Miracle-dz/UniFAR-FTUs huggingface dataset:
The rotavirus vaccine's withdrawal and physicians' trust in vaccine safety mechanisms.

OBJECTIVE To determine how the withdrawal from the market of the rotavirus vaccine has affected physicians' trust in vaccine safety mechanisms, future adherence to vaccine recommendations, and willingness to use a new rotavirus vaccine. DESIGN National survey mailed to 1228 randomly selected pediatricians and family physicians. MAIN OUTCOME MEASURES Confidence in vaccine safety mechanisms was defined by agreement with the statements that the system for determining vaccine safety before a vaccine is licensed works well and that the system for monitoring vaccine safety after vaccine licensure works well. Physicians who indicated that they would use a new rotavirus vaccine within 1 year of licensure and recommendation by professional organizations were classified as "early adopters. " Logistic regression was used to assess the relationship between trust in vaccine safety mechanisms and future early adoption of new rotavirus vaccines. RESULTS Following the withdrawal of the rotavirus vaccine, 83% of respondents believed the postlicensure surveillance system works well to monitor vaccine safety, while 22% of respondents believed the prelicensure system works well to determine vaccine safety. After adjusting for physician specialty and years in practice, respondents who believed the prelicensure vaccine safety system works well were significantly more likely to be early adopters than those with less confidence in prelicensure studies (adjusted odds ratio, 2.2 [95% confidence interval, 1.3-3.6]). CONCLUSIONS Physicians have different levels of trust in prelicensure studies that determine vaccine safety and postlicensure surveillance systems that monitor vaccine safety. Trust in prelicensure vaccine safety evaluations may be associated with early adherence to new vaccine recommendations.
The new clinical leadership role of senior charge nurses: a mixed methods study of their views and experience.

AIMS To investigate the experience and views of senior charge nurses in relation to the implementation of a national clinical leadership policy. BACKGROUND The role of the senior charge nurse in providing clinical leadership is evolving. However, recent evidence suggests that research is needed to inform the development of leadership and quality improvement and to connect them. METHODS Data were collected using an electronic survey to all senior charge nurses in one locality and semi-structured interviews with a subsample of respondents. Fifty (54%) senior charge nurses responded to the survey and nine were interviewed. RESULTS Senior charge nurses reported mainly positive perceptions of clinical leadership, clinical team performance and improvement of care delivery for patients following the leadership programme implementation. Themes related to confidence, quality improvement and team performance were generated. CONCLUSIONS 'Leading Better Care' was reported to enhance senior charge nurse clinical leadership, with some development needed to link the details of change management with the wider strategic direction. IMPLICATIONS FOR NURSING MANAGEMENT Nurse managers may wish to ensure that their clinical leaders have clarity of role in order to inspire confidence. Some challenges were noted in achieving improvement in quality and it is possible that if improvement in quality is the cornerstone of patient-centred care then it needs to be placed centrally in workload considerations.
ASSESSMENT OF NOISE POLLUTION FROM SAWMILL ACTIVITIES IN ILORIN, NIGERIA

This study examined noise pollution from sawmilling in Ilorin metropolis, Nigeria. Noise measurements were made using HD600 digital data logging sound level meter in conjunction with structured questionnaire which was designed to elicit noise related information. The results of the study showed that the background noise within the sawmills was 58.1-64.86 dB(A) while machine equivalent noise was 81.1-112.3 dB(A). Approximately 73% of all the noise measurements are above the recommended limit of 85 dB(A) and these high noise intensities can initiate or perpetuate some work related health challenges. Also a noise contour map which shows the spatial impact of sawmill noise on the metropolis was developed. Within the sawmills, most of the workers are unprotected, disturbed and complain of noise-related ailments such as tinnitus (96.6%), headache (86.6%) and hearing impairment (71.9%). Therefore noise prevention and control strategies are suggested in addition to frequent audiometric tests, training, education, and enforcement of noise regulations. http://dx.doi. org/10.4314/njt.v34i1. 9
Quality of life measures in alcohol dependent subjects and changes with abstinence and continued heavy drinking

This study evaluates the quality of life status of 39 male and 21 female Caucasian subjects admitted to a voluntary sector community alcohol detoxification unit. Baseline data including socio‐demographics, severity of alcohol dependence and alcohol problems were collected 4–5 days following admission. In addition, the following measures were obtained: Rotterdam Symptoms Checklist, the Beck Depression Inventory, the General Health Questionnaire 12, Chubon's Life Situation Survey and the Nottingham Health Profile. Subjects were followed up at 12 weeks, and subdivided into two groups: relapsers and non‐relapsers. A relapse was defined as drinking 21 or more units per week for men and 14 units or more per week for women over 7 consecutive days (1 unit is the equivalent of 8–10 g of absolute ethanol). Fifty‐eight (97%) subjects were successfully followed‐up, with 36 (62%) of the group relapsing to heavy drinking within 12 weeks. The results show that alcohol dependence is associated with a poor quality of life. Subjects rated poorly on the standardized questionnaires compared with the normative values for their reference populations. Relapsers and non‐relapsers differed significantly in their life situation, depression, physical and psychological symptom total scores and the Nottingham Health Profile sub‐score energy at 12 weeks compared with baseline, and these changes were investigated for each group. Within the relapse group a linear regression showed no association between any of the quality of life measures and time to relapse. Individual sub‐score analysis of the Nottingham Health Profile results point to the importance of sleep, social isolation, pain, physical mobility and anergia in alcohol dependency. There was little change as a result of either not remitting or returning to heavy drinking and overall these findings confirm that alcohol dependent subjects have a poor quality of life.
Efficacy of Multiple-Talker Phonetic Identification Training in Postlingually Deafened Cochlear Implant Listeners.

PURPOSE This study implemented a pretest-intervention-posttest design to examine whether multiple-talker identification training enhanced phonetic perception of the /ba/-/da/ and /wa/-/ja/ contrasts in adult listeners who were deafened postlingually and have cochlear implants (CIs). METHOD Nine CI recipients completed 8 hours of identification training using a custom-designed training package. Perception of speech produced by familiar talkers (talkers used during training) and unfamiliar talkers (talkers not used during training) was measured before and after training. Five additional untrained CI recipients completed identical pre- and posttests over the same time course as the trainees to control for procedural learning effects. RESULTS Perception of the speech contrasts produced by the familiar talkers significantly improved for the trained CI listeners, and effects of perceptual learning transferred to unfamiliar talkers. Such training-induced significant changes were not observed in the control group. CONCLUSION The data provide initial evidence of the efficacy of the multiple-talker identification training paradigm for CI users who were deafened postlingually. This pattern of results is consistent with enhanced phonemic categorization of the trained speech sounds.
Adjuvant imatinib therapy for gastrointestinal stromal tumors

Surgery is the standard of care for primary resectable gastrointestinal stromal tumors (GISTs), but half of surgically treated patients relapse. Imatinib (IM) has been shown to prolong recurrence‐free survival after complete surgery and is now approved as adjuvant therapy (400 mg/day) for high‐risk GIST patients. IM is well tolerated, with mild to moderate side effects observed. Whether adjuvant IM prolongs overall survival is under evaluation in two ongoing clinical trials. J. Surg. Oncol. 2011; 104:896–900. © 2011 Wiley Periodicals, Inc.
A new wide-band pulse-restoration technique for digital fiber-optic communication systems using temporal gratings

We demonstrate a new wide-band (over 20 nm) pulse-restoration technique, based on real-time Fourier transformation of an array of pulses acting as a temporal grating in a dispersive medium. A compression factor of 48 is demonstrated using an array of 16 coherent pulses. This method can be adapted for long-distance digital high-data rate, dense wavelength-division-multiplexed and time-division-multiplexed communication over single-mode fibers. We anticipate the pulse compression factor will vary by less than 10% over a bandwidth of 100 nm.
PRECLINICAL STUDY: Is withdrawal hyperalgesia in morphine‐dependent mice a direct effect of a low concentration of the residual drug?

Withdrawal of opioid drugs leads to a cluster of unpleasant symptoms in dependent subjects. These symptoms are stimulatory in nature and oppose the acute, inhibitory effects of opiates. The conventional theory that explains the opioid withdrawal syndrome assumes that chronic usage of opioid drugs activates compensatory mechanisms whose stimulatory effects are revealed upon elimination of the inhibitory opioid drug from the body. Based on previous studies that show a dose‐dependent dual activity of opiates, including pain perception, we present here an alternative explanation to the phenomenon of withdrawal‐induced hyperalgesia. According to this explanation, the residual low concentration of the drug that remains after cessation of its administration elicits the stimulatory withdrawal hyperalgesia. The goal of the present study was to test this hypothesis. In the present study we rendered mice dependent on morphine by a daily administration of the drug. Cessation of morphine application elicited withdrawal hyperalgesia that was completely blocked by a high dose of the opiate antagonist naloxone (100 mg/kg). Similarly, naloxone (2 mg/kg)‐induced withdrawal hyperalgesia was also blocked by 100 mg/kg of naloxone. The blockage of withdrawal hyperalgesia by naloxone suggested the involvement of opioid receptors in the phenomenon and indicated that withdrawal hyperalgesia is a direct effect of a residual, low concentration of morphine. Acute experiments that show morphine‐ and naloxone‐induced hyperalgesia further verified our hypothesis. Our findings offer a novel, alternative approach to opiate detoxifications that may prevent withdrawal symptoms by a complete blockage of the opioid receptors using a high dose of the opioid antagonist.
Lymphedema: Improving screening and treatment among at‐risk breast cancer survivors

&NA; Inadequate peripheral lymphedema screening is a persistent gap in the provision of quality survivorship care at many breast cancer centers. Lymphedema should be identified and treated during the subclinical stage, when it is more likely reversible. The purpose of this project was to integrate a screening process for patients with breast cancer at risk for lymphedema, using bioimpedance spectroscopy via the L‐Dex®, in a breast cancer center. A protocol was developed that included specific criteria for early patient referral to physical therapy. AT A GLANCEFor breast cancer survivors, a screening protocol should be established that uses bioimpedance spectroscopy to identify subclinical lymphedema.Advanced practice nurses should provide lymphedema education to patients.Early identification and referral to physical therapy based on the screening protocol could reduce the incidence of clinical lymphedema and the associated effects.
Age-dependent changes in the manifestations of gender-related differences in the cardiovascular regulation

Previous studies analyzed the age-dependence of cardiovascular parameters in females and males. Their obtained results agree that the complexity of the studied signals as well as the differences between females and males decrease with increasing age. According to this study, we can confirm these findings. Additionally, by using nonlinear methods from the field of symbolic dynamics, we were able to detect significant differences between the female and male subjects of older age on the basis of the heart rate variability.
The role of growth factors in diabetic peripheral neuropathy

Abstract Peripheral neuropathy afflicts 60% of all diabetic patients. Underlying the clinical disorder is the loss or degeneration of neurons, Schwann cells, and neuronal fibers. This degenerative pathology has prompted interest in the potential of growth factors as a therapy in diabetic neuropathy. Three lines of evidence support the theory that growth factors may be important in this disorder: (1) endogenous growth factors promote survival and health of neurons, (2) expression levels of growth factors are altered in diabetic neuropathy and peripheral neuron injury, and (3) growth factors induce neuronal regeneration in in vitro and in vivo models of diabetic injury. This review surveys the roles of several growth factors in diabetic neuropathy, including the neurotrophins, insulin‐like growth factors, cytokine‐like growth factors, and vascular endothelial growth factor. These growth factors are examined in terms of their expression during peripheral nerve injury and their protective and regenerative effects on peripheral neurons. Growth factor‐mediated neuroprotective signaling is discussed, particularly in relation to the recent research, suggesting that diabetic neuropathy‐induced degeneration stems from oxidative stress. Finally, the potential of growth factors as therapeutic agents is addressed, including an assessment of past growth factor clinical trials and other potential avenues of growth factor therapy.
Renal denervation in heart failure with normal left ventricular ejection fraction. Rationale and design of the DIASTOLE (DenervatIon of the renAl Sympathetic nerves in hearT failure with nOrmal Lv Ejection fraction) trial

Increasing evidence suggests an important role for hyperactivation of the sympathetic nervous system (SNS) in the clinical phenomena of heart failure with normal LVEF (HFNEF) and hypertension. Moreover, the level of renal sympathetic activation is directly related to the severity of heart failure. Since percutaneous renal denervation (pRDN) has been shown to be effective in modulating elevated SNS activity in patients with hypertension, it can be hypothesized that pRDN has a positive effect on HFNEF. The DIASTOLE trial will investigate whether renal sympathetic denervation influences parameters of HFNEF.
Dynamics of Brokerage Positions in Clusters: Evidence from the Spanish Foodstuffs Industry

Shifting away from traditional approaches orientated towards the analysis of the benefits associated with brokerage, this paper provides valuable insights into the dynamics of this network position and the opportunities to innovate that it provides. Using fine grain micro data collected in a foodstuff Spanish cluster, the evolution of different brokerage profiles is analyzed in depth. It was particularly evident how firm-level characteristics (status, former mediating experience and external openness) and their interactions may generate changes in the different brokerage roles over a period of time. The findings of this work partially validate expectations based on the network dynamics approaches. Status and previous mediating experience facilitate the creation of partnerships, fostering brokerage. Conversely, interaction effects demote brokerage activity at the intra-cluster level, suggesting the selective nature of brokers’ relational behavior.
Practicing Physician Education in Geriatrics: Lessons Learned from a Train‐the‐Trainer Model

Evidence of poor performance in the evaluation and management of common geriatric conditions suggests the need for changing physician behavior in these areas. Traditional lecture‐style continuing medical education (CME) has not been shown to be effective. Expert faculty initially trained 60 nonexpert peer educators to conduct small‐group, learner‐centered CME using tool kits on memory loss, incontinence, and depression. Peer educators presented 109 community‐based sessions to 1,309 medical practitioners. Surveys were administered to community participants immediately and 6 months after a session. Evidence of effectiveness included statistically significant increases in self‐reported knowledge, attitudes, and office‐based practices on the target topics at the time of training and at the 6‐month follow‐up (P<.001) and two‐thirds of respondents reporting continued use of three or more tools at 6 months. Participants reported that the interactive presentation aided their understanding of and ability to use the tool kits more than an off‐the‐shelf review (mean rating±standard deviation 4.1±0.71, with 1=not at all and 5=significantly). After the formal evaluation period, additional information about the project dynamics and tool kits was obtained through a small interview sample and an on‐line survey, respectively. Receiving copies of the tool kits was an important factor in enabling educators to offer sessions. Barriers to offering sessions included finding time, an audience, and space. Findings suggest that modest positive changes in practice in relation to common geriatric problems can be achieved through peer‐led, community‐based sessions using principles of knowledge translation and evidence‐based tool kits with materials for providers and patients.
OAT β-GLUCAN IN MILK PRODUCTS: IMPACT ON HUMAN HEALTH

The aim of this study was to determine the impact of the bioactive ingredient – oat β-glucan – on the quality characteristics of the fermented milk products (kefir, yogurt and fermented milk beverages) made on buttermilk-skimmed milk mixture base and establish the influence of the consumption of one of them on the health characteristics of volunteers. The enrichment of fermented milk products with 0.6 % oat β-glucan had no impact on the fermentation time, enhanced the apparent viscosity and changed sensory properties. The experiments of medical nutrition of volunteers showed a significant decrease of total (p<0.05) and low density lipoprotein (p<0.05) cholesterol, increase in high density lipoprotein cholesterol (p<0.01) in their blood after a 21-day period of consumption of fermented product with β-glucan. According to these findings, consumption of fermented milk beverage prepared on the buttermilk-skimmed milk base and enriched with oat β-glucan had a beneficial effect on human health.
The incidence of rheumatic fever in metropolitan Nashville, 1963-65.

THE INCIDENCE of rheumatic fever is difficult to establish even though the disease is reportable in most States. Reporting is far from complete, so that incidence based on official sources is highly inaccurate. The few attempts at rheumatic fever registry have been centered around casefinding, treatment, and streptococcal prophylaxis, rather than the collection of accu¬ rate data on incidence. One notable exception was the rheumatic fever registry in Miami, Fla. , of Saslaw and Schwartzman (1) aimed toward recording all known and suspected active rheu¬ matic fever episodes over the period 1955-58. It is desirable for epidemiologic reasons to determine the incidence of rheumatic fever. Such data make it possible to estimate temporal and group variations in morbidity rates, as well
Personality Change in the Preclinical Phase of Alzheimer Disease

Importance Changes in behavior and personality are 1 criterion for the diagnosis of dementia. It is unclear, however, whether such changes begin before the clinical onset of the disease. Objective To determine whether increases in neuroticism, declines in conscientiousness, and changes in other personality traits occur before the onset of mild cognitive impairment or dementia. Design, Setting, and Participants A cohort of 2046 community-dwelling older adults who volunteered to participate in the Baltimore Longitudinal Study of Aging were included. The study examined personality and clinical assessments obtained between 1980 and July 13, 2016, from participants with no cognitive impairment at first assessment who were followed up for as long as 36 years (mean [SD], 12.05 [9.54] years). The self-report personality scales were not considered during consensus diagnostic conferences. Main Outcomes and Measures Change in self-rated personality traits assessed in the preclinical phase of Alzheimer disease and other dementias with the Revised NEO Personality Inventory, a 240-item questionnaire that assesses 30 facets, 6 for each of the 5 major dimensions: neuroticism, extraversion, openness, agreeableness, and conscientiousness. Results Of the 2046 participants, 931 [45.5%] were women; mean (SD) age at first assessment was 62.56 (14.63) years. During 24 569 person-years, mild cognitive impairment was diagnosed in 104 (5.1%) individuals, and all-cause dementia was diagnosed in 255 (12.5%) participants, including 194 (9.5%) with Alzheimer disease. Multilevel modeling that accounted for age, sex, race, and educational level found significant differences on the intercept of several traits: individuals who developed dementia scored higher on neuroticism (&bgr; = 2.83; 95% CI, 1.44 to 4.22; P < .001) and lower on conscientiousness (&bgr; = −3.34; 95% CI, −4.93 to −1.75; P < .001) and extraversion (&bgr; = −1.74; 95% CI, −3.23 to −0.25; P = .02). Change in personality (ie, slope), however, was not significantly different between the nonimpaired and the Alzheimer disease groups (eg, neuroticism: &bgr; = 0.00; 95% CI, −0.08 to 0.08; P = .91; conscientiousness: &bgr; = −0.06; 95% CI, −0.16 to 0.04; P = .24). Slopes for individuals who developed mild cognitive impairment (eg, neuroticism: &bgr; = 0.00; 95% CI, −0.12 to 0.12; P = .98; conscientiousness: &bgr; = −0.09; 95% CI, −0.23 to 0.05; P = .18) and all-cause dementia (eg, neuroticism: &bgr; = 0.02; 95% CI, −0.06 to 0.10; P = .49; conscientiousness: &bgr; = −0.08; 95% CI, −0.16 to 0.00; P = .07) were also similar to those for nonimpaired participants. Conclusions and Relevance No evidence for preclinical change in personality before the onset of mild cognitive impairment or dementia was identified. These findings provide evidence against the reverse causality hypothesis and strengthen evidence for personality traits as a risk factor for dementia.