Miracle-dz/UniFAR-FTUs huggingface dataset:
Patients' self-report of procedural pain in the intensive care unit.

AIM To determine which routine nursing procedures performed on conscious intensive care unit (ICU) patients were painful and which routine procedures were not painful. BACKGROUND Current empirical evidence supports that routine procedures are often not viewed in the context of causing pain to the critically ill patient. Given the complexity of illness and the need to prioritize care in ICU patients, clinicians may not consider routine procedures as causing pain. With patients in intensive care undergoing frequent routine procedures, greater understanding of which procedures inflict pain is warranted to improve patient care and inform and shape nursing practice. DESIGN A prospective, descriptive study using a convenience sample of ICU patients was used. METHODS Sixty-one patients were asked to rate pain intensity experienced prior to and during a routine nursing procedure using a verbal numeric rating scale. The procedures observed were turning, tracheal suctioning, line removal, deep breathing and coughing exercises, simple dressings and drain removal. RESULTS Results showed that certain routine procedures cause pain with significant differences observed between pre- and postprocedure pain scores for drain removal (p = 0.042), deep breathing and coughing exercises (p = 0.003), suctioning (p = 0.025), positional change (p = 0.000) and line removal (p = 0.010). A higher proportion of morphine was administered to those patients undergoing drain removal (50%), deep breathing and coughing exercises (38.5%) and turns (32.6%) but results show that <50% of patients actually received analgesia. Heart rate, systolic and diastolic blood pressure all increased slightly postprocedure but were not found to be statistically significant. CONCLUSION Haemodynamic measures are not suitable indicators for the presence of pain. Nurses need to recognise that certain routine procedures can cause pain and should therefore plan patient care with this in mind. RELEVANCE TO CLINICAL PRACTICE Nurses need to recognise of the fact that routine procedures can cause pain and to use analgesia appropriately to minimize this pain. Practice guidelines should recommend that pain relieving measures be considered as part of routine procedural instructions. Analgesic prescription and administration could be improved for this patient group.
Credit Constraints, Student Transfer and Optimal Tax Policy

This paper derives optimal labor taxation to finance student transfer if educational investments are subject to credit constraints. Credit constraints are endogenously determined under the incentive constraint that individuals cannot be better-off by defaulting. Student transfer alleviates credit constraints by reducing students' need to borrow, but taxing labor can reduce private credit limit by exaggerating moral hazard problems associated with credit constraints. Numerical examples show that labor taxation tightens credit limit, especially if education is important, labor is elastic and if a large share of earnings can be seized in case of default. Consequently, the optimal tax rates should be lower.
Effect of Anodal Versus Cathodal Transcranial Direct Current Stimulation on Stroke Rehabilitation

Objective. We compared the long-term effect of anodal versus cathodal transcranial direct current stimulation (tDCS) on motor recovery in patients after subacute stroke. Methods. Forty patients with ischemic stroke undergoing rehabilitation were randomly assigned to 1 of 3 groups: Anodal, Cathodal (over-affected and unaffected hemisphere, respectively), and Sham. Each group received tDCS at an intensity of 2 mA for 25 minutes daily for 6 consecutive days over of the motor cortex hand area. Patients were assessed with the National Institutes of Health Stroke Scale (NIHSS), Orgogozo’s MCA scale (OMCASS), the Barthel index (BI), and the Medical Research Council (MRC) muscle strength scale at baseline, after the sixth tDCS session and then 1, 2, and 3 months later. Motor cortical excitability was measured with transcranial magnetic stimulation (TMS) at baseline and after the sixth session. Results. By the 3-month follow-up, all groups had improved on all scales with P values ranging from . 01 to . 0001. Improvement was equal in the Anodal and Cathodal groups. When these treated groups were combined and compared with Sham, significant interactions were seen for the OMCASS and BI scales of functional ability (P = .002 for each). There was increased cortical excitability of the affected hemisphere in all groups with the changes being greater in the real versus sham groups. There were borderline significant improvements in muscle strength. Conclusion. A brief course of 2 types of tDCS stimulation is superior to sham stimulation in enhancing the effect of rehabilitation training to improve motor recovery after stroke.
Safety and Efficacy of Short-Term Intrapulmonary Percussive Ventilation in Patients With Bronchiectasis

BACKGROUND: Treatment of bronchiectasis includes drugs, oxygen therapy, and bronchial-clearance maneuvers. OBJECTIVE: To assess the safety and efficacy of intrapulmonary percussive ventilation (IPV) compared to traditional standard chest physical therapy in patients with bronchiectasis and productive cough. METHODS: In a randomized crossover study, 22 patients underwent, on consecutive days, IPV and chest physical therapy. Before each treatment session, immediately after the session, 30 min after the session, and 4 hours after the session we measured SpO2, heart rate, respiratory rate, and (with a visual analog scale) the patient's subjective sensation of phlegm encumbrance and dyspnea. Immediately after each treatment session we also measured (via visual analog scale) the patient's discomfort. We also measured the volume and wet and dry weight of collected sputum. RESULTS: No adverse effects were so severe as to require discontinuation of treatment, and the incidence of adverse effects was similar in the groups (27%). Heart rate (P = .002) and respiratory rate (P = .047) decreased during treatment, and sensation of phlegm encumbrance improved (P = .03) with both treatments. Only IPV improved (P = .004) the sensation of dyspnea. The patients found IPV more comfortable than our traditional standard chest physical therapy (P = .03). Both treatments caused important phlegm production, but there were no differences in sputum volume, wet weight, or dry weight. CONCLUSIONS: In patients with bronchiectasis and productive cough, short-term IPV was as safe and effective as traditional chest physical therapy, with less discomfort.
Macrophage-Mediated Glial Cell Elimination in the Postnatal Mouse Cochlea

Hearing relies on the transmission of auditory information from sensory hair cells (HCs) to the brain through the auditory nerve. This relay of information requires HCs to be innervated by spiral ganglion neurons (SGNs) in an exclusive manner and SGNs to be ensheathed by myelinating and non-myelinating glial cells. In the developing auditory nerve, mistargeted SGN axons are retracted or pruned and excessive cells are cleared in a process referred to as nerve refinement. Whether auditory glial cells are eliminated during auditory nerve refinement is unknown. Using early postnatal mice of either sex, we show that glial cell numbers decrease after the first postnatal week, corresponding temporally with nerve refinement in the developing auditory nerve. Additionally, expression of immune-related genes was upregulated and macrophage numbers increase in a manner coinciding with the reduction of glial cell numbers. Transient depletion of macrophages during early auditory nerve development, using transgenic CD11bDTR/EGFP mice, resulted in the appearance of excessive glial cells. Macrophage depletion caused abnormalities in myelin formation and transient edema of the stria vascularis. Macrophage-depleted mice also showed auditory function impairment that partially recovered in adulthood. These findings demonstrate that macrophages contribute to the regulation of glial cell number during postnatal development of the cochlea and that glial cells play a critical role in hearing onset and auditory nerve maturation.
Recovery of orientation after electroconvulsive therapy

Studies which provide quantitative analyses of postictal disorientation following electroconvulsive therapy (ECT) are reviewed with emphasis on the variable of time since seizure induction as it relates to recovery of orientation. The studies make it clear that separable components of orientation (person, place, and time) recover at different rates following ECT. The length of disorientation tends to increase with increasing treatment number, but modifications of electrode placement (nondominant unilateral ECT) and electrical stimulus waveform (brief‐pulse ECT) result in a decrease in disorientation when compared to standard bilateral sinusoidal ECT. Bilateral ECT may produce more disorientation than dominant unilateral ECT if more generalized seizures occur with the former than the latter treatment modality. Practical implications of these issues are discussed.
Prevalence of Mycoplasma genitalium among HIV-infected men in São Paulo city detected by realtime polymerase chain reaction

Genital mycoplasmas are natural inhabitants of the male urethra and are potentially pathogenic species playing an aetiological role in both genital infections and male infertility. This study aims to determine the presence of Mycoplasma genitalium DNA in urine samples of HIV-1-infected men in São Paulo city. Realtime polymerase chain reaction (PCR) was performed using the primers My-ins and Mgso-2 and the Taqman probe Mgen-P1 as described previously. A total of 223 HIV-1-infected men were tested with a mean age of 44 years. Thirteen (5.8%) presented M. genitalium in urine and the co-infection was more common among homosexual men (76.9% versus 51.9%, P < 0.26). In conclusion, realtime PCR was a useful and rapid method for detecting M. genitalium DNA in urine samples. Further studies should be conducted to assess the clinical significance of these results on HIV transmission and its impact on HIV viral load.
Role of culture in celebrity endorsement: brand endorsement by celebrities in the Indian context

Celebrity endorsement is a big market in India and continues to grow bigger. However, in spite of prevalent use of celebrities for endorsement, not all celebrity endorsements have been successful. The list of unsuccessful examples suggest that it will be wrong to consider celebrity endorsement as an effective response to media clutter in all situations inspite of the intensity of involvement people have with celebrities in India. In the absence of existing celebrity endorsement theories to satisfactorily explain the phenomenon in India, this paper uses the lens of culture to develop propositions on how consumer attitude towards celebrity endorsements is a function of cultural parameters in emerging countries like India. We build our argument by using culture to explain the congruence between celebrity and consumers for elaborating celebrity endorsement in Indian markets.
Aerobic exercise attenuates blood pressure reactivity to cold pressor test in normotensive, young adult African-American women.

Exaggerated blood pressure reactivity to behavioral stress has been observed in the African-American population, and such a pressor response is believed to play a role in hypertension. Regular aerobic exercise has been shown to exert an anti-hypertensive effect, and this may alter the blood pressure hyperreactivity observed in African Americans. To test the hypothesis that aerobic exercise attenuates pressor reactivity in African Americans, we studied eight healthy aerobically-trained normotensive African-American females and five similar sedentary females. The stress stimuli consisted of the cold pressor test with the foot immersed in ice water for two minutes. The aerobic exercise training protocol consisted of six weeks of jogging at 60-70% of peak oxygen uptake (VO2peak), three days/week for 35 min/exercise session. Systolic blood pressure, diastolic blood pressure, mean arterial blood pressure, heart rate, cardiac output, total peripheral resistance, and forearm blood flow were measured. Manifestation of a training effect was illustrated by a 24.1 +/- 0.2% increase in VO2peak (26.9 +/- 1.2 mL x kg(-1) min(-1) vs 35.4 +/- 1.6 mL x kg(-1) min(-1)) (P<.05). Within the exercise-trained group there was a 6.3 +/- . 15% decrease in systolic pressure (129 +/- 4.6 mm Hg vs. 121 +/- 5.4 mm Hg) (P<.05), and a 5.0 +/- . 05% decrement in mean arterial blood pressure (99 +/- 3.3 mm Hg vs 94 +/- 3.6 mm Hg) (P<.05) during the cold pressor test. Pressor reactivity to cold stress did not change in the untrained group. Measures of heart rate, cardiac output, total peripheral resistance, and forearm blood flow were unaltered during conditions of the cold pressor test. We conclude that aerobic exercise attenuates the blood pressure reactivity to behavioral stress in young, adult normotensive African-American females. A lifestyle change such as exercising may play a role in reducing the risk of hypertension in African-American women.
Comparison of subjective olfaction ratings in patients with and without olfactory disorders

Abstract Objective: Olfactory dysfunction is common. The reliability of self-assessment tools for smell testing is still controversial. This study aimed to provide new data about the accuracy of olfactory self-assessment compared with a standardised smell test. Design: Prospective, controlled, cohort study of patients with olfactory disorders and healthy controls. Subjects: Ninety-six patients with a smell deficit and 71 controls were asked to rate their sense of smell on a visual analogue scale. Their olfactory abilities were also evaluated with the Sniffin' Sticks tests. Results: The whole cohort showed a significant correlation between visual analogue scale smell scores and Sniffin' Sticks total scores. This correlation was also significant in the patient group, but not in the control group. These results were independent of olfactory deficit aetiology and subject age. Conclusion: Self-assessment of olfaction is only a reliable indicator in smell-impaired patients, not in healthy controls. For an accurate assessment of olfaction, reliable, standardised tests are needed.
Beneficial Long Communication in the Multiplayer Electronic Mail Game

In the two-player electronic mail game (EMG), as is well-known, the probability of collective action is lower the more confirmations and re-confirmations are made available to players. In the multi-player EMG, however, as we show players may coordinate on equilibria where they require only few of the available confirmations from each other to act. In this case, increasing the number of available may either create equilibria with positive probability of collective action when none existed before, or may increase the probability of collective action, if equilibria with positive probability of collective action already existed for fewer available confirmations.
Self‐report pain and symptom measures for primary dysmenorrhoea: A critical review

Primary dysmenorrhoea (PD) is highly prevalent among women of reproductive age and it can have significant short‐ and long‐term consequences for both women and society as a whole. Validated symptom measures are fundamental for researchers to understand women's symptom experience of PD and to test symptom interventions. The objective of this paper was to critically review the content and psychometric properties of self‐report tools to measure symptoms of PD. Databases including PubMed, PsychoINFO, Cumulative Index of Nursing and Allied Health Literature, and Health and Psychosocial Instruments were searched for self‐report symptom measures that had been used among women with either PD or perimenstrual symptoms. A total of 15 measures met inclusion criteria and were included in the final analysis. The measures were categorized into generic pain measures, dysmenorrhoea‐specific measures, and tools designed to measure perimenstrual symptoms. These measures had varying degrees of comprehensiveness of symptoms being measured, relevance to PD, multidimensionality and psychometric soundness. No single measure was found to be optimal for use, but some dysmenorrhoea‐specific measures could be recommended if revised and further tested. Key issues in symptom measurement for PD are discussed. Future research needs to strengthen dysmenorrhoea‐specific symptom measures by including a comprehensive list of symptoms based on the pathogenesis of PD, exploring relevant symptom dimensions beyond symptom severity (e.g., frequency, duration, symptom distress), and testing psychometric properties of the adapted tools using sound methodology and diverse samples.
Host behaviour drives parasite genetics at multiple geographic scales: population genetics of the chewing louse, Thomomydoecus minor

Pocket gophers and their symbiotic chewing lice form a host–parasite assemblage known for a high degree of cophylogeny, thought to be driven by life history parameters of both host and parasite that make host switching difficult. However, little work to date has focused on determining whether these life histories actually impact louse populations at the very fine scale of louse infrapopulations (individuals on a single host) at the same or at nearby host localities. We used microsatellite and mtDNA sequence data to make comparisons of chewing‐louse (Thomomydoecus minor) population subdivision over time and over geographic space where there are different potential amounts of host interaction surrounding a zone of contact between two hybridizing pocket‐gopher subspecies. We found that chewing lice had high levels of population isolation consistent with a paucity of horizontal transmission even at the very fine geographic scale of a single alfalfa field. We also found marked genetic discontinuity in louse populations corresponding with host subspecies and little, if any, admixture in the louse genetic groups even though the lice are closely related. The correlation of louse infrapopulation differentiation with host interaction at multiple scales, including across a discontinuity in pocket‐gopher habitat, suggests that host behaviour is the primary driver of parasite genetics. This observation makes sense in light of the life histories of both chewing lice and pocket gophers and provides a powerful explanation for the well‐documented pattern of parallel cladogenesis in pocket gophers and chewing lice.
Digging for innate immunity since Darwin and Metchnikoff.

Immune systems are, increasingly, being studied from comparative perspectives. The analysis of the immune-defense systems of invertebrates, such as fruit flies and earthworms, is an important part of this effort. These systems are innate, natural non-specific, non-anticipatory and non-clonal. This is in contrast to the macrophage T and B systems that characterize vertebrate adaptive immunity whose properties can be categorized as adaptive, induced, specific, anticipatory, and clonal. In this review, we will focus on the earthworm system. Earthworms, like other complex invertebrates, possess several leukocyte types and synthesize and secrete a variety of immunoprotective molecules. The system as a whole effects phagocytosis, encapsulation, agglutination, opsonization, clotting and lysis of foreign components. At least two major leukocytes, small coelomocytes, and large coelomocytes mediate lytic reactions against several targets. Destruction of tumor cells in vitro shows that phagocytosis and natural killer cell responses are distinct properties of coelomocytes. A third type, the chlorogogen cell, synthesizes and sheds effector lytic molecules. Among the lytic molecules, three have been identified and sequenced (fetidins, CCF-1, lysenin) and another has been discovered (eiseniapore), while three other molecules, H(1) H(2) H(3), share agglutinating and lysing functions. In contrast to these, Lumbricin I is the only known molecule of the earthworm system that is antimicrobial but non-lytic. Altogether the cellular and humoral components of the earthworm system function to distinguish between self and not self, dispose of internal (cancer? ), damaged components and external antigens (microbes). The evolutionary context of the earthworm innate immune system is discussed at the end of this article.
The Phonological Status of the French Initial Accent and its Role in Semantic Processing: An Event-Related Potentials Study

French accentuation is held to belong to the level of the phrase. Consequently French is considered 'a language without accent' with speakers that are 'deaf to stress'. Recent ERP-studies investigating the French initial accent (IA) however demonstrate listeners not only discriminate between different stress patterns, but also prefer words to be marked with IA early in the process of speech comprehension. Still, as words were presented in isolation , it remains unclear whether the preference applied to the lexical or to the phrasal level. In the current ERP-study, we address this ambiguity and manipulate IA on words embedded in a sentence. Furthermore, we orthogonally manipulate semantic congruity to investigate the interplay between accentuation and later speech processing stages. Preliminary results on 14 participants reveal a significant interaction effect: the centro-frontally located N400 was larger for words without IA, with a bigger effect for semantically incongruent sentences. This indicates that IA is encoded at a lexical level and facilitates semantic processing. Furthermore, as participants attended to the semantic content of the sentences, the finding underlines the automaticity of stress processing. In sum, we demonstrate accentuation plays an important role in French speech comprehension and call for the traditional view to be reconsidered.
Differences and similarities between arrhythmogenic right ventricular cardiomyopathy and athlete’s heart adaptations

Background Regular intensive physical activity is associated with non-pathological changes in cardiac morphology. Differential diagnosis with arrhythmogenic right ventricular cardiomyopathy (ARVC) constitutes a frequent problem, especially in athletes showing ventricular arrhythmias with left bundle branch block morphology. Aim of the study To assess the different clinical and non-invasive instrumental features of the subjects affected by ARVC and by athletes. Methods Three groups of subjects (40 ARVC patients, 40 athletes and 40 controls, mean age 27 (9) years) were examined with family and personal history, physical examination, 12-lead ECG, 24-h ECG, signal-averaged ECG and 2-D and Doppler echocardiography. Results 12-Lead ECG was abnormal in 62% of ARVC patients versus 7.5% of athletes and 2.5% of controls (p<0.0001). Ventricular arrhythmias and late potentials were present in 70% and 55% of ARVC subjects, respectively (vs 5% of athletes and 7.5% of controls, p<0.0001). Left ventricular parietal wall thickness and left ventricular end-diastolic diameters were significantly higher in athletes. Both athletes and ARVC patients presented a right ventricular (RV) enlargement compared with controls. Moreover, RV outflow tract, measured on parasternal long axis and at the level of aortic root, was significantly larger in ARVC patients (33.6 (4.7) mm vs 29.1 (3.4) mm and 35.6 (6.8) mm vs 30.1 (2.9) mm; p<0.0001), and RV fractional shortening and ejection fraction were significantly lower in ARVC patients compared with athletes (40 (7.9)% vs 44 (10)%; p=0.05 and 52.9 (8)% vs 59.9 (4.5)%; p<0.0001). A thickened moderator band was found to be present in similar percentage in ARVC patients and athletes. Conclusions An accurate clinical and instrumental non-invasive evaluation including echocardiography as imaging technique allows to distinguish RV alterations typical of ARVC from those detected in athletes as a consequence of intensive physical activity.