Miracle-dz/UniFAR-FTUs huggingface dataset:
Randomized trial comparing intraoral ultrasound to landmark-based needle aspiration in patients with suspected peritonsillar abscess.

OBJECTIVES Traditionally, emergency physicians (EPs) have used anatomic landmark-based needle aspiration to drain peritonsillar abscesses (PTAs). If this failed, an imaging study and/or consultation with another service to perform the drainage is obtained. Recently, some EPs have used ultrasound (US) to guide PTA drainage. This study seeks to determine which initial approach leads to greater successful drainage. The primary objective of this study was to compare the diagnostic accuracy of EPs for detecting PTA or peritonsillar cellulitis (PTC) using either intraoral US or initial needle aspiration after visual inspection (the landmark technique [LM]). Secondary objectives included the successful aspiration of purulent material in those patients with a PTA in each arm, the use of computed tomography (CT) scanning in each arm, and the otolaryngology (ENT) consultation rate in each arm. METHODS This was a prospective, randomized, controlled clinical trial of a convenience sample of adult patients who presented to a single, large, urban university hospital. Patients were enrolled if they presented with a constellation of signs and symptoms that were judged to be a PTA. These patients were randomized to receive intraoral US or to undergo LM drainage. The US was performed using an 8-5 MHz intracavitary transducer immediately prior to the procedure. The probe was then withdrawn and the provider who did the US also performed the needle aspiration. The LM was performed using visual landmarks in a superior to inferior approach until pus was obtained or at least two sticks were performed. Anesthesia was standardized. Patients returned for follow-up in 2 days where a final diagnosis was rendered. RESULTS There were 28 patients enrolled, with 14 in each arm. US established the correct diagnosis more often than LM [(100%, 95% confidence interval [CI] = 75% to 100% vs. 64%, 95% CI = 39% to 84%; p = 0.04)]. US also led to more successful aspiration of purulent material by the EP than LM in patients with PTA [(100%, 95% CI =63% to 100% vs. 50%, 95% CI = 24% to 76%; p = 0.04)]. The ENT consult rate was 7% (95% CI = 0% to 34%) for US versus 50% (95% CI = 27% to 73%) for LM (p = 0.03). The CT usage rate was 0% for US versus 35% for LM (p = 0.04). CONCLUSIONS An initial intraoral US performed by EPs can reliably diagnose PTC and PTA. Additionally, using intraoral US to assist in the drainage of PTAs with needle aspiration leads to greater success compared to the traditional method of LM relying on physical exam alone.
Gray matter correlations of cognition in incident Parkinson's disease

We aimed to investigate whether mild cognitive impairment (MCI) in Parkinson's disease (PD) is characterized by region‐specific gray matter (GM) atrophy and to explore correlations between GM and cognition in PD. Magnetic resonance images of 42 newly diagnosed PD patients (of which 11 had MCI) and 37 normal controls were analyzed using voxel‐based morphometry. Analyses comparing groups showed no regional atrophy, and in patients there were no significant correlations between cognitive domain test performance and GM loss. In conclusion, GM atrophy does not seem to be a major feature of cognitive dysfunction in incident PD. © 2010 Movement Disorder Society
In vitro and in vivo activities of piritetrate (M-732), a new antidermatophytic thiocarbamate

Piritetrate (M-732), a new topical antifungal agent belonging chemically to the thiocarbamates, was demonstrated to possess a potent selective antidermatophytic activity. In terms of its MICs in susceptibility testing, mainly done by using Sabouraud dextrose agar plates, piritetrate exhibited several- to 10-fold-stronger antidermatophytic activity than tolnaftate, a reference thiocarbamate. Furthermore, piritetrate was found to show a broader antifungal spectrum than tolnaftate; relatively many species and strains of dematiaceous fungi, dimorphic fungi, and some other filamentous fungi as well as a few strains of Cryptococcus neoformans were fairly susceptible to piritetrate, while almost all the tested species and strains were resistant to tolnaftate. All the tested species of the genus Candida were, however, resistant to both compounds. Variables which can influence antimicrobial activity caused few changes in the MICs of either compound against Trichophyton mentagrophytes; however, an increase in the inoculum size resulted in a significant increase in the MICs. The antidermatophytic activities of piritetrate and tolnaftate were fungistatic but not fungicidal. Piritetrate also exhibited a more potent in vitro anti-T. mentagrophytes activity than clotrimazole or tolciclate. Piritetrate and tolnaftate had no antibacterial activity. The in vivo activity of topically administered piritetrate against experimental dermal infection of guinea pigs with T. mentagrophytes was more effective than that of tolnaftate both mycologically and clinically. Piritetrate manifested no acute toxicity in laboratory animals when administered even in large quantities by the oral, intraperitoneal, and topical routes.
Violence Prevention in a Small-scale Psychiatric Unit: Program Planning and Evaluation

Abstract Aggression against nurses and ancillary personnel is a major—overall under-reported—occupational problem in sociomedical facilities for psychiatric and demented patients. The frequency of violent incidents against workers in a residential rehabilitation unit was assessed during medical examinations in the workplace between 1996 and 2009. The majority of the workers had been subjected to physical aggression over time. A violence prevention program that included educational, organizational, and medical measures was implemented in 2002. Interrupted time series analysis showed that the aggression trend prior to intervention was flat (β1 = –0.004; SD = 0.003; P = 0.241), while there was a significant drop in aggressions after the intervention (β2 = –0.149; SD = 0.018; P < 0.0001). No late increase in trend was observed in the post-intervention period (β3 = –0.006; SD = 0.004; P = 0.175). The program contributed to reducing violence in the workplace.
A Postfunctionalist Theory of European Integration: From Permissive Consensus to Constraining Dissensus

Preferences over jurisdictional architecture are the product of three irreducible logics: efficiency, distribution and identity. This article substantiates the following claims: (a) European integration has become politicized in elections and referendums; (b) as a result, the preferences of the general public and of national political parties have become decisive for jurisdictional outcomes; (c) identity is critical in shaping contestation on Europe.
Tuning of power system stabilizers via genetic algorithm for stabilization of power system

The paper considers simultaneous placement and tuning of power system stabilizers for stabilization of power systems over a wide range of operating conditions using genetic algorithm. The power system operating at various conditions is considered as a finite set of plants. The problem of setting parameters of power system stabilizers is converted as a simple optimization problem that is solved by a genetic algorithm and an eigenvalue-based objective function. A single machine -infinite bus system and a multi-machine system are considered to test the suggested technique. The optimum placement and tuning of parameters of PSSs are done simultaneously. A PSS tuned using this procedure is robust at different operating conditions and structure changes of the system.
Sibling Relationships Among Children With ADHD

Objective: This study investigated the quality of sibling relationships among children with ADHD relative to those without ADHD. Additional analyses examined whether externalizing and internalizing problems comorbid with ADHD affected sibling relationships. Method: Participants were 77 children with ADHD and 14 nonproblem control children. Sibling relationships were assessed via three informants: mother report, self-report, and sibling report. Results: In analyses utilizing hierarchical linear modeling to combine data from the three informants, children with ADHD showed increased conflict in sibling relationships, relative to nonproblem children. Comorbid externalizing problems were associated with less warmth/ closeness and increased conflict in the sibling relationship and largely accounted for the finding that children with ADHD showed greater sibling relationship problems. Comorbid internalizing problems were associated with less warmth/closeness in the sibling relationship. Conclusion: It is recommended that sibling relationships be incorporated into theories of social impairment in ADHD. (J. of Att. Dis. 2008;11(4) 482-492)
An integrative review of expert nursing practice.

PURPOSE To review relevant literature on expert practice in nursing to assess common characteristics across the breadth of nursing specialties and work settings. ORGANIZING CONSTRUCT An integrative literature search was conducted with inclusion criteria: (a) primary studies of how clinical staff nurses develop and demonstrate expert practice; (b) subjects from variety of specialties, employment settings, and countries of origin; and (c) studies of clinical staff nurses and not nurses in advanced practice roles. METHODS Literature published between 1996 and 2009 was reviewed using MEDLINE and the Cumulative Index of Nursing and Allied Health Literature (CINAHL) using the key words "nursing,""expert," and "practice. " FINDINGS The characteristics of expert practice as explicated across a variety of specialty areas of practice and international settings included the following: knowing the patient, intuitive knowledge, reflective practice, risk taking, and skilled know-how. Involvement and engagement of the expert nurse with her or his patients underpin these characteristics. Themes were illustrated in a star model of nursing expert practice surrounded by support and grounded in emotional involvement. CONCLUSIONS Expert practice develops as nurses gain experience in a specialized practice setting, reflect on and learn from their experience, and develop meaningful relationships with their patients, families, and colleagues. CLINICAL RELEVANCE The findings provide an understanding of expert nursing practice that can serve as a foundation for efforts to transfer knowledge from expert nurses to less expert nurses in all practice settings to reduce the expertise gap that is now widening.
Waveguide miniaturization using uniaxial negative permeability metamaterial

A rectangular waveguide filled with anisotropic uniaxial metamaterial with transversal negative effective permeability is investigated both theoretically and experimentally. It is shown that such a waveguide supports propagation of the backward wave below the cutoff frequency, thus, it can be considered as a dual of the ordinary waveguide. The transversal dimension of this waveguide can be arbitrarily smaller than half of a wavelength in the filling material, provided that the transversal permeability is negative. This peculiar behavior may be used for fabrication of miniaturized rectangular waveguides. Several experimental miniaturized waveguides loaded with double ring resonators in 7 GHz frequency band have been designed, fabricated and tested. The measured results revealed backward-wave passband located below the cutoff frequency. Furthermore, it was experimentally shown that the increase of the physical length of the waveguide caused the decrease of the electrical length. This is a direct proof of the backward-wave propagation since the phase of the backward wave increases along the waveguide.
Integrated views of e-government website usability: perspectives from users and web diagnostic tools

It has now become evident that information and communication technologies (ICTs) are pertinent for economic prosperity, which has led to governments around the globe to offer online government products and services. For this purpose, websites offering information from governments to citizens and interaction between governments and citizens using static web pages and web portals are considered to be essential. This paper reports the results of an evaluative study of a cross-section of the e-government portals using a common set of performance metrics and web diagnostic engines and empirical evidence gathered from a diverse range of respondents. Results show that not only are there wide variations in the spectrum of information and services provided by these portals, but that significant work still needs to be undertaken to make the portals examples of 'best practice' e-government services.
Neuroimaging of Dementias

[Figure][1] I would like to thank Mauricio Castillo, Editor-in-Chief of the American Journal of Neuroradiology (AJNR ), for inviting me to be Guest Editor for the AJNR Special Collection, titled Neuroimaging of Dementias . There have been a significant progression of the number of studies
Lower Prevalence of Impaired Glucose Tolerance and Diabetes Associated With Daily Seal Oil or Salmon Consumption among Alaska Natives

OBJECTIVE To examine the association of seal oil and salmon consumption with impaired glucose tolerance (IGT) and non-insulin-dependent diabetes mellitus (NIDDM) among Alaska Natives. RESEARCH DESIGN AND METHODS Screening was performed on 666 Yup'ik Eskimos and Athabaskan Indians ≥40 years old in 15 villages. Self-administered questionnaires were used to obtain partial food frequency data. A case was defined as IGT or NIDDM, either newly discovered or known. Newly discovered cases (11 patients with NIDDM and 17 with IGT) were determined by random blood glucose testing followed by a 2-h 75-g oral glucose tolerance test (OGTT) for those with values ≥ 6.72 mmol/l or for subjects with unconfirmed histories of glucose intolerance. Known cases included 26 patients with NIDDM and 1 with IGT. Control subjects had random blood glucoses <6.72 or normal OGTT results. RESULTS Compared with less-than-daily consumption, both daily seal oil (odds ratio [OR] 0.2, 95% confidence interval [CI] 0.1–0.8) and daily salmon consumption (OR 0.5, CI 0.2–1.1) were associated with a lower prevalence of glucose intolerance, controlling for age, ethnicity, body mass index, and sex. The effects were similar when limited to newly discovered cases: OR 0.3, CI 0.1–1.3 for seal oil and OR 0.4, CI 0.1–1.3 for salmon. Consumption of seal oil at least five times per week was required to reduce risk. CONCLUSIONS Consumption of seal oil and salmon, high in ω-3 fatty acids, appears to lower the risk of glucose intolerance and is a potentially modifiable risk factor for NIDDM in Alaska Natives.
Aspirin improves outcome in high risk prostate cancer patients treated with radiation therapy

Purpose High-risk prostate cancer (PC) has poor outcomes due to therapeutic resistance to conventional treatments, which include prostatectomy, radiation, and hormone therapy. Previous studies suggest that anticoagulant (AC) use may improve treatment outcomes in PC patients. We hypothesized that AC therapy confers a freedom from biochemical failure (FFBF) and overall survival (OS) benefit when administered with radiotherapy in patients with high-risk PC. Materials and Methods Analysis was performed on 74 high-risk PC patients who were treated with radiotherapy from 2005 to 2008 at UT Southwestern. Of these patients, 43 were on AC including aspirin (95.6%), clopidogrel (17.8%), warfarin (20%), and multiple ACs (31.1%). Associations between AC use and FFBF, OS, distant metastasis, and toxicity were analyzed. Results Median follow-up was 56.6 mo for all patients. For patients taking any AC compared with no AC, there was improved FFBF at 5 years of 80% vs. 62% (P = 0.003), and for aspirin the FFBF was 84% vs. 65% (P = 0.008). Aspirin use was also associated with reduced rates of distant metastases at 5 years (12.2% vs. 26.7%, P = 0.039). On subset analysis of patients with Gleason score (GS) 9–10 histology, aspirin resulted in improved 5-year OS (88% vs. 37%, P = 0.032), which remained significant on multivariable analysis (P < 0.05). Conclusions AC use was associated with a FFBF benefit in high-risk PC which translated into an OS benefit in the highest risk PC patients with GS 9–10, who are most likely to experience mortality from PC. This hypothesis-generating result suggests AC use may represent an opportunity to augment current therapy.
Communication media for supporting distributed engineering design

Looks at the communication media and organisational change requirements to support teamwork in a virtual organisation. A large engineering design organisation faced problems of coordinating concurrent engineering activity and geographical distribution. These problems were identified in detail, and the requirement for the design of an integrated communication support system was specified. Our analysis specifically related organisational requirements to existing media and technologies, and led to the specification and implementation of a cooperative design tool utilising groupware. Issues of changing organisational culture and evaluation of the prototype are discussed, and the generalisation to other virtual organisations is considered.
Early use of polymyxin B hemoperfusion in abdominal septic shock: the EUPHAS randomized controlled trial.

CONTEXT Polymyxin B fiber column is a medical device designed to reduce blood endotoxin levels in sepsis. Gram-negative-induced abdominal sepsis is likely associated with high circulating endotoxin. Reducing circulating endotoxin levels with polymyxin B hemoperfusion could potentially improve patient clinical outcomes. OBJECTIVE To determine whether polymyxin B hemoperfusion added to conventional medical therapy improves clinical outcomes (mean arterial pressure [MAP], vasopressor requirement, oxygenation, organ dysfunction) and mortality compared with conventional therapy alone. DESIGN, SETTING, AND PATIENTS A prospective, multicenter, randomized controlled trial (Early Use of Polymyxin B Hemoperfusion in Abdominal Sepsis [EUPHAS]) conducted at 10 Italian tertiary care intensive care units between December 2004 and December 2007. Sixty-four patients were enrolled with severe sepsis or septic shock who underwent emergency surgery for intra-abdominal infection. INTERVENTION Patients were randomized to either conventional therapy (n=30) or conventional therapy plus 2 sessions of polymyxin B hemoperfusion (n=34). MAIN OUTCOME MEASURES Primary outcome was change in MAP and vasopressor requirement, and secondary outcomes were PaO(2)/FIO(2) (fraction of inspired oxygen) ratio, change in organ dysfunction measured using Sequential Organ Failure Assessment (SOFA) scores, and 28-day mortality. RESULTS MAP increased (76 to 84 mm Hg; P = .001) and vasopressor requirement decreased (inotropic score, 29.9 to 6.8; P < .001) at 72 hours in the polymyxin B group but not in the conventional therapy group (MAP, 74 to 77 mm Hg; P = .37; inotropic score, 28.6 to 22.4; P = .14). The PaO(2)/FIO(2) ratio increased slightly (235 to 264; P = .049) in the polymyxin B group but not in the conventional therapy group (217 to 228; P = .79). SOFA scores improved in the polymyxin B group but not in the conventional therapy group (change in SOFA, -3.4 vs -0.1; P < .001), and 28-day mortality was 32% (11/34 patients) in the polymyxin B group and 53% (16/30 patients) in the conventional therapy group (unadjusted hazard ratio [HR], 0.43; 95% confidence interval [CI], 0.20-0.94; adjusted HR, 0.36; 95% CI, 0.16-0.80). CONCLUSION In this preliminary study, polymyxin B hemoperfusion added to conventional therapy significantly improved hemodynamics and organ dysfunction and reduced 28-day mortality in a targeted population with severe sepsis and/or septic shock from intra-abdominal gram-negative infections. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00629382.
Pain, fatigue and well‐being one to five years after lung transplantation – a nationwide cross‐sectional study

RATIONALE AND AIM Little is known about persistent pain after lung transplantation. Therefore, the aim was to present a multidimensional assessment of self-reported pain 1-5 years after lung transplantation and its relationship with fatigue and transplant-specific well-being. METHODS This nationwide, cross-sectional cohort study is part of the self-management after thoracic transplantation study. A total of 117 lung recipients, all White, who were due for their annual follow-up at one (n = 35), two (n = 28), three (n = 23), four (n = 20) and 5 years (n = 11) after lung transplantation were included. We used three instruments; the Pain-O-Meter (POM), which provides information about pain intensity, sensation, location and duration, the MFI-19 fatigue instrument and the Organ Transplant Symptom and Well-being Instrument (OTSWI). Permission to carry out this study was granted by the Regional Ethical Review Board in southern Sweden (D-nr 2014-124). RESULTS The prevalence of pain was 51% after 1 year, 68% after 2 years, 69.5% after 3 years, 75% after 4 years and 54.5% after 5 years. Women experienced more pain than men. Lung recipients with pain reported lower well-being and higher symptom distress but were not more fatigued than those without pain. STUDY LIMITATIONS The limitations of this study are due to the cross-sectional design. The recruitment of patients during the study period was probably affected by the different conditions regarding staffing at the outpatient lung transplant clinic in the two thoracic transplant centres in Sweden. The slightly different approach to the care of these patients in the pre, peri and postoperative setting contributes to the heterogeneity of the study population. CONCLUSION Chronic bodily pain up to 5 years after lung transplantation reduces perceived well-being. Lung recipients with pain report higher symptom distress than those without pain.
Influence of light and food on the circadian clock in liver of rainbow trout, Oncorhynchus mykiss

ABSTRACT Several reports support the existence of multiple peripheral oscillators in fish, which may be able to modulate the rhythmic functions developed by those tissues hosting them. Thus, a circadian oscillator has been proposed to be located within fish liver. In this vertebrate group, the role played by the circadian system in regulating metabolic processes in liver is mostly unknown. We, therefore investigated the liver of rainbow trout (Oncorhynchus mykiss) as a potential element participating in the regulation of circadian rhythms in fish by hosting a functional circadian oscillator. The presence and expression pattern of main components of the circadian molecular machinery (clock1a, bmal1, per1 and rev-erbβ-like) were assessed. Furthermore, the role of environmental cues such as light and food, and their interaction in order to modulate the circadian oscillator was also assessed by exposing animals to constant conditions (absence of light for 48 h, and/or a 4 days fasting period). Our results demonstrate the existence of a functional circadian oscillator within trout liver, as demonstrated by significant rhythms of all clock genes assessed, independently of the environmental conditions studied. In addition, the daily profile of mRNA abundance of clock genes is influenced by both light (mainly clock1a and per1) and food (rev-erbβ-like), which is indicative of an interaction between both synchronizers. Our results point to rev-erbβ-like as possible mediator between the influence of light and food on the circadian oscillator within trout liver, since its daily profile is influenced by both light and food, thus affecting that of bmal1.