Miracle-dz/UniFAR-FTUs huggingface dataset:
The development of a framework for evaluating the impact of nurse consultant roles in the UK.

AIM To develop a framework to evaluate the impact of nurse consultants on patient, professional and organizational outcomes and identify associated indicators of impact. BACKGROUND Since nurse consultants were introduced into the UK in 2000, there has been growing interest in demonstrating their impact, although robust evidence of impact is lacking. Existing frameworks for evaluating the impact of advanced practice roles do not cover the four dimensions of the nurse consultant role sufficiently. DESIGN Multiple case study. METHOD Individual case studies of six nurse consultants in England were undertaken between December 2009-October 2010. Each case study involved interviews with the nurse consultant, healthcare staff, managers, patients and carers. Interviews explored participants' perceptions of the impact of the nurse consultant and indicators of actual and/or potential impact. Data were analysed using framework approach. FINDINGS Three domains of impact of nurse consultant roles were identified: clinical significance, professional significance and organizational significance. Each domain included three to four indicators of impact. All nurse consultants showed some evidence of impact in all three domains although the primary focus varied across the different nurse consultants. Due to the wide diversity in nurse consultant roles there was little commonality in the specific indicators of impact across all nurse consultants. CONCLUSION The framework for capturing the impact of nurse consultants could be used by researchers and by nurse consultants to demonstrate their impact. Further research is required to assess the suitability of the framework for capturing the impact of other advanced practice roles.
The relationship between physicians' self-reported target fasting blood glucose levels and metabolic control in type 2 diabetes. The QuED Study Group--quality of care and outcomes in type 2 diabetes.

OBJECTIVE To investigate the relationship between beliefs of physicians relative to intensive metabolic control in type 2 diabetes and levels of HbA1c obtained in a sample of their patients. RESEARCH DESIGN AND METHODS Physicians' beliefs were investigated through a questionnaire sent to a sample of self-selected clinicians participating in a nationwide initiative aimed at assessing the relationship between the quality of care delivered to patients with type 2 diabetes and their outcomes. At the same time, physicians were asked to collect clinical data on a random sample of their patients, stratified by age (<65 vs. > or = 65 years). Mean HbA1c levels in the study population were thus evaluated according to target fasting blood glucose (FBG) used by their physicians. RESULTS Of 456 physicians, 342 (75%) returned the questionnaire. Among the responders, 200 diabetologists and 99 general practitioners (GPs) recruited 3,297 patients; 2,003 of whom were always followed by the same physician and 1,294 of whom were seen by different physicians in the same structure on different occasions. Only 14% of the respondents used target FBG levels < or = 6.1 mmol/l, whereas 38% pursued values >7.8 mmol/l, with no statistically significant difference between diabetologists and GPs. The analysis of the relationship between FBG targets and metabolic control, restricted to those patients always seen by the same physician, showed a strong linear association, with mean HbA1c values of 7.0 +/- 1.6 for patients in the charge of physicians pursuing FBG levels < or = 6.1 mmol/l and 7.8 +/- 1.8 for those followed by physicians who used target values >7.8 mmol/l. After adjusting for patients' and physicians' characteristics, the risk of having HbA1c values > 7.0% was highly correlated with physicians' beliefs. Patients followed by different physicians in the same unit showed a risk of inadequate metabolic control similar to that of patients followed by physicians adopting a nonaggressive policy. CONCLUSIONS Doctors adopt extremely heterogeneous target FBG levels in patients with type 2 diabetes, which in turn represent an important independent predictor of metabolic control. To improve patient outcomes, physicians-centered educational activities aimed at increasing the awareness of the potential benefits of a tight metabolic control in patients with type 2 diabetes are urgently needed.
Sleep-disordered breathing in stable methadone programme patients: a pilot study.

AIMS To explore the possibility that stable MMP patients have sleep-disordered breathing (SDB) and abnormal sleep architecture defined by nocturnal sleep stages and sleep efficiency. DESIGN Observational. SETTING Regional Methadone Service and sleep disorders laboratory in a university affiliated hospital. Participants and measurements. Ten stable MMP patients and nine normal subjects were assessed clinically and with overnight polysomnography. FINDINGS There were no differences in age, sex and body mass index between the groups. The methadone dose ranged between 50 and 120 mg/day. Six patients had central apnoea index (CAI) greater than 5, four had a CAI greater than 10 and three of these exhibited periodic breathing. No normal subject had central sleep apnoea. The patients had lower sleep efficiency (p < 0.05), less slow wave sleep (p < 0.01), less rapid eye movement sleep (p < 0.05) and more Stage 2 sleep (p < 0.05) than controls. CONCLUSIONS Stable MMP patients have more sleep architecture abnormalities than controls and a higher prevalence of central sleep apnoea. Further studies are needed to confirm these findings, to delineate the mechanisms for the abnormalities and to assess whether the SDB is related to sudden death in stable MMP patients. We recommend that MMP patients have awake and sleep respiration assessed to identify those potentially at risk.
Bacteriological quality of on-farm manufactured goat cheese

SUMMARY The bacteriological quality of 198 ripened soft or semi-soft goat cheeses obtained from dairy farms and the retail trade was investigated. The cheeses were examined for total counts of aerobic bacteria, coliform bacteria (37 and 44 °C respectively), enterocoeci, coagulase positive staphylococci, Bacillus cereus and Clostridium perfringens. Cheeses obtained from dairy-farms were also determined for pH value. In terms of all tests performed, cheeses made of heat-treated milk with starter culture had the best prospects for fulfilling the criteria for 'fit for consumption '. Cheeses made of raw milk without starter culture made up the most unsatisfactory group from a food-hygiene point of view. Bacteriological guidelines for on-farm manufactured goat cheese are suggested.
Bidirectional effects on interhemispheric resting‐state functional connectivity induced by excitatory and inhibitory repetitive transcranial magnetic stimulation

Several recent studies using functional magnetic resonance imaging (fMRI) have shown that repetitive transcranial magnetic stimulation (rTMS) affects not only brain activity in stimulated regions but also resting‐state functional connectivity (RSFC) between the stimulated region and other remote regions. However, these studies have only demonstrated an effect of either excitatory or inhibitory rTMS on RSFC, and have not clearly shown the bidirectional effects of both types of rTMS. Here, we addressed this issue by performing excitatory and inhibitory quadripulse TMS (QPS), which is considered to exert relatively large and long‐lasting effects on cortical excitability. We found that excitatory rTMS (QPS with interstimulus intervals of 5 ms) decreased interhemispheric RSFC between bilateral primary motor cortices, whereas inhibitory rTMS (QPS with interstimulus intervals of 50 ms) increased interhemispheric RSFC. The magnitude of these effects on RSFC was significantly correlated with that of rTMS‐induced effects on motor evoked potential from the corresponding muscle. The bidirectional effects of QPS were also observed in the stimulation over prefrontal and parietal association areas. These findings provide evidence for the robust bidirectional effects of excitatory and inhibitory rTMSs on RSFC, and raise a possibility that QPS can be a powerful tool to modulate RSFC. Hum Brain Mapp 35:1896–1905, 2014. © 2013 Wiley Periodicals, Inc.
Regional distribution of pulmonary ventilation and perfusion in elderly subjects.

Using radioactive xenon, we measured the regional distribution of pulmonary ventilation and blood flow in six normal men, whose ages ranged between 65 and 75 yr. The measurements were made in the standing position. The static volume-pressure relation of the lungs was also measured in five of the subjects. The results indicate that by comparison with normal young men: (a) Blood flow to the upper lung zones was increased, although it still remained predominant in the lower zones. (b) Ventilation distribution during a vital capacity inspiration was similar to that seen in young subjects. (c) In five of the six elderly subjects, however, the distribution of ventilation in the resting tidal volume range was not preferential to the lower zones as it was in young men. This was probably caused by airway closure in the lower lung zones. The elderly subjects thus exhibit during normal tidal volume breathing a ventilation distribution pattern similar to that observed in young subjects when breathing at low lung volumes, i.e., near residual volume. This difference is probably due to the combined effect of the loss in elastic recoil of the lungs observed in the elderly subjects and of a decreased resistance to collapse of the aged airways. These findings suggest that in the elderly subjects there is a significant regional ventilation-perfusion impairment during quiet breathing, which may explain in part the reported increase in alveolar-arterial oxygen difference with advancing age.
Large molecular size prolactin with reduced receptor activity in human serum: high proportion in basal state and reduction after thyrotropin-releasing hormone.

ABSTRACT. Previous studies of PRL heterogeneity in serum have been chiefly confined to specimens with pathologically or physiologically elevated levels of the hormone. We have examined distribution patterns of PRL after Sephadex chromatography in the sera of eight normal adults before and 15, 60, and 120 min after iv TRH. Column eluates were concentrated by lyophilization and assayed by both RIA and radioreceptor assay (RRA). Lyophilization produced no significant changes in immunological activity of the different fractions. High proportions (mean, 24% range, 12–38%) of immunoreactive material appearing close to the void volume (big big PRL) were noted in all specimens in the resting state. The proportions of big and little (monomer) PRL were 18% and 58%, respectively. The relative proportion of big big PRL declined abruptly 15 min after TRH (mean, 12.9% range, 3–23%), with a corresponding increase in little PRL; there was a restoration of the zero-min pattern by 60–120 min. Receptor assays confirmed this.
Ideal Language Philosophy and Experiments on Intuitions

Proponents of linguistic philosophy hold that all non-empirical philosophical problems can be solved by either analyzing ordinary language or developing an ideal one. I review the debates on linguistic philosophy and between ordinary and ideal language philosophy. Using arguments from these debates, I argue that the results of experimental philosophy on intuitions support linguistic philosophy. Within linguistic philosophy, these experimental results support and complement ideal language philosophy. I argue further that some of the critiques of experimental philosophy are in fact defenses of ideal language philosophy. Finally, I show how much of the current debate about experimental philosophy is anticipated in the debates about and within linguistic philosophy. Specifically, arguments by ideal language philosophers support experimental philosophy.
A one-year trial of lamivudine for chronic hepatitis B. Asia Hepatitis Lamivudine Study Group.

BACKGROUND AND METHODS In preliminary trials, lamivudine, an oral nucleoside analogue, has shown promise for the treatment of chronic hepatitis B. We conducted a one-year, double-blind trial of lamivudine in 358 Chinese patients with chronic hepatitis B. The patients were randomly assigned to receive 25 mg of lamivudine (142 patients), 100 mg of lamivudine (143), or placebo (73) orally once daily. The patients underwent liver biopsies before entering the study and after completing the assigned treatment regimen. The primary end point was a reduction of at least two points in the Knodell necroinflammatory score. RESULTS Hepatic necroinflammatory activity improved by two points or more in 56 percent of the patients receiving 100 mg of lamivudine, 49 percent of those receiving 25 mg of lamivudine, and 25 percent of those receiving placebo (P<0.001 and P=0.001, respectively, for the comparisons of lamivudine treatment with placebo). Necroinflammatory activity worsened in 7 percent of the patients receiving 100 mg of lamivudine, 8 percent of those receiving 25 mg, and 26 percent of those receiving placebo. The 100-mg dose of lamivudine was associated with a reduced progression of fibrosis (P=0.01 for the comparison with placebo) and with the highest rate of hepatitis B e antigen (HBeAg) seroconversion (loss of HBeAg, development of antibody to HBeAg, and undetectable HBV DNA) (16 percent), the greatest suppression of HBV DNA (98 percent reduction at week 52 as compared with the base-line value), and the highest rate of sustained normalization of alanine aminotransferase levels (72 percent). Ninety-six percent of the patients completed the study. The incidence of adverse events was similar in all groups, and there were few serious events. CONCLUSIONS In a one-year study, lamivudine was associated with substantial histologic improvement in many patients with chronic hepatitis B. A daily dose of 100 mg was more effective than a daily dose of 25 mg.
Adherence to Antiretroviral Therapy in Patients Receiving Free Treatment From a Government Hospital in Blantyre, Malawi

Objectives:To compare 3 measures of adherence to antiretroviral therapy (ART) in HIV-positive adults receiving free treatment from a public hospital in Malawi. Methods:Adherence was measured over 1 month by pill count (PC), self-report, and a medication event monitoring system (MEMS). Results:Data from 80 patients were available for analysis. The mean patient age was 38.6 years, and 57.5% were female. The mean adherence using the MEMS cap (MC) was 88.1%. Forty-six (57.5%) patients had MC adherence ≥95%, and 13 (16.2%) had <80% adherence. There was no association between MC adherence and time on ART. Mean PC adherence was 98.6%, significantly higher than MC adherence (P < 0.001). There was no clear relation between PC and MC adherence: 4 patients had MC adherence <20% but PC adherence of 100%. Self-reports of missing a tablet did not correlate with poor MC adherence. Conclusions:The study shows the complexities of measuring adherence and probable overestimation of adherence by PC and self-report. Because these are the main methods used in developing countries, this raises concerns about the development of drug resistance. Improved methods are needed to detect nonadherence in developing countries, and validation of MC data with drug levels and virologic outcome in this setting is important.
A Numerical Study on Physical Characterizations of Microwave Scattering and Emission from Ocean Foam Layer

This paper presents a numerical study of microwave scattering and emission from a foamcovered ocean surface. The foam layer is modeled as an inhomogeneous layer with randomly rough airfoam and foam-seawater boundaries. Kelvin’s Tetrakaidecahedron structure is selected as the skeleton for simulating the air bubbles in the foam layer. The electromagnetic characteristics of the foam layer, including absorption and scattering coefficients for both vertical and horizontal polarizations, are calculated using a multilevel volume UV fast algorithm to accelerate the numerical computation of three dimensional Maxwell’s equations. The surface scattering at air-foam and foam-seawater interfaces is determined using the integral equation model (IEM). The microwave emission from the foam-covered ocean surface, which accounts for multiple incoherent interactions within the foam layer and between the foam and interfaces, is modeled using the vector radiative transfer approach and numerically solved using the matrix doubling method. The model analyses of volume scattering and absorption of the foam layer reveal that the volume scattering coefficient of a foam layer increases with increasing water fraction at all selected frequencies, and its polarization dependence is negligible at a water fraction less than 2%. At 10.8GHz and 18GHz, the H-polarized scattering coefficient is smaller than the V polarized scattering coefficient for a larger water fraction; the opposite occurs at 36.5GHz, at which V polarized scattering is weaker compared to H-polarized scattering. The model analyses of emission from a foam-covered ocean surface reveal that the emissivities at all selected operating frequencies have similar dependencies with water fraction and frequency, and they exhibit different sensitivities to water fractions. Moreover, the emissivities at high operating frequencies exhibit higher sensitivities to water fractions than the lower ones.
Effectiveness of Teleassistance at Improving Quality of Life in People with Neuromuscular Diseases

Abstract Rare neuromuscular diseases (NDs) are a group of inherited or acquired neurological pathologies affecting the muscles and the nervous system. Their low prevalence and high geographical dispersion can cause isolation and difficulties in social interaction between affected equals. New technologies, such as videoconferencing, offer a complementary option for improving the health of this population. The purpose of this study was to assess the effectiveness of a teleassistance program at improving health-related quality of life (HRQoL) through social interaction in adults with NDs. The sample consisted of 45 participants affected by rare NDs. Twenty-four participants were assigned to the experimental group (EG), which participated in the videoconferencing sessions, and 21 to the control group. Three questionnaires were administered: WHO-DAS II, Sickness Impact Profile, and SF-36 Health Survey. Effectiveness was assessed by a pre-post design. An online psychosocial program was applied over three-month period. Data revealed an improvement of the EG in psychosocial variables, e.g. “Getting along with people” (z = –2.289, r = –.47, p ≤ .05) or “Psychosocial Domain” (z = –2.404, r = –.49, p ≤ .05), and in physical variables, e.g. “Life activities” (z = –2.844, r = –.58, p ≤ .05). Social interaction appeared as a relevant factor at improving HRQoL levels. High levels of satisfaction about the teleassistance program were reported.
Effects of Pyriproxyfen on California Red Scale (Hemiptera: Diaspididae) Development and Reproduction

Abstract Two life stages of a laboratory colony of California red scale, Aonidiella aurantii (Maskell) (Hemiptera: Diaspididae), were exposed to 10 concentrations of pyriproxyfen to evaluate the effect of this insect growth regulator (IGR) on scale development and fecundity. First instars exposed to pyriproxyfen responded with mortality during the first and second molts. Second instars were more tolerant of pyriproxyfen than were first instars, indicating that growers should treat California red scale in the field before the first molt to achieve maximum efficacy. Male scales responded with an LC50 12-fold lower and an LC90 47-fold lower than was observed for female scales. Female scales that survived first instar exposure to pyriproxyfen experienced reduced fecundity with increasing pyriproxyfen concentration. Reduced fecundity was due to reduced survival of the females rather than sterility. Results from this study provide baseline California red scale susceptibility data for pyriproxyfen, and they suggest that 1 ppm pyriproxyfen can be used as a concentration that would discriminate between susceptible and resistant populations of scales. Field monitoring for incipient pyriproxyfen resistance in California red scale should be implemented in the San Joaquin Valley of California, and if resistance is detected, integrated resistance management strategies should be used to slow the progression of resistance.
Effect of a shear flow on the planform of thermal convection in a fluid of variable viscosity.

It is well known that if the variation with temperature of viscosity is taken into account, the onset of convection in an infinite layer of fluid that is heated from below takes the form of hexagonal convection cells. It is also well known that in a sufficiently strong shear flow, rolls aligned with the flow direction are the preferred mode of convection. Here the process by which a steady or unsteady shear flow de- stroys the usual hexagonal cell pattern is investigated. The critical size of the shear flow that enables rolls to be established at the onset of convection is determined for the case when the stress is prescribed at the boundaries.
Prevalence of rheumatic diseases in Taiwan: a population study of urban, suburban, rural differences.

OBJECTIVE To determine the prevalence of symptomatic rheumatic disease in rural, urban and suburban areas of Taiwan by a 2-staged population survey. METHODS Nine thousand subjects over 20 years old were sampled proportional to age and sex for the area from 3 administrative areas in Taiwan. A pretested questionnaire to screen for potential rheumatic disorders and/or disability was administered in the communities by health workers. Subjects who screened positive were examined by a rheumatologist who assigned a final diagnosis based on established criteria. RESULTS A total of 8998 persons over age 20 residing in Hen-San (rural area), Sien-Dien (suburban), and Cu-Tien (urban) were studied. Twenty-five percent (2272) of the population indicated rheumatic problems: 1124 of 2271 were evaluated by a rheumatologist with serological and radiological testing. The response rates were 49.7% in Hen-San, 50.7% in Sien-Dien and 48.5% on Cu-Tien. After age and sex adjustment, the prevalence of rheumatic symptoms in Hen-San, Sien-Dien, and Cu-Tien was 24.3, 18.4 and 26.3% respectively. It was significantly higher in rural Hen-San and urban Cu-Tien than in Sien-Dien. The prevalence of rheumatoid arthritis (RA) in Hen-San, Sien-Dien, and Cu-Tien was 0.26, 0.78, and 0.93%, osteoarthritis (OA) was 6.3, 5.8, 5.1%, ankylosing spondylitis (AS) was 0.54, 0.19, 0.4%, gout was 0.16, 0.67, 0.67%, respectively. The prevalence of RA in Sien-Dien and Cu-Tien was significantly higher than in Hen-San (p < 0.05) but were not statistically different for OA, AS and gout among those 3 sites. Only one case of systemic lupus erythematosus (SLE) was found in urban Cu-Tien for a prevalence of 0.033%. CONCLUSION Our results suggest that the prevalence of RA and AS is similar to that reported in Caucasians. We could not confirm anecdotal reports that SLE was common or that it is more common than RA in people of Chinese ancestry. The prevalence of OA of the hip is comparatively uncommon in our population. The difference in prevalence of rheumatism, RA, OA and gout in these areas suggests areas of further study.