Miracle-dz/UniFAR-FTUs huggingface dataset:
Evaluation of the Mobile Acute Care of the Elderly (MACE) service.

IMPORTANCE Older adults are particularly vulnerable to adverse events during hospitalization for acute medical problems. The Mobile Acute Care of the Elderly (MACE) service is a novel model of care delivered by an interdisciplinary team, designed to deliver specialized care to hospitalized older adults to improve patient outcomes. OBJECTIVE To evaluate the impact of the MACE service when compared with general medical service (usual care). DESIGN Prospective, matched cohort study. SETTING The Mount Sinai Hospital, an urban tertiary acute care hospital. PARTICIPANTS Patients aged 75 years or older admitted because of an acute illness to either the MACE service or usual care. Patients were matched for age, diagnosis, and ability to ambulate independently. EXPOSURES Admission to the MACE service when compared with admission to usual care. MAIN OUTCOME MEASURES Patient outcomes included incidence of adverse events, including falls, pressure ulcers, restraint use, and catheter-associated urinary tract infections, along with length of stay, rehospitalization within 30 days, functional status at 30 days, and patient satisfaction during care transitions, measured with the 3-item Care Transition Measure. RESULTS A total of 173 matched pairs of patients were recruited. The mean (SD) age was 85.2 (5.3) and 84.7 (5.4) years in the MACE and usual-care groups, respectively. After adjustment for confounders, patients in the MACE group were less likely to experience adverse events (9.5% vs 17.0%; adjusted odds ratio, 0.11; 95% CI, 0.01-0.88; P = .04) and had shorter hospital stays (0.8 days, 95% CI, 0.7-0.9; P = .001) than patients receiving usual care. Patients in the MACE group were not less likely to have a lower rate of rehospitalization within 30 days than those in the usual-care group (odds ratio, 0.91; 95% CI, 0.39-2.10; P = .83). Functional status did not differ between the 2 groups. Care Transition Measure scores were 7.4 points (95% CI, 2.9-11.9; P = .001) higher in the MACE group. CONCLUSIONS AND RELEVANCE Admission to the MACE service was associated with lower rates of adverse events, shorter hospital stays, and better satisfaction. This model has the potential to improve care outcomes among hospitalized older adults. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00927160.
Posterior atrophic jaws rehabilitated with prostheses supported by 6 mm-long, 4 mm-wide implants or by longer implants in augmented bone. Preliminary results from a pilot randomised controlled trial.

PURPOSE To evaluate whether 6 mm-long by 4 mm-wide dental implants could be an alternative to at least 10 mm-long implants placed in bone augmented with bone substitutes in posterior atrophic jaws. MATERIALS AND METHODS Twenty patients with bilateral atrophic mandibles and 20 patients with bilateral atrophic maxillae, having 5 to 7 mm of bone height above the mandibular canal or below the maxillary sinus, were randomised according to a split-mouth design to receive one to three 6 mm-long and 4 mm-wide implants or at least 10-mm long implants in augmented bone at two centres. Mandibles were vertically augmented with interpositional equine bone blocks and resorbable barriers, and implants were placed after 3 months. Maxillary sinuses were augmented with particulated porcine bone via a lateral window and implants were placed simultaneously. All implants were submerged and loaded, after 4 months, with provisional prostheses. Four months later, definitive screw-retained metal-ceramic prostheses were delivered. Outcome measures were prosthesis and implant failures, any complication, time needed to fully recover mental nerve function (only for mandibular implants) and patient preference. RESULTS All screened patients had sufficient bone width to support 4 mm-diameter implants. Patients were followed up to 5 months post-loading and none dropped out. There were no statistically significant differences in graft, implant or prosthesis failures, though significantly more intra- and postoperative complications occurred at grafted sites. Fourteen complications occurred in 12 patients at augmented sites versus none at short implants. All complications occurred before loading. Three complications were associated with the failure of the mandibular grafts (15%), determining the failures of 3 implants in one patient and 2 prostheses could not be delivered. One patient was re-grafted and 2 patients received short implants instead. Apart from those complications associated with graft failures, there were 4 perforations of the sinus membrane during sinus lifting and 7 temporary lower lip paraesthesiae lasting up to 4 days with no long-term consequences for the patients. All maxillary implants and prostheses were successful. All 20 patients treated with mandibular implants and 15 patients treated with maxillary implants preferred short implants, whereas 5 patients treated with maxillary implants described both procedures as equally acceptable. These differences were statistically significant. CONCLUSIONS Short-term data (5 months after loading) indicate that 6 mm-long implants with a conventional diameter of 4 mm achieved similar if not better results than longer implants placed in augmented bone. Short implants might be a preferable choice to bone augmentation, especially in posterior mandibles since the treatment is faster, cheaper and associated with less morbidity. However, 5- to 10-year post-loading data are necessary before making reliable recommendations.
Up-regulation of Acetyl-CoA Carboxylase α and Fatty Acid Synthase by Human Epidermal Growth Factor Receptor 2 at the Translational Level in Breast Cancer Cells*

Expression of the HER2 oncogene is increased in ∼30% of human breast carcinomas and is closely correlated with the expression of fatty acid synthase (FASN). In the present study, we determined the mechanism by which FASN and acetyl-CoA carboxylase α (ACCα) could be induced by HER2 overexpression. SK-BR-3 and BT-474 cells, breast cancer cells that overexpress HER2, expressed higher levels of FASN and ACCα compared with MCF-7 and MDA-MB-231 breast cancer cells in which HER2 expression is low. The induction of FASN and ACCα in BT474 cells were not mediated by the activation of SREBP-1. Exogenous HER2 expression in MDA-MB-231 cells induced the expression of FASN and ACCα, and the HER2-mediated increase in ACCα and FASN was inhibited by both LY294002, a phosphatidylinositol 3-kinase inhibitor, and rapamycin, a mammalian target of rapamycin (mTOR) inhibitor. In addition, the activation of mTOR by the overexpression of RHEB in MDA-MB-231 cells increased the synthetic rates of both FASN and ACCα. On the other hand, FASN and ACCα were reduced in BT-474 cells by a blockade of the mTOR signaling pathway. These changes observed in their protein levels were not accompanied by changes in their mRNA levels. The 5′- and 3′-untranslated regions of both FASN and ACCα mRNAs were involved in selective translational induction that was mediated by mTOR signal transduction. These results strongly suggest that the major mechanism of HER2-mediated induction of FASN and ACCα in the breast cancer cells used in this study is translational regulation primarily through the mTOR signaling pathway.
Characterization of the promotion of altered hepatic foci by 2,3,7,8-tetrachlorodibenzo-p-dioxin in the female rat.

Previous studies have suggested that 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) acts as a promoting agent in various organ systems including the rat liver. Since a major characteristic of the stage of tumor promotion is its operational reversibility, we have assessed whether TCDD-induced promotion is reversible in a two-stage model of hepatocarcinogenesis. In this model, female Fischer F344 rats were administered a single, intragastric dose of the initiating agent, diethylnitrosamine (DEN, 10 mg/kg), at the peak of proliferation induced by a partial hepatectomy. TCDD was then administered biweekly (0.14 micrograms/kg, s.c.) for 1, 3 or 5 months. One group of animals was killed at each of these time points, while a second group was maintained for each time point for an additional 6 months in the absence of further TCDD. Four serial frozen sections of liver were each stained with a different enzyme marker of altered hepatic foci (AHF). The AHF were identified and the number and volume fraction determined by quantitative stereology. Exposure to TCDD resulted in an increase in the number and size of AHF in the initiated relative to the uninitiated rats. Increasing the duration of promotion with TCDD led to an increase in the number of AHF per liver, the volume fraction of the liver occupied by AHF and the number of markers expressed aberrantly by a single AHF. Discontinuation of TCDD administration for 6 months before killing the animals resulted in a decrease in the total number of AHF observed, but those AHF that remained increased in size with an overall increase in volume fraction of AHF. Analysis of the size class distribution for AHF for each of the periods of TCDD promotion revealed an increase in the larger AHF but a decrease in the smaller, thereby resulting in an overall decrease in number of AHF with an increase in the volume fraction of AHF. Increasing the duration of the TCDD exposure prior to its withdrawal led to an increased AHF size, phenotypic complexity and number of AHF remaining after cessation of TCDD administration. Although the levels of TCDD in livers of rats 6 months after cessation of TCDD administration were still greater than background, they were markedly reduced compared to immediately after administration. Thus, cessation of exposure to TCDD after a brief duration led to a reversal of its promotional effects on the majority of AHF, while prolonged exposure led to maintained promotion of a minority of AHF.
The relationship of role-related variables to job satisfaction and commitment to the organization in a restructured hospital environment.

BACKGROUND AND PURPOSE Many factors in today's hospitals can influence how physical therapists view their work experience. Changing roles, with the accompanying stress, and professionalism may contribute to a therapist's perception of his or her job and the organization in which he or she works. In this study, the relationship between changes in physical therapist role behaviors following hospital restructuring and 2 work-related outcomes--job satisfaction and commitment to the organization--was studied. The influence of stress and occupational commitment on these outcomes also was examined. SUBJECTS AND METHODS Through a survey of 273 hospital-based physical therapists, changes in physical therapist role behaviors, levels of stress, occupational commitment, job satisfaction, and commitment to the organization following restructuring were identified and examined. RESULTS Six role behavior dimensions reflecting professional and organizational responsibilities were identified from the data. After controlling for sample demographics, the professional role behaviors, specifically those reflecting interaction and integration with other practitioners, appeared to exert a small, but positive, influence on job satisfaction and commitment to the organization. In addition, occupational commitment had a positive influence, whereas stress had a negative influence on job satisfaction and commitment to the organization. DISCUSSION AND CONCLUSION Multiple aspects of a clinician's role could influence job satisfaction and commitment to the organization following hospital restructuring. The most influential factor was stress, which often accompanies organizational change. However, the positive influence of occupational commitment and the role behaviors that involve increased interaction with other people reflect professional role characteristics described in the Guide to Physical Therapist Practice were noted.
Age and noise-induced hearing loss

The purpose of the study was to evaluate the effect of noise, age and confounders in noise-induced hearing loss (NIHL). Information about work exposure, the use of hearing protective devices, audiogram, environmental and biological factors was collected from 406 paper mill workers exposed to noise levels of 91-94 dB(A), 124 forest workers exposed to noise levels of 96-99 dB(A) and 176 shipyard workers exposed to noise levels 95-97 dB(A). In addition to noise exposure, we collected the following confounders: smoking habits, serum cholesterol, systolic or diastolic blood pressure and use of analgesics. Subjects were classified based on median values, into high- and low-risk groups. The confounders were a significant source of hearing loss (HL) in younger and elderly groups of subjects, serum cholesterol level being the most important. In risk analysis the confounders partly masked the effects of noise in the development of HL. For subjects with less than two confounders, occupational noise exposure determined the development of NIHL. As the number of confounders increased, the noise exposure was overruled by these factors in the development of HL. In analysis where the subjects were matched with pairs by age, exposure, blood pressure and serum cholesterol level, the elderly subjects were more susceptible to NIHL than younger subjects. Factors independently but causally related to age were important in the development of NIHL among workers exposed to noise levels below 98 dB(A).
Characteristics of Postural Tremor in Normal and in Various Abnormal States

POSTURAL OR STATIC TREMOR is the involuntary, rhythmic movement of a limb when that limb has assumed a particular posture. It is commonly tested for by having the individual hold his hands and arms extended at a 90-degree angle from the trunk. The presence of this tremor in otherwise normal persons was described at least as early as 1876l when Beaunis commented on the 10.5 per second rhythm of muscular contractions. However, it was Eshner in 18962 who definitely established the fact that postural tremor was a normal phenomenon; it was he who coined the term “tremograph. ” In spite of this early demonstration of postural tremor in normals, no mention of this normal phenomenon is made in most modern text books, the usual classifications of tremor, or the majority of scientific papers on tremor, and the reader is more often than not left with the impression that tremor in itself is an abnormal sign.
Palliative care and support for people with neurodegenerative conditions and their carers.

AIM to identify and compare the needs for supportive care/palliative care services of people in Australia with Motor Neurone Disease (MND), Multiple Sclerosis (MS), Huntington's Disease (HD) and Parkinson's Disease (PD) and the needs of their carers. DESIGN national, descriptive survey of service use and support needs for 503 patients and 373 carers. Patients and carers were recruited from the databases of the disease associations in three Australian states. Patients were excluded if recently diagnosed or too sick or disabled to complete the survey. This was a specification of the ethics committee overseeing this project. FINDINGS the MND and HD groups had the greatest needs for support and appeared most receptive to a palliative approach. The MS group was least likely to have a carer and more likely to live alone. HD and PD groups had the highest rates of anxiety and HD groups had the highest rate of depression. CONCLUSIONS patients and carers who received more tailored services and more palliative care services were the most satisfied. Therefore, results highlight the need for tailored and flexible models of care for these groups with unique care requirements.
Protection against acetaminophen toxicity in CYP1A2 and CYP2E1 double-null mice.

Acetaminophen (APAP) hepatotoxicity is due to its biotransformation to a reactive metabolite, N-acetyl-p-benzoquinone imine (NAPQI), that is capable of binding to cellular macromolecules. At least two forms of cytochrome P450, CYP2E1 and CYP1A2, have been implicated in this reaction in mice. To test the combined roles of CYP1A2 and CYP2E1 in an intact animal model, a double-null mouse line lacking functional expression of CYP1A2 and CYP2E1 was produced by cross-breeding Cyp1a2-/- mice with Cyp2e1-/- mice. Animals deficient in the expression of both P450s developed normally and exhibited no obvious phenotypic abnormalities. Comparison of the dose-response to APAP (200-1200 mg/kg) indicated that double-null animals were highly resistant to APAP-induced toxicity whereas the wild-type animals were sensitive. Administration of 600 to 800 mg/kg of this drug to male wild-type animals resulted in increased plasma concentrations of liver enzymes (alanine aminotransferase, sorbitol dehydrogenase), lipidosis, hepatic necrosis, and renal tubular necrosis. In contrast, when APAP of equivalent or higher dose was administered to the double-null mice, plasma levels of liver enzymes and liver histopathology were normal. However, administration of 1200 mg of APAP/kg to the double-null mice resulted in infrequent liver lipidosis and mild kidney lesions. Consistent with the protection from hepatotoxicity, the expected depletion of hepatic glutathione (GSH) content was significantly retarded and APAP covalent binding to hepatic cytosolic proteins was not detectable in the double-null mice. Likewise, in vitro activation of APAP by liver microsomes from the double-null mice was approximately one tenth of that in microsomes from wild-type mice. Thus, the protection against APAP toxicity afforded by deletion of both CYP2E1 and CYP1A2 likely reflects greatly diminished production of the toxic electrophile, NAPQI.
Study of Perpendicular AME Media in a Linear Tape Drive

The magnetic recording performance of perpendicularly oriented advanced metal evaporated (AME) media is studied in a linear tape drive. A modified evaporation process produces the perpendicular orientation, which substantially reduces the writing asymmetry of obliquely oriented AME media in a linear recording environment. While the read back signal exhibits characteristics of perpendicular media, the timing-based servo signal in the drive enables track-following performance with a 1 sigma position error signal (PES) of 0.2 mum . The read channel correctable error rate at the LTO Gen 4 operating point is 10-6 in both the forward and backward directions and the durability of the tape exceeds 100 000 passes without signal degradation.
Exhaled tidal volume overestimation in mechanically ventilated patients with large cardiogenic oscillation

Objectives:In postcardiac surgery patients, we often noticed that monitored tidal volumes exceeded the ventilator settings. We investigated whether cardiogenic oscillation causes overestimation of tidal volume. Design:Prospective, observational, clinical study. Setting:Surgical intensive care unit in a national heart institute. Patients:Eight postcardiac surgery patients (age 13–70). Interventions:Patients were paralyzed and received flow-triggered volume-controlled ventilation with a tidal volume of 10 mL/kg. In random order, two types of ventilator (Bird 8400 STi and Servo-300) and two respiratory rates (5 and 10 breaths/min) were applied to each patient via a disposal ventilatory circuit and heat-and-moisture exchanger. For each ventilator, we adjusted the flow-triggering sensitivity to prevent autotriggering due to cardiogenic oscillation: 10 L/min for the Bird 8400 STi and green zone for the Servo-300. Measurements and Main Results:The magnitude of cardiogenic oscillation during mechanical ventilation was defined as peak expiratory flow fluctuation at end-expiration. We recorded tidal volume using the monitoring devices on the ventilators and calculated the discrepancy from the set tidal volume.Cardiogenic oscillation was significantly greater with the Bird 8400STi (4.0 ± 1.8 L/min) than with the Servo-300 (1.7 ± 0.8 L/min). With the Bird 8400 STi, the discrepancy between monitored tidal volume and set tidal volume ranged from 15 to 260 mL when the respiratory rate was 5 breaths/min and from −9 to 75 mL at 10 breaths/min; there was a linear correlation between the overestimation of tidal volume and the magnitude of cardiogenic oscillation. In contrast, with the Servo-300, the discrepancy was relatively small (−36 to 14 mL). Conclusions:In mechanically ventilated patients with large cardiogenic oscillation, exhaled tidal volume is overestimated on at least one model of ventilator.
Outcome of "unknown" head injury patients at a tertiary care neurosurgical centre.

CONTEXT A large number of patients are admitted to hospitals in large cities without any identification. These "unknown" patients represent a unique problem in developing countries. There is no systematic study in world literature on this subgroup of patients. AIMS To elucidate the natural history and outcome of traumatic brain injury patients admitted in the department of neurosurgery as "unknowns". SETTINGS AND DESIGN Retrospective analysis of all traumatic brain injury patients admitted to the department of neurosurgery as "unknown", between January 2002 and March 2005. RESULTS Three hundred and twenty five patients were admitted as unknowns over a 3 year and 3 months period. Most of the patients were young males and became known during their hospital stay. Overall, 33 patients stayed for longer than one month, with 4 of them staying for longer than 6 months. Mortality in mild, moderate and severe head injury group was 1%, 6% and 46% respectively. CONCLUSIONS Unknown patients represent a unique subgroup in metropolitan cities like Delhi. Managing them raises several medico-legal issues. Many of them occupy hospital beds for longer duration than required. There is an acute shortage of rehabilitation homes in Delhi for long term care and rehabilitation of such patients.