Miracle-dz/UniFAR-FTUs huggingface dataset:
Safety and security in acute admission psychiatric wards in Ireland and London: a comparative study.

AIMS AND OBJECTIVES The comparative element of this study is to describe safety and security measures in psychiatric acute admission wards in the Republic of Ireland and London; to describe differences and similarities in terms of safety and security patterns in the Republic of Ireland and London; and to make recommendations on safety and security to mental health services management and psychiatric nurses. BACKGROUND Violence is a serious problem in psychiatric services and staff experience significant psychological reactions to being assaulted. Health and Safety Authorities in the UK and Ireland have expressed concern about violence and assault in healthcare, however, there remains a lack of clarity on matters of procedure and policy pertaining to safety and security in psychiatric hospitals. DESIGN A descriptive survey research design was employed. METHODS Questionnaires were circulated to all acute wards in London and in Ireland and the resulting data compared. RESULTS A total of 124 psychiatric wards from London and 43 wards from Ireland were included in this study and response rates of 70% (London) and 86% (Ireland) were obtained. Differences and similarities in safety and security practices were identified between London and Ireland, with Irish wards having generally higher and more intensive levels of security. CONCLUSIONS There is a lack of coherent policy and procedure in safety and security measures across psychiatric acute admission wards in the Republic of Ireland and London. Given the trends in European Union (EU) regulation, there is a strong argument for the publication of acceptable minimum guidelines for safety and security in mental health services across the EU. RELEVANCE TO CLINICAL PRACTICE There must be a concerted effort to ensure that all policy and procedure in safety and security is founded on evidence and best practice. Mental health managers must establish a review of work safety and security procedures and practices. Risk assessment and environmental audits of all mental health clinical environments should be mandatory.
PXR cross-talks with internal and external signals in physiological and pathophysiological responses

Abstract Pregnane X receptor (PXR), an orphan member of the nuclear receptor superfamily, is a major xeno-sensing transcription factor. In response to xenobiotic exposure, PXR regulates genes involved in the metabolism and transport of xenobiotics to protect the body from their harmful effects. Recent progress has revealed that PXR responds not only to such external signals but also to internal signals to help the body adapt to changes in the internal environment, including dysregulation of the immune system. PXR responds to external and internal signals by up- or down-regulating certain metabolic pathways and cellular signals through gene regulation. PXR is a potential therapeutic target for inflammatory as well as metabolic diseases, although its activation may also have unfavorable effects on human health. This review will discuss the recent progress in the understanding of the physiological and pathophysiological roles of PXR and their implications in human diseases and drug therapy by elucidating the molecular mechanisms underlying PXR-mediated gene regulation.
QbD for pediatric oral lyophilisates development: risk assessment followed by screening and optimization

Abstract Objective: This study proposed the development of oral lyophilisates with respect to pediatric medicine development guidelines, by applying risk management strategies and DoE as an integrated QbD approach. Methods: Product critical quality attributes were overviewed by generating Ishikawa diagrams for risk assessment purposes, considering process, formulation and methodology related parameters. Failure Mode Effect Analysis was applied to highlight critical formulation and process parameters with an increased probability of occurrence and with a high impact on the product performance. To investigate the effect of qualitative and quantitative formulation variables D-optimal designs were used for screening and optimization purposes. Results: Process parameters related to suspension preparation and lyophilization were classified as significant factors, and were controlled by implementing risk mitigation strategies. Both quantitative and qualitative formulation variables introduced in the experimental design influenced the product’s disintegration time, mechanical resistance and dissolution properties selected as CQAs. The optimum formulation selected through Design Space presented ultra-fast disintegration time (5 seconds), a good dissolution rate (above 90%) combined with a high mechanical resistance (above 600 g load). Conclusions: Combining FMEA and DoE allowed the science based development of a product with respect to the defined quality target profile by providing better insights on the relevant parameters throughout development process. The utility of risk management tools in pharmaceutical development was demonstrated.
Family structure and trends in US fathers’ time with children, 2003–2013

Father’s child care time increased substantially between 1965 and 2011. The objective of this paper is to examine whether there was continued change in father care time and whether father time was linked to family structure and partner’s employment. Data on the time use of men aged 18–64 living with children under age 18 were drawn from the American Time Use Survey from 2003 to 2013 (N = 20,609). Not all fathers reported child care time; the proportion of fathers reporting primary child care increased during the recession but by 2013 had returned to pre-recessionary levels. Fathers’ total time in child care increased significantly as did their time in play and management activities. The additional amount of child care time contributed by unemployed fathers was substantial – 40 to 55 minutes per day – compared to employed fathers with employed wives. The recession impacted single fathers’ care more than partnered fathers’.
Serum Concentrations of the Type I and III Procollagen Propeptides as Biochemical Markers of Growth Velocity in Healthy Infants and Children and in Children with Growth Disorders

ABSTRACT: The reproducibility and specificity of a new, rapid, simple RIA for measuring the concentration of the soluble carboxypropeptide of type I procollagen (PICP) in serum was confirmed. Serum PICP was determined in 442 healthy Caucasian subjects ranging in age from 3 wk to 18 y. Highest PICP values (mean ± SD: 2200 ± 350 μg/L) occurred in infants less than 3 mo of age, falling by 70% at 2 y and by an additional 10% at 4 y. There was no significant change in serum PICP between 4 and 16 y of age (330 ± 130 μg/L), but a decrease to adult levels of <160 μg/L, occurred by 18 y. In 76 children with growth disorders, serum PICP was related to linear growth velocity (p < 0.001), although there were no significant differences in PICP among the 38 children with growth hormone insufficiency, the 21 short children with no endocrinologic abnormality, or the 17 tall children. All 15 prepubertal children treated with growth hormone for 3 mo showed significant increases in both growth velocity and serum PICP, with a significant relationship (p < 0.01) between the degree of increases. The rise in serum PICP at 3 mo (but not baseline PICP values) predicted the increase in growth velocity after 1 y of treatment. Similar changes were observed in the concentration of the aminopropeptide of type III procollagen, except that serum aminopropeptide of type III procollagen showed a definite increase during puberty and a wider spread of values in growth disorders. We conclude that measuring serum PICP by the new, reproducible assay reflects height velocity in prepubertal children and may be a useful biochemical means of monitoring growth rates.
A note on redundancy averaging

It is well known that the performance of direction-of-arrival estimation and beamforming algorithms degrades in the presence of correlated signals. Since techniques like spatial and weighted smoothing, which were developed for decorrelating the signals, suffer from reduced effective aperture, several authors have recently proposed redundancy averaging as an alternative spatial averaging method. Considering a two-source signal model and the asymptotic case, the authors show analytically that this technique results in an eigenstructure which is inconsistent with that of the underlying signal model. In particular, the resulting signal subspace fills up the whole M-dimensional space, where M is the array size, and the resulting covariance matrix is not guaranteed to be nonnegative definite. It is shown that complete decorrelation is not possible with this method even if the array size is infinitely large. >
Unusual cause of weight loss in a patient with HIV–hepatitis C virus coinfection

Recombinant interferon α (IFN α), alone or in combination, is used extensively in the treatment of hepatitis C infection. IFN therapy is not free of side-effects and autoimmune thyroiditis is one of its rare side-effects. We present here a case of a patient with hepatitis C virus–human immunodeficiency virus coinfection on interferon therapy who presented with significant weight loss. He was found to have IFN-related autoimmune thyrotoxicosis and responded to antithyroid drugs and propanolol. Therefore, this case highlights that IFN-induced thyroiditis is an unusual side-effect and that during treatment, a thyroid-stimulating hormone assay should be performed at regular intervals (every 8–12 weeks).
Detection of early atherosclerosis with B mode carotid ultrasonography: assessment of a new quantitative approach.

PURPOSE To examine the relation between carotid artery (CA) intima-media thickness (IMT) assessed by B mode ultrasonography (US), presence of plaques and major risk factors in a population without known vascular disease. Alternative methods of quantifying US results and implications for starting lipid-lowering therapy were also explored. DESIGN Prospective study. SETTING Specialized lipid clinic. PATIENTS One hundred and sixty patients with hyperlipidemia but without symptomatic coronary or peripheral vascular disease were examined by US, of whom 92 patients with normal blood pressure who were not receiving lipid-lowering treatment were included in the analysis. INTERVENTIONS B mode US of the CA was performed. Measurements were made of the IMT of the right and left common CA, and the average IMT (AIMT) was calculated. The number of plaques (PN) in the CA and its bifurcations was counted, and the average total thickness (ATT), the total area (TA), and average plaque thickness (APT) were calculated. RESULTS Stepwise regression analysis showed that age, the ratio of total cholesterol to high-density-lipoprotein cholesterol, weight and smoking significantly predicted ATT, APT and PN. By contrast, age, weight and apo B levels predicted AIMT. Detection of patients with CA abnormalities was improved by incorporating plaque dimensions: AIMT had a 63% sensitivity in detecting CA abnormalities, whereas TA had a sensitivity of 72%. CONCLUSION Indices of CA atherosclerosis that integrate the contribution of plaque to overall atheroma burden are related to known risk factors and are more sensitive than AIMT for detection of abnormalities.
Hormone replacement use, arterial distensibility, cardiac structure and circadian blood pressure profile in menopausal women

Observational and interventional studies that evaluate the impact of hormone replacement therapy (HRT) on cardiovascular changes have produced inconsistent and inconclusive results. The present study sought to elucidate the influence of HRT on aortic distensibility, left ventricular mass (LVM) and 24‐h blood pressure (BP) profile in 38 menopausal women who were either HRT users or non‐users. The two groups were similar for age, ambulatory BP, aortic distensibility, cardiac mass, lipid profile and body mass index but differed in clinic diastolic BP (DBP). HRT non‐dippers had significantly lower clinic and daytime DBP and a smaller nocturnal BP reduction than dippers. Daytime DBP was significantly and inversely related to duration of HRT use. The present study demonstrates that hormonal therapy after menopause lowers DBP, but shows no significant influence on aortic distensibility, cardiac mass or 24‐h BP profile. HRT users who were dippers demonstrated a significantly greater nocturnal BP reduction. Long‐term controlled trials are needed to better define the effects of estrogen and progestin on the aorta, the heart and 24‐h BP profile in normotensive and hypertensive menopausal women.
A Comparison of SVM and GMM-Based Classifier Configurations for Diagnostic Classification of Pulmonary Sounds

Goal: The aim of this study is to find a useful methodology to classify multiple distinct pulmonary conditions including the healthy condition and various pathological types, using pulmonary sounds data. Methods: Fourteen-channel pulmonary sounds data of 40 subjects (healthy and pathological, where the pathologies are of obstructive and restrictive types) are modeled using a second order 250-point vector autoregressive model. The estimated model parameters are fed to support vector machine and Gaussian mixture model (GMM) classifiers which are used in various configurations, resulting in eight different methodologies in total. Results: Among the eight methodologies, the hierarchical GMM classifier yields the best performance with a total correct classification rate of 85%, where the term hierarchical refers here to first classifying the data into healthy and pathological classes, then the pathological class into obstructive and restrictive types. Both the sensitivity and specificity for the healthy versus pathological classification at the first stage of hierarchy are 90%. Conclusion: The newly proposed methodologies provide improved results compared to the previous study. The hierarchical framework is suggested for diagnostic classification of pulmonary sounds, although the algorithms are still open for further improvements. Significance: This study proposes new methodologies for diagnostic classification of pulmonary sounds, and suggests using a hierarchical framework for the first time.
Noninvasive Evaluation of Myocardial Systolic Dysfunction in the Early Stage of Kawasaki Disease: A Speckle-Tracking Echocardiography Study

Background: Evaluation of myocardial function by speckle-tracking echocardiography is a new method for the early diagnosis of systolic dysfunction. Objectives: We aimed to determine myocardial speckle-tracking echocardiography indices in Kawasaki Disease (KD) patients and compare them with the same indices in control subjects. Patients and Methods: Thirty-two patients (65.5% males) with KD and 19 control subjects with normal echocardiography participated in this study. After their demographic characteristics and clinical findings were recorded, all the participants underwent transthoracic echocardiography. Strain (S), Strain Rate (SR), Time to Peak Strain (TPS), and Strain Rate (TPSR), longitudinal velocity and view point velocity images in the two, three, and four-chamber views were semi-automatically obtained via speckle-tracking echocardiography. Results: Among the patients, Twenty-four cases (75%) were younger than 4 years. Mean global S and SR was significantly reduced in the KD patients compared to controls (17.03 ± 1.28 vs. 20.22 ± 2.14% and 1.66 ± 0.16 vs. 1.97 ± 0.25 1/second, respectively), while there were no significant differences regarding mean TPS, TPSR, longitudinal velocity and view point velocity. Using repeated measure of analysis of variances, we observed that S and SR decreased from base to apical level in both groups. The change in the pattern of age adjusted mean S and SR across levels was significantly different between the groups (P < 0.001 for both parameters). Conclusions: We showed changes in S and SR assessed in KD patients versus control subjects in the acute phase of KD. However, we suggest that further studies be undertaken to compare S and SR in the acute phase and thereafter in KD patients.
Clustering the Results of Brainstorm Sessions: Applying Word Similarity Techniques to Cluster Dutch Nouns

This research addresses the problem of clustering the results of brainstorm sessions. Going through all ideas and clustering them can be a time consuming task. In this research we design a computer-aided approach that can help with clustering of these results. We have limited ourselves to looking at single words, while at the same time we identify the different factors that could influence the results. These factors are: (1) word similarity algorithm, (2) dimensionality, (3) cluster count, (4) clustering algorithm, and (5) the evaluation approach. In total we tested six word similarity algorithms, two clustering techniques and three evaluation methods, in order to see which configuration works best for the task. We found evidence that the clustering of these results is feasible, though the results are influenced by the subjective behaviour of human interpreters.
Time-Dependent Changes in the Plasma Concentration of Matrix Metalloproteinase 9 after Acute Myocardial Infarction

Matrix metalloproteinase (MMP)-2 and MMP-9 are believed to play a pathophysiologic role in acute myocardial infarction (MI). The time course of their plasma concentrations in correlation with the extent of myocardial damage is unclear. In a prospective study, 20 patients with proven acute MI underwent successful reperfusion within 6 h after the onset of symptoms. The patients were divided into two groups according to the size of their MI, i.e. large or moderate MI. Plasma concentrations of MMP-2, MMP-9 and tissue inhibitor of metalloproteinase (TIMP)-1 were determined on admission, and after 24 h, 48 h, 1 week, 4 weeks, 3 months and 6 months. MMP-2 levels remained unchanged over time in both groups. The plasma concentration of MMP-9 was elevated on admission in patients with large MI versus moderate MI (195 ± 190 versus 78 ± 63 ng/ml, p < 0.01) as determined by left ventriculography, and returned to baseline (18 ± 16 ng/ml) by 1 week after MI. TIMP-1 levels rose slowly in patients with large MI and returned to baseline at 6 months. The ratio of MMP-9 to TIMP-1 was significantly increased on admission in both groups and returned to baseline at 48 h. These data suggest that MMP-9 might play a pathophysiologic role during the early phase of acute MI.
WEB 2.0-SUPPORT FOR CHANGE MANAGEMENT DURING BPMS IMPLEMENTATION USING AN OPEN SOURCE APPROACH

The authors argue that business process management systems (BPMS) are exposed to similar risks of failure as are traditional enterprise resource planning (ERP) systems. Change management is a significant critical success factor, and has to be managed well. Given the socio-technical nature of the implementation environment, communication and collaboration are crucially important to the success of change management. The authors provide an example of how collaboration and communication, as part of change management during BPMS implementation, can be achieved in practice, based on the use of Web 2.0 tools and an open source approach. OPSOMMING Die outeurs voer aan dat besigheidsprosesbestuurstelsels aan soortgelyke falings-risiko’s blootgestel is as tradisionele ondernemingshulpbron-stelsels. Veranderings-bestuur is 'n beduidende kritiese suksesfaktor wat goed bestuur moet word. As gevolg van die sosiotegniese aard van die implementeringsomgewing is kommunikasie en samewerking van deurslaggewende belang as deel van die veranderingsbestuurs-proses.Die outeurs wys met behulp van ’n voorbeeld hoe samewerking en kommunikasie as deel van veranderingsbestuur bewerkstellig kan word met behulp van Web 2.0 gereedskap en ’n oopbronbenadering.
No Place Like Home? Potential Pathways to Loneliness in Older Adults Under the Care of a Live-In Foreign Home Care Worker

ABSTRACT The arrangement in which frail older adults from the developed world are cared for in their homes by individuals from the developing world has become increasingly prevalent worldwide. In Israel, this arrangement is termed foreign home care. In this article, the authors first describe the global phenomenon of foreign home care of frail older adults as well as the more local characteristics of this arrangement in Israel. The authors then describe the concept of loneliness. Based on empirical and theoretical knowledge in the field of loneliness, the authors argue that older adults under live-in foreign home care may be particularly prone to feelings of loneliness for several reasons: some that are general to older adults with cognitive or physical disability and others that are specific to this particular caregiving arrangement. The authors conclude by providing ideas for future practice and research on this highly vulnerable group that, to date, has received only minimal research attention.
Relationship of impaired glucose tolerance to left ventricular structure and function: The Strong Heart Study.

BACKGROUND We have identified increased left ventricular (LV) mass, wall thickness, relative wall thickness, and reduced systolic function in diabetic individuals after adjusting for blood pressure and body mass index. However, the cardiovascular correlates of impaired glucose tolerance (IGT), a precursor of diabetes, are unknown. METHODS We compared LV measurements between 457 American Indian participants in the Strong Heart Study with IGT (34% men) by World Health Organization criteria and 888 participants (49% men) with normal glucose tolerance. RESULTS Participants with IGT were older (60 vs 59 years, P < .01), more overweight (body mass index, 32 +/- 6 vs 29 +/- 5 g/m(2)), and had higher systolic blood pressure (129 +/- 20 vs 124 +/- 18 mm Hg, P < .001) and heart rate (67 +/- 10 vs 66 +/- 11 beats/min, P = .011). In univariate analyses, women but not men with IGT had higher LV mass (mean, 150 vs 138 g, P < .001) and cardiac index (2.6 vs 2.5 L/min/m(2), P < . 05). LV wall thicknesses and relative wall thickness were greater in women and men with IGT. Regression analysis, adjusting for multiple covariates in the entire study population, identified independent associations of IGT with higher LV relative wall thicknesses, LV mass/height(2.7), and cardiac output/height(1.83). CONCLUSIONS IGT is associated with increased LV wall thickness, mass, and cardiac output independent of effects of relevant covariates.
Effects of Radiofrequency Electromagnetic Fields on the Human Nervous System

The effects of exposure to radiofrequency electromagnetic fields (EMF), specifically related to the use of mobile telephones, on the nervous system in humans have been the subject of a large number of experimental studies in recent years. There is some evidence of an effect of exposure to a Global System for Mobile Telecommunication (GSM)-type signal on the spontaneous electroencephalogram (EEG). This is not corroborated, however, by the results from studies on evoked potentials. Although there is some evidence emerging that there may be an effect of exposure to a GSM-type signal on sleep EEG, results are still variable. In summary, exposure to a GSM-type signal may result in minor effects on brain activity, but such changes have never been found to relate to any adverse health effects. No consistent significant effects on cognitive performance in adults have been observed. If anything, any effect is small and exposure seems to improve performance. Effects in children did not differ from those in healthy adults. Studies on auditory and vestibular function are more unequivocal: neither hearing nor the sense of balance is influenced by short-term exposure to mobile phone signals. Subjective symptoms over a wide range, including headaches and migraine, fatigue, and skin itches, have been attributed to various radiofrequency sources both at home and at work. However, in provocation studies a causal relation between EMF exposure and symptoms has never been demonstrated. There are clear indications, however, that psychological factors such as the conscious expectation of effect may play an important role in this condition.