Miracle-dz/UniFAR-FTUs huggingface dataset:
Depressive Symptoms among Older Residents in Assisted Living Facilities

Responding to the dramatic growth in Assisted Living Facilities (ALFs), the present study focused on mental health among older residents in ALFs. We assessed the effects of physical health constraints (chronic conditions, functional disability, and self-rated health) and psychosocial resources (social network, sense of mastery, religiosity, and attitude toward aging) on depressive symptoms. A sample of 150 residents (Mage = 82.8, SD = 9.41) from 17 facilities in Florida was used for analyses. Higher levels of depressive symptoms were observed among older residents with a greater level of functional disability, poorer self-rated health, lower sense of mastery, less religiosity, and less positive attitude towards aging. In addition, the linkages between physical and mental health were modified by psychosocial resources. For older residents with more positive beliefs and attitudes (a higher sense of mastery, greater religiosity, and more positive attitudes toward aging), the adverse effects of functional disability or poorer self-rated health on depressive symptoms were attenuated. The protective roles of psychosocial resources against physical health constraints yield important implications for designing prevention and intervention strategies for the mental health of older populations in ALF settings.
Occupational exposure to endotoxins and lung cancer risk: results of the ICARE Study

Objectives To investigate the role of occupational exposure to endotoxins in lung cancer in a French population-based case–control study (ICARE (Investigation of occupational and environmental causes of respiratory cancers)). Methods Detailed information was collected on the occupational history and smoking habits from 2926 patients with histologically confirmed lung cancer and 3555 matched controls. We evaluated each subject’s endotoxin exposure after cross referencing International Standard Classification of Occupations (ISCO) codes (for job tasks) and Nomenclature d'Activités Françaises (NAF) codes (for activity sectors). Endotoxin exposure levels were attributed to each work environment based on literature reports. ORs and 95% CIs were estimated using unconditional logistic regression models and controlled for main confounding factors. Results An inverse association between exposure to endotoxins and lung cancer was found (OR=0.80, 95% CI 0.66 to 0.95). Negative trends were shown with duration and cumulative exposure, and the risk was decreased decades after exposure cessation (all statistically significant). Lung cancer risk was particularly reduced among workers highly exposed (eg, in dairy, cattle, poultry, pig farms), but also in those weakly exposed (eg, in waste treatment). Statistically significant interactions were shown with smoking, and never/light smokers were more sensitive to an endotoxin effect than heavy smokers (eg, OR=0.14, 95% CI 0.06 to 0.32 and OR=0.80, 95% CI 0.45 to 1.40, respectively, for the quartiles with the highest cumulative exposure, compared with those never exposed). Pronounced inverse associations were shown with adenocarcinoma histological subtype (OR=0.37, 95% CI 0.25 to 0.55 in the highly exposed). Conclusions Our findings suggest that exposure to endotoxins, even at a low level, reduces the risk of lung cancer.
Action selection in the striatum : implications for Huntington's disease

Although the basal ganglia have been widely studied and implicated in signal processing and action selection, little information is known about the active role that the striatal microcircuit plays in action selection in the basal ganglia-cortical-thalamic loops. To address this knowledge gap we use a large scale three dimensional spiking model of the striatum, combined with a rate coded model of the basal ganglia-cortical-thalamic loop, to asses the computational role the striatum plays in action selection. We identify robust transient phenomena generated by the striatal microcircuit, which temporarily enhances the difference between two competing cortical inputs. We show that this transient is sufficient to modulate decision making in the basal ganglia-thalamo-cortical circuit. We also find that the transient selection originates from a novel adaptation effect in single striatal projection neurons, which is amenable to experimental testing. Finally, we compared transient selection with models implementing classical steady-state selection. We challenged both forms of model to account for recent reports of paradoxically enhanced response selection in Huntington's disease patients. We found that steady-state selection was uniformly impaired under all simulated Huntington's conditions, but transient selection was enhanced given a sufficient Huntington's-like increase in NMDA receptor sensitivity. I propose a mechanistic underpinning to a novel neural compensatory mechanism, responsible for improved cognition in severe neuro-degeneration. Thus, our models provide an intriguing hypothesis for the mechanisms underlying the paradoxical cognitive improvements in manifest Huntington's patients, which is consistent with recent behavioural data.
A Comparison of Mesh Refinement in the Global MPAS-A and WRF Models Using an Idealized Normal-Mode Baroclinic Wave Simulation

AbstractIdealized normal-mode baroclinic wave simulations are conducted to examine the impact of continuous mesh refinement compared with stepwise changes in resolution using nested grids. The nested-grid results are produced using the Advanced Research Weather Research and Forecasting (WRF-ARW) Model, hereafter ARW, and the continuous refinement results are produced using the atmospheric component of the Model for Prediction Across Scales-Atmosphere (MPAS-A). For the nested domain simulations with the ARW, variants of both one-way and two-way nesting techniques are examined. Significant reflection and distortion of waves are evident in results using one-way nesting, with the error increasing with decreasing boundary-update frequency. With continuous updating of the boundary conditions in one-way and two-way nesting, wave distortion is still evident near the lateral boundaries but the distortion is much less than with infrequent boundary updates. The conformal Voronoi meshes in MPAS provide a much smoothe.
Perceptual Abilities of Children with the Nucleus 22‐Channel Cochlear Implant

THE PRIMARY OBJECTIVE of the clinical trials in children was to demonstrate that the Nucleus cochlear implant was safe and effective in this population. The demonstration of effectiveness was thought to primarily relate to improvements in speech perception skills, with and without lipreading, after implantation. For postoperative benefit to be considered meaningful, performance with the implant was required to significantly exceed the child’s preoperative performance in the better hearing ear. Best-aided performance preoperatively was typically with binaural amplification, or in about one-quarter of the subjects, vibrotactile devices. As was described in detail by Mecklenburg et al (see Chap. 2), for the purposes of the clinical trial each child was an individual experiment. Preto postoperative changes in performance were analyzed for each test on each child to determine the effectiveness of the device. The data from 80 subjects were analyzed in this manner and on the basis of these data, the Food and Drug Administration granted marketing approval on June 27, 1990. With the accrual of additional patient data since that time, the focus of research interest broadened to include the following questions: (1 ) does performance improve significantly after implantation; (2) does performance continue to improve with longer term experience using the implant; (3) are there factors that predict performance on speech perception measures; (4) do children with congenital deafness achieve the same skill level postoperatively as do children who acquired language before the onset of deafness; and (5) does the type and effectiveness of postoperative rehabilitation influence overall performance.
Long‐term safety and efficacy of long‐acting risperidone in elderly psychotic patients

This subgroup analysis of the 6‐month, open‐label Switch to Risperidone Microspheres (StoRMi) trial evaluated long‐term safety and efficacy of a direct conversion to risperidone long‐acting injectable (RLAI) in 52 elderly patients (≥65 years) with psychosis stabilized on oral or depot antipsychotic. Study outcomes included adverse events, movement disorder severity, psychiatric symptoms, functional ability, quality of life and patient satisfaction. Change in the Positive and Negative Syndrome Scale at endpoint was the primary efficacy measure. The most common dosage of RLAI used at endpoint was 25 mg every 14 days (60%). The trial was completed by 81% of patients, with six patients discontinuing treatment due to an adverse event. Tolerability was good and most side effects were mild to moderate. Serious adverse events occurred in 11 patients. Two of these (suicidal attempt, n = 1; exacerbation of disease, n = 1) were considered possibly related to RLAI. Conversion to RLAI resulted in significant improvements in movement disorder severity, psychiatric symptoms, functional status and patient satisfaction. Mean PANSS total decreased by 15.8 at endpoint, with 23 patients (46.9%) experiencing a ≥20% improvement. This post‐hoc analysis supports that RLAI is well tolerated and safe in elderly patients with psychotic illnesses switched from stable antipsychotic regimens, and suggests possible efficacy, although inferences are limited. Copyright © 2007 John Wiley & Sons, Ltd.
Origin of Class 1 and 2 Integrons and Gene Cassettes in a Population-Based Sample of Uropathogenic Escherichia coli

ABSTRACT The prevalence of urinary tract infections (UTI) caused by trimethoprim-sulfamethoxazole (TMP-SMX)-resistant Escherichia coli is increasing and varies geographically in the United States. Recent community-based UTI studies have demonstrated geographic clustering of an Escherichia coli clonal group, suggesting occurrence of a community outbreak of UTI. A large proportion of this clonal group (designated CgA) isolated from women in a California college community was found to be resistant to TMP-SMX. We wished to determine if the acquisition of TMP-SMX resistance by CgA occurred before or after the CgA strains were introduced into this community. Between October 1999 and January 2000 and between October 2000 and January 2001, 482 E. coli isolates were consecutively collected from the urine samples of women with UTI at a student health clinic and analyzed for determinants of TMP-SMX resistance. In particular, the distribution of integrons harboring resistance cassettes for TMP-SMX (dfr) was examined. Among 95 TMP-SMX-resistant isolates, 68 and 27 isolates carried class 1 and class 2 integrons, respectively. A class 1 integron was found in 25 (93%) of 27 TMP-SMX-resistant CgA isolates but in only 43 (63%) of 68 TMP-SMX-resistant non-CgA isolates (P < 0.001) and in none of 44 TMP-SMX-susceptible E. coli isolates (P < 0.0001). CgA strains carried only a single arrangement of class 1 gene cassettes (dfrA17-aadA5), while the non-clonal group strains carried nine different cassette arrangements. These results support the idea that CgA strains acquired their resistance at a common site prior to their spread to the college community.
Antidepressant drug use in primary care: a record linkage study in Tayside, Scotland

Depression is a common psychiatric disorder in general practice.1 There is consensus that antidepressants should be given in sufficient dose and for sufficiently long if treatment is to be effective.2 Tricyclic antidepressants carry warnings about their use in patients with cardiac diseases, and they have well known anticholinergic effects that could cause predictable toxicity. Selective serotonin uptake inhibitors are thought to be devoid of such effects. We studied the use and safety of antidepressant drugs in the community, with reference to their labelled warnings. We studied patient specific dispensed prescribing3 for antidepressant drugs and admissions to hospital for possible adverse effects over 14 months using a record linkage database that covers the population of Tayside, Scotland (about 400 000 subjects). 4 The dose and duration of use of antidepressants was determined, as was the number …
The trajectory of cognitive decline in the pre-dementia phase in memory clinic visitors: findings from the 4C-MCI study

Background We investigated the course of decline in multiple cognitive domains in non-demented subjects from a memory clinic setting, and compared pattern, onset and magnitude of decline between subjects who progressed to Alzheimer's disease (AD) dementia at follow-up and subjects who did not progress. Method In this retrospective cohort study 819 consecutive non-demented patients who visited the memory clinics in Maastricht or Amsterdam between 1987 and 2010 were followed until they became demented or for a maximum of 10 years (range 0.5–10 years). Differences in trajectories of episodic memory, executive functioning, verbal fluency, and information processing speed/attention between converters to AD dementia and subjects remaining non-demented were compared by means of random effects modelling. Results The cognitive performance of converters and non-converters could already be differentiated seven (episodic memory) to three (verbal fluency and executive functioning) years prior to dementia diagnosis. Converters declined in these three domains, while non-converters remained stable on episodic memory and executive functioning and showed modest decline in verbal fluency. There was no evidence of decline in information processing speed/attention in either group. Conclusions Differences in cognitive performance between converters to AD dementia and subjects remaining non-demented could be established 7 years prior to diagnosis for episodic memory, with verbal fluency and executive functioning following several years later. Therefore, in addition to early episodic memory decline, decline in executive functions may also flag incident AD dementia. By contrast, change in information processing speed/attention seems less informative.
Validation of the respiratory toxics exposure score (RTES) for chronic obstructive pulmonary disease screening

ObjectiveOur aim is to evaluate the validity of exhaled carbon monoxide (CO) and of a newly-created score as markers of Chronic Obstructive Pulmonary Disease (COPD). Materials and MethodsThe CO level was measured in a derivation subsample of a cross-sectional study and linked to COPD diagnosis; its predictors were evaluated, and a scale was constructed. It was evaluated in a validation subsample and in a clinical setting.ResultsIndividuals with COPD had higher CO levels than healthy individuals. CO level significant predictors were cigarettes per day, waterpipes per week, lower age, male gender, living close to diesel exhaust, heating home with the use of diesel, and having indoor family smokers. A score composed of CO predictors was able to significantly predict COPD (Ora = 4–7.5). ConclusionsCoupled with the clinical judgment of physicians, this scale would be an excellent low-cost tool for screening COPD, in absence of spirometry.
Assessment of the effects of erythromycin, neostigmine, and metoclopramide on abomasal motility and emptying rate in calves.

OBJECTIVE To determine and compare the effects of erythromycin, neostigmine, and metoclopramide on abomasal motility and emptying rate in suckling calves. ANIMALS 6 male Holstein calves (15 to 40 days of age). PROCEDURE Calves were monitored for 1 hour before being fed milk replacer (60 mL/kg; time, 0 minutes) and then were monitored for another 3 hours. Calves received 6 treatments in randomized order: erythromycin (8.8 mg/kg, IM) at -30 minutes; low-dose erythromycin (0.88 mg/kg, IM) at -30 minutes; erythromycin (8.8 mg/kg, IM) at -30 minutes and neostigmine (0.02 mg/kg, SC) at -30 and 90 minutes; neostigmine (0.02 mg/kg, SC) at -30 and 90 minutes; metoclopramide (0.1 mg/kg, IM) at-30 and 90 minutes; and placebo (2 mL of saline [0.9% NaCl] solution, SC) at -30 minutes. Abomasal volume was calculated from ultrasonographic measurements of abomasal width, length, and height. Abomasal motility and emptying rate were assessed by measuring luminal pressure and change in abomasal volume over time. RESULTS Administration of erythromycin (8.8 mg/kg) increased the frequency of abomasal luminal pressure waves and the mean abomasal luminal pressure and decreased the half-time of abomasal emptying by 37%. Administration of metoclopramide, neostigmine, and low-dose erythromycin (0.88 mg/kg) did not alter abomasal motility, mean luminal pressure, or emptying rate. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that administration of erythromycin at the labeled antimicrobial dose (8.8 mg/kg, IM) exerted an immediate, marked prokinetic effect in healthy suckling calves, whereas administration of metoclopramide or neostigmine did not alter abomasal motility or emptying rate.
Evidence for nonreciprocal organization of the mouse auditory thalamocortical‐corticothalamic projection systems

We tested the hypothesis that information is routed from one area of the auditory cortex (AC) to another via the dorsal division of the medial geniculate body (MGBd) by analyzing the degree of reciprocal connectivity between the auditory thalamus and cortex. Biotinylated dextran amine injected into the primary AC (AI) or anterior auditory field (AAF) of mice produced large, “driver‐type” terminals primarily in the MGBd, with essentially no such terminals in the ventral MGB (MGBv). In contrast, small, “modulator‐type” terminals were found primarily in the MGBv, and this coincided with areas of retrogradely labeled thalamocortical cell bodies. After MGBv injections, anterograde label was observed in layers 4 and 6 of the AI and AAF, which coincided with retrogradely labeled layer 6 cell bodies. After MGBd injections, thalamocortical terminals were seen in layers 1, 4, and 6 of the secondary AC and dorsoposterior AC, which coincided with labeled layer 6 cell bodies. Notably, after MGBd injection, a substantial number of layer 5 cells were labeled in all AC areas, whereas very few were seen after MGBv injection. Further, the degree of anterograde label in layer 4 of cortical columns containing labeled layer 6 cell bodies was greater than in columns containing labeled layer 5 cell bodies. These data suggest that auditory layer 5 corticothalamic projections are targeted to the MGBd in a nonreciprocal fashion and that the MGBd may route this information to the nonprimary AC. J. Comp. Neurol. 507:1209–1227, 2008. © 2008 Wiley‐Liss, Inc.
Outcome of Adverse Events and Medical Errors in the Intensive Care Unit

Adverse events and medical errors (AEs/MEs) are more likely to occur in the intensive care unit (ICU). Information about the incidence and outcomes of such events is conflicting. A systematic review and meta-analysis were conducted to examine the effects of MEs/AEs on mortality and hospital and ICU lengths of stay among ICU patients. Potentially eligible studies were identified from 4 major databases. Of 902 studies screened, 12 met the inclusion criteria, 10 of which are included in the quantitative analysis. Patients with 1 or more MEs/AEs (vs no MEs/AEs) had a nonsignificant increase in mortality (odds ratio = 1.5; 95% confidence interval [CI] = 0.98-2.14) but significantly longer hospital and ICU stays; the mean difference (95% CI) was 8.9 (3.3-14.7) days for hospital stay and 6.8 (0.2-13.4) days for ICU. The ICU environment is associated with a substantial incidence of MEs/AEs, and patients with MEs/AEs have worse outcomes than those with no MEs/AEs.
Reactions of GPs to a triage-controlled referral system for cancer genetics.

BACKGROUND The demand for genetic services is increasing as public awareness about 'predictive' tests increases and commercial marketing initiatives develop. In the UK, genetic services vary widely between regions. To manage demand, an all-Wales cancer genetics service based on telephone triage and referral guidelines was designed and implemented. OBJECTIVES The aim of this study was to examine the reactions of GPs to a cancer genetics service controlled by referral guidelines and a triage system, and the perceived impact genetics will have on general practice. METHODS We conducted a structured qualitative study in primary care using sequential focus group discussions with 14 GPs, representing 12 practices divided into two groups (service providers and educationalists). The doctors were introduced to the 'new' genetics, briefed about the service and the referral guidelines and given an outline of the topics to be discussed. All discussions were recorded, transcribed and analysed. RESULTS The GPs in this study had not considered how they and their teams would handle the practical implications of the 'new' genetics. They had no major objections to a triage system as a means of regulating access to a scarce specialist service, but were concerned about two issues. First, that an insistence on the completion of a postal questionnaire as a means of obtaining an initial assessment could disadvantage some individuals and, secondly, that it was not clear to either the GP or the patient that the risk assessment would be undertaken by a telephone interview. Although there was some concern about yet another set of referral guidelines, participants accepted that the potential demand for cancer genetics services had to be regulated. CONCLUSION The acceptance by GPs of this triage system represented a reluctant acknowledgement that primary care, in its present organizational form, cannot provide high quality genetic counselling. However, the realization that this represented a relinquishment of the normal generalist role led to the emergence of ambivalence and a wish to consider how best to accommodate this new need in primary care.
Concurrent Septic Arthritis and Osteomyelitis in Children

Introduction: Septic arthritis and osteomyelitis can both independently cause substantial morbidity. With concomitant septic arthritis and osteomyelitis, the septic arthritis may be treated without knowledge of the adjacent osteomyelitis resulting in delayed treatment. This study aims to identify factors that may help to diagnosis concurrent infections (CI) earlier. Methods: A retrospective chart review of 200 patients with septic arthritis was performed. Patients with CI were compared with patients with septic arthritis alone using tests determined by the nature of the variable being analyzed (the &khgr;2 test, the Fisher exact test, the Cochran-Armitage trend test, and the Kruskal-Wallis test.). Results: Two hundred patients were eligible and analyzed, of which 43 (21.5%) had CI. On the basis of age, CI were most common in newborns and adolescents (P<0.0001). On the basis of location, 72% of shoulder infections (P<0.0001) were concurrent, whereas <50% of elbows, hips, knees, and ankle were CI. The most common infective organism was methicillin-sensitive Staphylococcus aureus (P<0.0001). CI were significantly associated with increased median (6) days of clinical symptoms before presentation (P<0.0001), increased duration of median (6) days of hospital stay (P<0.0001), increased number of operative procedures (P=0.005), and increased need for ICU admission (P=0.024). Conclusions: Utilizing advanced imaging (CT scan, bone scan, and/or MRI) in patients with septic arthritis who are younger than 4 months of age, between ages 13 and 20 years, with septic arthritis involving the shoulder, and with symptoms for more than 6 days may shorten hospital stays, decrease the number of operative procedures required, and possibly limit infection-related sequelae by identifying CI earlier. Level of Evidence: III.