Miracle-dz/UniFAR-FTUs huggingface dataset:
The effect of computerized physician order entry on medication errors and adverse drug events in pediatric inpatients.

OBJECTIVE Computerized physician order entry (CPOE) has the potential to reduce patient injury resulting from medication errors. We assessed the impact of a CPOE system on medication errors and adverse drug events (ADEs) in pediatric inpatients. DESIGN A retrospective cohort study. SETTING Tertiary care pediatric hospital. PARTICIPANTS Pediatric inpatients on 3 medical and 2 surgical wards. INTERVENTION CPOE system implemented on 2 medical wards and compared with 1 medical and 2 surgical wards that continued to use hand written orders. OUTCOME MEASURES Rate of medication error and ADEs before and after CPOE implementation. RESULTS In 6 years, a total of 804 medication errors were identified with 18 ADEs, resulting in patient injury among 36 103 discharges and 179 183 patient days. The overall medication error rate (MER) was 4.49 per 1000 patient days. Before the introduction of CPOE, the MERs of the intervention versus control wards were indistinguishable (ratio = 0.93; 95% confidence interval [CI] = 0.76, 1.13). After the introduction of CPOE, the MER was 40% lower on the intervention than on the control wards (ratio = 0.60; 95% CI = 0.48, 0.74). On average, 490 patient days are required to see the benefit of one less medication error using CPOE. We did not demonstrate a similar effect of CPOE for ADEs (ratio of rate ratios = 1.30; 95% CI 0.47, 3.52). CONCLUSIONS The introduction of a commercially available physician computer order entry system was associated with a significant decrease in the rate of medication errors but not ADEs in an inpatient pediatric population.
Apoptosis and necrosis in liver disease

Abstract: Liver cell injury and cell death is a prominent feature in all liver disease processes. During the last 5–10 years, most research activities focused almost exclusively on evaluating apoptotic cell death and the corresponding intracellular signaling pathways. Although this effort led to substantial progress in our understanding of the mechanisms of apoptosis, it also created substantial confusion regarding the predominant mode of cell death and the relevance of apoptosis in a variety of liver disease models, as discussed in this review for acetaminophen and troglitazone hepatotoxicity, obstructive cholestasis and viral hepatitis. Part of the problem is related to the fact that there is no specific assay or parameter, with the exception of morphological changes in vivo, which allows the unequivocal distinction between apoptosis and oncotic necrosis. In addition, some aspects of the signaling pathways are similar. Therefore, to make progress in identifying relevant pharmacological intervention strategies to prevent or attenuate human liver disease processes, it is of critical importance to apply several different experimental approaches and analyze as many parameters as possible. In addition, positive controls for the assumed process should be used whenever possible and mechanisms of cell injury should only be investigated in model systems relevant for the human pathophysiology.
Horizontal and Vertical Individualism and Collectivism Among College Students in the United States, Taiwan, and Argentina

Abstract Among college students in the United States, Taiwan, and Argentina, the author examined the strength of 4 cultural patterns (horizontal collectivism, vertical collectivism, horizontal individualism, vertical individualism; H. C. Triandis, 1995). A 3-group confirmatory factor analysis established the measurement equivalence among the 3 samples before the comparison. The Taiwanese and the Argentine samples were more vertically collectivist than the U.S. sample. The U.S. and the Taiwanese samples were more vertically individualistic than the Argentine sample. The U.S. sample was more horizontally individualistic than the Argentine sample, which, in turn, was more horizontally individualistic than the Taiwanese sample.
Treatment of Parkinson's disease in Spain

To assess the patterns of drug use in Parkinson's disease in Spain, information about the clinical characteristics and current treatment of 1,803 parkinsonian patients was obtained from a nationwide survey, involving 241 physicians with practice based on the different assistance levels of the Spanish National Healthcare System. Approximately 90% of the patients were treated with levodopa, regardless of the characteristics of their physicians, but the use of the other available antiparkinsonian treatments was highly influenced by the medical specialty and interest in movement disorders of the prescribing doctors. © 2002 Movement Disorder Society
Activation of the hypoxia‐inducible factor pathway and stimulation of angiogenesis by application of prolyl hydroxylase inhibitors

Hypoxia‐inducible transcription factors (HIF) mediate complex adaptations to reduced oxygen supply, including neoangiogenesis. Regulation of HIF occurs mainly through oxygen‐dependent destruction of its α subunit. In the presence of oxygen, two HIFα prolyl residues undergo enzymatic hydroxylation, which is required for its proteasomal degradation. We therefore tested whether pharmacological activation of HIFα by hydroxylase inhibitors may provide a novel therapeutic strategy for the treatment of ischemic diseases. Three distinct prolyl 4‐hydroxylase inhibitors—l‐mimosine (l‐Mim), ethyl 3,4‐dihydroxybenzoate (3,4‐DHB), and 6‐chlor‐3‐hydroxychinolin‐2‐carbonic acid‐N‐carboxymethylamid (S956711)—demonstrated similar effects to hypoxia (0.5% O2) by inducing HIFα protein in human and rodent cells. l‐Mim, S956711, and, less effectively, 3,4‐DHB also induced HIF target genes in cultured cells, including glucose transporter 1 and vascular endothelial growth factor, as well as HIF‐dependent reporter gene expression. Systemic administration of l‐Mim and S956711 in rats led to HIFα induction in the kidney. In a sponge model for angiogenesis, repeated local injection of the inhibitors strongly increased invasion of highly vascularized tissue into the sponge centers. In conclusion, structurally distinct inhibitors of prolyl hydroxylation are capable of inducing HIFα and HIF target genes in vitro and in vivo and induce adaptive responses to hypoxia, including angiogenesis.
HIGH-FIDELITY PCR ASSAY DISCRIMINATES BETWEEN IMMATURE LIPOLEXIS OREGMAE AND LYSIPHLEBUS TESTACEIPES (HYMENOPTERA: APHIDIIDAE) WITHIN THEIR APHID HOSTS

Abstract Species-specific molecular markers were developed to identify and distinguish between two parasitoids of the brown citrus aphid, Toxoptera citricida Kirkaldy, in Florida. PCR primers were developed for Lysiphlebus testaceipes Cresson and Lipolexis oregmae Gahan (= scutellaris Mackauer) with DNA sequences from the internal transcribed spacer (ITS) region between the 5.8S and 28S nuclear rRNA genes. With High-fidelity PCR, the L. testaceipes-specific primer produced a 520-bp band while that of L. oregmae resulted in a 270-bp band. Eggs of both parasitoids within their aphid hosts could be detected by 6 h after oviposition, but 100% detection rates only occurred after 24 h. A sensitivity analysis indicated that a parasitoid egg within a single aphid could be detected 100% of the time when combined with DNA from up to 36 unparasitized aphids. A single first instar parasitoid could be detected by High-fidelity PCR when the parasitized aphid was combined with up to 500 unparasitized aphids, indicating a high level of sensitivity. Species-specific primers detected both immature parasitoid species within aphids commonly found in citrus in Florida, including Aphis craccivora Koch, Aphis gossypii Glover, Aphis spiraecola Patch, Toxoptera aurantii Boyer and T. citricida. This High-fidelity PCR assay provides an efficient method to monitor establishment of L. oregmae in citrus groves in this classical biological control program in Florida.
Safety and immunogenicity of meningococcal A and C polysaccharide conjugate vaccine in adults

A meningococcal vaccine containing group A and C polysaccharides conjugated to CRM197 was evaluated in 50 adults. Vaccinees were entered into one of five groups: 30 adults received a single dose of either 22, 11, or 5.5 micrograms of the conjugated A-C vaccine; 10 received an approved meningococcal vaccine; and 10 received saline injections. Local and systemic reactions to vaccines were recorded, and immune responses were determined. The experimental meningococcal vaccine was well tolerated, with the most frequent reaction being pain at the injection site. Both A and C polysaccharide components of the experimental vaccine were highly immunogenic, and total antibody concentrations 1 month postvaccination were not significantly different from the mean antibody concentrations among adults given the approved meningococcal vaccine. In addition, significant rises in immunoglobulin G, A, and M antibodies to both A and C polysaccharides occurred. Antibody concentrations measured at 6 and 12 months postvaccination had declined but remained significantly higher than prevaccination concentrations. Postvaccination meningococcal group C functional antibody activity increased more than 600-fold for both the polysaccharide and the conjugate vaccines. Further studies of this conjugated meningococcal vaccine are indicated for young children and infants.
The treatment of adult idiopathic thrombocytopenic purpura

16 adult idiopathic thrombocytopenic purpura (ITP) patients, with mean age 51 years, were treated by 5 weekly slow intravenous infusions of vinblastine (0.1 mg/kg). When a complete or partial response (CR or PR) was obtained, slow infusions were repeated at 2‐weekly then monthly intervals, as maintenance therapy. In 4 cases with ITP of recent onset, but presenting contraindication or failure to prednisone and high dose intravenous immunoglobulins, CR was obtained in all patients after 4 to 15 days (mean 9.5). Only one of these patients relapsed. In 12 cases of refractory chronic ITP (of whom 10 had been splenectomized), there were 2 CR, 6 PR and 4 failures. The 8 responding patients had a mean interval to response of 20 days. The 6 PR were short and did not exceed 15 days. Our results do not support a superiority of this treatment compared to other modes of administration of vinca alkaloids in ITP (intravenous bolus, vinca loaded platelets).
SEROLOGICAL CHARACTERIZATION OF ESCHERICHIA COLI. STUDY IN ACUTE AND RECURRENT URINARY TRACT INFECTIONS IN INFANTS AND CHILDREN.

The character and prevalence of the O, H, and combined O and H serotypes of E. coli from children with urinary tract infection are described. The data presented include 288 strains of E. coli isolated from 164 patients. In addition the data from 28 patients with both an acute and a recurrent urinary tract infection are analyzed. Eighty-five per cent of the recurrent infections were caused by an organism serologically at variance with that causing the initial infection. However, in approximately one-fourth of these there was some question whether the serologic difference represented a truly different strain. On this basis it would appear, contrary to earlier thinking, that most recurrences of infection represent reinfection with a new strain rather than relapse with an original strain. The serologic characterization of strains of E. coli promises to aid materially our understanding of the natural history, epidemiology, and pathogenesis of pyelonephritis in infancy and childhood.
Hospitalists as Emerging Leaders in Patient Safety: Lessons Learned and Future Directions

Objective: To examine the results of a multi-institution, hospitalist-centered consortium designed to disseminate knowledge of best practices relevant to patient safety and to facilitate institutional innovation around such practices. Methods: The Hospitalists as Emerging Leaders in Patient Safety (HELPS) consortium consisted of a hospitalist lead and a patient safety representative from each of 9 health care systems in southeastern Michigan. The consortium's aim was to provide rapid dissemination of best practices in patient safety through regular group meetings and to facilitate implementation and analysis of hospitalist-led patient safety initiatives. Key safety targets included prevention of device-related infections, creating a culture of safety, care transitions, medication safety, fall prevention, perioperative care, intensive care unit safety, and end-of-life care. Participating institutions were free to implement any of the best practices and had access to the expertise of the HELPS coordinating site. Surveys were used to assess knowledge dissemination among participants. Results: Participating institutions described their patient safety initiative and identified several key barriers and facilitators encountered during implementation. Common themes emerged among both barriers and facilitators. In postmeeting surveys to measure dissemination, consortium participants answered a mean of 84.2% (SD = 19.2) of the questions correctly. Conclusions: The HELPS consortium successfully disseminated knowledge regarding best practices and identified common barriers and facilitators faced by hospitalists and institutions attempting to improve safety. The next step is to transform the consortium into a robust quality collaborative that leverages key facilitators and prospectively addresses barriers to implementing high-impact interventions in a multihospital setting.
Local staging of pancreatic carcinoma with multi-detector row CT: use of curved planar reformations initial experience.

PURPOSE To evaluate the utility of curved planar reformations compared with standard transverse images in the assessment of pancreatic tumors. MATERIALS AND METHODS Forty-three patients suspected of having pancreatic tumors underwent contrast material-enhanced biphasic multi-detector row computed tomography (CT). Curved planar reformations were generated along the pancreatic duct, common bile duct, and major mesenteric vessels. Three blinded independent readers assessed the curved planar reformations and transverse images separately for the presence of tumor, resectability, and vascular involvement. The results were compared with those of a consensus panel who evaluated the curved planar reformations and transverse images together along with clinical data and surgical findings. RESULTS Of 43 patients, 20 had pancreatic malignancies as judged by the consensus panel and proven at biopsy and/or clinical follow-up. For tumor detection, transverse images and curved planar reformations had an average sensitivity of 95.0% and 98.4% (P >.05), respectively, and an average specificity of 90.9% and 91.3% (P >.05), respectively. For tumor resectability, transverse images and curved planar reformations had an average sensitivity of 85.7% and 71.4% (P >.05), respectively, and an average specificity of 85.2% and 84.3% (P >.05), respectively. Average interpretation time was 6.4 minutes with transverse images and 4.1 minutes with curved planar reformations. CONCLUSION Curved planar reformations are equivalent to transverse images in the detection of pancreatic tumors and determination of surgical resectability.
On Presentation of Optimal Treatment Plan in Radiotherapy of Parotid Cancer: A Comparison of Nine Techniques in Three Dimensional Conformal Radiation Therapy (3DCRT)

Materials and Methods: CT of parotid patients during 2012 to 2014 is used. Twelve patients were evaluated by TPS Core plan, 3D dose distribution and using of dose-volume histogram (DVH), nine techniques were evaluated: a. 6MV photons, 3-fields AP (wedge), PA (wedge), lateral (open), b. unilateral 10 Mev electrons, c. unilateral 14 Mev electrons, d. Mixed beam technique using 6MV photon and 10 Mev electron (1:4 weighting), e. Mixed beam technique using 6MV photon and 14 Mev electron (1:4 weighting), f. unilateral 10 Mev electrons with bolus (0.5 cm bolus is used), g. unilateral 14 Mev electrons with bolus (0.5 cm bolus is used), h. Mixed beam technique using 6MV photon and 10 Mev electron (1:4 weighting) with Bolus (0.5 cm bolus is used), i. Mixed beam technique using 6MV photon and 14Mev electron (1:4 weighting) with Bolus (0.5 cm bolus is used) Results: Using of DVH to appraise, the dose to OARs are 0 for techniques 6MV photons, (3-fields), unilateral 10 Mev electrons with and without Bolus, unilateral 14 Mev electrons with & without Bolus. The highest conformal and homogeneity index and near to 1 were for 6MV photons, 3-fields, unilateral 14 Mev electrons with and without Bolus, mixed beam technique using 6MV photon and 14 Mev electron with and without Bolus.
Development of the Comprehension and Appreciation of Fables

The authors proposed and tested a model of fable comprehension and appreciation. They proposed that fables are metaphoric in that they teach moral lessons about human activity, and that apprehension of the moral derives from a belief in a just world. In Study 1, children from kindergarten to 8th grade and college students received Aesop fables, reversed-outcome Aesop fables, and fable-like stories. As predicted, kindergartners and some 1st graders did not demonstrate a belief in a just world and did not differentiate between normal and reversed-outcome Aesop fables. Quality of morals provided by older participants was superior to that of younger participants. In Study 2, the quality of fable moral was found to be significantly correlated with quality of proverb and metaphor interpretation. Also, memory for goal or intention story elements was found to be related to quality of moral produced. Directions for future research are identified.
Bortezomib, lenalidomide and dexamethasone (VRD) combination as salvage therapy in refractory angioimmunoblastic T cell lymphoma

Dimopoulos, M. , Kyle, R. , Fermand, J.P., Rajkumar, S.V. , San Miguel, J., Chanan-Khan, A. , Ludwig, H. , Joshua, D. , Mehta, J., Gertz, M. , Avet-Loiseau, H. , Beksac, M. , Anderson, K.C. , Moreau, P., Singhal, S. , Goldschmidt, H. , Boccadoro, M. , Kumar, S. , Giralt, S. , Munshi, N.C. & Jagannath, S. (2011) Consensus recommendations for standard investigative workup: report of the International Myeloma Workshop Consensus Panel 3. Blood, 117, 4701–4705. Dinner, S. , Witteles, W. , Witteles, R. , Lam, A. , Arai, S. , Lafayette, R. , George, T.I. , Schrier, S.L. & Liedtke, M. (2013) The prognostic value of diagnosing concurrent multiple myeloma in immunoglobulin light chain amyloidosis. British Journal of Haematology, 161, 367–372. Pardanani, A. , Witzig, T.E. , Schroeder, G. , McElroy, E.A. , Fonseca, R. , Dispenzieri, A. , Lacy, M.Q. , Lust, J.A. , Kyle, R.A. , Greipp, P.R. , Gertz, M.A. & Rajkumar, S.V. (2003) Circulating peripheral blood plasma cells as a prognostic indicator in patients with primary systemic amyloidosis. Blood, 101, 827–830. The International Myeloma Working Group (2003) Criteria for the classification of monoclonal gammopathies, multiple myeloma and related disorders: a report of the International Myeloma Working Group. British Journal of Haematology, 121, 749–757.
Acyl Coenzyme A-binding Protein Augments Bid-induced Mitochondrial Damage and Cell Death by Activating μ-Calpain*

Activation of calpain has been shown to occur in some contexts of cell injury and to be essential for loss of cell viability. Part of this may be mediated at the mitochondrial level. It has been demonstrated that calpain activity is necessary for the complete discharge of apoptosis-inducing factor from the mitochondrial intermembrane space and can cause the cleavage of full-length Bid to a more potent truncated form (Polster, B. M., Basanez, G., Etxebarria, A., Hardwick, J. M., and Nicholls, D. G. (2005) J. Biol. Chem. 280, 6447-6454). In this study, we identify acyl-CoA-binding protein (ACBP) as playing a critical role in the activation of calpain upon exposure of mitochondria to both full-length Bid and truncated Bid (t-Bid). Suppression of ACBP levels by small interfering RNA inhibited the t-Bid-induced activation of mitochondrial μ-calpain and release of apoptosis-inducing factor from the mitochondrial intermembrane space and the cleavage of full-length Bid to t-Bid. Moreover, ACBP required the presence of the peripheral benzodiazepine receptor (for which ACBP is a ligand) to be retained at the mitochondria, to activate μ-calpain, and to amplify Bid-induced mitochondrial damage.
Level of Fetuin-A, Endothelin-1 and sex hormones in the serum of isolated systolic hypertensive patients

Background: Arterial stiffness is characterised by isolated systolic hypertension (ISH). Factors such as Fetuin-A, Endothelin-1 (ET-1), Testosterone (TEST), and Progesterone (PROG) have been demonstrated to be involved in arterial stiffness. If changes in blood level of these parameters are detected in ISH and hypertensive patients, it can reflect their expression, production, and association with the pathophysiology of these diseases. Since this association of ISH and hypertension (HTN) with above mentioned factors is still not clear, the present study was carried out for their identification in such diseases. Methods: Serum level of these parameters was measured through ELISA in three groups: (I) ISH patients (n=9), (II) hypertensive patients (n=7), and (III) normal subjects (n=7). Results: Significantly reduced levels of Fetuin-A (0.17Â±0.03 I·g/ml, n=39) were observed in ISH (p<0.05) without significant changes in TEST (19.2Â±1.9, n=15), PROG (0.72Â±0.2, n=19), and ET-1 (0.09Â±0.02, n=30) levels compared to normal subjects. However, in HTN, increased ET-1 (0.2Â±0.03, n=14, p<0.05) and decreased TEST (8.125Â±1.8, n=9, p<0.05) with non-significant changes in Fetuin-A (0.29Â±0.06, n=18) and PROG (0.67Â±0.3, n=7) levels have been observed. Conclusion: Low levels of Fetuin-A, in ISH suggests its possible contribution in the pathophysiology of arterial stiffness and subsequently causing increase in systolic blood pressure. An increase in the (ET-1) endothelin-1, and decrease in TEST in hypertensive patients suggests their possible involvement in physiology and pathophysiology of these vascular diseases. These findings open new avenues for further studies regarding pathophysiology of ISH and HTN that may lead to finding a better treatment for these diseases.
Anti-tumor activity of Titanocene Y in xenografted Caki-1 tumors in mice

The benzyl-substituted unbridged titanocene bis-[(p-methoxybenzyl)cyclopentadienyl] titanium(IV) dichloride (Titanocene Y) was tested in vitro against human renal cancer cells (Caki-1), in which it showed an IC50 value of 36×10–6 mol/l. Titanocene Y was then given in vivo in doses of 10, 20, 30, 40 and 50 mg/kg on 5 consecutive days to Caki-1-bearing mice, and it showed concentration-dependent and statistically significant tumor growth reduction with respect to a solvent-treated control cohort. The maximum tolerable dose of Titanocene Y was determined to be 40 mg/kg and it showed significantly better tumor volume growth reduction than cisplatin given at a dose of 2 mg/kg. This superior activity of Titanocene Y with respect to cisplatin will hopefully lead to clinical tests against metastatic renal cell cancer in the near future.
Carbohydrate/glycan-binding specificity of legume lectins in respect to their proposed biological functions.

The lectins, proteins which specifically recognize carbohydrate moieties, have been extensively studied in many biochemical and structural aspects in order to establish the molecular basis of this non-catalytic event. On the other hand, their clinical and agricultural potentials have been growing fast. Although lectins, mainly those from legume plants, had been investigated for biological properties, studies about the physiological functions of lectins are scarce in literature. Therefore, despite the accumulated data on lectins (as proteins), the role played by these signalizing molecules is poorly discussed. In the light of our accumulated results on legume lectins, specially those obtained from plants belonging to the Diocleinae sub-tribe and available data in literature, we discuss here the main hypothesis of their functions according to their carbohydrate/glycan-binding specificity.