Miracle-dz/UniFAR-FTUs huggingface dataset:
The Retail Revolution in Health Care

This book unveils and demystifies a revolution occurring in health care in the United States and beyond and how it will reform the health care system. There is something new in health care. Retail clinics, sometimes partnering with prestigious health-care institutions such as the Cleveland Clinic, offer an affordable, accessible solution for delivering primary-care services to underserved populations. The Retail Revolution in Health Care presents an overview of the retail health trend and its implications for consumers, employers, health care providers, health care companies, insurers, and health policy makers. The authors examine the phenomenon of retail health care from an entrepreneurial perspective, discussing the growth of retail care beyond traditional retail establishments and possible performance indicators to assess health outcomes. They report on the differing perspectives of retail care from a variety of experts, including doctors, nurses, patients, and insurers. Finally, they address business realities in the United States and globally as they affect the clinics. Retail clinics will almost certainly play a key role as either an alternative to national health insurance or a component of health reform. This important book explores their part in furthering the availability of health care for all Americans.
La evaluacion de impacto en la practica

Impact evaluation figures among a broad range of complementary methods that support evidence-based policy. Although this book focuses on quantitative impact evaluation methods, it begins by placing them in the broader results context, which also includes monitoring and other types of evaluation. Part 1 seeks to establish and quantify how an intervention affects the outcomes that are of interest to analysts and policy makers. Part 2 of this book explains what impact evaluations do, what questions they answer, what methods are available for conducting them, and the advantages and disadvantages of each. Part 3 focuses on the operational steps in managing or commissioning an impact evaluation. These steps constitute the building blocks of an impact evaluation that will answer the policy questions that have been formulated and estimate the causal impact of the program. Impact evaluations are a worthwhile investment for many programs and that, coupled with monitoring and other forms of evaluation, they allow for a clear understanding of the eff ectiveness of particular social policies.
Approches statistiques et filtrage vectoriel de trajectoires spectrales pour l'identification du locuteur independante du texte

L'identification du locuteur consiste a attribuer une identite au locuteur d'un enonce. Cette identite sera celle du locuteur d'une base de reference qui est le plus proche de ce locuteur inconnu, au sens d'une mesure de similarite donnee. Le mode independant du texte signifie qu'il n'y a aucune contrainte sur le contenu des phrases prononcees. Au cours de cette these, nous developpons un ensemble de mesures de similarite reposant sur une modelisation statistique gaussienne de vecteurs de parametres obtenus a l'issue d'une analyse spectrale. Ces mesures reposent essentiellement sur les matrices de covariance de ces vecteurs de parametres. Une symetrisation de ces mesures est egalement proposee. Toutes ces mesures, sous leurs differentes formes, sont systematiquement testees sur les bases timit et ntimit. Une fois ces mesures de reference etablies, nous tentons de prendre en compte les aspects dynamiques des sequences de vecteurs de parametres. Ceci nous conduit a etudier les modeles auto-regressifs vectoriels dans le cadre de l'identification du locuteur. Nous testons systematiquement differentes facons de combiner les erreurs residuelles de prediction obtenues a l'aide de ces modeles, et comparons les resultats aux mesures de reference precedentes. Nous mettons en uvre egalement un protocole experimental qui permet de mesurer l'efficacite des modeles ar-vectoriels en identification du locuteur apres avoir detruit la structure temporelle des vecteurs de parametres. Nous etablissons alors un formalisme beaucoup plus general pour le filtrage des sequences de vecteurs de parametres, que nous appelons filtrage vectoriel de trajectoires spectrales. Ce formalisme englobe un grand nombre d'approches classiques en traitement de la parole, parmi lesquelles on trouve les modeles ar-vectoriels, l'analyse cepstrale, les parametres et , la parametrisation rasta, la transformee en cosinus de trajectoires spectrales, l'avantage de ce type de filtrage est qu'il opere simultanement dans les dimensions temporelle et frequentielle. Nous presentons finalement un autre filtrage particulier, qui entre dans le cadre du formalisme precedent. Ce filtrage repose sur une analyse en composantes principales temps-frequence de parole multi-locuteur. En conclusion, il apparait que le filtrage vectoriel de trajectoires spectrales est tres prometteur, puisqu'il permet de prendre en compte une evolution temporelle des vecteurs de parametres, tout en filtrant ces memes vecteurs dans la dimension frequentielle. Il permet aussi d'unifier de nombreuses approches differentes. En outre, ce travail suggere de nouvelles approches au niveau de la representation du signal de parole, et plus particulierement dans le cadre de la reconnaissance de la parole et du locuteur. Ce type de filtrage peut enfin s'appliquer a d'autres familles de signaux.
The MEK1/2 Pathway as a Therapeutic Target in High-Grade Serous Ovarian Carcinoma

Rationale High-grade serous ovarian carcinoma (HGSOC) is the deadliest of gynecological cancers due to high rate of recurrence and acquired chemoresistance. Mutation and activation of the RAS/MAPK pathway has been linked to cancer cell proliferation and therapeutic resistance in numerous cancers. While RAS mutations are not commonly observed in HGSOC, less is known about downstream pathway activation. We therefore sought to investigate the role of MEK1/2 signaling in ovarian cancer. Methods MEK1/2 pathway activity was evaluated in clinical HGSOC tissue samples and ovarian cancer cell lines by using tissue microarray-based immunohistochemistry, immunoblotting, and RT-qPCR. OVCAR8 and PEO4 HGSOC cell lines were used to assess the effect of MEK1/2 inhibition on cell viability, proliferation rate, and stem-like characteristics. Xenografts were used in mice to investigate the effect of MEK1/2 inhibition on tumor growth in vivo. A drug washout experimental model was used to study the lasting effects of MEK1/2 inhibition therapy. Results MEK1/2 signaling is active in a majority of HGSOC tissue samples and cell lines. MEK1/2 is further stimulated by cisplatin treatment, suggesting that MEK1/2 activation may play a role in chemotherapy resistance. The MEK1/2 inhibitor, trametinib, drastically inhibits MEK1/2 downstream signaling activity, causes prominent cell cycle arrest in the G1/0-phase in cell cultures, and reduces the rate of tumor growth in vivo, but does not induce cell death. Cells treated with trametinib display a high CD133+ fraction and increased expression of stemness-associated genes. Transient trametinib treatment causes long-term increases in a high ALDH1 activity subpopulation of cells that possess the capability of surviving and growing in non-adherent conditions. Conclusions MEK1/2 inhibition in HGSOC cells efficiently inhibits proliferation and tumor growth and therefore may be a promising approach to suppress ovarian cancer cell growth. MEK1/2 inhibition promotes stem-like properties, thus suggesting a possible mechanism of resistance and that a combination with CSC-targeting drugs should be considered.
Species associations and trait dissimilarity in communities of ectoparasitic arthropods harboured by small mammals at three hierarchical scales

1. This study tested the relationships between the probability of pairwise species co‐occurrence and pairwise dissimilarity in their traits in infracommunities (across assemblages harboured by conspecific individual hosts within a locality), component communities (across assemblages harboured by host species within a locality), and compound communities (across assemblages in different localities) of fleas and gamasid mites parasitic on small mammals in Western Siberia.
Informing sea turtle outreach efforts to maximize effectiveness

Most sea turtle (Cheloniidae) species worldwide are endangered or threatened, with threats causing harm to sea turtles predominantly human‐induced. Thus, prevention of further declines to these imperiled species will require alteration of human behaviors. Regulations, incentives, and environmental education are 3 strategies that could be used to alter human behavior. Our goal was to determine how to maximize effectiveness of one of these strategies—education efforts. We investigated knowledge deficiencies and light pollution behaviors of individuals living in a region with nesting sea turtles, in an effort to determine the best approach to promote sea turtle conservation. During 2014, we mailed a survey to 3,000 property owners in 4 coastal counties in Florida, USA, to achieve 3 objectives: assess what topic areas were misunderstood; discern who had knowledge deficiencies; and determine who had adopted turtle‐friendly lighting practices. The best predictors of knowledge included geographic factors (county, proximity of residences to the beach), demographic characteristics (age), and behaviors (individual’s beach visitation rates). One practice that can reduce harm to sea turtles was common: use of window treatments to reduce light pollution. However, other practices harmful to sea turtles were prevalent, including long durations of use of outdoor lighting and use of light bulbs with wavelengths that can disturb sea turtles. Our results suggest that educational efforts could be enhanced by specifically focusing on increasing awareness of the effects of human actions on sea turtles, targeting individuals who visit the beach infrequently and live far from it to foster greater connection with these ecosystems, and publicizing a variety of options that could reduce harm to sea turtles so individuals feel a sense of freedom of choice. © 2019 The Wildlife Society.
ROLE OF MACROPHAGE MIGRATION INHIBITORY FACTOR (MIF) AND MIF PROMOTER POLYMORPHISMS IN THE PATHOGENESIS OF SEVERE MALARIAL ANEMIA

Severe malarial anemia (SMA), caused by infections with Plasmodium falciparum, is one of the leading causes of childhood mortality in sub-Saharan Africa. Although the molecular determinants of SMA are largely undefined, dysregulation in host-derived inflammatory mediators influences disease severity. Macrophage migration inhibitory factor (MIF) is an important regulator of innate inflammatory responses that has recently been shown to suppress erythropoiesis and promote pathogenesis of SMA in murine models. The role of MIF in childhood malarial pathogenesis was investigated by examining peripheral blood MIF production in children residing in a hyperendemic area of Gabon, and a holoendemic region of western Kenya. The relationship between MIF concentrations and monocytic acquisition of hemozoin, and the effects of MIF on erythropoiesis in vivo and in vitro were investigated. In addition, the influence of genetic variation at MIF -173 (G/C) and -794 (CATT5-8) on MIF production and susceptibility to SMA and high-density parasitemia (HDP) was examined. Circulating MIF concentrations and peripheral blood mononuclear cells (PBMC) MIF production progressively declined with increasing anemia severity and increasing levels of hemozoin-containing monocytes. However, circulating MIF concentrations were not significantly associated with reticulocyte production in children with acute malaria. Additional experiments in malaria-naive individuals demonstrated that hemozoin caused both increased and decreased MIF production in cultured PBMC based on genetic differences. In addiiton, a novel in vitro model of erythropoiesis was developed and used to demonstrate that treatment with exogenous MIF or blocking endogenous MIF did not signifcantly impact on the efficiency of erythropoiesis. Genetic analyses revealed that the MIF -173 CC genotype was associated with an increased risk of HDP compared to MIF -173 GG. In addition, individuals with the MIF -794CATT6/-173G haplotype were significantly protected from SMA while those with -794CATT7/8/-173C haplotypes were at an increased risk of developing SMA. Taken together, our findings demonstrate that SMA is associated with decreased MIF production and that individuals with high MIF-producing genetic variants are less susceptible to severe malaria. The public health significance of this study is that investigations presented here increase our understanding of protective inflammatory responses to childhood malaria, which is critical in the formulation of an effective malarial vaccine.
Achieving Food Security in a Climate Change Environment: Considerations for Environmental Kuznets Curve Use in the South African Agricultural Sector

This study relates agricultural income and agricultural carbon dioxide (CO2) emissions in the context of environmental Kuznets curves for South Africa. We posit likely relationships between UN Sustainable Development Goals (SDG) 1, 2 and 13, relating food production to climate change action. CO2 emissions, income, coal energy consumption and electricity energy consumption time series data from 1990 to 2012 within the South African agricultural sector were used. The autoregressive distributive lag bounds-test and the error correction model were used to analyse the data. The results show long-run relationships. However, agricultural income was only significant in the linear and squared models. Changes in agricultural CO2 emissions from the short run towards the long run are estimated at 71.9%, 124.7% and 125.3% every year by the linear, squared and cubic models, respectively. Exponentially increasing agricultural income did not result in a decrease in agricultural CO2 emissions, which is at odds with the Kuznets hypothesis. The study concludes that it will be difficult for South Africa to simultaneously achieve SDGs 1, 2 and 13, especially given that agriculture is reliant upon livestock production, the largest CO2 emitter in the sector. The sector needs to shift to renewable energy consumption with fewer CO2 emissions.
Browning reduces the availability—but not the transfer—of essential fatty acids in temperate lakes

Atmospheric changes are leading to the browning of northern lakes (i.e. increases in catchment‐derived dissolved organic matter [DOM]), consequently altering phytoplankton biomass and community composition. We hypothesised that lake browning and the concurrent increase in nutrients drive a shift towards greater cyanobacteria biomass. We further hypothesised that, as a consequence of this shift in phytoplankton, the content of ω‐3 (n‐3) essential fatty acids (EFA) in seston would decline, affecting the subsequent transfer of EFA to consumers across the plant–animal interface in pelagic regions of lakes. We tested these hypotheses in the epilimnion of 30 temperate lakes in Ontario (Canada), representing a gradient of lake browning, with dissolved organic carbon (DOC) ranging from 2 to 10 mg/L and total phosphorus ranging from 6.0 to 48.5 μg/L. In each of these lakes, the concentration and composition of DOM, the biomass of phytoplankton and cyanobacteria, and the EFA content of seston, cladocerans, and copepods were measured. An increase in aromatic DOM was associated with increased phytoplankton and cyanobacteria biomass. Due to the lower content of the EFA eicosapentaenoic acid (EPA; 20:5n‐3) and docosahexaenoic acid (DHA; 22:6n‐3) in cyanobacteria, this increase in phytoplankton biomass was associated with a decline in EPA and DHA content in lake seston. However, there was no significant change in EFA content of cladocerans and copepods. This homeostatic (diet‐independent) EFA composition in zooplankton suggested that, as the phytoplankton community shifted towards more cyanobacteria with lower EFA content, the cladocerans and copepods may have met their nutritional requirements by relying on alternative food sources (e.g. heterotrophic ciliates and flagellates) capable of either trophically upgrading phytoplankton‐produced EPA and DHA, or synthesising EPA and DHA de novo. Results from this study indicate that increasing DOC from low (2 mg DOC/L) to moderate levels (15 mg DOC/L) may increase the importance of the microbial pathway in the trophic transfer of EPA and DHA from basal resources to zooplankton. However, this supplementary transfer of EFA through the microbial food web may not sustain high EPA and DHA levels in zooplankton when lake browning starts to limit primary production (>15 mg DOC/L).
Orthotopic ileal neobladder creation according to the original surgical method “Belgrade pouch“ - a ten-years experience

Background/Aim. The principle of continent urinary derivations is based on the formation of a reservoir as similar as native bladder is, with satisfactory capacity, high level of continence, low pressure and small resorbent surface as possible to prevent metabolic disorders. Methods. This prospective and partially retreospective study included 148 patients with organ confined muscle invasive bladder cancer, operated on in a ten-year period, and followed up in a 3-year period. After a radical cystectomy, an original surgical technique of creating ? U? shaped orthotopic neobladder using a short ileal segment, average length of 30 cm, called ? Belgrade pouch? , was performed. Results. The results of 126 male and 22 female patients, three years following the surgery, showed average pouch capacity of 477 (330? 659) mL, insignificant residual urine of 52 (0? 92) mL, and the averageurinary frequency was five times within 24 h. Day time continence was present in 90% of patients and nighttime continence in 88% of patients, 7% of patients had mild acidosis, and 3% of patients had vitamin B12 deficiency. Conclusion. The neobladder created according to the ? Belgrade pouch? technique showed excellent results comparabile with standard techniques, with adequate capacity, high continence rate, favourable 24 h voiding frequency, insignificant residual urine, and a significantly lower rate of metabolic complications during the 3 years of the follow-up period.
Intraoperative evoked potential monitoring for detecting cerebral injury during adult aneurysm clipping surgery: a systematic review and meta-analysis of diagnostic test accuracy

Objectives We aim to evaluate the diagnostic test accuracy (DTA) of intraoperative evoked potential (EP) monitoring to detect cerebral injury during clipping of cerebral aneurysms. Design Systematic review. Data sources Major electronic databases including MEDLINE, EMBASE, LILACS. Eligibility criteria We included studies that reported the DTA of intraoperative EP monitoring during intracranial aneurysm clipping procedures in adult patients. Data extraction and synthesis After quality assessment, we performed a meta-analysis using the bivariate random effects model, and calculated the possible range of DTA point estimates using a new best-case/worst-case scenario approach to quantify the impact of rescue intervention on DTA. Results A total of 35 studies involving 4011 patients were included. The quality of the primary studies was modest and the heterogeneity across studies was high. The pooled sensitivity and specificity for predicting postoperative neurological deficits for the somatosensory evoked potential (SSEP) monitoring was 59% (95% CI: 39% to 76%; I2: 76%) and 86% (95% CI: 77% to 92%; I2: 94%), for motor evoked potential (MEP) monitoring was 81% (95% CI: 58% to 93%; I2: 54%) and 90% (95% CI: 86% to 93%; I2: 81%), and for combined SSEP and MEP monitoring was 92% (95% CI: 62% to 100%) and 88% (95% CI: 83% to 93%). The best-case/worst-case range for the pooled point estimates for sensitivity and specificity for SSEP was 50%–63% and 81%–100%, and for MEP was 59%–74% and 93%–100%, and for combined SSEP and MEP was 89%–94% and 83%–100%. Conclusions Due to the modest quality and high heterogeneity of the existing primary studies, it is not possible to confidently support or refute the diagnostic value of EP monitoring in cerebral aneurysm clipping surgery. However, combined SSEP and MEP appears to provide the best DTA for predicting postoperative stroke. Contrary to popular assertion, the modest sensitivity of SSEP monitoring is not explained by the use of rescue intervention. PROSPERO registration number CRD42015016884.
Midwives' perceptions of a midwife obstetric unit in a hospital setting

In 1997 a midwife obstetric unit was opened in a large academic hospital. The staff were recruited from those who had been redeployed. Thus this unit was unlike other midwife obstetric units where the units are geographically distanced from the nearest referral hospital and are usually staffed by midwives who have an advanced diploma in midwifery. Prior to commencing in the unit, the staff were given a skills updating course.
Verbal thinking in rhythm: motor-to-sensory transformation network mediates imagined singing

What enables us to think verbally? We hypothesized that the interaction between motor and sensory systems induced speech representation without external stimulation or overt articulation. This motor-to-sensory transformation formed the neural basis that enabled us to think verbally. Analogous to the frequency tracking of neural responses to auditory stimuli, we asked participants to imagine singing lyrics of famous songs rhythmically while their neural electro-magnetic signals were recorded using magnetoencephalography (MEG). We found that when participants imagined with less temporal variation, the neural oscillation at the delta band (same frequency band as the rhythm in the songs) showed more consistent phase coherence across trials. This neural phase tracking of imagined singing was observed in a frontal-parietal-temporal network – the proposed motor-to-sensory transformation pathway, including inferior frontal gyrus (IFG), insula, premotor, intra-parietal sulcus (IPS), temporal-parietal junction (TPJ), primary auditory cortex, and superior temporal gyrus and sulcus (STG & STS). These results suggest that neural oscillations can entrain the rhythm of our mental activity. The coherent activation in the motor-to-sensory transformation neural network mediates the internal construction of perceptual representation and forms the neural computation foundation for inner speech during verbal thinking.
Philosophy of Nursing: An Introduction

Introduction The Nature of Philosophy of Nursing Nursing Knowledge (i): Propositional and Practical Knowledge Nursing Knowledge (ii): Carper and Benner on Knowledge Nursing the Person (i): Ontology Nursing the Person (ii): A Person as a Narrative Caring in Nursing (i): Intentional Care Caring in Nursing (ii): Ontological Care Nature of Nursing (i): Nursing as Science Nature of Nursing (ii): Nursing as Art or Practice The Prospects for a Theory of Nursing Glossary Bibliography Index