Miracle-dz/UniFAR-FTUs huggingface dataset:
A review of the activity and effects of nurse-led care in diabetes.

AIMS AND OBJECTIVES To identify systematically, summarize and critically appraise the current evidence regarding the activity and effects of nurse-led care in diabetes. BACKGROUND A diverse range of nurse-led models of care exist in diabetes. Primary studies have been conducted evaluating these models, but review and synthesis of the findings from these studies has not been undertaken. METHOD Systematic searches of CINAHL, MEDLINE and British Nursing Index from 1996 until June 2006. The searches were supplemented by an extensive hand search of the literature through references identified from retrieved articles. RESULTS Twenty-two relevant publications were identified and included findings from both primary and secondary care. The evidence indicates that nurses are involved in specific areas of care including education, individualized care, patient safety, promotion of self-care, acquisition of physical skills and psychological support. Improved glycemic control, diabetic symptoms, cost-effectiveness and decreased length of hospital stay are the main benefits of nurse-led interventions in diabetes care. Disease management protocols are the main mechanism by which nurses adjust and titrate medicines for patients with diabetes. Patient evaluations of nurse-led care report improved self-care and patient knowledge. CONCLUSIONS Findings of the review are generally positive. However, there are methodological weaknesses and under researched issues e.g. poor descriptions of the nurse interventions, the educational needs of nurses and the prescription of medicines by nurses for patients with diabetes, that point to a need for further rigorous evaluation. RELEVANCE TO CLINICAL PRACTICE Nurse-led care is an integral element of the diabetes service offered to patients. This review highlights the effect of this care and the issues that require consideration by those responsible for the development of nurse-led models in diabetes care.
Dermatological problems in geriatric patients: a hospital based study.

Geriatric health care has become a major issue worldwide. There are no data regarding geriatric dermatologic diseases are available from Nepal. Patients of 60 years and above were enrolled in the Nepali fiscal year 2067(April 2010-April 2011). The data included age, sex, place, and diagnosis. The aim of the study is to determine the characteristic pattern and frequency of dermatoses in dermatologic patients aged 60 years and above. There were total of 6442 patients who visited out patients department. Out of which frequency of geriatric patients were 330, which constitute about 5.1%. The male to female ratio was 50% each. The most common cutaneous dermatoses was eczema 35.8%, fungal infection 13.6%, viral infection 7%, followed by pruritus 7.3%, scabies and photodermatitis 4.5% each, Inflammatory papulosquamous disorder 3.3%, Bacterial infection and Icthyosis 2.1% each, vesiculobullous 1.8%, tumors and pigmentary disorder 0.6% and Miscellaneous group (keratoderma, callus, urticaria, diabetic ulcer, burgers disease, burning feet syndrome, Rosacea, Drug rash-amoxicillin, senile acne, prurigo nodularis, hansens disease, pellagra, Actinic cheilitis) 15.8%. Few patients had more than one dermatoses which constitute < 1% . Photodermatitis was found to be statistically significant. The most common dermatoses were Eczema in females followed by Photodermatitis and comparatively in males viral and fungal infections were common. This study depicts various characteristic patterns of dermatoses seen in elderly. Eczema and infections was found to be most common diseases seen in elderly. Further epidemiologic studies including treatment, follow-up of elderly patients has to be carried out to know the burden of the disease and decrease morbidity and psychological concern associated with diseases.
When Should Renal Replacement Therapy for Acute Kidney Injury Be Initiated and Discontinued?

Background: Critically ill patients with acute kidney injury (AKI) are at high risk for death and frequently require initiation of renal replacement therapy (RRT). There is wide variation in clinical practice on the indications for and timing of initiation and discontinuation of RRT. Numerous clinical and biochemical factors (i.e. uremic, metabolic, fluid balance) have been used; however, at present there is no consensus to guide clinicians on the most favorable time to initiate and/or discontinue RRT to optimize patient outcomes. Methods: In this review, we appraise the available clinical studies that have assessed timing of initiation and/or discontinuation of RRT for critically ill patients with AKI. ‘Timing’ of initiation has been variably defined including use of conventional biomarkers (i.e. serum urea and creatinine), urine output, fluid balance, and time relative to intensive care unit admission. Conclusions: Numerous studies consistently point toward a survival benefit to early initiation of RRT; however, there is a paucity of high-quality randomized trials. If early RRT is associated with clinical benefit, it remains uncertain whether this is attributable to more rapid metabolic/uremic control, management of fluid balance or a combination of clinical factors. In addition, timing of RRT initiation is likely context-specific and varies by clinical factors and/or etiology of AKI. There is also little data to accurately distinguish in advance between the injured kidney that will need extracorporeal renal support and one that retains capacity for early recovery. Fewer studies have evaluated the process of weaning of RRT or ideal methods to predict sufficient recovery to avoid re-initiation. Longer duration of RRT support, higher illness severity and lower urine output (independent of diuretic therapy) have all predicted need for re-initiation. Additional investigations on these issues are clearly warranted and urgently needed.
Performance Assessment of the Fecal Leukocyte Test for Inpatients

ABSTRACT Traditionally, fecal leukocyte testing detects large bowel inflammation or disruption, conditions that allow leukocytes into the stool. However, test usefulness with inpatients is unclear. Two hundred five inpatients who had undergone one to three tests were identified, and their FLT results were compared to their gastrointestinal disease diagnoses at time of discharge. A specificity of 92% for detecting intact colonic mucosae in inpatients was found.
Seeing into old age: vision function beyond acuity.

PURPOSE To provide a comprehensive description of vision function beyond acuity in older individuals. METHODS A sample of 900 individuals between the ages of 58 and 102 years (mean age of 75.5) was binocularly tested wearing habitual correction on a battery of psychophysical tests including high and low contrast acuity, low contrast low luminance acuity, disability glare, contrast sensitivity, color vision, stereoacuity, recovery from glare, and attentional visual fields. RESULTS High contrast acuity is reasonably well maintained on average, even into very old ages. Spatial vision measures under conditions of reduced contrast or luminance, or glare reveal significant impairment in a large portion of the aged. Many older individuals also have greatly reduced stereopsis, poor color discrimination, and severely restricted peripheral fields under conditions of divided attention. A single exponential function relating performance to age fits all spatial vision data sets. The function for individual spatial measures lies at different positions along the age scale. The derived aging function with a time constant of approximately 15 years also fits results from other recent aging studies of acuity and contrast sensitivity. CONCLUSIONS Standard visual acuity underestimates the degree of vision function loss suffered by many older individuals under the nonoptimal viewing conditions encountered in daily life. All spatial vision functions show a similar rate of decline with age of the population, but the age at which decline begins varies among measures.
Graft loss due to recurrent lupus nephritis in living-related kidney donation.

BACKGROUND AND OBJECTIVES Major predisposing risks for the development of SLE in the nontransplant setting have been reported to include female gender, ethnicity, and genetic factors among others. In the current study, we aimed to determine whether increasing haplotype match in living donor renal transplantation would have a negative impact on the long-term rates of graft loss due to lupus nephritis recurrence. DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS Data were provided by the Organ Procurement and Transplantation Network--United Network for Organ Sharing. Living-related primary kidney transplants performed between January 1, 1988, and December 31, 2007 with the native renal diagnosis of lupus nephritis for all patients alive and with functioning graft at discharge were included. The cumulative probability rates of allograft loss due to recurrence of lupus nephritis (RLN) stratified by haplotype match and immunosuppression were obtained. RESULTS The cumulative probability rates of graft loss due to RLN in primary kidney transplant recipients receiving cyclosporine-based immunosuppression were 4.8% (n = 187), 2.9% (n = 602), and 0.7% (n = 192) for recipients with 0-, 1-, and 2-haplotype matches, respectively. Similarly, recipients receiving "all maintenance" immunosuppressive therapy with 0-, 1-, and 2-haplotype matches had graft loss rates of 4.3% (n = 433), 2.3% (n = 1049), and 0.5% (n = 303), respectively. Chi-squared analyses revealed no significant gender or ethnic background differences among haplotype groups. Compared with 0-haplotype, 1- and 2-haplotype matched recipients were generally younger. CONCLUSIONS Living-related kidney donation with increasing haplotype match is unexpectedly associated with lower rates of allograft loss due to RLN. Potential contributory factors to this positive effect are not known.
SELECTION ON LOCOMOTOR PERFORMANCE CAPACITY IN A NATURAL POPULATION OF GARTER SNAKES

Selection on locomotor performance was determined for a series of marked and recaptured individuals from a population of garter snakes (Thamnophis sirtalis fitchi) in Northern California. We measured snake length and mass, burst speed, endurance on a treadmill, and the distance crawled around a stationary circular track. Size‐corrected values (residuals) of mass and locomotor performance were generated from the scaling equations of S–V length (SVL). Randomization tests and regressions were used to determine the probability that a trait was a significant predictor of survivorship, and a nonparametric, cubic spline estimate of the fitness function was used to facilitate detection of the patterns of selection. From 275 (“cohort”) snakes measured and tested within 8 days of birth in 1985, 79 were recaptured in the spring–summer of 1986 and subsequent years. Birth SVL was the only significant (randomization P = 0.022) predictor of neonatal survival from 1985 to 1986 with directional selection favoring larger individuals. In addition to the lab‐born cohort, 382 field‐born snakes from all ages in the population were captured, tested, and released during spring–summer 1986. Similar to the 1985 cohort, the survivorship of 37 of 86 neonates from 1986 to 1987 showed no significant relationship with any residual value using any statistical test. Survivorship from 1986 to 1987 for 127 of 250 yearlings (including 32 lab‐born cohort snakes) analyzed with the randomization test showed that greater values of both speed (P = 0.007) and distance residual (P = 0.008) significantly favored survival, whereas intermediate values of mass residual (P = 0.006) were significantly more likely to survive. Univariate regressions predicting the survival of yearlings from 1986 to 1987 gave similar results to the randomization test, but in a multiple regression with yearling burst speed residual, distance capacity residual, and a quadratic term of mass residual, distance capacity residual was the least important predictor variable. For the survivorship of 37 of the 113 older snakes, greater burst speed residual significantly favored survival (randomization P = 0.001).
Tool Support for the Evaluation of Matching Algorithms in the Eclipse Modeling Framework

In the field of model-driven development, sophisticated support for comparing model versions is urgently needed. Unfortunately, algorithms for model matching have been rarely evaluated so far. This paper deals with two extensions to the Eclipse Modeling Framework (EMF) that facilitate the evaluation of matching algorithms for EMF models, with the goal to combine user involvement and automated testing in the evaluation process. First a tree editor is presented that allows for the manual and semi-automated creation of match models which formalize the intended matching result. Second a benchmarking procedure is implemented which – given the intended match and the actual results of matching algorithms – automatically derives the number of a and b errors in a target-performance comparison. These results are valuable for drawing conclusions about the specific qualities of matching algorithms or for finding an adequate set of parameters for a configurable algorithm.
Use of Low‐Literacy Decision Aid to Enhance Knowledge and Reduce Decisional Conflict Among a Diverse Population of Adults With Rheumatoid Arthritis: Results of a Pilot Study

Despite innovations in treatment of rheumatoid arthritis (RA), adherence is poor and disparities persist. Shared decision making (SDM) promotes patient engagement and enhances adherence; however, few tools support SDM in RA. Our objective was to pilot a low‐literacy medication guide and decision aid to facilitate patient‐clinician conversations about RA medications.
Improving the Efficacy of Games for Change Using Personalization Models

There has been a continuous increase in the design and application of computer games for purposes other than entertainment in recent years. Serious games—games that motivate behavior and retain attention in serious contexts—can change the attitudes, behaviors, and habits of players. These games for change have been shown to motivate behavior change, persuade people, and promote learning using various persuasive strategies. However, persuasive strategies that motivate one player may demotivate another. In this article, we show the importance of tailoring games for change in the context of a game designed to improve healthy eating habits. We tailored a custom-designed game by adapting only the persuasive strategies employed; the game mechanics themselves did not vary. Tailoring the game design to players’ personality type improved the effectiveness of the games in promoting positive attitudes, intention to change behavior, and self-efficacy. Furthermore, we show that the benefits of tailoring the game intervention are not explained by the improved player experience, but directly by the choice of persuasive strategy employed. Designers and researchers of games for change can use our results to improve the efficacy of their game-based interventions.
Retinoic acid stimulates plasminogen activator inhibitor 2 production by blood mononuclear cells and inhibits urokinase‐induced extracellular proteolysis

Retinoids have been shown to modulate several functions of mononuclear phagocytes. We investigated the in vitro effect of all‐trans‐retinoic acid (ATRA) on the production of two major fibrinolytic components, urokinase‐type plasminogen activator (u‐PA) and PA inhibitor 2 (PAI‐2), by human blood mononuclear cells (MNC). ATRA caused a dose‐dependent (range 0.01–10 μm) accumulation of PAI‐2 antigen and activity into the cell culture medium, with a maximal increase (about 5‐fold over control) at a concentration of 1–10 μm. Similarly, a dose‐dependent increase in PAI‐2 antigen was observed in cell extracts upon ATRA stimulation. Northern blot analysis showed a parallel increase in the amount of PAI‐2 mRNA in ATRA‐treated cells. Time‐course experiments with 1 μm ATRA showed enhanced PAI‐2 mRNA expression as early as 2 h, reaching a maximum at 4–6 h and then declining at 18–24 h, and a time‐dependent increase in PAI‐2 antigen in the cell culture medium. At variance with PAI‐2, u‐PA was not influenced by the drug. To establish whether ATRA‐induced changes influenced the fibrinolytic process, we evaluated the effect of MNC stimulated with ATRA on u‐PA‐induced degradation of diluted plasma clots. ATRA‐treated cells markedly inhibited clot lysis induced by low concentrations of u‐PA. The effect was due to enhanced extracellular PAI‐2 accumulation since it was observed with conditioned medium from ATRA‐treated cells; it was abolished by the addition of neutralizing anti‐PAI‐2 antibodies and was negligible when single‐chain t‐PA was used instead of u‐PA. Since monocyte/macrophage‐mediated, plasminogen‐dependent extracellular proteolysis has been proposed as an important mechanism of tissue damage in several inflammatory states, our findings might contribute to better explain the anti‐inflammatory properties of retinoids.
Control-Free Dynamic Spectrum Access for Cognitive Radio Networks

Dynamic spectrum access (DSA) promises to resolve spectrum scarcity and low spectrum utilization caused by today's static spectrum access (SSA) policy. In DSA, secondary users dynamically search and access spectrum bands that are temporarily unused by primary users. In this paper, we propose a control-free DSA algorithm for cognitive radio networks (CRN). Our algorithm enables each CRN node to select its operation band without coordination and exchange of control messages with neighbors. The contribution of our algorithm is that such an independently selected band can reach neighbors with high probability, while streamlining control complexity and overhead in DSA. We develop an analytical model to evaluate performance. Numerical results show that our control-free DSA algorithm can achieve very good performance.
Biogeography of Mediterranean Hotspot Biodiversity: Re-Evaluating the 'Tertiary Relict' Hypothesis of Macaronesian Laurel Forests

The Macaronesian laurel forests (MLF) are dominated by trees with a laurophyll habit comparable to evergreen humid forests which were scattered across Europe and the Mediterranean in the Paleogene and Neogene. Therefore, MLF are traditionally regarded as an old, 'Tertiary relict' vegetation type. Here we address the question if key taxa of the MLF are relictual. We evaluated the relict hypothesis consulting fossil data and analyses based on molecular phylogenies of 18 representative species. For molecular dating we used the program BEAST, for ancestral trait reconstructions BayesTraits and Lagrange to infer ancestral areas. Our molecular dating showed that the origins of four species date back to the Upper Miocene while 14 originated in the Plio-Pleistocene. This coincides with the decline of fossil laurophyllous elements in Europe since the middle Miocene. Ancestral trait and area reconstructions indicate that MLF evolved partly from pre-adapted taxa from the Mediterranean, Macaronesia and the tropics. According to the fossil record laurophyllous taxa existed in Macaronesia since the Plio- and Pleistocene. MLF are composed of species with a heterogeneous origin. The taxa dated to the Pleistocene are likely not 'Tertiary relicts'. Some species may be interpreted as relictual. In this case, the establishment of most species in the Plio-Pleistocene suggests that there was a massive species turnover before this time. Alternatively, MLF were largely newly assembled through global recruitment rather than surviving as relicts of a once more widespread vegetation. This process may have possibly been triggered by the intensification of the trade winds at the end of the Pliocene as indicated by proxy data.
Survey Paper : Pervasive Displays for Information Presentation

Weiser’s seminal vision of ubiquitous computing had calm information presentation at its heart and identified an important challenge in providing pervasive yet unobtrusive information display while avoiding problems of information overload. Since this vision was first articulated, a range of approaches have emerged for presenting information on pervasive displays and digital screens of varying sizes are now an everyday feature of our environments. Such displays provide significant opportunities for presenting information in-situ to support users in a range of activities, and the growing expectation is that there is constant peripheral access to digital information. In this article we review three different pervasive display technologies used for information presentation: traditional 2D display media, urban media façades, and novel display hardware. Our survey identifies five emerging trends that cross all three technologies: an increasing focus on situatedness, a movement towards non-expert users, growing demand for accessible interaction, a potential for new applications of data, and a difficulty in balancing ‘calm’ computing against presentation of data at an appropriate granularity and complexity.
Fast Spectral Velocity Estimation Using Adaptive Techniques: In-Vivo Results

—Adaptive spectral estimation techniques are known to provide good spectral resolution and contrast even when the observation window(OW) is very short. In this paper two adaptive techniques are tested and compared to the averaged periodogram (Welch) for blood velocity estimation. The Blood Power spectral Capon (BPC) method is based on a standard minimum variance technique adapted to account for both averaging over slow-time and depth. The Blood Amplitude and Phase Estimation technique (BAPES) is based on ﬁnding a set of matched ﬁlters (one for each velocity component of interest) and ﬁltering the blood process over slow-time and averaging over depth to ﬁnd the power spectral density estimate. In this paper, the two adaptive methods are explained, and performance is assessed in controlled steady ﬂow experiments and in-vivo measurements. The three methods were tested on a circulating ﬂow rig with a blood mimicking ﬂuid ﬂowing in the tube. The scanning section is submerged in water to allow ultrasound data acquisition. Data was recorded using a BK8804 linear array transducer and the RASMUS ultrasound scanner. The controlled experiments showed that the OW could be signiﬁcantly reduced when applying the adaptive methods without compromising spectral resolution or contrast. The in-vivo data was acquired using a BK8812 transducer. OWs of 128, 64, 32 and 16 slow-time samples were tested. Spectrograms with duration of 2 seconds were generated. Welch’s method required 128 samples to give a reasonable spectrogram, whereas the BPC only required 32 samples before the SNR became a limiting factor. The BAPES managed to display the spectrogram with sufﬁcient quality at 16 slow-time samples.
Play Activities Program to Relieve Chronic Pain and Enhance Functional Mobility and Psychological Well‐Being for Frail Older Adults: A Pilot Cluster Randomized Controlled Trial

sary in women older than 65, 51.0% of respondents reported that it is sometimes or often necessary. Women were significantly more likely than men to indicate that it is essential (78.7% vs 21.3%; P = .005). When asked whether osteoporosis screening is necessary in men older than 65, 51.0% of respondents reported that it is not necessary or rarely necessary. More women reported that it was essential for men older than 65 to be screened for osteoporosis, but this was not statistically significant (81.9% vs 18.2%; P = .13). Women were significantly more likely than men to perceive osteoporosis screening as useful or very useful (73.8% vs 26.2%; P < .001) and likely or extremely likely to accept osteoporosis screening if offered (75.0% vs 25.0%; P < .001). Approximately 40% of respondents perceive prior fracture as a risk factor for osteoporosis, and women were significantly more likely than men to perceive female sex as a risk factor for osteoporosis (69.6% vs 30.4%; P = .006).