Miracle-dz/UniFAR-FTUs huggingface dataset:
Patient engagement in hospital health service planning and improvement: a scoping review

Objectives Patient engagement (PE) improves patient, organisation and health system outcomes, but most research is based on primary care. The primary purpose of this study was to describe the characteristics of published empirical research that evaluated PE in hospital health service improvement. Design Scoping review. Methods Five databases were searched from 2006 to September 2016. English language studies that evaluated patient or provider beliefs, participation in PE, influencing factors or impact were eligible. Screening and data extraction were done in triplicate. PE characteristics, influencing factors and impact were extracted and summarised. Results From a total of 3939 search results, 227 studies emerged as potentially relevant; of these, 217 were not eligible, and 10 studies were included in the review. None evaluated behavioural interventions to promote or support PE. While most studies examined involvement in standing committees or projects, patient input and influence on decisions were minimal. Lack of skill and negative beliefs among providers were PE barriers. PE facilitators included careful selection and joint training of patients and providers, formalising patient roles, informal interaction to build trust, involving patients early in projects, small team size, frequent meetings, active solicitation of patient input in meetings and debriefing after meetings. Asking patients to provide insight into problems rather than solutions and deploying provider champions may enhance patient influence on hospital services. Conclusions Given the important role of PE in improving hospital services and the paucity of research on this topic, future research should develop and evaluate behavioural interventions for PE directed at patients and providers informed by the PE barriers and facilitators identified here. Future studies should also assess the impact on various individual and organisational outcomes.
Leishmania histone H1 overexpression delays parasite cell‐cycle progression, parasite differentiation and reduces Leishmania infectivity in vivo

Episomal expression of Leishmania histone H1 sense mRNAs in Leishmania major promasigotes was found previously to result in overexpression of this molecule and to reduce parasite infectivity in vitro. Herein, we evaluated the in vivo infectivity of these transfectants, in BALB/c mice, and showed that it is dramatically reduced. No lesions were observed in this group of mice and this was associated with an extremely low number of parasites both in the footpad and in the draining lymph nodes. Interestingly, the transfectants‐reduced infectivity was associated with a delay in their cell‐cycle progression and differentiation to axenic amastigotes, assessed in vitro. Therefore, the dramatic reduction in their infectivity may be attributed to the above‐mentioned phenotypic modifications. As the metazoan linker histone H10 homologue is known to delay cell‐cycle progression in mammalian cells we investigated whether its Leishmania counterpart, which possesses homology to its C‐terminal region, when expressed in mammalian cells may also affect their cell‐cycle progression. It was thus shown that Leishmania histone H1 expressed in COS7 and NIH 3T3 cells, delays cell‐cycle progression in these cells too. The latter strengthens the phenotype observed in Leishmania and provides evidence that critical functions of histone H1 molecules are conserved throughout evolution.
[Incidence rate and acupuncture-moxibustion treatment of post-stroke depression].

OBJECTIVE To understand the incidence of post-stroke depression (PSD) and the therapeutic effect of acupuncture-moxibustion. METHODS Five hundred and sixty cases were rating with Hamilton depression scale, and lesion parts, gender, age and property of stroke between the PSD and non-PSD were compared by analysis of variance, chi2 test, and then the patients of PSD were randomly divided into two groups and treated respectively with Prozac-20 and acup-moxibustion at Sishencong (EX-HN 1), Anmian, Neiguan (PC 6), Shenmen (HT 7), Zusanli (ST 36), Sanyinjiao (SP 6), Taichong (LR 3), Zhaohai (KI 6), Shenmai (BL 62). RESULTS The total incidence rate of PSD was 43.9%, with no relation to the lesion parts, gender, age and property of stroke (P > 0.05), and there were very significant differences in HAMD scores before and after treatment in the two groups (P < 0.0001), with no significant difference in the effective rate between the two groups (P > 0.05). CONCLUSION PSD has a high incidence and influences the recovery of nervous function, and it should be treated at early stage. Acup-moxibustion and Prozac-20 have similar therapeutic effect.
Expression profiling correlates with treatment response in women with advanced serous epithelial ovarian cancer

The majority of epithelial ovarian carcinomas are of serous subtype, with most women presenting at an advanced stage. Approximately 70% respond to initial chemotherapy but eventually relapse. We aimed to find markers of treatment response that might be suitable for routine use, using the gene expression profile of tumor tissue. Thirty one women with histologically‐confirmed late‐stage serous ovarian cancer were classified into 3 groups based on response to treatment (nonresponders, responders with relapse less than 12 months and responders with no relapse within 12 months). Gene expression profiles of these specimens were analyzed with respect to treatment response and survival (minimum 36 months follow‐up). Patients' clinical features did not correlate with prognosis, or with specific gene expression patterns of their tumors. However women who did not respond to treatment could be distinguished from those who responded with no relapse within 12 months based on 34 gene transcripts (p < 0.02). Poor prognosis was associated with high expression of inhibitor of differentiation‐2 (ID2) (p = 0.001). High expression of decorin (DCN) and ID2 together was strongly associated with reduced survival (p = 0.003), with an estimated 7‐fold increased risk of dying (95% CI 1.9–29.6; 14 months survival) compared with low expression (44 months). Immunohistochemical analysis revealed both nuclear and cytoplasmic distribution of ID2 in ovarian tumors. High percentage of nuclear staining was associated with poor survival, although not statistically significantly. In conclusion, elevated expression of ID2 and DCN was significantly associated with poor prognosis in a homogeneous group of ovarian cancer patients for whom survival could not be predicted from clinical factors. © 2006 Wiley‐Liss, Inc.
Concurrent self-regulatory efficacy as a mediator of the goal: Exercise behaviour relationship

Examining exercise as a single goal-directed behaviour, without acknowledging the influence of other concurrent goals, may oversimplify the self-regulation needed in daily life. Concurrent self-regulatory efficacy, confidence in one’s ability to self-regulate the management of multiple goals, was explored as a potential mediator in the relationship between value of an exercise goal and future exercise behaviour. Undergraduate students were observed during a 4-week examination period where they faced greater than usual challenges to exercising regularly. Consistent with self-efficacy theory, concurrent self-regulatory efficacy was a significant partial mediator of the value of an exercise goal–exercise behaviour relationship.
Resource predictability and host specificity in fleas: the effect of host body mass

Ecological specialization is hypothesized to result from the exploitation of predictable resource bases. For parasitic organisms, one prediction is that parasites of large-bodied host species, which tend to be long-lived, should specialize on these hosts, whereas parasites of small host species, which represent more ephemeral and less predictable resources, should become generalists. We tested this prediction by quantifying the association between the level of host specificity of fleas and the mean body mass of their mammalian hosts, using published data from 2 large, distinct geographical regions (South Africa and northern North America). In general, we found supporting evidence that flea host specificity, measured either as the number of host species exploited or their taxonomic distinctness, became more pronounced with increasing host body mass. There were, however, some discrepancies among the results depending on the different measures of host specificity, the geographical region studied, or whether we used the raw values or phylogenetically independent contrasts. These are discussed with respect to other forces acting on the evolution of host specificity in parasites, as well as in the context of the regions' contrasting evolutionary histories. Overall, though, our findings indicate that the exploitation of large-bodied, and therefore long-lived, host species has promoted specialization in fleas, most likely because these hosts represent predictable resources.
Nuclear Energy: Danger Only in Case of Accidents?

The environmental impacts of nuclear energy are highly underestimated. Nuclear weapons, atomic bomb tests, and nuclear accidents are considered a danger for the environment and a human cancer risk. However, childhood leukemia is consistently elevated near nuclear power plants and the Chernobyl accident entailed elevated human birth sex ratios across Europe. We studied the annual sex ratio near nuclear facilities in Germany, France, and Switzerland at the municipality level. We will demonstrate that low doses of ionizing radiation cause effects in human beings. This is shown by strongly consistent spatial-temporal shifts in the human sex ratio trends in the vicinity of nuclear facilities. In the chosen countries complete official data on over 70 million gender specific annual births at the municipality level are available. By Lambert-93 coordinates (France) and GK3 coordinates (Germany, Switzerland) we determined the minimum distances of municipalities from major nuclear facilities. Spatial-temporal trend analyses of the annual sex ratio depending on municipalities’ minimum distances from nuclear facilities were carried out. Applying ordinary linear logistic regression (jump or broken-stick functions) and non-linear logistic regression (Rayleigh functions) we demonstrate that the sex ratio at birth shows the influence of mutagenic ionizing radiation on human health. As important environmental chemical contaminants are also mutagenic, the usefulness of the sex ratio at birth as a genetic health indicator can be inferred by analogy.
Melatonin Supplementation Ameliorates Energy Charge and Oxidative Stress Induced by Acute Exercise in Rat Heart Tissue.

BACKGROUND Regular physical exercises may help people to be more resistant to everyday problems; however, how acute and intense exercises affect the heart tissues functioning with maximum capacity and how melatonin changes the effect of acute and intense exercises are still not obvious. We aimed to comprehend whether melatonin intravenous injection supports the oxidative/antioxidative conditions and energy charge in heart tissues of rats exposed to acute swimming exercise. METHODS Thirty Wistar-albino male rats were categorized into 3 groups with equal number of subjects. Control group performed no application, and acute intensive swimming exercise group were subjected to acute intensive swimming exercise for 30 minutes, and melatonin group were applied 25 mg/kg single dose melatonin administration prior to 30 minutes acute intensive swimming exercise. The levels of malondialdehyde (MDA), and superoxide dismutase, catalase and glutathione peroxidase activities were measured by spectrophotometric method; and the levels of 3-nitrotyrosine (3-NT) and energy charge were determined by a high performance liquid chromatography. RESULTS Tissue MDA and 3-NT levels of the acute intensive exercise group were found to be higher than the control group. It was also found that the melatonin administration increased the energy charge and antioxidant activities, while decreased tissue MDA and 3-NT levels in heart tissues. Our results provide evidence for melatonin that can exert potent protective effects on oxidative stress and energy charge for heart tissues in acute swimming exercise. CONCLUSIONS These findings suggest that the direct beneficial effects of melatonin could be potentially applied on prevention of oxidative stress and energy deficit.
Adaptive Encoding Strongly Improves Function Approximation with CMAC

The Cerebellar Model Arithmetic Computer (CMAC) (Albus 1981) is well known as a good function approximator with local generalization abilities. Depending on the smoothness of the function to be approximated, the resolution as the smallest distinguishable part of the input domain plays a crucial role. If the binary quantizing functions in CMAC are dropped in favor of more general, continuous-valued functions, much better results in function approximation for smooth functions are obtained in shorter training time with less memory consumption. For functions with discontinuities, we obtain a further improvement by adapting the continuous encoding proposed in Eldracher and Geiger (1994) for difficult-to-approximate areas. Based on the already far better function approximation capability on continuous functions with a fixed topologically distributed encoding scheme in CMAC (Eldracher et al. 1994), we present the better results in learning a two-valued function with discontinuity using this adaptive topologically distributed encoding scheme in CMAC.
Mycobacterial manipulation of vacuolar sorting

Approximately one‐third of the world's population is infected with Mycobacterium tuberculosis, and the World Health Organization estimates 1.6 million deaths were caused by M. tuberculosis in 2005. The enormous worldwide burden of disease underscores the proficiency by which M. tuberculosis is able to evade eradication by the host, subverting innate and adaptive defences. At the cellular level, mycobacteria are able to modulate macrophage defences by altering phagosome maturation. This review focuses on the bacterial proteins and lipids that are important in establishing the mycobacterial replicative niche. While there is a detailed molecular description of the vacuole and an increasing number of bacterial effectors have been implicated in creating this compartment, exactly how they intersect host cell processes remains ill‐defined. However, the emerging picture is that an array of lipid and protein effectors collaborate to create and maintain the mycobacterial phagosome.
Prospective multicenter randomized trial comparing physician versus patient transfer for primary percutaneous coronary intervention in acute ST-segment elevation myocardial infarction.

BACKGROUND Primary percutaneous coronary intervention (PCI) has been identified as the first therapeutic option for patients with acute ST-segment elevation myocardial infarction (STEMI). The strategy of transferring patient to a PCI center was recently recommended for those with acute STEMI who were present to PCI incapable hospitals, which include lack of facilities or experienced operators. In China, some local hospitals have been equipped with PCI facilities, but they have no interventional physicians qualified for performing primary PCI. This study was conducted to assess the feasibility, safety and efficacy of the strategy of transferring physician to a PCI-equipped hospital to perform primary PCI for patients with acute STEMI. METHODS Three hundred and thirty-four consecutive STEMI patients with symptom presentation = 12 hours in five local hospitals from November 2005 to November 2007 were randomized to receive primary PCI by either physician transfer (physician transfer group, n=165) or patient transfer (patient transfer group, n=169) strategy. Door-to-balloon time, in-hospital and 30-day major adverse cardiac events (MACE, including death, non-fatal re-infarction, and target vessel revascularization) were compared between the two groups. RESULTS Baseline characteristics between the two groups were comparable. Thrombolysis in myocardial infarction (TIMI) 3 flow was revealed in more patients in the physician transfer group at initial angiography (17.6% vs 10.1%, P<0.05). The success rate of primary PCI (96.3% vs 95.4%, P>0.05) and length of hospital stay were similar between the two groups ((15+/-4) days vs (14+/-3) days, P>0.05). In the physician transfer group, door-to-balloon time was significantly shortened ((95+/-20) minutes vs (147+/-29) minutes, P<0.0001) and more patients received primary PCI with door-to-balloon time less than 90 minutes (21.2% vs 7.7%, P<0.001). During hospitalization, MACE occurred in 6.7% and 11.2% of patients in the physician and patient transfer groups, respectively (P=0.14). At 30-day clinical follow-up, the occurrence rates of death, non-fatal re-infarction, and target vessel revascularization (TVR) were 3.6% vs 5.9%, 4.2% vs 8.9%, and 1.2% vs 2.4% in the physician and patient transfer groups, respectively (all P>0.05). The cumulative composite of MACE was significantly reduced (8.9% vs 17.2%, P=0.03) and MACE free survival (91.0% vs 82.9%, P<0.05) was significantly improved in the physician transfer group at 30 days. CONCLUSION The strategy of transferring physician to local hospital to perform primary PCI for patients with acute STEMI is feasible, safe and efficient in reducing the door-to-balloon time and 30-day MACE rate.
Serotyping of Dengue Virus from Deadly Outbreaks of Pakistan

Dengue virus (DENV) belonging to the family Flaviviridae consists of 4 serotypes (DEN-1, 2, 3 & 4) causing severe illnesses like dengue fever (DF), Dengue Hemorrhagic Fever (DHF) and Dengue Shock Syndrome (DSS). Dengue fever has become an emerging disease in Pakistan during the past 5-7 years with an increase in the number of cases every year since 2006. The current study aimed at identifying the serotypes of dengue virus involved in 2011 outbreak of Pakistan. Samples were collected from all provinces of Pakistan. Patients were confirmed in the hospital by antibody captured Enzyme linked immunosorbent assay (ELISA). These ELISA positive serum samples were inoculated on HeLa cell line to raise the viral titer of dengue virus and then RT-PCR was done for serotyping of dengue virus. Initially D1, D2 primers were tried for serotyping of dengue virus but poor results were obtained. Then serotype specific primers were designed having equal fragment length targeting NS1 gene. This approach was successful in serotyping of dengue virus from Pakistani population. On Real time RT-PCR, Dengue virus (DENV) was detected in 43.33% (n=26) patientsout of 60 analyzed samples. Among 26 positive cases, 76.9% (n=20) were children and 23.1% (n=6) were adultsand 46.1% (n=12) were male and 53.8 % (n=14) were females. ELISA results of26 PCR positive cases show that 53.8% (n=14) were positive for IgM, 15.4 % (n=4) were positive for IgG and 30.8 % (n=8) were positive for both IgG and IgM. In this study DEN-2 was detected in 13.3% (n=8) patients, DEN-3 was detected in 16.67% (n=10) patients and DEN-2 & DEN-3 coinfection was detected in 13.3% (n=8) patients. We did not detected DEN-1 & DEN-4 in 2011 outbreak of Pakistan in 60 analyzed samples. By this study we can conclude that DEN-2 and DEN-3 were the main serotypes involved in 2011 outbreaks in Pakistan.
Clinical efficacy of atosiban treatment in late abortion and preterm labour of twin pregnancy

The objective of this study was to investigate the clinical efficacy and adverse events of treatment with the oxytocin receptor antagonist atosiban in late abortion and preterm labour of twin pregnancy. A total of 60 pregnant women with twin pregnancy who experienced late abortion and preterm labour were randomly divided into two groups: the first group included 30 cases of a short course of treatment (18 hours), and the second group included 30 cases of a long course of treatment (45 hours). The treatment efficacy, adverse events and pregnancy outcomes for the pregnant women in the two groups were compared, and the treatment efficacy for the pregnant women with different cervical lengths (CLs) was analysed. The rates of the 48 h and 7 d effective tocolysis for the long course of treatment group were significantly superior to the same rates for the short course of treatment group, and the differences were statistically significant (P<0.05). The comparison of the safety between the two groups showed no statistically significant differences (P>0.05). When the program of the short course of treatment was employed, the rates of the 48 h and 7 d effective tocolysis of the group with CL ≥20 mm were significantly superior to the same rates for the group with CL <20 mm, and the differences were statistically significant (P<0.05). When the program of the long course of treatment was employed, the rates of the 48 h and 7 d effective tocolysis of the group with CL ≥20 mm and the group with CL <20 mm showed no significant difference (P>0.05). In addition, a total of 101 cases of neonates survived, with 19 cases of death. Atosiban can effectively extend the pregnancy time for twin pregnancy with late abortion and preterm labour. The long course of the treatment program was more effective and performed better for the cases in which CL <20 mm. The long course of treatment did not increase the adverse events for the mothers and infants.
Sex differences in cognitive domains and their clinical correlates in higher-functioning autism spectrum disorders

Despite the skewed sex ratio, few studies have addressed possible cognitive sex differences in autism spectrum disorders (ASDs). This study compared visual attention to detail (ATTD) and selected executive functions (EF) in 35 males and 21 females with higher-functioning ASD and unaffected sibling controls. Females with ASD outperformed males on EF as assessed by the Trail Making Test B-A. Males with ASD showed superior performance for ATTD as measured by the Block Design Test (BD) when compared with females. EF difficulties in males were correlated with more stereotypic behaviours and interests on the Autism Diagnostic Interview-Revised or the Autism Diagnostic Observation Schedule. The results indicated clinically meaningful cognitive sex differences in ASD, particularly an association between EF and stereotypic behaviours and interests. ATTD as a potential basis for specific cognitive strengths (e.g. scientific/savant skills) might be more pronounced in males with ASD.
Iterative type I polyketide synthases involved in enediyne natural product biosynthesis

Enediyne natural products are potent antibiotics structurally characterized by an enediyne core containing two acetylenic groups conjugated to a double bond in a 9‐ or 10‐membered carbocycle. The biosynthetic gene clusters for enediynes encode a novel iterative type I polyketide synthase (PKSE), which is generally believed to initiate the biosynthetic process of enediyne cores. This review article will cover research efforts made since its discovery to elucidate the role of the PKSE in enediyne core biosynthesis. Topics covered include the unique domain architecture, identification, and characterization of turnover products, and interaction with partner thioesterase protein. © 2014 IUBMB Life, 66(9):587–595, 2014