Miracle-dz/UniFAR-FTUs huggingface dataset:
Defining and Measuring Integrated Patient Care: Promoting the Next Frontier in Health Care Delivery

Integration of care is emerging as a central challenge of health care delivery, particularly for patients with multiple, complex chronic conditions. The authors argue that the concept of “integrated patient care” would benefit from further clarification regarding (a) the object of integration and (b) its essential components, particularly when constructing measures.To address these issues, the authors propose a definition of integrated patient care that distinguishes it from integrated delivery organizations, acknowledging that integrated organizational structures and processes may fail to produce integrated patient care. The definition emphasizes patients’ central role as active participants in managing their own health by including patient centeredness as a key element of integrated patient care. Measures based on the proposed definition will enable empirical assessment of the potential relationships between the integration of organizations, the integration of patient care, and patient outcomes, providing valuable guidance to health systems reformers.
Objective sleepiness measures in pediatric obstructive sleep apnea.

OBJECTIVES Excessive daytime sleepiness (EDS) occurs frequently in adult patients with obstructive sleep apnea (OSA). However, the incidence of EDS in children with OSA is unknown. METHODS To determine overall daytime sleepiness in pediatric OSA, 54 children with OSA, 14 children with primary snoring (PS), and 24 controls (C) underwent an overnight diagnostic polysomnogram followed the next day by a multiple sleep latency test. RESULTS The mean apnea index was 15.1 +/- 9.5 standard deviation in OSA, 1.1 +/- 0.5 in PS, and 0.1 +/- 0.3 in C. Mean sleep latencies were 23.7 +/- 3.0 minutes in C, 23.7 +/- 3.1 minute in PS, and 20.0 +/- 7.1 minute in OSA patients. However, only 7 children with OSA had mean sleep latencies <10 minutes. In addition, shorter sleep latencies were more likely to occur in more obese OSA patients and those with more severe apnea index, and oxyhemoglobin desaturation. CONCLUSIONS Shortened sleep latencies occur in children with OSA, but EDS is infrequent and tends to develop among more severe and/or obese patients.
Early precut sphincterotomy and the risk of endoscopic retrograde cholangiopancreatography related complications: An updated meta-analysis.

AIM To study the cannulation and complication rates of early pre-cut sphincterotomy vs persistent attempts at cannulation by standard approach. METHODS Systematic search of PubMed, EMBASE, Web of Science, and the Cochrane Library for relevant studies published up to February 2013. The main outcome measurements were cannulation rates and post-endoscopic retrograde cholangiopancreatography (ERCP) complications. A comprehensive systematic search of the Cochrane library, PubMed, Google scholar, Scopus, National Institutes of Health, meta-register of controlled trials and published proceedings from major Gastroenterology journals and meetings until February 2013 was conducted using keywords. All Prospective randomized controlled trials (RCT) studies which met our inclusion criteria were included in the analysis. Prospective non-randomized studies and retrospective studies were excluded from our meta-analysis. The main outcomes of interest were post-ERCP pancreatitis, overall complication rates including cholangitis, ERCP-related bleeding, perforation and cannulation success rates. RESULTS Seven RCTs with a total of 1039 patients were included in the meta-analysis based on selection criteria. The overall cannulation rate was 90% in the pre-cut sphincterotomy vs 86.3% in the persistent attempts group (OR = 1.98; 95%CI: 0.70-5.65). The risk of post-ERCP pancreatitis (PEP) was not different between the two groups (3.9% in the pre-cut sphincterotomy vs 6.1% in the persistent attempts group, OR = 0.58, 95%CI: 0.32-1.05). Similarly, there was no statistically significant difference between the groups for overall complication rate including PEP, cholangitis, bleeding, and perforation (6.2% vs 6.9%, OR = 0.85, 95%CI: 0.51-1.41). CONCLUSION This meta-analysis suggests that pre-cut sphincterotomy and persistent attempts at cannulation are comparable in terms of overall complication rates. Early pre-cut implementation does not increase PEP complications.
Sparse additive regression on a regular lattice

We consider estimation in a sparse additive regression model with the design points on a regular lattice. We establish the minimax convergence rates over Sobolev classes and propose a Fourier‐based rate optimal estimator which is adaptive to the unknown sparsity and smoothness of the response function. The estimator is derived within a Bayesian formalism but can be naturally viewed as a penalized maximum likelihood estimator with the complexity penalties on the number of non‐zero univariate additive components of the response and on the numbers of the non‐zero coefficients of their Fourer expansions. We compare it with several existing counterparts and perform a short simulation study to demonstrate its performance.
Hospital Related Stress Among Patients Admitted to a Psychiatric In-patient Unit in India

The psychiatric patient’s attitudes towards hospitalization have found an association between patient perceptions of the ward atmosphere and dissatisfaction. The aim of the study was to determine the aspects of stress related to hospitalization in inpatients admitted to a psychiatric facility. Fifty in-patients of both sexes admitted consecutively to a psychiatric unit in a General Hospital were asked to rate the importance of, and their satisfaction with, 38 different aspects of in-patient care and treatment. Results showed that the major sources of stress were related to having a violent patient near to his/her bed; being away from family; having to stay in closed wards; having to eat cold and tasteless food; losing income or job due to illness, being hospitalized away from home; not able to understand the jargons used by the clinical staff and not getting medication for sleep. A well-differentiated assessment of stress and satisfaction has implications for the evaluation of the quality of psychiatric care and for the improvement of in-patient psychiatric care.
The influence of non-cognitive and cognitive ability on individuals' stock market participation

Stock market participation is found to be positively related to cognitive, as well as non-cognitive ability, controlling for wealth, income, age, and other demographic and socioeconomic factors. Interestingly, the effects are of economic significant magnitudes, e.g. participation is on average 11.49% larger among those with high compared with low cognitive and non-cognitive abilities, and holds also when controlling for individuals risk preferences. The later indicates that cognitive and non-cognitive abilities have a role in affecting financial decisions also through non-preference driven effects. Limitations in non-cognitive ability do further explain non-participation among affluent individuals.
Subjective audio quality over a secure IEEE 802.11n network

This paper presents an empirical evaluation of audio quality generated by a G.711 codec and transmitted over IEEE 802.11n, IEEE 802.11b, and IEEE 802.11g Wireless Local Area Networks (WLANs). Audio quality decline due to additional calls or by securing the WLAN with Internet Protocol Security (IPsec) is quantified. Results suggest that audio quality over an IEEE 802.11n WLAN is not higher than over an IEEE 802.11b WLAN for up to 10 simultaneous calls. The data strongly suggest that toll quality audio (MOS ≥ 4.0) is not currently practical over IEEE 802.11 WLANs secured with WPA2, even using the G.711 codec.
Double bromodomain‐containing gene Brd2 is essential for embryonic development in mouse

The BET subfamily of bromodomain‐containing genes is characterized by the presence of two bromodomains and a unique ET domain at their carboxyl termini. Here, we show that the founding member of this subfamily, Brd2, is an essential gene by generating a mutant mouse line lacking Brd2 function. Homozygous Brd2 mutants are embryonic lethal, with most Brd2−/− embryos dying by embryonic day 11.5. Before death, the homozygous embryos were notably smaller and exhibited abnormalities in the neural tube where the gene is highly expressed. Brd2‐deficient embryonic fibroblast cells were observed to proliferate more slowly than controls. Experiments to explore whether placental insufficiency could be a cause of the embryonic lethality showed that injecting diploid mutant embryonic stem cells into tetraploid wild‐type blastocysts did not rescue the lethality; that is Brd2‐deficient embryos could not be rescued by wild‐type extraembryonic tissues. Furthermore, there were enhanced levels of cell death in Brd2‐deficient embryos. Developmental Dynamics 238:908–917, 2009. © 2009 Wiley‐Liss, Inc.
Plasma membrane calcium ATPase isoforms in astrocytes

The plasma membrane Ca2+‐ATPase (PMCA) is an essential component of the machinery responsible for cellular Ca2+ homeostasis. Together with the Na+/Ca2+ exchanger, the plasma membrane Ca2+‐ATPase (PMCA) is responsible for the extrusion of Ca2+ from the cytosol. Although both PMCAs and Na+/Ca2+ exchangers are present in high amounts in the brain, it is thought that only the latter localize to glia. This study investigates whether PMCAs are also present in astrocytes and thus are components of Ca2+ signalling in this cell type.
The effect of national team training on lower extremities injuries in elite female taekwondo athletes

Taekwondo is an exciting and popular sport field. Through many risk factors in this field that causing body injuries in athletes. The aim of this study was to investigate the effect of a preseason high intensity training period on appearance of lower extremities injuries (joint, muscular, skin, bone) in elite young and teenage female taekwondo athletes. Therefore we collected the data of 12 teenage females with mean age 15.5±0.71years, weight 49±4.2 kg, height 166.5±0.71 cm, and with sport background 5.0. 4 years, and 12 young females with mean age 20.43±1.9 years, weight 64.6±9.5 kg, height 171.9±6.9 cm, sport background 9±4.4 years, that were in national team camp, to prepare for London 2012 Olympic games and Asian competitions. We provided a questionnaire to found the injuries in different limbs of participations that record the injuries in three stages (start of camp, 6 th . week and 12 th . week of preparation training). The research method was semi experimental and used mix repeated measure (p≤0.05). The results showed that there are no significant differences between joint, muscular, skin, and bone injuries between young and teenage groups. Also there is no different between the stages of training. More over the most injuries were muscular injuries that frequently observed in lower extremities of young athletes. Thus we propose that medical practitioners of teams, athletes and coaches must remember the points mentioned in this research to prevention the lower extremities injuries.
Survey of furan in foods and coffees from five European Union countries

Canned and jarred baby foods (74), canned and jarred adult foods (63) and 70 coffees sold in Belgium, Italy, Portugal, Spain and The Netherlands were analysed for their furan content using a validated automated headspace GC–MS procedure. Seven balsamic vinegars from Italy and Spain were also analysed. All 74 baby food samples contained detectable furan, with an average level of 37 ng/g. A total of 54 of 63 canned and jarred foods contained detectable furan with an average level of 24 ng/g. Levels of furan in coffee as consumed were very variable and reflected different preparation methods and coffee strengths. Over 50% of Italian samples contained more than 200 ng/g, whereas over 20% of Belgian coffees contained less than 21 ng/g furan. Some brews made from fine grained coffee contained much more furan than did brews made from normal or coarse grained coffee. Although furan was low in most instant coffees, two Italian products “instant espresso” and “instant mocha” contained about 150 ng/g furan. Balsamic vinegars from Spain contained 159–662 ng/g of furan; however, other samples from Spain and Italy contained only 6–25 ng/g.
The National Environmental Respiratory Center (NERC) experiment in multi-pollutant air quality health research: I. Background, experimental strategy and critique

Abstract The National Environmental Respiratory Center Program was initiated as an experiment to explore strategies for identifying the components of complex air pollution mixtures that cause health effects associated statistically with air pollution. A strategy involving multivariate analysis of a composition-concentration-response database was adopted. A novel database was created by exposing rodents daily for up to six months to one of four combustion-related mixtures and measuring respiratory, cardiovascular and general toxicological responses after one week or six months of exposure. The mixtures included multiple concentrations of diesel and gasoline engine exhaust, hardwood smoke and simulated downwind coal combustion emissions. After reporting the biological effects of each mixture and comparing effects among them, 47 significant effects were selected for multiple additive regression tree analysis to identify putative causal components. Although the four mixtures provided a database marginally sufficient for the analysis, the results suggested the putative causes of 19 significant effects with acceptable confidence. This article describes and critiques the Program and its strategy. The integrated results are presented in two accompanying papers, and mixture-specific results were presented in preceding papers, which are cited. The experiment demonstrated the potential utility of the general approach and identified certain cause–effect relationships for confirmatory studies. A follow-up study provided support for causation by the components implicated for one of those relationships. The advantages and disadvantages of the Program’s management and funding strategies are discussed.
Analysis of time trends in adaptive designs with application to a neurophysiology experiment.

Time trends are present in many sequential experiments. Adaptive designs use accruing data to select future design points. It has been observed that the presence of time trends in adaptive designs can bias results of the study. We propose one method of dealing with time trends in analysing adaptive designs. The method, relevance weighted likelihood, weights individual components of the likelihood differently. Consequently, one can downweight earlier data if there is a clear time trend that converges at some point in the study. We apply this methodology to a data set from an adaptive design in neurophysiology. We find that the method is robust and useful in getting more precise estimates of an individual subject's median response.
The spatial orienting of attention: sensory facilitation or response bias?

Abstract : Visually evoked brain potentials were recorded from young adult subjects in response to flashed target stimuli that occurred at attended (expected) or unattended spatial locations. Attention was directed to the left or right visual field by a warning cue (arrow) that designated the most probable location of the target flash, to which subjects made a speeded discriminative response. Targets presented to the expected location were found to elicit brain potentials of enhanced amplitude over the occipital scalp regions, in relation to targets at the opposite, unexpected location. The evoked potentials to attended-field targets were increased in amplitude as early as 90-100 msec post-stimulus, but the basic waveform of the response was not altered. These results support the proposal of Posner and associates that the spatial cueing and orienting of attention produces a facilitation of sensory evoked activity in the visual pathways. Keywords: Visual system physiology; Event-related brain potentials.
Underwater Sounds of Pinnipeds

Descriptions and analyses are presented of underwater sounds made by six species of seals in captivity, Zalophus californianus, Phoca vitulina, P. (Pusa) hispida, P. (Pagophilus) groenlandica, Halichoerus grypus, and Cystophora cristata. The suitability of these very faint sounds for echolocation is discussed.
A constitutional balanced t(3;8)(p14;q24.1) translocation results in disruption of the TRC8 gene and predisposition to clear cell renal cell carcinoma

Studying the molecular basis of familial renal cell carcinoma (RCC) has allowed identification of novel RCC genes involved in the pathogenesis of both inherited and sporadic RCC. We describe a constitutional balanced t(3;8)(p14;q24.1) translocation found in a brother and sister with bilateral clear cell RCC (CC‐RCC) diagnosed in their forties. Consistent with a prior report, we demonstrated by RT‐PCR of RNA from lymphoblastoid cells fusion mRNAs derived from the fragile histidine triad (FHIT) at 3p14 and TRC8 at 8q24.1 in both affected siblings. Cytogenetic analysis of a CC‐RCC tumor from the affected sister from short‐term tumor cell culture showed both diploid and pseudotetraploid populations containing the translocation and normal appearing chromosomes 3 and 8. Fluorescent in situ hybridization using bacterial artificial chromosomes containing sequences from the FHIT and TRC8 genes demonstrated normal FHIT signals and TRC8 signals on nontranslocated chromosomes in the constitutional blood sample, but the TRC8 signal was absent in a subset of diploid and pseudotetraploid cells from the tumor. The tumor also contained a heterozygous VHL frameshift somatic mutation. These results confirm that balanced translocations disrupting the TRC8 and FHIT genes result in an increased genetic susceptibility for bilateral CC‐RCC. The presence of diploid and tetraploid tumor cells with and without TRC8 deletions on the nontranslocated chromosome suggest that loss of the remaining normal allele of TRC8 may contribute to tumor development at later stages. © 2007 Wiley‐Liss, Inc.
Arterial ammonia levels in cirrhosis are determined by systemic and hepatic hemodynamics, and by organ function: a quantitative modelling study

Hyperammonaemia is a common complication of chronic liver failure. Two main factors are thought to underlie this complication: a loss of hepatic detoxification function and the development of portosystemic shunting. However, few studies have tried to quantify the importance of portosystemic shunting. Here, we used a theoretical approach to test the hypothesis that the development of portosystemic shunting is sufficient to cause hyperammonaemia in cirrhosis.
Determination of Amitriptyline in the Hair of Psychiatric Patients

A study was conducted on 60 psychiatric patients to evaluate the reliability of a drug-exposure screening test based on gas chromatography/mass spectrometry analysis of hair samples for amitriptyline, and the possibility of using the hair concentrations of amitriptyline to monitor patients' therapeutic compliance. The qualitative test was found to be very reliable (sensitivity 93.3%; specificity 100%; positive and negative predictive values 100 and 93.8%) in assessing the consumer status of patients over a period of 2 months before analysis. Hair levels of amitriptyline ranged from 0 to 17.21 ng mg-1. A significant relationship (r=0.563; P < 0.002) was found between the hair concentrations and the cumulative intake of amitriptyline over the studied period, but was not judged close enough to estimate one individual's therapeutic compliance. The results are discussed in the light of existing literature.
Improving Medication Error Reporting in Hospice Care

The aims of this study are to determine the incidence of medication errors, characterize the type/severity of errors, and estimate the impact of an educational intervention on medication error processes in a hospice population. Medication errors from 2 hospice organizations were collected and coded for type of error/ outcome severity. The educational intervention included a 2-hour in-service and twice weekly reminders. A survey to assess participants’ change in knowledge and attitudes regarding medication error reporting through the study period and was administered at 3 different time points. Data analysis revealed that medication error reporting increased in one hospice program, that participants’ ability to correctly identify medication errors increased (P < .001), and awareness of medication errors in hospice care increased (P < .01) after the intervention.
Salivary Carbonic Anhydrase Isoenzyme VI Is Located in the Human Enamel Pellicle

Salivary carbonic anhydrase (CA VI) appears to protect teeth from caries via mechanisms other than direct regulation of salivary pH and buffering capacity. To elucidate whether CA VI acts in the local microenvironment of the tooth surface, we studied the location and activity of the enzyme in the human enamel pellicle. The study was performed using a specific rabbit antiserum to human CA VI in conjunction with immunostaining and immunoblot techniques. CA activity was demonstrated using a histochemical staining method. CA VI immunostaining of extracted teeth having in vivo formed pellicle showed that the enzyme is present in the enamel pellicle. Immunostaining for salivary α–amylase, which is known to be present in the pellicle, showed a similar staining pattern. The presence of CA VI in the enamel pellicle was confirmed by immunoblotting of in vivo formed pellicle proteins. In vitro studies showed that CA VI binds to polished enamel surfaces from both saliva and solutions of purified enzyme. The intensity of the CA VI immunostaining on the enamel surface was dependent on the concentration of the applied enzyme. The histochemical staining of in vitro formed enamel pellicle confirmed that the bound enzyme retains its enzymatic activity. The presence of active CA VI in the human enamel pellicle suggests that it may accelerate the removal of acid by functioning locally in the pellicle layer on dental surfaces.
Great Expectations: Discourse and Affect During Field Emergence

Abstract Studies show that discourses are important in legitimating emerging fields. However, we still lack understanding of how potential participants’ interpretations of discourses shape their involvement in emerging fields – particularly when the field’s definition is ambiguous. Drawing on an in-depth study of the emerging nanotechnology field we show that individuals’ affective responses to discourses play an important role in their decisions to participate. We find that discourse, expectations, affective responses, and participation in emerging fields are mutually constituted, and develop a model that shows these interconnections. Theoretically, our study expands understandings of discourse and field emergence by incorporating affect.
The investigation of concept mapping as a scaffolding tool in a technologically-mediated, mobile learning, augmented reality environment

This study investigated concept maps as a form of support for primary school students' development of conceptual understanding, historical empathy, and for promoting collaborative learning. Students used the same historical learning augmented reality application on a mobile device, worked in pairs, and were divided in two conditions: the experimental group (n=12), supported by a tablet-based concept mapping tool, and the control group (n=11), who only used the learning application on the same mobile devices. The results showed that the experimental group students gained a deeper conceptual understanding after the visit, as evidenced by their concept maps and their discussions during their visit.