Miracle-dz/UniFAR-FTUs huggingface dataset:
Improving the asthma disparity gap with legal advocacy? A qualitative study of patient-identified challenges to improve social and environmental factors that contribute to poorly controlled asthma

ABSTRACT Objective: To identify challenges that disadvantaged adults with asthma face in mitigating social and environmental factors associated with poor symptom control. Methods: Using a community-engaged approach, we partnered with a community health center in New Haven, CT to conduct in-person interviews and a written survey of asthmatic adults with poor symptom control. Using the constant comparative method, we analyzed participant interviews to establish emerging themes and identify common barriers to improved outcomes. Through a written survey utilizing clinically validated questions, we assessed information on access to medical care, asthma control, and selected social and environmental risk factors. Results: Twenty-one patients (mean age 47, 62% female, 71% Black, 95% insured by Medicaid) participated. The average Asthma Control Test (ACT) score was 11.6. Seventy-six percent of participants were currently employed and of those, 75% reported work-related symptoms. Among participants currently in housing, 59% reported exposure to domiciliary mice and 47% to mold. We identified three themes that summarize the challenges the study participants face: 1) Lack of knowledge about home and workplace asthma triggers; 2) Lack of awareness of legal rights or resources available to mitigate adverse conditions in the home or work environment; and 3) Fear of retaliation from landlords or employers, including threats of eviction, sexual assault, and job loss. Conclusion: Patients with poorly controlled asthma in a disadvantaged urban northeast community identified common barriers in both the domestic and work environments that impeded attainment of symptom control. These challenges may be best addressed through legal advocacy for those most at risk.
Design of crosswalks for children A synthesis of best practice

A synthesis of best practice was done to come up with a "best design" of crosswalks used by children. The analysis is based on studies from three sites in Sweden and three in Israel, research results concerning "ideal" interactions, and a review of additional countermeasures as described in the literature. Our presumption is that actual vehicle speeds should be below 20 km/h where children (aged 7 to 12 years) are crossing a street, especially if they are walking unaccompanied by an adult. The results of field studies show that a "best design" to reach this should include a speed-reducing device located before the crosswalk. The optimal distance from such a device to the crosswalk is about 10 m if the speed limit is 30 km/h or lower. For streets with 50 km/h speed limits, a longer distance of 15 to 20 m is needed and, as a complimentary measure, the crosswalk itself should also be elevated. At approaches with two lanes or more, multiple-threat conflicts occur due to vehicles overtaking stopped ones in the adjacent lane. These conflicts are a threat especially to children, as they often are hidden behind the stopped vehicle if it has stopped too close to the crosswalk. To provide a stronger message for alerting drivers to stop and to stop early, and not to overtake a stopped car in an adjacent lane, advanced yield bars or stop lines are needed. For those, a distance to the crosswalk of about 10 m is recommended. To secure travel speeds below 20 km/h, additional measures like camera enforcement of speeds near the crosswalk might be needed. Within a few years, ITS technology may govern speeds at marked crosswalks, and speed-reducing measures will be less needed at that time. However, for the foreseeable future, older vehicles lacking such technology will still be allowed on streets and even in newer vehicles, speed-control systems may be voluntary and possible to switch off. Therefore, we believe that investments into the measures discussed in this paper will have a role to play for decades to come.
Absenteeism and Associated Factors in Workers of a High-Level Educational Institution, Cartagena-Colombia

To analyze the sociodemographic characteristics, organizational factors and cardiovascular risk factors related to work absenteeism in a higher education institution in the city of Cartagena-Colombia. Cross-sectional analytical study with a probabilistic sample of 162 workers. We recorded sociodemographic data, personal and family history, in addition, we performed a physical examination that included: abdominal circumference, height, weight and blood pressure. Also, clinical laboratory tests were performed for the analysis of lipid profile (total cholesterol, HDL cholesterol and triglycerides) and fasting blood glucose, determined by enzymatic colorimetric and automated methods. A frequency of absenteeism of 24.7% was estimated, being more frequent in the age group of 40 to 49 years and with a statistically significant difference between women and men. All the organizational variables studied showed a statistical association with work absenteeism. In contrast, the only cardiovascular risk factors that showed statistical association were: abdominal obesity and personal history of arterial hypertension. The evidences found allow us to think about the need to implement, immediately, a program of lifestyle change and healthy work, which includes a motivational strategy of change that, together, reduce the occurrence of absenteeism and the prevalence of cardiovascular risk factors found in the study population.
A study and comparative analysis of managerial and leadership effectiveness in the National Health Service: an empirical factor analytic study within an NHS Trust hospital

The research described in this article was concerned primarily with identifying the criteria of managerial/leadership effectiveness applying at the middle and front line levels of management within an NHS Trust Hospital using critical incident technique and factor analysis methods. The findings suggest that the self-perceptions of managers and the perceptions of superiors and subordinates are very similar, and only differ on a limited number of criteria. This challenges the 'perspective-specific' models of managerial effectiveness advocated by some researchers. The results are compared against those from a near identical study carried out by the author within one part of the British Civil Service, and the results from a different but comparable factor analytic study carried out by other researchers elsewhere in the NHS. The results suggest the existence of generalized criteria of managerial effectiveness, which lend considerable support to the notion of the 'universally effective manager'. This challenges the 'contingent models' of managerial effectiveness advocated by various expert commentators. In addition, the research supports the new model of transformational leadership offered by Alimo-Metcalfe and Alban-Metcalfe for application within both the NHS and local government, and adds to the empirical base supporting the current drive towards evidence-based practice in management within the healthcare sector.
Sequential Emergence of Antibiotic Resistance in Enterococcal Bloodstream Isolates over 25 Years

ABSTRACT We determined the antibiotic susceptibilities of 1,785 enterococcal bloodstream isolates collected over 25 years. Antibiotic resistance emerged at a greater rate in Enterococcus faecium than in other enterococcal species, and E. faecium isolates became proportionally more common over time. Our findings confirm the pattern of emerging antibiotic resistance among enterococci and highlight the increasing importance of E. faecium as a cause of bloodstream infection.
All‐Hazards Homeowners Insurance: Challenges and Opportunities

In the United States, standard homeowners insurance policies cover damages resulting from fire, wind, and hail, but exclude damages caused by floods and earthquakes. This is not the practice worldwide: several countries include all perils in homeowners insurance. Building on two fundamental insurance principlesâ€”that premiums reflect risk and that support for lowâ€ income households come from public funding, not insurance premium subsidiesâ€”this article proposes a strategy for developing an allâ€ hazards homeowners insurance policy in the United States that should be attractive to both private insurers and property owners. It outlines critical supporting roles for the public sector and proposes modifications to the National Flood Insurance Program that could provide a foundation for allâ€ hazards insurance.
Analgesic effects of botulinum toxin A: a randomized, placebo‐controlled clinical trial

Postoperative pain in children with spastic cerebral palsy (CP) is often attributed to muscle spasm and is difficult to manage using opiates and benzodiazepines. Adductor‐release surgery to treat or prevent hip dislocation in children with spastic CP is frequently performed and is often accompanied by severe postoperative pain and spasm. A double‐blinded, randomized, placebo‐controlled clinical trial of 16 patients (mean age 4.7 years) with a mainly spastic type of CP (either diplegic or quadriplegic in distribution) was used to test the hypothesis that a significant proportion of postoperative pain is secondary to muscle spasm and, therefore, might be reduced by a preoperative chemodenervation of the target surgical muscle by intramuscular injection of botulinum toxin A (BTX/A). Compared with the placebo, BTX/A was found to be associated with a reduction in mean pain scores of 74% (P<0.003), a reduction in mean analgesic requirements of approximately 50% (P<0.005), and a reduction in mean length of hospital admission of 33% (P<0.003). It was concluded that an important component of postoperative pain in the patient population is due to muscle spasm and this can be managed effectively by preoperative injection with BTX/A. These findings may have implications for the management of pain secondary to muscle spasm in other clinical settings.
Loss of mitochondrial membrane potential is associated with increase in mitochondrial volume: Physiological role in neurones

Mitochondrial volume homeostasis is a housekeeping cellular function, thought to help regulate oxidative capacity, apoptosis, and mechanical signaling. The volume is mainly regulated by potassium flux into and out of the matrix and controlled by the electrochemical potential. Mitochondrial depolarization will therefore affect this flux but studies showing how have not been consistent, and it is unclear what mitochondrial volume changes also occur. The aim of the present study was to investigate mitochondrial volume changes in permeabilized neurons under various bioenergetic conditions using deconvolution confocal microscopy. Under control conditions, mitochondria in situ appeared rod‐shaped with mean length, surface area, and volume values of 2.29 ± 0.10 µm, 1.41 ± 0.10 µm2, and 0.062 ± 0.006 µm3, respectively (n = 42). Valinomycin, a K+‐selective ionophore, increased mitochondrial volume by 63 ± 22%, although surface area was almost unchanged because mitochondrial shape became more spherical. Pinacidil, an opener of mitochondrial ATP‐dependent channels, produced similar effects, although some mitochondria were insensitive to its action. Mitochondrial depolarization with the protonophore FCCP, or with respiratory chain inhibitors antimycin and sodium azide was associated with a considerable increase in mitochondrial volume (by 75%–140%). Effects of mitochondrial modulators were also studied in intact neurones. Tracking of single mitochondria showed that during 65 ± 2% of their time, mitochondria were motile with an average velocity of 0.19 ± 0.01 µm/s. Antimycin, azide, and FCCP induced mitochondrial swelling and significantly decreased mitochondrial motility. In the presence of pinacidil, swollen mitochondria had reduced their motility, although mitochondria with normal volume stayed motile. These data show that mitochondrial depolarization was followed by significant swelling, which, in turn, impaired mitochondrial trafficking. J. Cell. Physiol. 206: 347–353, 2006. © 2005 Wiley‐Liss, Inc.
Social constraint and an absence of sex‐biased dispersal drive fine‐scale genetic structure in white‐winged choughs

This study used eight polymorphic microsatellite loci to examine the relative effects of social organization and dispersal on fine‐scale genetic structure in an obligately cooperative breeding bird, the white‐winged chough (Corcorax melanorhamphos). Using both individual‐level and population‐level analyses, it was found that the majority of chough groups consisted of close relatives and there was significant differentiation among groups (FST = 0.124). However, spatial autocorrelation analysis revealed strong spatial genetic structure among groups up to 2 km apart, indicating above average relatedness among neighbours. Multiple analyses showed a unique lack of sex‐biased dispersal. As such, choughs may offer a model species for the study of the evolution of sex‐biased dispersal in cooperatively breeding birds. These findings suggest that genetic structure in white‐winged choughs reflects the interplay between social barriers to dispersal resulting in large family groups that can remain stable over long periods of times, and short dispersal distances which lead to above average relatedness among neighbouring groups.
Prevalence and Laboratory Profile of Hepatitis B Virus Co-infected Nigerian Children with Human Immunodeficiency Virus

Aims: To determine the prevalence of HBV co-infection in HIV-infected children and compare the baseline laboratory profile of mono-infected and co-infected patients. Study Design: This was a retrospective cohort study. Place and Duration of Study: AIDS Prevention Initiative in Nigeria (APIN)-supported HIV clinic of Jos University Teaching Hospital, Jos, Nigeria between January 2008 and December 2012. Original Research Article International Journal of TROPICAL DISEASE & Health, 4(7): 773-781, 2014 774 Methodology: We reviewed the clinical records of 452 treatment-naive children aged 2 months to 15 years confirmed to be HIV positive with Polymerase Chain Reaction (PCR) for children <18 months or Western blot for children ≥18 months. The baseline laboratory tests included: HBsAg, plasma viral load and alanine transaminase (ALT), CD4T cell count for children ≥5years or CD4T cell % for children <5years. Results: Three hundred and ninety-four (87.2%) were mono-infected with HIV while 58 (12.8%) were co-infected with HIV and HBV (HIV/HBV). At baseline, the median viral load was 4.6 log copies/mL for mono-infected compared to 4.7 log copies/mL for HIV/HBV (P=.48). The median CD4T cell count was 366 cells/μL for mono-infected compared to 332 cells/μL for HIV/HBV (P=.64). The median CD4T cell % was 19% for mono-infected compared to 17% for HIV/HBV (P =.29). The median ALT level for the whole cohort was 23 IU/L for mono-infected compared to 26 IU/L for HIV/HBV (P=.15). However the median ALT level for mono-infected children aged 11-15 years was 28IU/L compared to 43 IU/L for co-infected children of same age (P =.008). Conclusion: A high rate of hepatitis B co-infection was observed in HIV-infected children at our centre; however more severe HIV disease was not observed. Older children coinfected with HBV had significantly higher ALT levels compared to their mono-infected counterparts. Early detection is therefore necessary in order to develop an appropriate treatment plan for children co-infected with HIV and HBV.
A performance comparison of FBMC modulation schemes with short perfect reconstruction filters

In this paper, we study the performance of filter bank based multicarrier (FBMC) transmission systems over doubly-dispersive channels. FBMC generalizes traditional orthogonal frequency-division multiplexing (OFDM) schemes, allowing a non-rectangular sub-channel pulse shape in the time domain. This approach leads to a better spectral containment that improves interference mitigation in several time-variant environments. A general analysis describes the transmultiplexer structure and the time-variant multipath channel model. We specify rectangular filters and short perfect reconstruction (PR) filters that give rise to two families of FBMC transceivers. A performance comparison between these schemes is performed in terms of bit-error-rate using a single-tap per sub-channel equalizer. This study emphasizes the low complexity of the FBMC transceivers in the case of short filters and discusses its usefulness through simulation results in two mobility scenarios.
Oral mucositis in pediatric patients undergoing hematopoietic stem cell transplantation: Clinical outcomes in a context of specialized oral care using low‐level laser therapy

OM is a painful inflammatory condition of the oral mucosa, derived from the toxic effects of chemotherapy and radiotherapy. High OM severity is frequently present in HSCT pediatric patients, who exhibit multiple painful ulcers that limit their mastication and swallowing, leading to poor nutritional status. Few studies have demonstrated OM clinical outcomes in young patients undergoing HSCT. Feasibility of oral care and LLLT on OM prophylaxis and treatment is also poorly discussed. The aim of this study was to describe a specialized oral care protocol that included LLLT for pediatric patients undergoing transplantation and to demonstrate the clinical outcomes after OM prevention and treatment. Data from OM‐related morbidity were collected from 51 HSCT pediatric patients treated daily with LLLT, followed by standard oral care protocols. All the patients, even infants and young children, accepted the daily oral care and LLLT well. The majority (80.0%) only exhibited erythema in the oral mucosa, and the maximum OM degree was WHO II. Patients who had undergone autologous and HLA‐haploidentical transplants showed OM with the lowest severity. The frequency of total body irradiation and methotrexate prescriptions was higher in adolescents when compared with infants (p = 0.044), and adolescents also exhibited OM more severely than infants and young children. We found that good clinical outcomes were obtained using this therapy, mainly in regard to the control of OM severity and pain reduction in the oral cavity. Specialized oral care, including LLLT, is feasible and affordable for HSCT pediatric patients, although some adaptation in the patient's oral hygiene routine must be adopted with help from parents/companions and clinical staff.
Corticosteroids in the treatment of severe sepsis and septic shock in adults: a systematic review.

CONTEXT The benefit of corticosteroids in severe sepsis and septic shock remains controversial. OBJECTIVE We examined the benefits and risks of corticosteroid treatment in severe sepsis and septic shock and the influence of dose and duration. DATA SOURCES We searched the CENTRAL, MEDLINE, EMBASE, and LILACS (through March 2009) databases as well as reference lists of articles and proceedings of major meetings, and we contacted trial authors. STUDY SELECTION Randomized and quasi-randomized trials of corticosteroids vs placebo or supportive treatment in adult patients with severe sepsis/septic shock per the American College of Chest Physicians/Society of Critical Care Medicine consensus definition were included. DATA EXTRACTION All reviewers agreed on trial eligibility. One reviewer extracted data, which were checked by the other reviewers and by the trials' authors whenever possible. Some unpublished data were obtained from the trials' authors. The primary outcome for this review was 28-day mortality. RESULTS We identified 17 randomized trials (n = 2138) and 3 quasi-randomized trials (n = 246) that had acceptable methodological quality to pool in a meta-analysis. Twenty-eight-day mortality for treated vs control patients was 388/1099 (35.3%) vs 400/1039 (38.5%) in randomized trials (risk ratio [RR], 0.84; 95% confidence interval [CI], 0.71-1.00; P = .05; I(2) = 53% by random-effects model) and 28/121 (23.1%) vs 24/125 (19.2%) in quasi-randomized trials (RR, 1.05, 95% CI, 0.69-1.58; P = .83). In 12 trials investigating prolonged low-dose corticosteroid treatment, 28-day mortality for treated vs control patients was 236/629 (37.5%) vs 264/599 (44%) (RR, 0.84; 95% CI, 0.72-0.97; P = .02). This treatment increased 28-day shock reversal (6 trials; 322/481 [66.9%] vs 276/471 [58.6%]; RR, 1.12; 95% CI, 1.02-1.23; P = .02; I(2) = 4%) and reduced intensive care unit length of stay by 4.49 days (8 trials; 95% CI, -7.04 to -1.94; P < .001; I(2) = 0%) without increasing the risk of gastroduodenal bleeding (13 trials; 65/800 [8.1%] vs 56/764 [7.3%]; P = .50; I(2) = 0%), superinfection (14 trials; 184/998 [18.4%] vs 170/950 [17.9%]; P = .92; I(2) = 8%), or neuromuscular weakness (3 trials; 4/407 [1%] vs 7/404 [1.7%]; P = .58; I(2) = 30%). Corticosteroids increased the risk of hyperglycemia (9 trials; 363/703 [51.6%] vs 308/670 [46%]; P < .001; I(2) = 0%) and hypernatremia (3 trials; 127/404 [31.4%] vs 77/401 [19.2%]; P < .001; I(2) = 0%). CONCLUSIONS Corticosteroid therapy has been used in varied doses for sepsis and related syndromes for more than 50 years, with no clear benefit on mortality. Since 1998, studies have consistently used prolonged low-dose corticosteroid therapy, and analysis of this subgroup suggests a beneficial drug effect on short-term mortality.
Effective enterprise communication and learning attitude in business performance : a case study on SMEs

The purpose of this paper is to describe the role of entrepreneurial communication in entrepreneurial learning and how such communication shapes business attitudes which in turn impact on perfromance of the small-medium enterprises in Indonesia. The data for this research was derived from small medium entreprenuers from the furniture industry around Bandung, a capital city of the West Java Province. The data collection techniques, included observations, interviews, reading compiled data and also use of audio-visual analyses and simulations. This study concludes that good business or entrepreneurial communication is of great contribution to entrepreneurial learning which in turn affects performances of enterprises including small-medium enterprises across Indonesia as one of the fastest emerging economies in Southeast Asia.This therefore means that in an effort to build strong small-medium enterprises there is need for better business communication, better entrepreneurial learning approaches which are able to impact on the performance and attitudes of the small-medium enterprise owners moreso a developing country such as Indonesia.