Miracle-dz/UniFAR-FTUs huggingface dataset:
SHIFTS IN AIR-CONDUCTION THRESHOLDS PRODUCED BY PULSED AND CONTINUOUS CONTRALATERAL MASKING.

In the present investigations, auditory threshold shifts for either constant or pulsed pure tones were observed while a steady or pulsed narrow band of white noise was delivered to the contralateral ear via an insert receiver. The narrow‐band masker, centered around 4000 cps, was presented at intensity levels of 50, 70, and 90 dB SPL while thresholds were obtained from the test ear at 4000, 1000, and 250 cps. The results demonstrate, first, that larger threshold shifts occur when the test signal and the masker are pulsed simultaneously than when the masker is continuous; second, that a continuous masker may be as effective as the pulsed masker if the test tone is also continuous; third, that more contralateral masking is found when the test tone and masker are close in frequency; and, last, that a small increase in the average threshold shift occurs as the intensity level of the masker increases. Several interpretations are offered in explanation of the threshold shifts for the continuous continuous and pulsed pulsed (simultaneous) conditions.
Hepatitis C Virus Screening and Management of Seroconversions in Hemodialysis Facilities

Over the past two decades, healthcare‐associated exposure has increasingly been proved to be a means of hepatitis C virus (HCV) transmission, especially in hemodialysis facilities. The prevalence of HCV among hemodialysis patients is known to be several times greater than that of the general population of the United States, and chronic HCV infection is associated with significant morbidity and mortality among these patients. During 2008–2011, HCV infection outbreaks were identified in multiple US hemodialysis facilities, resulting in at least 46 new HCV infections among hemodialysis patients. These outbreaks, linked to infection control breaches, also highlight the failure of some facilities to follow established guidelines for routine HCV antibody (anti‐HCV) screening and response to new HCV infection among hemodialysis patients. Current national guidelines recommend screening of hemodialysis patients for anti‐HCV on facility admission and, for susceptible patients, on a semiannual basis.
Falls in RAC-OST-POL Study: epidemiological study in postmenopausal women aged over 55 years.

INTRODUCTION Falls are often noted in elderly women. They may have serious clinical consequences. The aim of the study is the presentation of epidemiological data on falls in postmenopausal women. MATERIAL AND METHODS A total of 978 women in mean age 65.9 ± 7.6 years from the population of Raciborz district were included. In a questionnaire the following data were gathered: falls in last 12 months, place of stay, kind of job, marital status, education, smoking, underlying diseases, and used medications. RESULTS Falls occurred in 328 women (33.5%). The number of falls correlated positively with increasing age, (r = 0.13, p < 0.0001). The falls rate was not related to weight and height, but weak, significant correlation with body mass index was noted (r = 0.076, p< 0.05). Among 286 women with prior osteoporotic fracture falls were present in 40.9%, which was significantly more than the 30.4% seen in women without fracture (Chi-square test; 10.05; df = 1; p < 0.01). Falls were fewer often among women from the city of Raciborz (29.8%) than in women from the rural population (39.7%). After adjustment for age, rural stay, diabetes type 1, renal failure, rheumatoid arthritis, bronchial asthma, and depression revealed influence on falls occurrence. As was shown by logistic regression, age, rural stay, prior fracture, diabetes type 1, bronchial asthma, and depression increased the risk of fall. The cumulative number of these risk factors correlated with the number of falls (r = 0.22, p < 0.000001). CONCLUSIONS Falls are common among postmenopausal women, and their occurrence is modified by several factors including age, place of stay, and some co-morbidities.
The attitudes of patients with chronic conditions towards nurse prescribing medications.

AIM To explore the attitudes of patients with chronic conditions towards the expansion of nurse authority, with an emphasis on nurse prescribing of medications for chronic conditions. BACKGROUND The rising number of chronically ill patients in Israel, concurrent with a shortage of physicians, has led to the delegation of authority from physicians to nurses, and this is particularly conspicuous in the prescribing of medication for chronic conditions. METHOD In this correlational study, a questionnaire was distributed to 230 community-based chronically ill men and women aged 18 and older who take at least one regular medication. Data were collected from February to April 2012. Data analysis was performed with the SPSS 19 programme. It includes descriptive and inferential statistics. RESULTS Most respondents are in favour of expanding nurse authority to prescribing medication for chronic conditions but object to expanding nurse authority to prescribing new medication. Respondents also object to expanding nurse authority to prescribing medication for chronic conditions in the field of psychiatry. The older respondents and the higher their image of nursing, as well as their knowledge on expanding nurse authority to prescribing medication for chronic conditions, the more positive their attitudes towards this expansion of authority. CONCLUSIONS This study provides support for nurse prescribing of medication for chronic conditions in Israel. Policymakers in the field of nursing understand the national significance of increasing public awareness of expanding nurse authority to prescribe medication for chronic conditions.
Hypothalamic‐Pituitary‐Adrenal Axis Function in Sjögren's Syndrome

Abstract: To date, evidence suggests that rheumatic diseases are associated with hypofunctioning of the hypothalamic‐pituitary‐adrenal (HPA) axis. Sjögren's syndrome (SS), the second most common autoimmune disorder, is characterized by diminished lacrimal and salivary gland secretion. To examine HPA axis activity in SS patients, the adrenocorticotropin (ACTH) response to ovine corticotropin‐releasing factor (oCRH) was used as a direct measure of corticotrophic function, and the plasma cortisol response to the ACTH released during oCRH stimulation as an indirect measure of adrenal function. Significantly lower basal ACTH and cortisol levels were found in patients with SS and were associated with a blunted pituitary and adrenal response to oCRH compared to normal controls. Fibromyalgia (FM) patients demonstrated elevated evening basal ACTH and cortisol levels and a somewhat exaggerated peak, delta, and net integrated ACTH response to oCRH. A subgroup of SS patients also met the diagnostic criteria for FM and demonstrated a pituitary‐adrenal response that was intermediate to SS and FM. These findings suggest not only adrenal axis hypoactivity in SS and FM patients, but also that varying patterns of adrenal and thyroid axes dysfunction may exist in patients with different rheumatic diseases.
Tai Chi vs. combined exercise prescription: A comparison of their effects on factors related to falls.

BACKGROUND Regular exercise training is one of the core components of multifactorial fall-prevention programs. OBJECTIVE To compare the effect of Tai Chi and combined exercise prescription that consists of three main components of an exercise prescription on static balance, dynamic balance, fear of falling and mood. METHODS Sixty older adults aged 55-76 were randomly assigned to Group 1 (Tai Chi exercise) or Group 2 (combined exercise prescription). Exercise was performed three times a week over a period of 12 weeks. Single Leg-Stance-Eyes Open (SLS-EO), Single Leg-Stance Eyes Closed (SLS-EC), computerized balance measurements, the Timed Up and Go (TUG) test, Berg Balance Scale (BBS), the Survey of Activities and Fear of Falling in the elderly (SAFFE), the Geriatric Depression Scale (GDS), and the Beck Depression Scale (BDS) were assessed before and after the final training session. RESULTS Both exercise groups yielded better results in dynamic balance assessments (TUG and BBS) at the 12th week (p< 0.05). Group 1 also showed significant improvements in the measurements of SLS-EO, SLS-EC, SAFFE, GDS, and BDS during the post-intervention period (all p< 0.05). When the groups were compared, a significant difference was found between groups in favor of Group 1 in terms of the SLS-EO and SAFFE (p< 0.05). CONCLUSIONS It can be concluded that Tai Chi may be a more successful exercise intervention for factors-related to falls in older people.
An atypical mycobacterial infection of the shoulder

Mycobacterium malmoense is an acid-fast non-tuberculous organism that most commonly causes pulmonary infection. Extrapulmonary infection has also been reported. With an increased emphasis being placed on the clinical importance of this organism, especially within Europe, we report the first case of septic arthritis of the shoulder caused by this organism. We also highlight the importance of considering atypical mycobacterium infection in the differential diagnosis of shoulder infection and issues surrounding the management of this entity.
Postoperative white blood cell count predicts atrial fibrillation after cardiac surgery.

BACKGROUND Postoperative atrial fibrillation (AF) occurs in as many as 50% of cardiac surgery patients and represents the most common postoperative rhythm complication. The cause of AF after cardiac surgery is incompletely understood, and its prevention remains suboptimal. Currently the role of inflammation and oxidative stress on electrical remodeling is under investigation, and recent studies have demonstrated that C-reactive protein levels are elevated in AF. The purpose of the present study was to investigate the correlation between the postoperative white blood cell (WBC) count as a marker of inflammation and the development of postoperative AF after cardiac surgery. METHODS AND RESULTS Patients undergoing elective cardiac surgery in the absence of significant left ventricular dysfunction (n = 253; average age, 65 +/- 11 years) were recruited to the present prospective study. Atrial fibrillation developed during the postoperative period in 99 patients (39.1%) of the total study population. The WBC count was prospectively assessed in all patients to determine the predictive value of baseline and postoperative WBC count on development of postoperative AF. Baseline WBC count was 6.8 +/- 1.9 x 10(9)/L and 6.8 +/- 2.2 x 10(9)/L (p = 0.95), respectively, in patients with and without postoperative AF; and postoperative peak WBC count was 16.3 +/- 6.5 x 10(9)/L and 15 +/- 4.2 x 10(9)/L (p = 0.048), respectively, in patients without postoperative AF. However, neither baseline nor peak monocyte count differed significantly among patients with and without postoperative AF: 0.43 +/- 0.15 x 10(9)/L and 0.46 +/- 0.46 x 10(9)/L (p = 0.5), and 0.91 +/- 0.3 x 10(9)/L and 0.93 +/- 0.4 x 10(9)/L (p = 0.8), respectively. In addition to a more pronounced increase in peak WBC count (above v below median; odds ratio [OR], 1.8; 95% confidence interval [CI], 1.1-2.7; p < 0.05), increasing age (above v below median; OR, 2.6; CI, 1.2-3.9; p < 0.01), surgery for valvular heart disease versus coronary artery bypass grafting (OR, 2.8; CI, 1.1-3.5; p < 0.01), development of postoperative complications, such as stroke, infections, or unstable hemodynamics (OR, 1.9; CI, 1.0-7.5; p < 0.05), and perioperative nonuse of beta-adrenergic blockers (OR, 1.7; CI, 1.1-4.9; p < 0.05) were identified as independent predictors of postoperative AF by multivariate logistic regression analysis. CONCLUSIONS Cardiac surgery is associated with an elevated postoperative WBC count that represents a common marker of inflammation. A more pronounced increase in postoperative WBC count independently predicts development of postoperative AF. These data provide additional evidence to support the association between the inflammatory response and postoperative AF.
Overexpression of SOCS3 inhibits astrogliogenesis and promotes maintenance of neural stem cells

To investigate the effects of suppressors of cytokine signaling 3 (SOCS3) on neural stem cell fate, stem cells were infected with an adenoviral vector expressing SOCS3. Three days later, western blot analysis and immunocytochemical analysis revealed that the protein level of MAP2 and the number of MAP2‐positive cells were significantly increased in SOCS3‐transfected cells, whereas the protein level of GFAP and the number of GFAP‐positive cells were significantly decreased. Furthermore, promoter assay revealed a significant reduction in the transcriptional level of signal transducer and activator of transcription 3 (Stat3) in the transfected cells. In addition, the mRNA levels of Notch family member (notch1) and inhibitory basic helix‐loop‐helix (bHLH) factors (hes5 and id3) were significantly up‐regulated 1 day after overexpression of SOCS3. Three days after transfection, the mRNA level of hes5 was significantly decreased, whereas that of notch1 was still up‐regulated. Moreover, all of SOCS3‐positive cells expressed Nestin protein but did not express MAP2 or GFAP proteins. These data indicate that overexpression of SOCS3 induced neurogenesis and inhibited astrogliogenesis in neural stem cells. Our data also show that SOCS3 promoted maintenance of neural stem cells.
An epidemiological study of trichotillomania in Israeli adolescents.

OBJECTIVE To determine the prevalence of trichotillomania and comorbid psychopathology in nonreferred adolescents. METHOD Using a questionnaire and interview, 794 Israeli 17-year-olds were screened for current and past hair-pulling and comorbid psychopathology. RESULTS Eight current or past hair-pullers (5 male, 3 female) were identified, yielding a lifetime prevalence of hair-pulling of 1%. Four subjects reported current hair-pulling (point prevalence of 0.5%). None of these reported alopecia, distress, or tension before pulling; only two reported relief after pulling. Thus, none met the full DSM-III-R criteria for trichotillomania. Four subjects reported past but not current hair-pulling, with bald spots in two cases. Three of the four current hair-pullers had significant obsessive-compulsive symptoms, a significantly elevated rate compared to the entire screened population. Two subjects with obsessive-compulsive disorder also had generalized anxiety disorder and, in one case, chronic simple vocal tics. Hair-pullers did not differ significantly from non-hair-pullers in IQ, physical fitness, and overall competency, or prevalence of other comorbid disorders. CONCLUSIONS In a community adolescent sample, only 25% of hair-pullers reported resulting bare spots and none endorsed both rising tension and subsequent relief. The prevalence of obsessive-compulsive symptoms was significantly elevated in these nonreferred hair-pullers.
Characteristics of U.S. emergency departments that offer routine human immunodeficiency virus screening.

OBJECTIVES The association between emergency department (ED) characteristics, ED director's perceptions of preventive services, and the availability of human immunodeficiency virus (HIV) screening are unknown. The authors hypothesized that, after adjusting for ED operational and demographic characteristics, teaching hospital status would be associated with increased availability, and ED crowding and ED director agreement with barriers to screening would be associated with decreased availability. METHODS This was a secondary, cross-sectional analysis on previously collected data from 2008 to 2009 regarding availability of ED preventive services. Data were obtained from a random sample of 277 EDs in which ED directors provided information on ED characteristics and availability of HIV screening and rated five barriers to providing preventive services. The association between the availability of HIV screening and teaching hospital and crowding status, ED volume, urban-rural location, ownership, geographic region, patient demographics, state HIV testing consent laws, and ED director opinions on barriers to providing preventive services were determined in univariate analyses and a multivariate logistic regression model. RESULTS Nineteen percent of the sampled EDs offer HIV screening. Teaching hospitals offer HIV screening more frequently than nonteaching hospitals (38% vs. 18%; p = 0.03), but after adjusting for other characteristics in a multivariate model, this association was not significant (relative risk ratio [RR] = 2.07, 95% confidence interval [CI] = 0.91 to 3.59). ED crowding also was not significantly associated with screening availability (RR = 0.66, 95% CI = 0.34 to 1.21). However, public ownership (RR = 2.13, 95% CI = 1.28 to 3.14), 24-hour social work (RR = 1.87, 95% CI = 1.02 to 2.99), uninsured population ≥35% (RR = 2.48, 95% CI = 1.39 to 3.69), increased local nonwhite minority population percentage (RR = 1.14 per 10%, 95% CI = 1.02 to 1.26), and state laws allowing opt-out consent for testing (RR = 1.76, 95% CI = 1.01 to 2.74) were associated with increased availability of screening in multivariable analysis. EDs whose directors were concerned about added costs were associated with decreased availability of screening (RR = 0.45, 95% CI = 0.23 to 0.85). CONCLUSIONS After adjusting for other ED operational and demographic characteristics, ED crowding and teaching hospital affiliation were not independently associated with the availability of HIV screening. EDs whose directors were concerned about the cost of preventive services were less likely to provide routine HIV screening. Addressing ED director's concerns about the added costs of ED preventive services, increasing social work availability, and implementing testing laws consistent with Centers for Disease Control and Prevention (CDC) recommendations may facilitate increased adoption of ED HIV screening.
Therapeutic targeting of NOD1 receptors

The nucleotide‐binding oligomerization domain 1 (NOD1) protein is an intracellular receptor for breakdown products of peptidoglycan (PGN), an essential bacterial cell wall component. NOD1 responds to γ‐D‐glutamyl‐meso‐diaminopimelic acid, which is an epitope unique to PGN structures from all Gram‐negative bacteria and certain Gram‐positive bacteria. Upon ligand recognition, NOD1 undergoes conformational changes and self‐oligomerization mediated by the nucleotide‐binding NACHT domains, followed by the recruitment and activation of the serine threonine kinase receptor‐interacting protein 2 leading to the activation of NF‐κB and MAPK pathways and induction of inflammatory genes. Much of our knowledge is derived from seminal studies using mice deficient in NOD1 and confirming an essential role for NOD1 in the host immune response against gastrointestinal and respiratory pathogens. In addition, recent studies have revealed a role for intracellular NOD1 receptors in the regulation of vascular inflammation and metabolism. This review will discuss our current understanding of intracellular NOD1 receptors in host immunity and chronic inflammatory disorders with a focus on cardiovascular diseases. Although therapeutic advances may have to wait until the complex interplay with pathogens, danger signals, other pattern recognition receptors and overlapping metabolic pathways is further unravelled, the steadily growing body of knowledge suggest that NOD1 antagonism might represent attractive candidate to reduce excessive inflammation associated to intestinal, cardiovascular and metabolic diseases.
Effect of the Association Between the Tray and Impression Techniques on Angulated Implants Using the All-on-Four System.

T he impression represents a critical clinical stage to obtaining an accurate three-dimensional representation of the intraoral relationship between implants, teeth, and adjacent structures. Any inaccuracy during the impression stage will result in a lack of fit and misfit of the prosthesis, especially in implant-supported prostheses. In 1993, Barret et al verified that obtaining an accurate model for rehabilitation with implants depends on the type of impression material, the technique, the tray, and the number and position of the implants. In 2010, Sorrentino et al noted that impressions performed with angled implants exhibited lower accuracy than those made with parallel implants. Impression materials, with the addition of silicone, facilitated the creation of accurate impressions of parallel implants. In contrast, polyether exhibited better results with parallel implants. The authors concluded that the angulation of the implants could cause tension within the impressions, most likely due to the greater forces necessary to remove the molds from the stone cast. Furthermore, nonparallel implants negatively affect the accuracy of casts as well as the type of tray. The open tray allows for the copings to remain in the impression, reducing the deformation of the impression material and, consequently, the effect on the implant angulation. Few studies have been conducted to assess which could interfere in the final accuracy of impression in case of nonparallel implants on the final accuracy of the impression. Therefore, the aim of this study was to analyze the effect of the association among trays, impression technique, and the type of stone with angled implants under standardized laboratory conditions. The null hypothesis was that there would be no difference among the groups.
The Role of the Champion in Primary Care Change Efforts: From the State Networks of Colorado Ambulatory Practices and Partners (SNOCAP)

Background: Change champions are important for moving new innovations through the phases of initiation, development, and implementation. Although research attributes positive health care changes to the help of champions, little work provides details about the champion role. Methods: Using a combination of immersion/crystallization and matrix techniques, we analyzed qualitative data, which included field notes of team meetings, interviews, and transcripts of facilitator meetings, from a sample of 8 practices. Results: Our analysis yielded insights into the value of having 2 discrete types of change champions: (1) those associated with a specific project (project champions) and (2) those leading change for entire organizations (organizational change champions). Relative to other practices under study, those that had both types of champions who complemented each other were best able to implement and sustain diabetes care processes. We provide insights into the emergence and development of these champion types, as well as key qualities necessary for effective championing. Conclusions: Practice transformation requires a sustained improvement effort that is guided by a larger vision and commitment and assures that individual changes fit together into a meaningful whole. Change champions—both project and organizational change champions—are critical players in supporting both innovation-specific and transformative change efforts.
Hierarchical Decentralized Network Reconfiguration for Smart Distribution Systems—Part II: Applications to Test Systems

A hierarchical decentralized network reconfiguration approach to minimize power losses for smart distribution systems was presented in Part I. In this paper, the proposed approach is applied to four test distribution systems to examine its performance. A demonstration system consisting of the test system and distributed intelligent agents is built using MATLAB/Simulink to illustrate how the decentralized approach is implemented. Simulation results of the proposed approach are then compared with results of a centralized implementation and the harmony search method. It is shown that the decentralized approach can achieve similar results as other methods with significantly reduced computation time. The impacts of time-varying loads and faults are also studied through dynamic network reconfiguration on the 118-bus test system. Simulation results illustrate that dynamic network reconfiguration with time-ahead planning can determine the optimal configuration for each operating period to significantly reduce system energy losses. The enhanced performance of the hierarchical decentralized approach is clearly established.