Miracle-dz/UniFAR-FTUs huggingface dataset:
A Concept Analysis of Person-Centered Care

The term person-centered care (PCC) has been frequently used in the literature, but there is no consensus about its meaning. This article uses Walker and Avants’s method of concept analysis as a framework to analyze PCC. A literature search was completed and data were collected using several search engines (CINAHL, Medline, PubMed, and Cochrane Review). The key words used were “individualized-care,” “person-centered care,” “patient-centered care,” “client-centered care,” and “resident-centered care. ” Attributes, antecedents, and consequences of PCC were identified. Empirical referents were provided to measure PCC from the perspective of the person receiving care and finally, a model case provides an exemplar of the concept.
Risk perception of participants in a family‐based genetic screening program on familial hypercholesterolemia

The aim of this article is threefold. First, we describe the accuracy of people's risk perception who have been screened on familial hypercholesterolemia (FH) in a family‐based screening program. Second, we identify factors that modify risk perception. Finally, we show the influence of risk perception on subsequent preventive behavior. The risk perception of 556 screenees (677 participants, overall response = 82%) was measured by postal questionnaires on three occasions: at screening and 3 days and 7 months after the test result was reported to the patient. Presentation of the risk was precategorized and given both as numerical (1 in x) and as verbal probability. In addition, medication use and attitudes toward gene therapy were determined 7 months after screening. On average, the screenees underestimated their numeric risk of having FH and getting a myocardial infarction (MI). Furthermore, FH‐positive screenees perceived that they were at greater risk of MI than FH negatives, and screenees with the highest actual risk used medication more, perceived a greater risk, and opted more often for future gene therapy. Risk perception of having FH was influenced by cholesterol level, while MI risk perception was affected by age, education, cholesterol level, and cardiovascular disease (CVD) in the family. We conclude that FH‐positive screenees correctly perceive a higher risk of getting a heart attack than do FH‐negative screenees. Screenees did not believe that MI was inevitable, and risk perception was associated with both medication use and the intention to opt for gene therapy, but not with other preventive measures. Thus, genetic risk notification seems to be acceptable and does not lead to aversion to preventive behavior. © 2002 Wiley‐Liss, Inc.
Maternal anxiety and fetal movement patterns in late pregnancy

Abstract Objective: To determine whether maternal anxiety affects fetal movement patterns in the third trimester of pregnancy. Methods: The inclusion criteria were a state of good health and a singleton pregnancy between 36 and 40 weeks. Thirty healthy pregnant women were included. The Beck Anxiety Inventory (BA) questionnaire with 21 self-reported items validated for the Brazilian population was applied. The women were asked to record the number of minutes taken to perceive 10 fetal movements once a day for one week. Anxiety symptoms were rated as moderate or severe according to the BAI total score. Results: The mean BAI score was 20.8 (SD = 10.2) and the mean time to count 10 fetal movements was 24.3 min (SD = 6.6 min). The BAI items significantly associated with moderate or severe maternal anxiety were numbness or tingling, fear of the worst happening, terrified, feeling of choking, fear of losing control and fear of dying. There was a statistically significant negative correlation between the total BAI score and the mean time of 10 perceived fetal movements (p < 0.0001; rho = −0.70; 95% CI for rho −0.84 to −0.45). Conclusions: Maternal anxiety seems to affect fetal movement patterns in late pregnancy and is associated with the mother’s increased perception of fetal activity.
A Special Application Criterion of the Nine-Switch Converter With Reduced Conduction Loss

The nine-switch converter is a multiport converter having two three-phase terminals and a dc-link, just like a 12-switch back-to-back (BTB) converter, but with 25% reduction of active switch count. However, the reduction from 12-switch to 9-switch may not always be an efficient choice considering losses in the switches. Only the load–source combination for the ac–ac common frequency mode and the source–source combination for the ac–dc different frequency (ac–dc DF) mode have been reported, so far, to yield relatively lower loss for the nine-switch converter. This paper shows that the nine-switch converter can have relatively lower loss even with a load–source combination, instead of only source–source combination in its ac–dc DF mode—when the upper terminal is connected to a dc load and the lower terminal is connected to an ac source. Mathematical proof is presented with derivation of the particular operating parameters for which the nine-switch converter will have comparatively lower losses. The analysis is validated with simulation and experimental results of a 1-kW system. Finally, the benchmark of the application criteria of the nine-switch converter for having lower conduction loss than the BTB converter is updated in this paper.
A meta-analysis of the antitumor effect and safety of bisphosphonates in the treatment of multiple myeloma.

BACKGROUND The objective of this meta-analysis was to determine the effectiveness and safety of bisphosphonates (BPs) for patients with multiple myeloma (MM). METHODS The study included patients with MM, who were randomly allocated to receive either BPs or control. PubMed/Medline, Embase, the Cochrane Database of Systematic Reviews (CDSR), and the Cochrane Central Register of Controlled Trials were searched up to January 2014, and only published trials were included in the analysis. There was no language restriction. The results were analyzed using RevMan 5.2 software, which was provided by Cochrane Collaboration. RESULTS Six randomized controlled trials (RCTs) covering 1951 patients with MM were included in the analysis. The clodronate subgroup showed superior progression-free survival compared to the other groups. The pooled hazard ratio (HR) was 0.57 [95% confidence interval (CI) 0.33-0.99, P = 0.04]. Regarding overall survival (OS), only zoledronic acid showed a clear advantage (HR = 0.51, 95% CI 0.33-0.77, P = 0.002) All BPs were effective at reducing skeletal-related events (SREs). The pooled risk ratios for the outcome of SREs were 0.72 (95% CI: 0.62-0.84, P < 0.0001) for the clodronate subgroup, 0.66 (95% CI: 0.48-0.91, P = 0.007) for the pamidronate subgroup, and 0.65 (95% CI: 0.46-0.91, P = 0.01) for the zoledronic acid subgroup. Several adverse events (AEs) were mentioned in the included RCTs; however, the pooled results showed no statistically significant differences between the BP groups and the control. CONCLUSIONS The present meta-analysis demonstrated that zoledronic acid may improve the OS of patients with MM. All BPs markedly decreased SREs and were tolerated well.
Rational Prescribing of Extended-Spectrum Penicillin β-Lactamase Inhibitor Combinations: Focus on Ticarcillin/Clavulanic Acid

OBJECTIVE To provide an overview of the clinical pharmacokinetics and pharmacodynamics of ticarcillin/clavulanic acid and to reassess traditional dosage recommendations based on contemporary pharmacokinetic and pharmacodynamic principles. DATA SOURCES Published ticarcillin and clavulanic acid pharmacokinetic data derived from infants and children combined with data obtained from a rigorous, dose-escalation study performed in 12 healthy adults. Pharmacodynamic correlates were derived from published in vitro susceptibility data for the combination drug ticarcillin/clavulanic acid. DATA SYNTHESIS: Limited differences were observed in the pharmacokinetic disposition profiles between ticarcillin and clavulanic acid and relative to subject age. Integration of these data with defined pathogen minimum inhibitory concentrations underscores the appropriateness of an extended dosing interval (e.g., q8h to q12h) for many infections and demonstrates the probable therapeutic interchangeability of the following three intravenous dosing regimens: 3.1 g every 6 hours, 75 mg/kg every 8 hours, and 100 mg/kg every 12 hours of a 30:1 ticarcillin/clavulanic acid combination. CONCLUSIONS Integration of pharmacokinetic and pharmacodynamic data is an appropriate means to assess/reassess dosing recommendations for antimicrobial agents. Initial ticarcillin/ clavulanic acid dose recommendations did not account for known dynamic interactions for this combination antibiotic. Pharmacokinetic data in infants, children, and adults support a less frequent dosing interval (q8h to q12h) for the treatment of infections arising outside the central nervous system.
Intestinal parasitic infections: prevalences in HIV/AIDS patients in a Thai AIDS-care centre

Abstract During 2005, the intestinal parasitic infections in the adult HIV/AIDS patients in a combined AIDS-care centre and hospice in Thailand were identified in a cross-sectional study. Overall, 41 (45.6%) of the 90 stool samples investigated, by microscopy and/or PCR, were found parasite-positive. Cryptosporidium was the genus most commonly encountered, with 27 (30.0%) of the patients positive for Cr. hominis and four (4.4%) positive for Cr. meleagridis. Enterocytozoon bieneusi, always of genotype D, was detected in five (5.6%) of the patients while two patients (2.2%) were found infected with Blastocystis, just one patient (1.1%) was found infected with Cyclospora cayetanensis and one more (1.1%) was found positive for Isospora belli. The only helminth infection detected was opisthorchiosis and that was only seen in two (2.2%) of the subjects. Patients with stools of unusual consistency (categorized as mucous, loose–watery or watery) were more likely to be found infected with one or more species of protozoan parasite than the patients with stools of normal consistency (P=0.022). In a multivariate analysis, compared with the other subjects, the patients with stools of unusual consistency were 4.9-fold more likely to have (opportunistic) intestinal infection with parasitic protozoa (with a 95% confidence interval for the adjusted odds ratio of 1.370–17.350; P=0.014). Although there was also a trend for stools of unusual colour (red–brown, red–orange, green, black or grey) to be positively associated with intestinal parasitic infection, this was not statistically significant (P=0.658). The observation of the consistency of stools of HIV/AIDS patients could help in the presumptive diagnosis of opportunistic protozoan infections and allow parasitological investigation to be targeted at the cases most likely to be found positive.
Ultrastructural changes in the sublingual salivary gland of prenatal buffalo (Bubalus bubalis)

Aim: The present study was aimed to elucidate ultrastructural changes in the development of sublingual salivary gland of buffalo during prenatal life. Materials and Methods: The study was carried out on sublingual salivary gland of 36 buffalo fetuses ranging from 13.2 cm curved crown-rump length (CVRL) (88th day) to full term. The fetuses were categorized into three groups based on their CVRL. Results: The cells lining the terminal tubules were undifferentiated with poorly developed cytoplasmic organelles but lacked secretory granules (SGs) at 13.2 cm CVRL (88th day). The SGs appeared first in the form of membrane-bound secretory vesicles with homogeneous electron-dense as well as electron-lucent contents at 21.2 cm CVRL (122nd day); however, mucous acinar cells contained electron-lucent granules, while serous secretory cells as well as serous demilunes showed electron-dense granules at 34 cm CVRL (150th day) of prenatal life. At 53.5 cm CVRL (194th day), both mucous and serous acini were differentiated by the density of SGs. Conclusion: The cytoplasm of acinar cells was filled with mitochondria, rough endoplasmic reticulum, and Golgi profiles in mid and late fetal age groups. The SGs were increased in number during the late fetal age group. The myoepithelial cells (MECs) were located at the base of the acinar cells as well as intercalated and striated ducts and were stellate in shape. The ultrastructure of MEC revealed a parallel stream of myofilaments in the cytoplasm and its processes. The mucous cells were predominantly present in the sublingual salivary gland and were pyramidal in shape.
Impacts of a spring heat wave on canopy processes in a northern hardwood forest

Heat wave frequency, duration, and intensity are predicted to increase with global warming, but the potential impacts of short‐term high temperature events on forest functioning remain virtually unstudied. We examined canopy processes in a forest in Central Ontario following 3 days of record‐setting high temperatures (31–33 °C) that coincided with the peak in leaf expansion of dominant trees in late May 2010. Leaf area dynamics, leaf morphology, and leaf‐level gas‐exchange were compared to data from prior years of sampling (2002–2008) at the same site, focusing on Acer saccharum Marsh. , the dominant tree in the region. Extensive shedding of partially expanded leaves was observed immediately following high temperature days, with A. saccharum losing ca. 25% of total leaf production but subsequently producing an unusual second flush of neoformed leaves. Both leaf losses and subsequent reflushing were highest in the upper canopy; however, retained preformed leaves and neoformed leaves showed reduced size, resulting in an overall decline in end‐of‐season leaf area index of 64% in A. saccharum, and 16% in the entire forest. Saplings showed lower leaf losses, but also a lower capacity to reflush relative to mature trees. Both surviving preformed and neoformed leaves had severely depressed photosynthetic capacity early in the summer of 2010, but largely regained photosynthetic competence by the end of the growing season. These results indicate that even short‐term heat waves can have severe impacts in northern forests, and suggest a particular vulnerability to high temperatures during the spring period of leaf expansion in temperate deciduous forests.
Case Reports of Aripiprazole Causing False-Positive Urine Amphetamine Drug Screens in Children

Urine drug screens (UDSs) are used to identify the presence of certain medications. One limitation of UDSs is the potential for false-positive results caused by cross-reactivity with other substances. Amphetamines have an extensive list of cross-reacting medications. The literature contains reports of false-positive amphetamine UDSs with multiple antidepressants and antipsychotics. We present 2 cases of presumed false-positive UDSs for amphetamines after ingestion of aripiprazole. Case 1 was a 16-month-old girl who accidently ingested 15 to 45 mg of aripiprazole. She was lethargic and ataxic at home with 1 episode of vomiting containing no identifiable tablets. She remained sluggish with periods of irritability and was admitted for observation. UDS on 2 consecutive days came back positive for amphetamines. Case 2 was of a 20-month-old girl who was brought into the hospital after accidental ingestion of an unknown quantity of her father’s medications which included aripiprazole. UDS on the first day of admission came back positive only for amphetamines. Confirmatory testing with gas chromatography–mass spectrometry (GC-MS) on the blood and urine samples were also performed for both patients on presentation to detect amphetamines and were subsequently negative. Both patients returned to baseline and were discharged from the hospital. To our knowledge, these cases represent the first reports of false-positive amphetamine urine drug tests with aripiprazole. In both cases, aripiprazole was the drug with the highest likelihood of causing the positive amphetamine screen. The implications of these false-positives include the possibility of unnecessary treatment and monitoring of patients.
Neuronal architecture of the mosquito deutocerebrum

Mosquito behavior is heavily dependent on olfactory and mechanosensory cues, which are detected by receptor neurons on the antenna and on the palps. Recent progress in mosquito sensory genomics highlights the need for an up‐to‐date understanding of the neural architecture of the mosquito brain. Here we present a detailed description of the neural structure of the primary target of the majority of these neurons, the deutocerebrum, in the African malaria (Anopheles gambiae) and yellow fever (Aedes aegypti) mosquitoes. Special focus is made on the olfactory system, the antennal lobe (AL), where we present high‐resolution three‐dimensional models of the ALs of male and female Ae. aegypti. These models reveal a sexual dimorphism in the number of glomeruli, 49 and 50 glomeruli in male and female mosquitoes, respectively, and in the size of several of the identified glomeruli. The fine structure of receptor neuron terminations in the AL and the rest of the deutocerebrum is described, as are the arborizations of intrinsic deutocerebral neurons and neurons providing output to higher brain areas. In the AL a specific and very large center receiving input from the mechanosensory Johnston's organ is revealed as a multilobed structure receiving peripheral input according to a somatotopic pattern. Within the antennal nerve a specific neuropil containing early, bouton‐like ramifications of receptor neurons is described. Within the glomerular array of the AL, neurons providing a possible feedback circuit to antennal receptor neurons are shown. With these results we provide a new resolution in mosquito deutocerebral architecture. J. Comp. Neurol. 493:207–240, 2005. © 2005 Wiley‐Liss, Inc.
Risk factors for serious adverse effects of thiopurines in patients with Crohn's disease.

PURPOSE Thiopurines are effective in attaining and maintaining remission in patients with inflammatory bowel diseases (IBD). The major drawback of these drugs are their serious adverse effects (SAE), highlighting the importance of preemptive identification of patients at risk. We aimed to examine whether gene polymorphisms in GSTM1, GSTT1 and TPMT, combined with various clinical parameters, can predict thiopurine induced SAE. METHODS A retrospective cohort of 176 Crohn's Disease (CD) patients treated with thiopurines (131 with 6MP and 45 with azathioprine) was genotyped for common polymorphisms in GSTM1, GSTT1 and TPMT. Clinical data including SAE, age, ethnicity, gender and smoking status were extracted from patient charts. SAEs evaluated were myelosuppression, hepatotoxicity and pancreatitis. Associations between demographic, clinical, and genetic variables and thiopurine induced SAE were assessed. RESULTS Twenty-four patients (14%) developed SAE, revealing a significant association between thiopurine induced SAE and GSTM1-null genotype (P=0.05), older age (P=0.016) and active smoking status (P=0.043) and SAE. On multi-variant analysis, past or current smokers were at increased risk for developing thiopurine related SAE (OR 2.915, CI 95%: 1.199- 7.084), specifically pancreatitis (p<0.001). No association was found between TPMT or GSTT1 polymorphisms and the development of SAE. CONCLUSIONS Active smoking and GSTM1-null genotype appear to be risk factors for thiopurine induced SAEs (i.e. myelosuppression, hepatotoxicity and pancreatitis) in patients with CD. Corroboration of these associations in larger cohorts is warranted.
A single-centre 10-year experience with Candida bloodstream infections.

OBJECTIVE To describe the clinical and microbiological features associated with Candida bloodstream infections observed at Hôpital Maisonneuve-Rosemont (Montreal, Quebec) between August 1996 and July 2006. METHODS Episodes were retrieved from the microbiology laboratory. Different patient episodes and different isolate episodes in the same patient were selected. Antifungal susceptibility was determined by the Clinical and Laboratory Standards Institute's (USA) M27A2 method. RESULTS A total of 190 different episodes of candidemia in 185 patients were identified. Eleven (6%) episodes occurred in outpatients. Candida albicans was identified in the majority of episodes (57%). Its frequency remained stable over the years. The proportion of Candida krusei candidemia episodes increased between 2003 and 2006, but this was not statistically significant. A central venous indwelling catheter or a peripherally inserted central catheter line was present in the majority of patients (167 [88%]). Of the indwelling catheters removed at the time of diagnosis, 39% were positive for Candida species on culture. Overall, voriconazole was the most active agent (the minimum inhibitory concentration required to inhibit the growth of 90% of organisms was 0.5 mg/L). Resistance to fluconazole was observed in 26 (14%) isolates (C albicans, 4%; versus non-albicans Candida species, 27%; P<0.001). Being on the hematology-oncology unit at the time of diagnosis (adjusted OR 7.8; 95% CI 2.3 to 27.1; P=0.001) and having received fluconazole or itraconazole within the past three months (adjusted OR 8.3; 95% CI 2.8 to 24.4; P<0.001) were significantly associated with resistance to fluconazole in multivariate analysis. CONCLUSIONS At Hôpital Maisonneuve-Rosemont, the frequency and species distribution of blood isolates of Candida remained stable over the past decade. In vitro resistance of C albicans to fluconazole and itraconazole remained minimal; resistance of non-albicans Candida species to fluconazole did not increase significantly. The new antifungal agents all had high in vitro activity against the bloodstream Candida isolates.