Miracle-dz/UniFAR-FTUs huggingface dataset:
Why are advance care planning decisions not implemented? Insights from interviews with Australian general practitioners.

BACKGROUND Advance care planning (ACP) is thought to enhance patient autonomy and improve end-of-life care. However, there is evidence that when patients engage in ACP, the resultant plans are often not implemented. This has been attributed to either nonadherence by health professionals or inadequacies in ACP such as inaccessibility of the plans, plans providing ambiguous or conflicting instructions, and inappropriate focus on the completion of documents rather than communication. However, it is not known whether these postulated reasons are consistent with the experiences and views of health care professionals providing end-of-life care in the community. OBJECTIVE Our aim was to explore the perspectives of general practitioners (GPs) on factors influencing the implementation of ACPs. METHODS We conducted semi-structured, open-ended interviews of a purposive sample of 17 Australian GPs. Interview transcripts were analysed using constructionist grounded theory utilizing NVivo 9 software. RESULTS Factors that were considered to have an important influence on the implementation of ACPs include: ACP factors such as form, legal standing, accessibility, clarity, currency, and specificity; illness factors such as quality of life, function, diagnosis, prognosis, and prognostic certainty; family factors such as family attitudes to ACP and different conceptualizations on whether care is provided to individuals or to a family unit; and organizational and care setting factors such as health care facility's attitudes and policies in relation to end-of-life care. CONCLUSIONS Problems in implementation of ACPs are multifactorial and not necessarily due to deliberate nonadherence by health professionals. Potential solutions to improve the clinical impact of ACP are discussed.
Impact of intensive insulin therapy on neuromuscular complications and ventilator dependency in the medical intensive care unit.

RATIONALE Critical illness polyneuropathy/myopathy causes limb and respiratory muscle weakness, prolongs mechanical ventilation, and extends hospitalization of intensive care patients. Besides controlling risk factors, no specific prevention or treatment exists. Recently, intensive insulin therapy prevented critical illness polyneuropathy in a surgical intensive care unit. OBJECTIVES To investigate the impact of intensive insulin therapy on polyneuropathy/myopathy and treatment with prolonged mechanical ventilation in medical patients in the intensive care unit for at least 7 days. METHODS This was a prospectively planned subanalysis of a randomized controlled trial evaluating the effect of intensive insulin versus conventional therapy on morbidity and mortality in critically ill medical patients. All patients who were still in intensive care on Day 7 were screened weekly by electroneuromyography. The effect of intensive insulin therapy on critical illness polyneuropathy/myopathy and the relationship with duration of mechanical ventilation were assessed. MEASUREMENTS AND MAIN RESULTS Independent of risk factors, intensive insulin therapy reduced incidence of critical illness polyneuropathy/myopathy (107/212 [50.5%] to 81/208 [38.9%], p = 0.02). Treatment with prolonged (> or = 14 d) mechanical ventilation was reduced from 99 of 212 (46.7%) to 72 of 208 (34.6%) (p = 0.01). This was statistically only partially explained by prevention of critical illness polyneuropathy/myopathy. CONCLUSION In a subset of medical patients in the intensive care unit for at least 7 days, enrolled in a randomized controlled trial of intensive insulin therapy, those assigned to intensive insulin therapy had a reduced incidence of critical illness polyneuropathy/myopathy and were treated with prolonged mechanical ventilation less frequently.
The Primate Striatum: Neuronal Activity in Relation to Spatial Attention Versus Motor Preparation

The primate basal ganglia are known to be involved in the initiation and control of visually guided movements. However, the precise role of these structures is not clear, partly because most neurophysiological studies have not dissociated neuronal activity related to visuomotor processing from that reflecting other aspects of behaviour, such as shifts of spatial attention. Moreover, the way the basal ganglia function together with the frontal cortex during movement initiation and execution is still a matter of debate. In an effort to clarify these issues, we recorded single neurons from the striatum (caudate nucleus and putamen) in two rhesus monkeys trained to perform a conditional visuomotor task, and compared their properties with those of the frontal cortex. The experimental paradigm was designed to distinguish neuronal activity associated with shifts of attention from that reflecting motor preparation. In a given trial, an identical visual stimulus could serve as a cue for the reorientation of spatial attention or as a cue for establishing a motor set depending on when it occurred during that trial. Additional aspects of the paradigm were designed to identify neurons whose activity differed when various stimulus configurations instructed the same action (stimulus effect), as well as neurons whose activity differed when two different actions were instructed by the same stimulus (movement effect). The majority of cells (60%) were preferentially active after instructional cues, 38% discharged preferentially after attentional cues, and the remaining 2% of cells discharged equally after both types of cue. Neurons active after instructional cues were further analysed for stimulus and movement effects. During movement preparation, the activity of the vast majority of striatal cells (putamen, 81%; caudate, 76%) varied significantly when different stimuli instructed the same action. Likewise, when different movements were instructed by the same stimulus, preparatory activity of a majority of cells (putamen, 92%; caudate, 82%) changed. Consequently, a substantial proportion of cells showed combined stimulus and movement effects. Comparison of these neuronal properties with those of the dorsal premotor cortex showed significantly higher proportions of cells in the striatum whose activity reflected sensory or sensorimotor processing. These results suggest that the basal ganglia are involved in shifting attentional set and in high‐order processes of movement initiation, including the linking of sensory information with behavioural responses.
Translation, Adaptation, and Validation of the Brazilian Version of the Dickman Impulsivity Inventory (Br-DII)

Impulsivity has mainly been described as a negative or dysfunctional characteristic associated with several disorders. However, impulsivity is not only related to dysfunctional outcomes and may explain individual differences in optimal human functioning as well. The Dickman Impulsivity Inventory (DII) is a self-report instrument measuring both the dysfunctional and the functional aspects of impulsivity. In this study, we performed the translation and cultural adaptation of the DII to the Brazilian context and analyzed its psychometric properties. Translation and cultural adaptation followed a rigorous process, which relied on an expert panel in the cross-cultural adaptation of psychological instruments. Data from 405 undergraduate students were obtained for the Brazilian version of the DII (Br-DII). The 23 items of the Br-DII was considered unsuitable according to model fit indices of the Confirmatory Factor Analysis (both for Oblique and Orthogonal models). Exploratory Factor Analysis showed an 18 items version of the Br-DII to be suitable (CFI = 0.92; TLI = 0.90, and RMSEA = 0.057). The DII’s 18 items version also showed adequate Cronbach’s alpha, intraclass correlation coefficient, and convergent and discriminant validity with the BIS-11. Therefore, the Br-DII demonstrated reliability and validity in the measurement of functional and dysfunctional impulsivity.
Androgen receptor‐mediated repression of novel target genes

The androgen receptor (AR) plays a pivotal role in prostate cancer (PCa) initiation and progression. To date, studies have focused disproportionately on androgen‐stimulated genes such as prostate‐specific antigen (PSA), while repressed genes have gained little attention, even though they too may be involved in regulating cell growth, differentiation, and apoptosis.
Dexmedetomidine and the reduction of postoperative delirium after cardiac surgery.

BACKGROUND Delirium is a neurobehavioral syndrome caused by the transient disruption of normal neuronal activity secondary to systemic disturbances. OBJECTIVE The authors investigated the effects of postoperative sedation on the development of delirium in patients undergoing cardiac-valve procedures. METHODS Patients underwent elective cardiac surgery with a standardized intraoperative anesthesia protocol, followed by random assignment to one of three postoperative sedation protocols: dexmedetomidine, propofol, or midazolam. RESULTS The incidence of delirium for patients receiving dexmedetomidine was 3%, for those receiving propofol was 50%, and for patients receiving midazolam, 50%. Patients who developed postoperative delirium experienced significantly longer intensive-care stays and longer total hospitalization. CONCLUSION The findings of this open-label, randomized clinical investigation suggest that postoperative sedation with dexmedetomidine was associated with significantly lower rates of postoperative delirium and lower care costs.
Orbital and rotational atherectomy during percutaneous coronary intervention for coronary artery calcification

Severe coronary artery calcification (CAC) increases the complexity of percutaneous coronary intervention (PCI) by inhibiting optimal stent expansion, leading to an increased risk of death, myocardial infarction, repeat revascularization, and stent thrombosis. Coronary atherectomy modifies and debulks calcified plaque to facilitate PCI. Although there is no clear consensus, and further studies are needed, the decision to perform atherectomy should be based upon the presence of fluoroscopic CAC or with the use of intravascular imaging. The management of CAC in the modern era relies on rotational and orbital atherectomy to prepare the lesion to facilitate stent delivery and optimal expansion. While the two technologies differ in equipment, technique, and mechanism of action, the available literature suggests similar efficacy and safety of the two systems, although head‐to‐head comparisons are limited. While rotational and orbital atherectomy have been shown to have excellent procedural success in terms of facilitating stent delivery, no system has been shown to reduce long‐term major adverse cardiovascular events, although the definitive trial for orbital atherectomy has not been completed. Additional trials are needed to find the population who would derive the most benefit of atherectomy and to compare the two systems in a prospective manner.
An unbalanced autosomal translocation (7;9) associated with feminization

A newborn girl presented with generalized mild dysmorphic features. She later developed heart failure and hydrocephalus, and died aged 5 months. Chromosome analysis revealed an unbalanced reciprocal translocation (with partial trisomy for half of the long arm of 7 and partial monosomy for the short arm of chromosome 9) and normal but inappropriate sex chromosomes (XY). The karyotype (46, XY,‐9, + der(9), t(7;9)(q31.1;p23)pat) was inferred from her father who was a balanced carrier: 46, XY,(7;9)(q31.1;p23). The evidence of the present case, when considered with that of previous reports, suggests that deletion of genes on the 9p may have caused the feminization and therefore that the 9p region may contain genes which are important in the normal process of testis formation.
Follow‐up study of thymomas with special reference to their clinical stages

Follow‐up data were obtained for 96 cases of thymoma. The one‐year survival rate was 84.3%, the three‐year 77.1%, the five‐year 74.1%, and the ten‐year 57.1%. The five‐year survival rate of total resection group was 88.9%; that of non‐radically treated group was 44.4%. Clinical stages were defined: Stage I—macroscopically encapsulated and microscopically no capsular invasion; Stage II—1. macroscopic invasion into surrounding fatty tissue or mediastinal pleura, or 2. microscopic invasion into capsule; Stage III—macroscopic invasion into neighboring organ; Stage IVa—pleural or pericardial dissemination; Stage IVb—lymphogenous or hematogenous metastasis. Five‐year survival rates of each clinical stage were 92.6% in Stage I, 85.7% in Stage II, 69.6% in Stage III, and 50% in Stage IV. Recurrence after total resection was found in six of 69 cases. Seven of 13 patients treated by subtotal resection survived more than five years with postopertive radiotherapy.
A Blind Spot in Public Broadcasters’ Discovery of the Public: How the Public Values Public Service

Confronted with new technological options, changing usage patterns and rising criticism, public service broadcasters (PSBs) are paying fresh attention to the public as a target for accountability. This article first investigates how PSBs are repositioning themselves through increased responsiveness to and collaboration with the public and assesses the permissibility of such strategies, bearing in mind the traditional ethos and core principles of public service. The second part reacts to the finding that, while there is much talk about the public and the need to reconnect, little is known about the public’s perception regarding the importance of the idea of public service in times of media change. Results of a Swiss representative case study show that people still consider public service highly important in times of the Internet. Unexpectedly, linear regression and structural equation modeling reveal that this assessment is virtually independent of sociodemographics and individual values.
Development and Validation of a Brief Mental Health Screening Instrument for Newly Incarcerated Adults

The authors report the development and initial psychometric evaluation of gender-specific brief screening instruments to identify undetected psychiatric impairment on incarceration. Women and men completed the Correctional Mental Health Screen (CMHS), a 56-item screen derived from validated measures. Representative subsamples completed structured diagnostic interviews within 5 days. An 8-item screen for women and a 12-item screen for men identified inmates with current Axis I psychiatric disorders with 83% to 100% accuracy on the basis of cut points chosen to maximize negative predictive power. The CMHS showed evidence of incremental predictive utility compared with two previously validated correctional mental health screening measures with White and Black men and White women. Incremental validity was not supported with Black women, for whom the CMHS performed well in identifying true cases but not in ruling out noncases. Analyses of internal consistency, interrater, and retest reliability and convergent, discriminant, and criterion validity supported the psychometric status of the CMHS.
Racial/Ethnic Differences in Non-Work at Work

Evidence from the American Time Use Survey 2003–2012 suggests that minority employees, especially men, spend a small but statistically significant amount of time not working at the workplace relative to non-Hispanic whites. The time differences remain significant but decrease by 25 to 50% when accounting for detailed industry and occupation controls. Union status, public- or private-sector attachment, payment method, and educational attainment do not explain the differences, although health status is important among African Americans. The estimates imply that the differences in non-work at the worksite can explain up to 10% of the adjusted wage gap between minority and non-Hispanic white workers.
Do Your Students Get It? Quiz It! The Android Classroom Response System

This paper presents the design and a pilot study of a real-time response system for Android mobile devices, created to enhance active learning methods and assess students' understanding. The prototype system named Quiz It, consists of a lecturer mobile application, a student mobile application and a supportive lecturer administration web environment. Quiz It can be used by Android mobile phones or tablets with access to the Internet. In order to investigate whether Quiz It responds sufficiently under real conditions and get an overview about students' attitude towards its use, we conducted a pilot study with 23 students who used the application during a laboratory lecture. The results indicated that no problems were encountered in use and students reported that they had a positive experience with the application.
Inducible site-specific recombination in the brain.

The Cre/loxP recombination system allows the generation of tissue-specific somatic mutations in mice. Additional temporal control of somatic mutagenesis is highly desirable, as this would permit a more precise analysis of gene function in complex systems such as the central nervous system. Extending our previous studies, we compared several ligand-regulated recombinases, in which the ligand-binding domain (LBD) of the progesterone receptor or the estrogen receptor was fused to the Cre recombinase. A fusion protein between the Cre recombinase and a truncated LBD of the progesterone receptor was chosen to obtain inducible recombination in the brain. This fusion protein can be activated by the synthetic steroid RU486, but not by the physiological hormone progesterone. Its expression was targeted to the brain using regulatory sequences of the calcium-calmodulin-dependent kinase IIalpha or the Thy-1 gene. Application of RU486 to the mice induced Cre-mediated recombination of a lacZ reporter transgene in the cortex and hippocampus, showing that spatially and temporally controlled gene targeting can be mediated in the brain.
Crisis Narratives and the Abandonment of CSR during the Financial Crisis: Notes from Systems Integrated

ABSTRACT Studies of environmental accounting systems within organisations have highlighted significant benefits to the commercial organisation arising upon adoption, insisting that economic and commercial benefits, whilst sometimes being unexpected, are an important driver in adopting such systems. But studies rarely elucidate instances where these apparent benefits are lost. This paper presents the case of Systems Integrated (SI), and provides an analysis of SI’s environmental accounting and reporting systems during the financial crisis in order to elaborate one such case of the abandonment of environmental accounting systems. The case demonstrates that the dogged pursuit of an organisational value creation strategy led to environmental accounting practices being perceived as both a means of reporting social and environmental performance and as a source of potential value creation. However, by the financial crisis, a purely value creation rationale pervaded leading to the eventual abandonment of SI’s environmental accounting system.
Scopic valuations: how digital tracking technologies shape economic value

Abstract How do market actors in the contemporary economy make decisions when they are uncertain of the value of what is being traded? To answer this question, this paper analyses the changing temporal and spatial orientation of economic valuations in increasingly digitalized economies, in which markets can no longer be understood as locally bound and closed sites of valuation and exchange. Drawing on ethnographic material from the fishing industry, the paper shows how digital tracking technologies link and synchronize auction markets with real-time information on fishing activities. Hence, ‘scopic media’ such as chart plotters and computer screens are not only deployed by skippers to monitor one another, but are also used as valuation devices that recontextualize local knowledge for the purpose of coping with economic uncertainty. As a consequence of this panoptic valuation regime, fishermen control their virtual identities by disciplining harvesting practices according to their buyers’ expectations.
cDNA microarray analysis of the gene expression of murine leukemia RAW 264.7 cells after exposure to propofol

Propofol (2,6‐diisopropylphenol) is the most extensively used general anesthetic‐sedative agent and it is employed in clinical patients. It has been shown that propofol exhibits anticancer activities. However, there is no available information to address propofol‐induced cytotoxic effects and affected gene expressions on murine leukemia cells. Therefore, we investigated the effects of propofol on the levels of protein and gene expression, which are associated with apoptotic death in mouse leukemia RAW 264.7 cells in vitro. Results indicated that propofol induced cell morphological changes, cytotoxicity, and induction of apoptosis in RAW 264.7 cells in vitro. Western blot analysis demonstrated that propofol promoted Fas, cytochrome c, caspase‐9 and −3 active form and Bax levels, but inhibited Bcl‐xl protein level which led to cell apoptosis. Furthermore, cDNA microarray assay indicated that propofol significantly enhanced 5 gene expressions (Gm4884; Gm10883; Lce1c; Lrg1; and LOC100045878) and significantly suppressed 26 gene expressions (Gm10679; Zfp617; LOC621831; LOC621831; Gm5929; Snord116; Gm3994; LOC380994; Gm5592; LOC380994; Gm4638; LOC280487; Gm4638; Tex24; A530064D06Rik; BC094916; EG668725; Gm189; Hist2h3c2; Gm8020; Snord115; Gm3079; Olfr198; Tdh; Snord115; and Olfr1249). Based on these observations, propofol‐altered apoptosis‐related proteins might result from induction of apoptotic gene expression and inhibition of cell growth gene expression, which finally led to apoptosis in a mouse leukemia cell line (RAW 264.7) in vitro. © 2011 Wiley Periodicals, Inc. Environ Toxicol 28: 471–478, 2013.