or over the telephone 1 week after SNF discharge, focusing on reviewing medications and assessing adherence. Hospitalizations and emergency department (ED) visits 30 days after SNF discharge of individuals who received care from this model was compared with those of individuals who received usual care from a nurse practitioner and geriatrician. From October 2012 through December 2013, the intervention was delivered to 87 individuals, with 189 individuals serving as the control group. After adjusting for age, sex, race, and payor, those receiving the intervention had a lower risk of ED visits (odds ratio (OR) = 0.46, 95% confidence interval (CI) = 0.22–0.97), although there was no significant difference in hospitalizations (OR = 0.47, 95% CI = 0.21–1.08). The study suggests that an interprofessional approach involving a pharmacist may be beneficial in reducing ED visits 30 days after SNF discharge.
Autologous Myoblasts for the Treatment of Fecal Incontinence

Objective: The aim of this study was to evaluate the efficacy of intrasphincteric injections of autologous myoblasts (AMs) in fecal incontinence (FI) in a controlled study. Summary of Background Data: Adult stem cell therapy is expected to definitively cure FI by regenerating damaged sphincter. Preclinical data and results of open-label trials suggest that myoblast therapy may represent a noninvasive treatment option. Methods: We conducted a phase 2 randomized, double-blind, placebo-controlled study of intrasphincteric injections of AM in 24 patients. The study compared outcome after AM (n = 12) or placebo (n = 12) injection using Cleveland Clinic Incontinence (CCI), score at 6 and 12 months. Patients in the placebo group were eligible to receive frozen AM after 1 year. Results: At 6 months, the median CCI score significantly decreased from baseline in both the AM (9 vs 15, P = 0.02) and placebo (10 vs 15, P = 0.01) groups. Hence, no significant difference was found between the 2 groups (primary endpoint) at 6 months. At 12 months, the median CCI score continued to ameliorate in the AM group (6.5 vs 15, P = 0.006), while effect was lost in the placebo group (14 vs 15, P = 0.35). Consequently, there was a higher response rate at 12 months in the treated than the placebo arm (58% vs 8%, P = 0.03). After delayed frozen AM injection in the placebo group, the response rate was 60% (6/10) at 12 months. Conclusions: Intrasphincteric AM injections in FI patients have shown tolerance, safety, and clinical benefit at 12 months despite a transient placebo effect at 6 months.
Thickness-dependent charge transport in few-layer MoS2 field-effect transistors

Molybdenum disulfide (MoS2) is currently under intensive study because of its exceptional optical and electrical properties in few-layer form. However, how charge transport mechanisms vary with the number of layers in MoS2 flakes remains unclear. Here, exfoliated flakes of MoS2 with various thicknesses were successfully fabricated into field-effect transistors (FETs) to measure the thickness and temperature dependences of electrical mobility. For these MoS2 FETs, measurements at both 295 K and 77 K revealed the maximum mobility for layer thicknesses between 5 layers (∼3.6 nm) and 10 layers (∼7 nm), with ∼70 cm2 V−1 s−1 measured for 5 layer devices at 295 K. Temperature-dependent mobility measurements revealed that the mobility rises with increasing temperature to a maximum. This maximum occurs at increasing temperature with increasing layer thickness, possibly due to strong Coulomb scattering from charge impurities or weakened electron–phonon interactions for thicker devices. Temperature-dependent conductivity measurements for different gate voltages revealed a metal-to-insulator transition for devices thinner than 10 layers, which may enable new memory and switching applications. This study advances the understanding of fundamental charge transport mechanisms in few-layer MoS2, and indicates the promise of few-layer transition metal dichalcogenides as candidates for potential optoelectronic applications.
Does a Combination of Laparoscopic Approach and Full Fast Track Multimodal Management Decrease Postoperative Morbidity?: A Multicenter Randomized Controlled Trial

Objective: The aim of this study was to assess whether association of laparoscopic approach and full fast track multimodal (FFT) management can reduce postoperative morbidity after colorectal cancer surgery, as compared to laparoscopic approach with limited fast-track program (LFT). Summary of Background Data: Recent advances in colorectal cancer surgery are introduction of laparoscopy and FFT implementation. Methods: Patients eligible for elective laparoscopic colorectal cancer surgery were randomized into 2 groups: FFT or LFT care (with only early oral intake and mobilization starting on Day 1). Primary outcome was postoperative 30-day morbidity, according to Clavien-Dindo classification. Results: Two hundred seventy patients were randomized and 263 were analyzed: 130 in FFT group and 133 in LFT group, including 106 colon (FFT: n = 52 and LFT: n = 54) and 157 rectal cancer (FFT: n = 78 and LFT: n = 79). Postoperative 30-day mortality was nil. Overall postoperative 30-day morbidity did not show any difference between the groups (FFT: 35% vs LFT: 29%, P = 0.290), neither regarding the overall population, nor in the colon (FFT: 23% vs LFT: 19%, P = 0.636) or rectal (FFT: 44% vs LFT: 35%, P = 0.330) cancer subgroups. Severe postoperative morbidity was also not different between groups (FFT: 12% vs LFT: 8%, P = 0.266). After multivariate regression analysis, only early intravenous catheter removal (on day 2) [odds ratio: 0.390; 95% confidence interval: (95% CI 0.181–0.842); P = 0.017] and the absence of intraoperative lidocaine intravenous perfusion (odds ratio: 0.182, 95% CI 0.042–0.788; P = 0.019) were identified as independent predictive factors of reduced postoperative morbidity. Conclusion: Addition of FFT multimodal management to laparoscopic approach with early oral intake and mobilization does not reduce postoperative morbidity after colorectal cancer surgery.
Epoch-based likelihood models reveal no evidence for accelerated evolution of viviparity in squamate reptiles in response to cenozoic climate change.

A broad scale analysis of the evolution of viviparity across nearly 4,000 species of squamates revealed that origins increase in frequency toward the present, raising the question of whether rates of change have accelerated. We here use simulations to show that the increased frequency is within the range expected given that the number of squamate lineages also increases with time. Novel, epoch-based methods implemented in BEAST (which allow rates of discrete character evolution to vary across time-slices) also give congruent results, with recent epochs having very similar rates to older epochs. Thus, contrary to expectations, there was no accelerated burst of origins of viviparity in response to global cooling during the Cenozoic or glacial cycles during the Plio-Pleistocene. However, if one accepts the conventional view that viviparity is more likely to evolve than to be lost, and also the evidence here that viviparity has evolved with similar regularity throughout the last 200 Ma, then the absence of large, ancient clades of viviparous squamates (analogs to therian mammals) requires explanation. Viviparous squamate lineages might be more prone to extinction than are oviparous lineages, due to their prevalance at high elevations and latitudes and thus greater susceptibility to climate fluctuations. If so, the directional bias in character evolution would be offset by the bias in extinction rates.
Respiratory Problems in Parkinson Disease

Parkinson disease (PD), also known as paralysis agitans, is a common neurodegenerative disorder. In patients with PD and other extrapyramdial disorders, respiratory problems commonly contribute to morbidity and mortality and all physicians who are interested in this field must be able to do proper management of them. Pulmonary function assessment is recommended in PD, irrespective of severity of disease.
Relation of Dysglycemia to Structural Brain Changes in a Multiethnic Elderly Cohort

Abnormally high glucose levels (dysglycemia) increase with age. Epidemiological studies suggest that dysglycemia is a risk factor for cognitive impairment but the underlying pathophysiological mechanisms remain unclear. The objective of this study was to examine the relation of dysglycemia clinical categories (normal glucose tolerance (NGT), pre‐diabetes, undiagnosed diabetes, known diabetes) with brain structure in older adults. We also assessed the relation between dysglycemia and cognitive performance.
Postoperative Tachyarrhythmias: On-Pump versus Off-Pump Coronary Artery Bypass Grafting

Objective. Tachyarrhythmias, after coronary artery bypass graft (CABG) surgery, develop in 11%–40% of patients. Surgery technique (on-pump or off-pump) might affect incidence of post-CABG tachyarrhythmias. Methods. The study included 60 patients undergoing CABG (≥2 grafts) with left ventricle ejection fraction (LV EF) >40%. Patients were divided into two groups equally: group A (on-pump) and group B (off-pump). Patients were subjected to electrocardiographic monitoring (7 days postoperatively), transthoracic echocardiography, with recording of surgical details and complications. Results. Data collected between December 2012 and May 2013 showed no significant difference between two groups regarding incidence of postoperative tachyarrhythmias with statistically significant higher incidence of supraventricular tachycardia in group B () and a trend towards higher incidence of atrial fibrillation in group A. Patients who developed postoperative tachyarrhythmias in group A showed higher prevalence of family history of coronary artery disease and higher incidence of postoperative chest infections (), while those in group B showed higher mean LV EF (pre- and postoperatively) (). Data were statistically described in terms of mean ± standard deviation. Comparison of numerical and categorical variables was done using Student’s - and Chi-square tests, respectively. Conclusion. Adopting off-pump CABG technique is not associated with less incidence of post-operative tachyarrhythmias, as compared to on-pump technique.
Efeito da técnica isostretching no equilíbrio postural

The purpose was to assess the effects of the isostretching technique on postural changes. Twelve subjects with increased thoracic kyphosis, scoliosis, head and shoulders protusion were treated with the isostretching technique in three one-hour weekly sessions. Subjects were dividded into two groups according to the number of sessions attended: group 1 (n=8), over 30 sessions; and group 2 (n=4) attended less than 30 sessions. In order to assess postural changes, subjects were photographed before and after treatment at anterior and posterior frontal planes, at upright sagittal plane and at anterior trunk flexion. Data were statistically analysed and significance level set at 5%. Group 1 results were satisfactory as to changes in letf Talles triangle (TΔ) alignment (f=0.00), hip angle (f=0.00), tibiotarsal angle (f=0.01), and thoracic kyphosis alignment (f=0.00). In group 2 subjects, results were satisfactory as to left knee angle (f=0.03), left TΔ f=0.00) and right TΔ (f=0.01) alignment, thoracic kyphosis (f=0.03) and head alignment (f=0.02). The isostretching technique, in the postures here adopted, was efficient in aligning thoracic spine in both groups and in improving flexibility in group 1; however, regardless of the number of sessions attended, no changes in frontal plane posture asymmetries were noticed.
Phenotypic correction of ornithine transcarbamylase deficiency using low dose helper‐dependent adenoviral vectors

Helper‐dependent adenoviral vectors (HDAd) can mediate long‐term phenotypic correction in the ornithine transacarbamylase (OTC)‐deficient mice model with negligible chronic toxicity. However, the high doses required for metabolic correction will result in systemic inflammatory response syndrome in humans. This acute toxicity represents the major obstacle for clinical applications of HDAd vectors for the treatment of OTC deficiency. Strategies for reducing the dose necessary for disease correction are highly desirable because HDAd acute toxicity is clearly dose‐dependent.
IDO1 Expression Is Associated With Immune Tolerance and Poor Prognosis in Patients With Surgically Resected Esophageal Cancer

Objectives: To evaluate the relationship between indoleamine 2, 3-dioxygenase (IDO1) expression and tumoral immune status and clinical outcome in esophageal cancer. Summary Background Data: IDO1 is a primary enzyme that generates immunosuppressive metabolites such as tryptophan and kynurenine. Like the PD-1/PD-L1 pathway, IDO1 plays a major role in tumor immunology and is a potential immune-based therapeutic target. Methods: The expressions of IDO1, CD8 (a marker of cytotoxic T cells), FOXP3 [a marker of regulatory T cells (Treg)], and PD-L1 in 305 curatively resected esophageal cancers were evaluated by immunostaining. Results: Overall survival was significantly better in the IDO1 negative cases (n 1⁄4 234) than in the IDO1 positive cases (n 1⁄4 71) [log-rank P 1⁄4 0.0041; hazard ratio (HR): 1.75; 95% confidence interval (CI): 1.12–2.67; P1⁄4 0.015]. CD8 high expression was significantly positively correlated with overall survival (log-rank P 1⁄4 0.025) and low IDO1 expression (P 1⁄4 0.044). The inverse correlation between CD8 and IDO1 expressions was confirmed by double immunostaining for IDO1 and CD8. Stratification based on IDO1 and CD8 expressions was also significantly associated with overall survival (logrank P 1⁄4 0.0024). In addition, the IDO1-positive group was correlated with high counts of FOXP3-positive cells (P 1⁄4 0.020), but not with PD-L1 expression status (P 1⁄4 0.19). Conclusions: IDO1 expression was associated with an unfavorable clinical outcome in esophageal cancer, supporting its role as a prognostic biomarker. Combining the IDO1 and CD8 statuses enabled further classification of the clinical outcomes of patients.
Two-dimensional materials for novel liquid separation membranes

Demand for a perfect molecular-level separation membrane with ultrafast permeation and a robust mechanical property for any kind of species to be blocked in water purification and desalination is urgent. In recent years, due to their intrinsic characteristics, such as a unique mono-atom thick structure, outstanding mechanical strength and excellent flexibility, as well as facile and large-scale production, graphene and its large family of two-dimensional (2D) materials are regarded as ideal membrane materials for ultrafast molecular separation. A perfect separation membrane should be as thin as possible to maximize its flux, mechanically robust and without failure even if under high loading pressure, and have a narrow nanochannel size distribution to guarantee its selectivity. The latest breakthrough in 2D material-based membranes will be reviewed both in theories and experiments, including their current state-of-the-art fabrication, structure design, simulation and applications. Special attention will be focused on the designs and strategies employed to control microstructures to enhance permeation and selectivity for liquid separation. In addition, critical views on the separation mechanism within two-dimensional material-based membranes will be provided based on a discussion of the effects of intrinsic defects during growth, predefined nanopores and nanochannels during subsequent fabrication processes, the interlayer spacing of stacking 2D material flakes and the surface charge or functional groups. Furthermore, we will summarize the significant progress of these 2D material-based membranes for liquid separation in nanofiltration/ultrafiltration and pervaporation. Lastly, we will recall issues requiring attention, and discuss existing questionable conclusions in some articles and emerging challenges. This review will serve as a valuable platform to provide a compact source of relevant and timely information about the development of 2D material-based membranes as well as fully explain up-to-date mechanisms and models of water transport and molecular separation behavior, which will arouse great interest among researchers entering or already working in the field of 2D material-based membranes.
Comprehensive gene expression profiling in lungs of mice infected with Mycobacterium tuberculosis following DNAhsp65 immunotherapy

The continued increase in tuberculosis (TB) rates and the appearance of extremely resistant Mycobacterium tuberculosis strains (XDR‐TB) worldwide are some of the great problems of public health. In this context, DNA immunotherapy has been proposed as an effective alternative that could circumvent the limitations of conventional drugs. Nonetheless, the molecular events underlying these therapeutic effects are poorly understood.
Filial piety revisited in the context of modernizing Asian societies

This paper discusses the concept of filial piety in the context of social changes in Asia, in particular Singapore. The changing meaning and expression of this concept, which is also a cultural value, has to be researched by Asian gerontologists. The empirical research in Singapore shows that while this concept is still considered important its definition is shifting.
Auditory and Respiratory Health Disorders Among Workers in an Iron and Steel Factory

Background: Iron is the world's most commonly used metal and can usually be found with other elements in the form of steel. The frequently recorded health disorders between iron and steel industry workers includes: respiratory and skin problems as well as noise-related hearing impairment. Objectives: Study auditory and respiratory health disorders among exposed workers in an iron and steel factory in Sadat city, Menoufiya governorate and assess workplace environment in the same factory. Participants and Methods: One hundred and six occupationally exposed male workers in an iron and steel factory was chosen and matched for age, sex, residence, education, income and smoking habit with a control (non exposed) group. A predesigned questionnaire including personal and occupational data and some respiratory and auditory manifestations was filled. All participants were subjected to spirometric measurements and audiometry. Environmental study for noise, dust and fumes measurements was also done. Results: Environmental study revealed higher mean value of noise and lower mean values of dust and fumes than the standard levels. Exposed workers showed significant higher prevalence of respiratory and auditory manifestations, spirometric and auditory findings than controls. With increasing years of employment, deterioration of spirometric measurements and audiometric changes increase. Conclusion: From environmental measures, although dust and fume levels were lower than the PEL; there were early changes in the spirometric measurements in exposed workers. Working in iron and steel industry may be associated with higher prevalence of chest manifestations, hearing impairment, changes in the mean values of different spirometric measurements and noise induced hearing loss. Recommendations: Exclusion of individuals having any respiratory or auditory manifestations during pre-employment medical examination. For early detection of respiratory and auditory disorders, spirometry and audiometry should be included in the periodic medical examination. Accurate health records of workers, so, those at risk can be monitored, and/or pre-placed. Using personal protective equipments especially masks and ear muffles as well as prohibit smoking in the workplace. Keywords: iron and steel Workers, hearing loss, respiratory disorders
Citizenship and Recovery for Everyone: A Global Model of Public Mental Health

A systematic review of the literature on health promotion as conveyed by the Ottawa Charter for Health Promotion yielded two major findings: health promotion and recovery in mental health have many values and features in common, and health promotion and recovery in mental health do not refer very much to one another. A global model of public mental health is therefore needed to bring recovery and health promotion together, to clarify the boundaries of mental health promotion and to promote citizenship for everyone. Inspired and adapted from the ecological approach initially developed on the basis of health promotion programs, the model introduced here addresses mainly the issue of recovery, which has been neglected recently in the literature on both public health and mental health promotion. It advocates the idea that recovery can explicitly be related to mental health promotion through the Ottawa Charter for health promotion. Many issues and sub-issues are addressed, and the global model suggests keeping track of various activities unfolding at five levels, with examples of citizen psychiatry. The uniqueness and additional contribution of this model to already existing literature are that the supranational level is a key component of an approach that would truly be global.
Outcomes of Neoadjuvant Transarterial Chemoembolization to Downstage Hepatocellular Carcinoma Before Liver Transplantation

Purpose:To evaluate outcomes of downstaging patients with advanced (American liver tumor study group stage III/IV) hepatocellular carcinoma (HCC) with transarterial chemoembolization (TACE) to allow eligibility for orthotopic liver transplant (OLT). Methods:From 1999 to 2006, 202 patients with HCC were referred for transplant evaluation. Seventy-six (37.6%) patients with stage III/IV HCC were potential transplant candidates if downstaging was achieved by TACE. OLT was considered based on follow-up imaging findings. The number of patients who were successfully downstaged within the Milan criteria, tumor response using Response Evaluation Criteria in Solid Tumors criteria, findings at explant, and outcomes after transplant were tracked. Results:Eighteen of 76 (23.7%) patients had adequate downstaging to qualify for OLT under the Milan criteria. By Response Evaluation Criteria in Solid Tumors, 27/76 (35.5%) patients had a partial response, 22/76 (29%) had stable disease, and 27/76 (35.5%) had progressive disease. Seventeen of 76 (22.4%) patients who met other qualifications underwent OLT after successful downstaging (13/38 stage III;4/38 stage IV). Explant review demonstrated 28 identifiable tumors in which post-TACE necrosis was greater than 90% in 21 (75%). At a median of 19.6 months (range 3.6–104.7), 16/17 (94.1%) patients who underwent OLT are alive. One patient expired 11 months after OLT secondary to medical comorbidities. One of 17 (6%) OLT patients had recurrent HCC. This patient underwent resection of a pulmonary metastasis and is alive, 63.6 months from OLT. Conclusion:Selected patients with stage III/IV HCC can be downstaged to Milan criteria with TACE. Importantly, patients who are successfully downstaged and transplanted have excellent midterm disease-free and overall survival, similar to stage II HCC.