Miracle-dz/UniFAR-FTUs huggingface dataset:
The needs of parents with chronically sick children: a literature review.

AIMS This paper aims to provide health care professionals with an enhanced knowledge of the needs of parents with chronically sick children. DESIGN The article takes the form of a critical literature review and examines eight research studies that were carried out from 1987 to 1997, written in the English language and analysing solely the needs or experiences of both parents with at least one chronically sick child. FINDINGS Appropriately all eight studies were carried out from the naturalistic paradigm and yielded rich data. The synthesis of the results of the papers found three main themes emerging: the need for normality and certainty, the need for information, and the need for partnership. CONCLUSION The results of the review serve to emphasize and reiterate the burden of the demands made on these parents, and act as a reminder of the need for empathetic care delivery.
Global Perspectives

See page 654 INFLAMMATORY NEUROLOGIC DISEASE IN SUB-SAHARAN AFRICA Inflammation occurs in response to infections or injury and is a sign of a healthy or functioning immune system. Infections involving the nervous system are common in sub-Saharan Africa (SSA), where they account for a sizable proportion of disease and deaths. These are caused by viruses, bacteria, fungi, protozoa, and helminthes, such as cryptococcus, toxoplasma, and tuberculosis (TB) in HIV infection, protozoa in cerebral malaria and trypanosomiasis, and helminthes in neurocysticercosis. Three chapters in the textbook Neurology in Africa review the direct effects of the main infectious diseases on the nervous system. However, there exists another group of disorders caused by an indirect effect of the immune response about which much less is known in SSA. These are antibodyand inflammatory-mediated and the resulting disorders are generally termed autoimmune. In this article, I briefly describe the main inflammatory-mediated neurologic disorders affecting the brain, spinal cord, neuromuscular junction, and muscle and describe their impact in SSA.
Family intervention in psychosis: who needs it?

The interest in families as part of the social environment of people suffering from psychosis dates from the war. The early ideas took the form of spec-ulation without adequate research underpinning, and were often couched in terms that suggested that families might be to blame for the sufferers' illness. Nevertheless, the speculations were a first attempt to appreciate the impact of the social environment on psychotic disorders. Formalized
Science-based views of drug addiction and its treatment.

MORE THAN TWO THIRDS OF people with addiction see a primary care or urgent care physician every 6 months, and many others are regularly seen by other medical specialists. These physicians are therefore in a prime position to help patients who may have drug abuse problems by recognizing and diagnosing the addiction, helping to direct patients to a program that can meet their treatment needs, and helping to monitor progress after specialty treatment and during recovery. Many physicians, however, find the domain of drug abuse particularly daunting and often avoid the issue with their patients. This is understandable given the relatively short shrift drug abuse is given in formal medical education. There is a widespread misperception that drug abuse treatment is not effective, which may account for the reluctance of physicians to even broach the subject of drug abuse or treatment with their patients. On the other hand, over the past 15 to 20 years, advances in science have revolutionized our fundamental understanding of the nature of drug abuse and addiction and what to do about it. In addition, there are now extensive data showing that addiction is eminently treatable if the treatment is welldelivered and tailored to the needs of the particular patient. There is an array of both behavioral and pharmacological treatments that can effectively reduce drug use, help manage drug cravings and prevent relapses, and restore people to productive functioning in society. Of course, not all drug abuse treatments are equally effective, and there is no single treatment appropriate for all patients. Fortunately, recent scientific advances have provided insights both into the nature of drug abuse and addiction and into the principles that characterize the most effective treatment approaches and programs. These treatment principles should make the primary care or nonaddiction specialty care physician’s tasks of screening and referral much easier.
Granulosa cell survival and proliferation are altered in polycystic ovary syndrome.

CONTEXT Polycystic ovary syndrome (PCOS) represents the most common endocrine abnormality in women of reproductive age. The cause of PCOS remains largely unknown, but studies suggest an intrinsic ovarian abnormality. OBJECTIVE The objective of the study was to test our hypothesis that differences in granulosa cell proliferation and apoptosis may underlie abnormalities that affect follicular development. DESIGN Granulosa cells were prepared from follicular fluid aspirated from 4- to 8-mm follicles of unstimulated ovaries during routine laparoscopy or laparotomy from women with anovulatory PCOS and those with regular ovulatory cycles. SETTING The study was conducted at a university hospital. PATIENTS Fourteen women with anovulatory PCOS and nine women with regular ovulatory cycles participated in the study. MAIN OUTCOME MEASURES Immunocytochemistry on granulosa cells to investigate apoptotic and proliferation rates, together with real-time RT-PCR to analyze gene expression profiles of apoptotic regulators, was measured. RESULTS Significantly lower apoptotic rates were found in granulosa cells from patients with PCOS, compared with women with regular ovulatory cycles (P=0.004). Lower apoptotic rates were associated with decreased levels of the apoptotic effector caspase-3 (P=0.001) and increased levels of the anti-apoptotic survival factor cellular inhibitor of apoptosis proteins-2 in the PCOS group that were coupled to higher proliferation rates (P=0.032). Gene expression profiling confirmed the immunocytochemical findings. CONCLUSIONS Our findings indicate that there are significant differences in the rate of cell death and proliferation in granulosa cell populations in PCOS patients. These are associated with decreased expression of apoptotic effectors and increased expression of a cell survival factor. These results provide new insights that may be useful in developing specific therapeutic intervention strategies in PCOS.
Isolated local recurrence or solitary solid organ metastasis after esophagectomy for cancer is not the end of the road.

Recurrent disease after esophagectomy bears an infaust prognosis, especially when multiple recurrences are present. But little is known about survival in patients with limited recurrence (solitary locoregional recurrence or solid organ metastasis). Herein, we report our experience with these subgroups. We analyzed 1754 consecutive patients surgically treated with curative resection for esophageal cancer and cancer of the gastroesophageal junction between 1990 and 2012. Seven subgroups were defined according to the recurrence type (locoregional vs. organ metastasis), the site of recurrence (abdominal, thoracic, cervical for lymph nodes and lung, liver, adrenals and others for organ metastasis) and also the number of lesions (one vs. multiple lymph node stations or organ metastasis) Of these groups; clinical isolated locoregional recurrence (ciLR) was defined as solitary lymph-node recurrence confined to one compartment (cervical, thoracic or abdominal, within or outside surgical dissection-field) at clinical staging. Clinical solitary solid organ metastasis (csSOM) was defined as metastasis in a resectable solid organ, i.e. liver, lung, brain or adrenal. Salvage therapies were grouped in five categories. Kaplan-Meier curves were used to calculate survival. Recurrent disease was observed in 766 patients (43.7%) with overall 5-year survival of 4.5% after diagnosis of recurrence. Fifty-seven patients (7.4%) showed ciLR and 110 (14.4%) csSOM. Median time-to-recurrence was 16.8 months in ciLR and 9.9 months in csSOM (P = 0.0074). Survival is significantly improved compared to supportive therapy when local therapy is possible (P < 0.0001). In 25 (15%) of ciLR or csSOM patients, surgical therapy with or without systemic therapy, yielded a 5-year survival of 49.9% (median 54.8 months) after diagnosis of recurrence. When surgery was impossible or contraindicated, the combination of chemoradiotherapy appeared to be superior to chemotherapy alone (respectively 27.0% vs. 4.6% 5-year survival) or radiotherapy alone (no 5-year survival). Recurrent disease after esophagectomy is a common problem with poor overall survival. However prolonged survival could be obtained in selected patients if the recurrent disease is limited to ciLR or csSOM, if surgery (+/- systemic therapy) can be performed. If not a combination of chemoradiotherapy seems to offer the second best option. Patients presenting with a ciLR or csSOM should be discussed in a dedicated multidisciplinary team meeting as to evaluate and define the place of salvage treatment which in well selected cases could offer a perspective of prolonged survival.
Associations Between Fine Motor Performance in Activities of Daily Living and Cognitive Ability in a Nondemented Sample of Older Adults: Implications for Geriatric Physical Rehabilitation

Objective: Fine motor ability (FMA) is essential in certain activities of daily living (ADL) and is considered mostly as a component of physical function. We hypothesize that cognitive ability explains significant variance in ADL-related FMA, above and beyond what is explained by physical ability (grip strength). Method: Origins of Variance in the Old Old Study (OCTO)-Twin participants (n = 218), aged 80+ (dementia, stroke, Parkinson’s disease excluded) were assessed on depressive symptoms (Center for Epidemiologic Studies–Depression Scale [CES-D]), a cognitive battery, grip strength, and FMA. Results: In a series of ordinary least squares regression models, FMA was not associated with gender or depressive symptoms, but was associated with age (marginally; β = −.164, p = .051), grip strength (β = −.381, p < .01), and one cognitive measure, perceptual speed (β = −.249, p < .01). Discussion: In nondemented older adults, cognitive speed predicts ADL-related FMA after controlling for age and physical ability. Physical rehabilitation of FMA in ADL tasks should consider the importance of cognitive ability, even in nondemented older adults.
A Large Scale Genetic Analysis of c-Myc-regulated Gene Expression Patterns* 210

The myc proto-oncogenes encode transcriptional regulators whose inappropriate expression is correlated with a wide array of human malignancies. Up-regulation of Myc enforces growth, antagonizes cell cycle withdrawal and differentiation, and in some situations promotes apoptosis. How these phenotypes are elicited is not well understood, largely because we lack a clear picture of the biologically relevant downstream effectors. We created a new biological system for the optimal profiling of Myc target genes based on a set of isogenic c-myc knockout and conditional cell lines. The ability to modulate Myc activity from essentially null to supraphysiological resulted in a significantly increased and reproducible yield of targets and revealed a large subset of genes that respond optimally to Myc in its physiological range of expression. The total extent of transcriptional changes that can be triggered by Myc is remarkable and involves thousands of genes. Although the majority of these effects are not direct, many of the indirect targets are likely to have important roles in mediating the elicited cellular phenotypes. Myc-activated functions are indicative of a physiological state geared toward the rapid utilization of carbon sources, the biosynthesis of precursors for macromolecular synthesis, and the accumulation of cellular mass. In contrast, the majority of Myc-repressed genes are involved in the interaction and communication of cells with their external environment, and several are known to possess antiproliferative or antimetastatic properties.
Typhoon Interaction with the Taiwan Topography During the Tropical Cyclone Structure - 2008 (TCS-08) Experiment

Abstract : The importance of accurate typhoon forecasts to the island of Taiwan and the existing challenges in this area are reviewed by Wu and Kuo (1999). A particular area of emphasis is understanding the physical processes resulting from the interaction between typhoons and the Central Mountain Range, which runs across the center of the island. Wu and Kuo (1999) discuss much of the earlier research in this area, but additional work has continued to be done in the last decade with an increasing focus on the resulting precipitation distributions over the island. While idealized studies such as Lin et al. (2005) have been important in clarifying the basic theory of cyclone-terrain interaction, case studies of actual events continue to be necessary to apply these theoretical ideas to real storms. The island of Taiwan was located within the study area of the Tropical Cyclone Structure - 2008 (TCS08) experiment which was carried out in August and September of 2008 in the western North Pacific. During the course of the TCS08, two storms made landfall on Taiwan: Typhoon Sinlaku in mid-September and Typhoon Jangmi two weeks later. These storms were both distinguished by especially large maximum rainfall accumulations, particularly in the case of Sinlaku. In this study, we will examine the effect of the Taiwan terrain on the track and precipitation distribution of these two storms using real data numerical model simulations. We will also present preliminary model results from Typhoon Morakot which struck Taiwan a year after TCS08 and produced as much rainfall as Sinlaku and Jangmi combined.
Renal ultrasound findings and their clinical associations in nephropathia epidemica: Analysis of quantitative parameters

Purpose: To evaluate renal US findings in patients with nephropathia epidemica (NE) and to determine whether changes in these findings are related to the clinical course of NE. Material and Methods: Renal US was undertaken in 23 hospital-treated NE patients during the acute phase of their disease (first study). The second US study was performed 3–6 months later. Results: The resistive index (RI) was abnormal in 12 patients and fluid collections (perirenal, pleural, pericardial, ascites) were found in 13 patients in the first study. Renal length decreased in every patient, cortical parenchymal thickness in 19 patients and RI in 18 patients from the first to the second studies. The mean change was significant in all parameters. Increased RI and presence of fluid collections in the first study as well as a greater change in length and RI between the first and the second studies were associated with high maximum daily urine excretion, substantial change in body weight between the anuric and polyuric phases, high maximum serum creatinine and urea concentration, high blood leukocyte count and low hematocrit value. Conclusion: Renal US changes occurred in every patient with NE. The severity of the findings was associated with fluid volume overload and degree of clinical renal insufficiency.
Role of organisational factors on the ‘weekend effect’ in critically ill patients in Brazil: a retrospective cohort analysis

Introduction Higher mortality for patients admitted to intensive care units (ICUs) during the weekends has been occasionally reported with conflicting results that could be related to organisational factors. We investigated the effects of ICU organisational and staffing patterns on the potential association between weekend admission and outcomes in critically ill patients. Methods We included 59 614 patients admitted to 78 ICUs participating during 2013. We defined ‘weekend admission’ as any ICU admission from Friday 19:00 until Monday 07:00. We assessed the association between weekend admission with hospital mortality using a mixed logistic regression model controlling for both patient-level (illness severity, age, comorbidities, performance status and admission type) and ICU-level (decrease in nurse/bed ratio on weekend, full-time intensivist coverage, use of checklists on weekends and number of institutional protocols) confounders. We performed secondary analyses in the subgroup of scheduled surgical admissions. Results A total of 41 894 patients (70.3%) were admitted on weekdays and 17 720 patients (29.7%) on weekends. In univariable analysis, weekend admitted patients had higher ICU (10.9% vs 9.0%, P<0.001) and hospital (16.5% vs 13.5%, P<0.001) mortality. After adjusting for confounders, weekend admission was not associated with higher hospital mortality (OR 1.05, 95% CI 0.99 to 1.12, P=0.095). However, a ‘weekend effect’ was still observed in scheduled surgical admissions, as well as in ICUs not using checklists during the weekends. For unscheduled admissions, no ‘weekend effect’ was observed regardless of ICU’s characteristics. For scheduled surgical admissions, a ‘weekend effect’ was present only in ICUs with a low number of implemented protocols and those with a reduction in the nurse/bed ratio and not applying checklists during weekends. Conclusions ICU organisational factors, such as decreased nurse-to-patient ratio, absence of checklists and fewer standardised protocols, may explain, in part, increases in mortality in patients admitted to the ICU mortality on weekends.
Dialogical Action Research at Omega Corporation

In dialogical action research, the scientific researcher does not "speak science" or otherwise attempt to teach scientific theory to the real-world practitioner, but instead attempts to speak the language of the practitioner and accepts him as the expert on his organization and its problems. Recognizing the difficulty that a practitioner and a scientific researcher can have in communicating across the world of science and the world of practice, dialogical action research offers, as its centerpiece, reflective one-on-one dialogues between the practitioner and the scientific researcher, taking place periodically in a setting removed from the practitioner's organization. The dialogue itself serves as the interface between the world of science, marked by theoria and the scientific attitude, and the world of the practitioner, marked by praxis and the natural attitude of everyday life. The dialogue attempts to address knowledge heterogeneity, which refers to the different forms that knowledge takes in the world of science and the world of practice, and knowledge contextuality, which refers to the dependence of the meaning of knowledge, such as a scientific theory or professional expertise, on its context. In successive dialogues, the scientific researcher and the practitioner build a mutual understanding, including an understanding of the organization and its problems. The scientific researcher, based on one or more of the scientific theories in her discipline, formulates and suggests one or more actions for the practitioner to take in order to solve or remedy a problem in his organization. Dialogical action research recognizes that the practitioner's experience, expertise, and tacit knowledge, or praxis, largely shapes how he understands the suggested actions and appropriates them as his own. Upon returning to his organization, he takes one or more of the suggested actions, depending on his reading of the situation at hand. The reactions or responses of the problem to the actions or stimuli of the practitioner would embody, in the practitioner's eyes, success or failure in solving or remedying the problem and, in the scientific researcher's eyes, evidence confirming or disconfirming the theory on which the action was based. The scientific researcher may then suggest, based on her theories, additional actions, hence initiating another cycle of action and learning. To illustrate dialogical action research, this paper reconstructs some dialogues between an information systems researcher and a managing director at a European company called Omega Corporation.
Electrical contact bounce in medium duty contacts

The basic phenomena of electrical contact bounce with the passage of current, in the medium duty range (1 to 30 A AC and DC), are investigated. Experimental results presented show that by considering individual impacts, an understanding of how current affects contact bounce is achieved. An automated test system is used to evaluate contact bounce. The surface degradation is evaluated by endurance testing, allowing the development of empirical relations between mechanical and electrical bounce. With this understanding it is shown how arc energy dissipation can be reduced by the designed reduction of impact kinetic energy, leading to prolonged contact life. <<ETX>>
Determinants of enhanced thromboxane biosynthesis in patients with systemic lupus erythematosus.

OBJECTIVE To evaluate the rate of thromboxane biosynthesis in patients with systemic lupus erythematosus (SLE), exploring the interplay between antiphospholipid antibodies (aPL) and 2 markers of endothelial perturbation: thrombin generation and platelet activation. METHODS A comparison of 11-dehydrothromboxane B2 (TXB2) excretion, which is a marker of in vivo platelet activation, aPL, von Willebrand factor (vWF) and tissue plasminogen activator (tPA), which are 2 circulating markers of endothelial perturbation, and plasma levels of the prothrombin fragment F1+2, which is a marker of thrombin generation, was performed in 40 SLE patients and 40 healthy subjects. Thromboxane metabolite excretion was also measured in 8 SLE patients before and after treatment with low-dose aspirin. RESULTS SLE patients had significantly higher 11-dehydro-TXB2 excretion, plasma F1+2, vWF, and tPA levels than controls. A statistically significant correlation was found between plasma levels of vWF and tPA and excretion of thromboxane metabolite. Moreover, significantly higher 11-dehydro-TXB2 was found in patients with aPL positivity and endothelial perturbation. Low-dose aspirin suppressed 11-dehydro-TXB2 by 80%, suggesting a predominant platelet source of enhanced thromboxane biosynthesis. After a median followup of 48 months, all SLE patients who experienced major cardiovascular events had thromboxane metabolite excretion, aPL positivity, and signs of endothelial perturbation. CONCLUSION We have characterized a sensitive marker of platelet activation, which is abnormal in SLE patients who were positive for aPL and endothelial perturbation. This analytical approach may help identify those patients at increased risk of thrombosis as potential candidates for antiplatelet therapy.
Matching between oral inward–outward movements of object names and oral movements associated with denoted objects

ABSTRACT In eight experiments, we explored matching effects between oral approach–avoidance movements triggered by word articulation and meaning of the objects the words denoted. Participants (total N = 1264) rated their liking for words that featured consonantal muscle stricture spots either wandering inwards (e.g., BODIKA, resembling ingestion movements) or outwards (e.g., KODIBA, resembling expectoration movements). These words were labelled as names for various objects. For objects the use of which entails ingestive oral actions (lemonade and mouthwash) inward words were preferred over outward words. For objects that trigger expectorative oral actions (toxical chemical, pill, and bubble gum) this preference was attenuated or even reversed (outward words were liked more than inward). Valence of the denoted object did not play a role in these modulations. Thus, the sagittal direction of mouth movements during silent reading meaningfully interacted with direction of oral actions associated with the denoted objects.