Miracle-dz/UniFAR-FTUs huggingface dataset:
Intensity of continuous renal-replacement therapy in critically ill patients.

BACKGROUND The optimal intensity of continuous renal-replacement therapy remains unclear. We conducted a multicenter, randomized trial to compare the effect of this therapy, delivered at two different levels of intensity, on 90-day mortality among critically ill patients with acute kidney injury. METHODS We randomly assigned critically ill adults with acute kidney injury to continuous renal-replacement therapy in the form of postdilution continuous venovenous hemodiafiltration with an effluent flow of either 40 ml per kilogram of body weight per hour (higher intensity) or 25 ml per kilogram per hour (lower intensity). The primary outcome measure was death within 90 days after randomization. RESULTS Of the 1508 enrolled patients, 747 were randomly assigned to higher-intensity therapy, and 761 to lower-intensity therapy with continuous venovenous hemodiafiltration. Data on primary outcomes were available for 1464 patients (97.1%): 721 in the higher-intensity group and 743 in the lower-intensity group. The two study groups had similar baseline characteristics and received the study treatment for an average of 6.3 and 5.9 days, respectively (P=0.35). At 90 days after randomization, 322 deaths had occurred in the higher-intensity group and 332 deaths in the lower-intensity group, for a mortality of 44.7% in each group (odds ratio, 1.00; 95% confidence interval [CI], 0.81 to 1.23; P=0.99). At 90 days, 6.8% of survivors in the higher-intensity group (27 of 399), as compared with 4.4% of survivors in the lower-intensity group (18 of 411), were still receiving renal-replacement therapy (odds ratio, 1.59; 95% CI, 0.86 to 2.92; P=0.14). Hypophosphatemia was more common in the higher-intensity group than in the lower-intensity group (65% vs. 54%, P<0.001). CONCLUSIONS In critically ill patients with acute kidney injury, treatment with higher-intensity continuous renal-replacement therapy did not reduce mortality at 90 days. (ClinicalTrials.gov number, NCT00221013.)
Acculturation and Family Cohesiveness in Mexican American Pregnent Women: Social and Health Implications

This article describes a classification system based on acculturation status and family cohcsivcncss and examines the extent to which these variables may determine the degree of exposure to high acculturative stress, social isolation, and health-related risk behaviors among Mexican American pregnant women. Empirical data from the Arizona Perinatal Acculturation Project was used to test the presence of an acculturation effect, a family cohesiveness effect, and a traditionalism effect, on a series of dependent variables including: socioeconomic status, acculturative stress, coping strategies, social support, and pregnancy risk factors. The results obtained from the postulated contrasts yielded several patterns of interest from the variables studied. A typology derived from the classification system was developed to illustrate common characteristics and demographic patterns within each of the four categories. Characteristics that are associated with these subgroups suggest how the health care system might respond appropriately to meet the health needs of subgroups of Mexican American women
Teacher Preparation: Implementing Theory Into Practice

Teacher preparation programs are mandated to prepare teachers that are ready for the changing landscape of the education profession. New accreditation requirements in preservice assessments and certification requirements for highly qualified teacher status are requiring teacher preparation programs to review their course plans. The purpose of the qualitative study was to examine how the graduates of a traditional teacher preparation program were implementing the PBL project design in their first year of teaching after receiving scaffolded instruction of the educational theory. The researcher explored which factors the graduate perceived allowed them to use PBL in their classroom. Using qualitative interviews, eight participants in their first year of teaching revealed that scaffolded instruction and the support of a mentor teacher provided them the confidence to implement elements of the PBL training in their classroom.
Electrocardiogram changes on myocardial ischemia-reperfusion model in rats

Objectives To explore the electrocardiogram changes of myocardial ischemia and reperfusion in rats.Methods Twenty three male rats were randomly divided into two groups:ischemia-reperfusion injury group(I/R group) and sham group.Surgery of left coronary artery ligation was carried on in I/R group,while only left coronary artery anatomy was performed in sham group.Post ligation for 35 min,reperfusion for 120 min were performed in I/R group.Heart infarct area was examined with tetrazolium chloride(TTC) staining.Changes of P wave,QRS complex,T wave,ST-segment,heart rates and the occurrence of arrhythmia were observed in electrocardiogram of lead Ⅱ. Results Three rats in I/R group died.There was no infarct area in sham group,while I/R group's infarct area was 45.31%±11.55%. Compared with sham group,R waves,P waves,T waves and ST-segment of I/R group rose during the occlusion of the left coronary artery.T waves and ST-segment descended when reperfused for 15 min,which was about 50%. Heart rates of I/R group declined during occlusion and resumed when reperfused.Ventricular arrhythmia appeared in I/R group,which occurred mainly after 5-10 min of the coronary artery occlusion and early reperfusion.Ventricular arrhythmia were mainly premature ventricular contractions,ventricular tachycardia,while occasional ventricular fibrillation and ventricular flutter were extremely seen.Conclusions ST-segment elevates,T wave amplitude increases within 15 min of myocardial ischemia,both of which could be considered as the sign of rat coronary artery ligation exactly.Within 15 min of reperfusion,. ST-segment and T wave drops more than 50% rapidly.Besides,heart rate declines after the ligation of coronary artery.
Experiences of the Lahti Project.

The project to be presented includes five municipalities in the Hordaland County, Western Norway. The participating municipalities were selected by application and have a population varying from about 1,000 to about 14,000 persons. In total the communities comprises approximately 43,000 persons. The National Directorate for the Prevention of Alcohol and Drug Problems is financing the project, and it is co-ordinated by a project leader situated at the Department of Health and Social Welfare, Hordaland County Administration. A team at the Department of Psychosocial Science, University of Bergen, is responsible for the evaluation. The project period is lasting from May 1994 throughout 1996 and the project is mainly based on the tradition of ’community organisation’. The project develops through five more or less overlapping stages (Bracht and Kingsbury 1990): 1. Community analysis, 2. Initiation and design, 3. Implementation, 4. Maintenance and consolidation and 5. Reassessment and dissemination. (Bracht and Kingsbury 1990). The target group is young persons between 16 and 25 years of age. The aim of the project is reducing the prevalence of alcoholand drug related problems and influencing factors contributing to these kind of problems. Furthermore, there is an object to obtain information about feasibility and possibilities of local prevention. After being selected for participation, each community chose a local project co-ordinator. Local boards were then recruited from diverse areas of community life. By September 1995, the local project groups had completed the major part of the initial community analysis (stage 1), ’stage 2' initiation and design, was nearly brought to an end and the implementation phase (stage 3) had started. A progress report will be presented.
Reviews and Self-selection Bias with Operational Implications

Reviews for products and services written by previous consumers have become an influential input to the purchase decision of customers. Many service businesses monitor the reviews closely for feedback as well as detecting service flaws, and they have become part of the performance review for service managers with rewards tied to improvement in the aggregate rating. Many empirical papers have documented a bias in the aggregate ratings, arising because of customers’ inherent self-selection in their choices and bounded rationality in evaluating previous reviews. Although there is a vast empirical literature analyzing reviews, theoretical models that try to isolate and explain the bias in ratings are relatively few. Assuming consumers simply substitute the average rating that they see as a proxy for quality, we give a precise characterization of the self-selection bias on ratings of an assortment of products when consumers confound ex ante innate preferences for a product or service with ex post experience and service quality and do not separate the two. We develop a parsimonious choice model for consumer purchase decisions and show that the mechanism leads to an upward bias, which is more pronounced for niche products. Based on our theoretical characterization, we study the effect on pricing and assortment decisions of the firm when potential customers purchase based on the biased ratings. Our results give insights into how quality, prices, and customer feedback are intricately tied together for service firms. This paper was accepted by David Simchi-Levi, operations management.
Dietary-induced Zinc Deficiency in low Income Countries: Challenges and Solutions The Avanelle Kirksey Lecture at Purdue University

Zinc deficiency has far-reaching consequences on maternal, infant, and child health, resulting in impairments in growth, immune competence, reproductive function, and neurobehavioral development. A major determinant of zinc deficiency in low-income populations is inadequate intakes of dietary zinc, induced by low zinc intakes, and poor bioavailability. Several food-based strategies can be used to enhance zinc intake including those designed to increase the consumption of cellular animal foods (ie, meat, poultry, fish), rich in absorbable zinc; national and targeted zinc fortification programs; and biofortification. Improvements in the bioavailability of zinc can be achieved by reducing the phytate content of unrefined cereals and legumes via soaking, fermentation, or germination at the household level, adding phytase enzyme to zinc fortificants, or producing low-phytate cereal varieties through biofortification involving plant breeding or genetic engineering. Many of these food-based strategies have the potential to improve zinc nutriture in low-income countries, especially in resource-poor households and across generations, with the aim of enhancing growth and pregnancy outcome and reducing child morbidity and mortality. To be effective, such strategies must be integrated with ongoing national agriculture, food, nutrition, and health education programs and implemented using a participatory approach to ensure their acceptability, adoption, and sustainability.
Qualitative Nursing Research: A Contemporary Dialogue

If you really want to be smarter, reading can be one of the lots ways to evoke and realize. Many people who like reading will have more knowledge and experiences. Reading can be a way to gain information from economics, politics, science, fiction, literature, religion, and many others. As one of the part of book categories, qualitative nursing research a contemporary dialogue always becomes the most wanted book. Many people are absolutely searching for this book. It means that many love to read this kind of book.
Leadership under Fire: How Governments Manage Crisis Communication

ABSTRACT Crisis leadership is fundamental to preventing, preparing for, managing, and learning from crises. Despite leadership during crises being heavily reliant on communicative processes, the research record has predominantly reduced crisis communication leadership to managing organizations’ images. To contribute to limited knowledge on leadership communication during crises, we interviewed 24 U.S. government leaders and conducted a content analysis of U.S. government communication leadership during a major wildfire. We find that crisis communication leadership involves crisis perceptiveness, humility, flexibility, presence, and cooperation. We offer a message catalog of crisis response options for government leaders and show how leaders employed some of these messages in response to a large-scale wildfire. This study expands the state of the art in crisis communication leadership research with implications for theory and practice.
Original paper Percutaneous mitral commissurotomy in pregnant women – long-term observations

Background: Percutaneous mitral commissurotomy (PMC) can be safely performed during pregnancy. However, there is still little known about follow-up results after PMC in populations of pregnant women taking into consideration childhood development. Aim: To evaluate long-term clinical follow-up and echocardiographic data on pregnant patients who underwent PMC in our centre and development of their infants. Material and methods: From January 1989 to December 1998, 15 pregnant women with mitral stenosis and severe congestive heart failure (mean gestational duration, 31.5 ±2.7 week) underwent PMC. The procedure was successful in all patients, resulting in a significant increase (0.85 ±0.3 cm2) in mitral valve area from 1.01 ±0.24 cm2 to 2.01 ±0.33 cm2 (p < 0.001) and New York Heart Association (NYHA) improvement to class I or II (13 and 2 patients respectively). Results: There was no maternal death, no abortion, no intrauterine growth restriction, and no stillbirth. One baby (6.6%) had cerebral palsy at birth. Long term follow-up of 17 years and 9 months was completed for 12 patients. Two patients (13%) underwent re-PMC, and one (6.6%) surgical mitral valve replacement 15, 17 and 19 years after the first procedure, respectively. All babies maintained normal growth and development without any clinical abnormalities, thyroid disease or malignancy. Conclusion: PMC is a safe and effective procedure, with favourable long-term results in the population of pregnant women with rheumatic mitral stenosis and severe congestive heart failure.
Megadose Methylprednisolone (MDMP) for the Treatment of Steroid Refractory Patient with Diamond-Blackfan (D-B) Anemia

I would like to reemphasize that MDMP is different than pulse methylprednisolone and conventional corticosteroid administration as was used for D-B anemia [5,6] long period as advised. In conventional corticosteroid treatment 1-2 mg/kg/day dose in gven 6-8 or 12 hours intervals. In pulse methyprednisolone treatment 1 g methlyprednisolone (MP) is giving i.v within 4 hours, at any time of the day. In MDMP treatment, methylprednisolone MP initial dose 30-100 mg/kg day is given within 10 to 15 minutes IV or at once orally arouned 6 am, 3 days then 20-50 mg/ kg, day for 4 days subsquently 10,5,2,1 mg/kg dose given for 1 week each according to response).
BEHAVIORAL MEDICINE FOR CHRONIC HEADACHE: OVERVIEW AND PRACTICAL TOOLS FOR THE PRACTICING PHYSICIAN

There are multiple reasons to justify the inclusion of behavioral medicine in headache management. Research identifies stress as a prevalent headache trigger or aggravator. The use of direct questions, headache diaries, and behavioral analysis can help identify relevant stressors. Stress management therapies consistently yield from 35% to 55% headache improvement over baseline and, when combined with appropriate medication, provide a synergistic effect. Smoking cessation and aerobic exercise can help. Use of compliance-enhancement techniques can improve adherence to both medical and behavioral treatment recommendations and may improve clinical outcomes. Behavioral factors play an important role in complex cases of medication-overuse headache. The addition of behavioral therapy (eg, biofeedback and nonpharmacological coping skills) can help reduce the high rates of relapse after drug withdrawal. Attention to psychiatric comorbidity, using focused empathic interview techniques, brief psychometric screens (eg, Beck Depression Inventory II), and patient checklists (Primary Care Evaluation of Mental Disorders [PRIME-MD]) can help the physician employ treatments that address both headache and relevant psychiatric conditions, increase patient satisfaction, and improve outcomes. Personality disorders are often comorbid with severe chronic daily headache conditions and complicate treatment. Appropriate therapeutic responses to behavioral red flags (the "hug" sign, entitlement expectations, pseudocoping, covert narcotic requests, "sincere" but disingenuous behavior, inappropriate underlying anger, problematic family issues) can keep headache treatment on a productive path. Simple communication guidelines can help reduce dysfunctional pain-related family behavior. Behavioral medicine referrals for biofeedback and stress management therapy can be useful in straightforward cases and should be a requirement for challenging patients and severe forms of chronic daily headache.
University of the State of New York

An analysis of the results of the licensing examinations since September 1, 1891, shows : That 8.9 per cent, of the old school2 candidates were rejected in 1892, 7.4 per cent in 1893 and 20.2 per cent, in 1894 ; that 25 per cent, of the homeopathic candidates were rejected in 1892, 9.5 per cent, in 1893, and 13.7 per cent, in 1894 ; that 50 per cent, of the eclectic candidates were rejected in 1892, 28.5 per cent, in 1893 and 50 per cent, in 1894.
T-Helper Cell Cytokine Expression Profiling in Rheumatoid Arthritis Patients by Flow Cytometric Bead Array Analysis

Background: Rheumatoid arthritis (RA) is the most common chronic autoimmune disease affecting multiple joints. A chronic imbalance in cytokine production by T-helper (Th) cells is likely a key factor in RA development. Our objective was to profile the serum cytokine expression from three key Th cell types (Th1, Th2, and Th17) in RA patients in order to correlate the resulting cytokine expression profiles with RA activity. Material and Methods: From a population of RA patients (n = 71) and healthy controls (n = 18), the serum concentra- tions of seven cytokines (IL-2, IL-4, IL-6, IL-10, IL-17A, IFN-γ, and TNF-α) were analyzed by flow cytometric bead array (CBA). Results: The serum concentrations of all seven cytokines were significantly higher in RA patients than in healthy controls. Interestingly, the serum concentration profiles varied with the 28-joint Disease Activity Score (DAS28), a measure of RA activity derived from joint indices (tender joints and swollen joints count) and the erythrocyte sedimentation rate. In the high RA activity group (DAS28 > 5.1), all seven cytokines were significantly elevated. In the moderate RA activity group (DAS28 between 3.2 and 5.1), only IL-2, IL-6, IL-10, and IL-17A were significantly increased. In the low RA activity group (DAS28 ≤ 3.2), only IL-2, IL-4, and TNF-α were significantly elevated. Conclusions: The Th cell-derived cytokine expression profile significantly changes across varying levels of RA activity. Th1/Th17 cell-derived TNF-α and Th2 cell-derived IL-4 appear to play more important roles in the early stages of RA, while all seven cytokines derived from Th1, Th2, and Th17 cells (IL-2, IL-4, IL-6, IL-10, IL-17A, IFN-γ, and TNF-α) are overtly involved in the advanced stages of RA.
ACL Reconstruction in Children: An Original Technique

Early reconstruction after anterior cruciate ligament (ACL) rupture in children with open physis was found to be a better strategy compared with delayed ACL reconstruction at skeletal maturity. This article focuses on an original technique for ACL reconstruction in children and adolescents. The rationale of the procedure is based on avoiding the danger of a femoral tunnel and fixation systems that may lead to growth arrest. Part of the quadriceps tendon with a trapezoidal patella bone block was harvested after arthroscopic exploration and addressing other intra-articular injuries like meniscal tears. The bone-tendon graft was inserted through a combined intraepiphyseal femoral tunnel drilled from outside-in under fluoroscopic imaging and a long vertical arthroscopically drilled transphyseal tibial tunnel. The bone block was impacted in the femoral tunnel, allowing primary fixation without any associated material. The tibial fixation is obtained with a strictly metaphyseal screw and postfixation with a staple. The advantages of the technique are multiple: anatomic and isometric reconstruction, arthroscopically surgery, strong adaptable long graft with excellent bone to bone press-fit fixation on the femur, and preservation of the femoral physis. Indications, the step-by-step procedure, postoperative care, complications, and results are reported in this paper.
Development of an Interactive Game for Education Regarding Sexually Transmitted Infections

Development of an Interactive Game for Education Regarding Sexually Transmitted Infections by Sherri Arrington Project Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice Walden University May 2019 Abstract Sexually transmitted infection (STI) prevalence rates are increasing in the United StatesSexually transmitted infection (STI) prevalence rates are increasing in the United States and globally. Education has been found to be an important strategy for increasing STI testing and treatment rates among sexually active young adults. The goal of this project was to develop an interactive educational game suitable for young adults to decrease the social and economic burden of STIs. The health belief model informed the project. A moderated usability evaluation was conducted using the concurrent think-aloud technique. The participants (N = 5) were a purposive sample of professionals who played the interactive game and then completed Schnall, Cho, and Lie’s Health-Information Technology Usability Evaluation Scale instrument. The findings revealed the necessity of (a) an introduction screen, (b) a reward system for correct answers, and (c) avatars, while also highlighting that (d) the effect on indicator value bars is difficult to understand and (e) the timer led to a feeling of being rushed. The Cronbach’s alpha for the participant group was 0.798, the subscale “Perceived Ease of Use” achieved an alpha level of 0.815, and the subscale “Perceived Usefulness,” 0.762. Refinements to the game based on these data might help to ensure that use of the interactive game contributes to social change by increasing knowledge of STIs in the young adult population. Development of an Interactive Game for Education Regarding Sexually Transmitted Infections