Miracle-dz/UniFAR-FTUs huggingface dataset:
Care Complexity Individual Factors Associated With Hospital Readmission: A Retrospective Cohort Study

PURPOSE To determine the frequency of care complexity individual factors documented in the nursing assessment and to identify the risk factors associated with hospital readmission within 30 days of hospital discharge. DESIGN Observational analysis of a retrospective cohort at a 700-bed university hospital in Barcelona, Spain. A total of 16,925 adult patient admissions to a ward or intermediate care units were evaluated from January to December 2016. Most patients were admitted due to cardiocirculatory and respiratory disorders (29.3%), musculoskeletal and nervous system disorders (21.8%), digestive and hepatobiliary conditions (17.9%), and kidney or urinary disorders (11.2%). METHODS Readmission was defined as rehospitalization for any reason within 30 days of discharge. Patients who required hospital readmission were compared with those who did not. The individual factors of care complexity included five domains (developmental, mental-cognitive, psycho-emotional, sociocultural, and comorbidity or complications) and were reviewed using the electronic nursing assessment records. Multivariate logistic analysis was performed to determine factors associated with readmission. FINDINGS A total of 1,052 patients (6.4%) were readmitted within 30 days of hospital discharge. Care complexity individual factors from the comorbidity or complications domain were found to be the most frequently e-charted (88.3%). Care complexity individual factors from developmental (33.2%), psycho-emotional (13.2%), mental-cognitive (7.2%), and sociocultural (0.7%) domains were less frequently documented. Independent factors associated with hospital readmission were old age (≥75 years), duration of first hospitalization, admission to a nonsurgical ward, major chronic disease, hemodynamic instability, immunosuppression, and relative weight of diagnosis-related group. CONCLUSIONS A substantial number of patients required readmission within 30 days after discharge. The most frequent care complexity individual factors recorded in the nursing assessment at index admission were related to comorbidity or complications, developmental, and psycho-emotional domains. Strategies related to transition of care that include clinical characteristics and comorbidity or complications factors should be a priority at hospital discharge and after leaving hospital, but other factors related to developmental and psycho-emotional domains could have an important effect on the use of healthcare resources. CLINICAL RELEVANCE Nurses should identify patients with comorbidity or complications, developmental, and psycho-emotional complexity factors during the index admission in order to be able to implement an effective discharge process of care.
The Pearling Transition Provides Evidence of Force-Driven Endosomal Tubulation during Salmonella Infection

ABSTRACT Bacterial pathogens exploit eukaryotic pathways for their own end. Upon ingestion, Salmonella enterica serovar Typhimurium passes through the stomach and then catalyzes its uptake across the intestinal epithelium. It survives and replicates in an acidic vacuole through the action of virulence factors secreted by a type three secretion system located on Salmonella pathogenicity island 2 (SPI-2). Two secreted effectors, SifA and SseJ, are sufficient for endosomal tubule formation, which modifies the vacuole and enables Salmonella to replicate within it. Two-color, superresolution imaging of the secreted virulence factor SseJ and tubulin revealed that SseJ formed clusters of conserved size at regular, periodic intervals in the host cytoplasm. Analysis of SseJ clustering indicated the presence of a pearling effect, which is a force-driven, osmotically sensitive process. The pearling transition is an instability driven by membranes under tension; it is induced by hypotonic or hypertonic buffer exchange and leads to the formation of beadlike structures of similar size and regular spacing. Reducing the osmolality of the fixation conditions using glutaraldehyde enabled visualization of continuous and intact tubules. Correlation analysis revealed that SseJ was colocalized with the motor protein kinesin. Tubulation of the endoplasmic reticulum is driven by microtubule motors, and in the present work, we describe how Salmonella has coopted the microtubule motor kinesin to drive the force-dependent process of endosomal tubulation. Thus, endosomal tubule formation is a force-driven process catalyzed by Salmonella virulence factors secreted into the host cytoplasm during infection. IMPORTANCE This study represents the first example of using two-color, superresolution imaging to analyze the secretion of Salmonella virulence factors as they are secreted from the SPI-2 type three secretion system. Previous studies imaged effectors that were overexpressed in the host cytoplasm. The present work reveals an unusual force-driven process, the pearling transition, which indicates that Salmonella-induced filaments are under force through the interactions of effector molecules with the motor protein kinesin. This work provides a caution by highlighting how fixation conditions can influence the images observed. This study represents the first example of using two-color, superresolution imaging to analyze the secretion of Salmonella virulence factors as they are secreted from the SPI-2 type three secretion system. Previous studies imaged effectors that were overexpressed in the host cytoplasm. The present work reveals an unusual force-driven process, the pearling transition, which indicates that Salmonella-induced filaments are under force through the interactions of effector molecules with the motor protein kinesin. This work provides a caution by highlighting how fixation conditions can influence the images observed.
Interventions for mental health problems in children and adults with severe intellectual disabilities: a systematic review

Objective Mental health problems are more prevalent in people with than without intellectual disabilities, yet treatment options have received little attention. The aim of this study was to identify and evaluate the effectiveness of pharmacological and psychological interventions in the treatment of mental health problems in children and adults with severe and profound intellectual disabilities, given their difficulties in accessing standard mental health interventions, particularly talking therapies, and difficulties reporting drug side effects. Design A systematic review using electronic searches of PsycINFO, PsycTESTS, EMBASE, MEDLINE, CINAHL, ERIC, ASSIA, Science Citation Index, Social Science Citation Index and CENTRAL was conducted to identify eligible intervention studies. Study selection, data extraction and quality appraisal were performed by two independent reviewers. Participants Study samples included at least 70% children and/or adults with severe or profound intellectual disabilities or reported the outcomes of this subpopulation separate from participants with other levels of intellectual disabilities. Interventions Eligible intervention studies evaluated a psychological or pharmacological intervention using a control condition or pre-post design. Outcomes Symptom severity, frequency or other quantitative dimension (e.g., impact), as assessed with standardised measures of mental health problems. Results We retrieved 41 232 records, reviewed 573 full-text articles and identified five studies eligible for inclusion: three studies evaluating pharmacological interventions, and two studies evaluating psychological interventions. Study designs ranged from double-blind placebo controlled crossover trials to single-case experimental reversal designs. Quality appraisals of this very limited literature base revealed good experimental control, poor reporting standards and a lack of follow-up data. Conclusions Mental ill health requires vigorous treatment, yet the current evidence base is too limited to identify with precision effective treatments specifically for children or adults with severe and profound intellectual disabilities. Clinicians therefore must work on the basis of general population evidence, while researchers work to generate more precise evidence for people with severe and profound intellectual disabilities. PROSPERO registration number CRD 42015024469.
Potential Applications of Venom Peptides as Anti-Thrombotic Agents for Management of Arterial and Deep-Vein Thrombosis.

BACKGROUND Thrombus is composed of two main substances i.e. red blood cells and aggregated platelets which make a web of inter-connected fibrin proteins. During injury it prevents bleeding, so it is very useful but it can be very dangerous if it is produced in healthy blood vessels and block the blood flow through it. Mural thrombi attaches with the blood vessels but in most cases do not block it completely. Venoms are an incredible source of peptides having amazing bioactivities with varying number of amino acid residues. Anticoagulant venom peptides however inhibit the enzyme taking part in coagulation like factor Xa and thrombin. The anticoagulant potential of venom peptides have also been reported by the degradation of the fibrin or fibrinogen related to serine or metalloproteases. Designing and development of numerous therapeutic agents or lead molecules mostly for cardiovascular diseases have been motivated from toxins/proteins from snake venoms. For example, disintegrins, a large family of platelet aggregation inhibitors found in viperid and crotalid snake venoms were the basis for designing of platelet aggregation inhibitors such as eptifibatide and tirofiban. CONCLUSION Ancrod isolated from Malayan pit viper venom can cause reduction in level of blood fibrinogen and has been effectively tried in various ischemic conditions, including stroke. In order to search for novel lead molecules, the emphasis should be on isolation and characterization of pharmacologically active snake venoms proteins affecting blood coagulation and platelet aggregation. In this review an attempt has been made to recapitulates and discuss venoms of different animals and arthropod having anticoagulant peptides for their potential use in therapeutics and diagnostics.
Detection of Clostridium tetani Neurotoxins Inhibited In Vivo by Botulinum Antitoxin B: Potential for Misleading Mouse Test Results in Food Controls

The presence of botulinum neurotoxin-producing Clostridia (BPC) in food sources is a public health concern. In favorable environmental conditions, BPC can produce botulinum neurotoxins (BoNTs) outside or inside the vertebrate host, leading to intoxications or toxico-infectious forms of botulism, respectively. BPC in food are almost invariably detected either by PCR protocols targeted at the known neurotoxin-encoding genes, or by the mouse test to assay for the presence of BoNTs in the supernatants of enrichment broths inoculated with the tested food sample. The sample is considered positive for BPC when the supernatant contains toxic substances that are lethal to mice, heat-labile and neutralized in vivo by appropriate polyclonal antibodies raised against purified BoNTs of different serotypes. Here, we report the detection in a food sample of a Clostridium tetani strain that produces tetanus neurotoxins (TeNTs) with the above-mentioned characteristics: lethal for mice, heat-labile and neutralized by botulinum antitoxin type B. Notably, neutralization occurred with two different commercially available type B antitoxins, but not with type A, C, D, E and F antitoxins. Although TeNT and BoNT fold very similarly, evidence that antitoxin B antiserum can neutralize the neurotoxic effect of TeNT in vivo has not been documented before. The presence of C. tetani strains in food can produce misleading results in BPC detection using the mouse test.
Implementing Central Composite Design for Developing Transdermal Diacerein-Loaded Niosomes: Ex vivo Permeation and In vivo Deposition

Background: Niosomes are surfactant-based vesicular nanosystems that proved their efficien-cy in transdermal delivery by overcoming skin inherent anatomic barrier; startum corneum. Central com-posite design is an efficient tool for developing and optimizing niosomal formulations using fewer exper-iments. Objective: The objective of this study was to prepare niosomes as a transdermal delivery system of di-acerein using film hydration technique, employing central composite design, for avoiding its oral gastroin-testinal problems. Methods: Three-level three-factor central composite design was employed for attaining optimal niosomes formulation with the desired characteristics. Three formulation variables were assessed: amount of salt in hydration medium (X1), lipid amount (X2) and number of surfactant parts (X3). DCN-loaded niosomes were evaluated for entrapment efficiency percent (Y1), particle size (Y2), polydispersity index (Y3) and zeta potential (Y4). The suggested optimal niosomes were subjected to further characterization and utilized as a nucleus for developing elastic vesicles for comparative ex vivo and in vivo studies. Results: The values of the independent variables (X1, X2 and X3) in the optimal niosomes formulation were 0 g, 150 mg and 5 parts, respectively. It showed entrapment efficiency percentage of 95.63%, parti-cle size of 436.65 nm, polydispersity index of 0.47 and zeta potential of -38.80 mV. Results of ex vivo permeation and skin deposition studies showed enhanced skin permeation and retention capacity of the prepared vesicles than drug suspension. Conclusion: Results revealed that a transdermal niosomal system was successfully prepared and evaluat-ed using central composite design which will result in delivering diacerein efficiently, avoiding its oral problems.
Depth variation and stereo processing tasks in natural scenes

Local depth variation is a distinctive property of natural scenes, but its effects on perception have only recently begun to be investigated. Depth variation in natural scenes is due to depth edges between objects and surface nonuniformities within objects. Here, we demonstrate how natural depth variation impacts performance in two fundamental tasks related to stereopsis: half-occlusion detection and disparity detection. We report the results of a computational study that uses a large database of natural stereo-images and coregistered laser-based distance measurements. First, we develop a procedure for precisely sampling stereo-image patches from the stereo-images and then quantify the local depth variation in each patch by its disparity contrast. Next, we show that increased disparity contrast degrades half-occlusion detection and disparity detection performance and changes the size and shape of the spatial integration areas (“receptive fields”) that optimize performance. Then, we show that a simple image-computable binocular statistic predicts disparity contrast in natural scenes. Finally, we report the most likely spatial patterns of disparity variation and disparity discontinuities (half-occlusions) in natural scenes. Our findings motivate computational and psychophysical investigations of the mechanisms that underlie stereo processing tasks in local regions of natural scenes.
Nickel toxicity in wood frog tadpoles: Bioaccumulation and sublethal effects on body condition, food consumption, activity, and chemosensory function

Nickel (Ni) concentrations in aquatic ecosystems can be amplified by anthropogenic activities including resource extraction. Compared with fish and invertebrates, knowledge of Ni toxicity in amphibians is limited, especially for northern species. We examined the effect of Ni on wood frog (Lithobates sylvaticus) tadpoles, the species with the widest and most northern distribution of any anuran in North America. Wood frog tadpoles were exposed to a Ni concentration gradient (0.02–5.5 mg/L of Ni at 164 mg/L as CaCO3 water hardness) for 8 d and examined for lethality, Ni bioaccumulation, and several sublethal endpoints including body condition, food consumption, activity, and chemosensory function. Nickel induced a sublethal effect on body condition (8‐d 10 and 20% effect concentrations [EC10 and EC20] of 1.07 ± 0.38 and 2.44 ± 0.51 mg/L of Ni ± standard error [SE], respectively) but not on food consumption, activity, or chemosensory function. Nickel accumulation in tadpole tissues was positively related to an increase in aqueous Ni concentration but was not lethal. Both the acute and chronic US Environmental Protection Agency water quality guideline concentrations for Ni (0.71 and 0.08 mg/L at 164 mg/L as CaCO3 water hardness, respectively) were protective against lethal and sublethal effects in wood frog tadpoles. In the present study, wood frog tadpoles were protected by current water quality guidelines for Ni and are likely not as useful as other taxa for environmental effects monitoring for this particular metal. Environ Toxicol Chem 2018;37:2458–2466. © 2018 SETAC
Spatial Distribution of Bactrocera dorsalis and Thaumatotibia leucotreta in Smallholder Avocado Orchards along Altitudinal Gradient of Taita Hills and Mount Kilimanjaro

Avocado (Persea americana) fruits are an important source of income and a nutritious food for small-scale growers and other stakeholders involved in farming along the Afrotropical highlands of Taita Hills and Mount Kilimanjaro in Kenya and Tanzania, respectively. Avocado fruits are infested by several insect pests, namely the Asian invasive fruit fly, Bactrocera dorsalis (Hendel) (Diptera: Tephritidae), and the false codling moth, Thaumatotibia leucotreta Meyrick (Lepidoptera: Tortricidae). However, there is inadequate information on the distribution patterns of these pests in small-scale avocado cropping systems in the East African highlands. This study was initiated to generate a spatial distribution map of B. dorsalis and T. leucotreta in avocado orchards at Taita Hills and Mount Kilimanjaro in Kenya and Tanzania, respectively. The two pests were monitored by using their respective parapheromone lures for two years between August 2012 and July 2014. Fruit damage was assessed by computing the proportion of infested fruits for B. dorsalis, whereas the damage score was used for T. leucotreta. Our results indicated that the mean number of B. dorsalis per trap per day differed significantly across elevation, being highest in lowland zone for both Taita Hills (15.90) and Mount Kilimanjaro (24.45). Similarly, the percentage infestation of ground collected fruits by B. dorsalis varied with altitude, being lowest at highlands above 1500 m.a.s.l. (0.66% and 0.83% for Taita Hills and Mount Kilimanjaro, respectively). Conversely, the mean number of T. leucotreta did not vary with altitude in either study area. However, the damage score for T. leucotreta infestation was significantly lower in the highlands of both transects (7.0% and11.1% for Taita Hills and Mount Kilimanjaro, respectively). These findings describe spatial trends that are important in formulating strategies aimed at suppressing the populations of B. dorsalis and T. leucotreta in East African avocado cropping systems.
Multiwinner Voting with Fairness Constraints

Multiwinner voting rules are used to select a small representative subset of candidates or items from a larger set given the preferences of voters. However, if candidates have sensitive attributes such as gender or ethnicity (when selecting a committee), or specified types such as political leaning (when selecting a subset of news items), an algorithm that chooses a subset by optimizing a multiwinner voting rule may be unbalanced in its selection -- it may under or over represent a particular gender or political orientation in the examples above. We introduce an algorithmic framework for multiwinner voting problems when there is an additional requirement that the selected subset should be ``fair'' with respect to a given set of attributes. Our framework provides the flexibility to (1) specify fairness with respect to multiple, non-disjoint attributes (e.g., ethnicity and gender) and (2) specify a score function. We study the computational complexity of this constrained multiwinner voting problem for monotone and submodular score functions and present several approximation algorithms and matching hardness of approximation results for various attribute group structure and types of score functions. We also present simulations that suggest that adding fairness constraints may not affect the scores significantly when compared to the unconstrained case.
Comparison of the efficacy and acceptability of Chinese herbal medicine in adult patients with heart failure and reduced ejection fraction: study protocol for a systematic review and network meta-analysis

Introduction Heart failure with reduced ejection fraction (HFrEF) is defined as the clinical diagnosis of heart failure (HF) and ejection fraction (EF) ≤40%, which is a severe public healthcare issue and brings a heavy social and economic burden for patients with HFrEF. Chinese herbal medicine (CHM) has a long history in treating HF. Questions concerning the efficacy and acceptability of CHM-related interventions in adult patients with HFrEF led us to use the method of systematic review and network meta-analysis to integrate direct and indirect evidence to create hierarchies for all CHM. Methods and analysis Nine medical databases, including PubMed, EMBASE (OVID), the Cochrane Library, Google Scholar, Web of Science, CNKI, VIP, Wanfang Database and CBM will be searched from the date of database inception to June 2015 (updated to March 2017) without language and publication status restriction. Completely randomised controlled trials (RCTs) comparing CHM or CHM plus routine treatment with CHM, CHM plus routine treatment, routine treatment, no treatment or placebo for adults with HFrEF will be examined. Our primary outcomes will include all-cause mortality, HF-related death, all-cause rehospitalisation, HF-related rehospitalisation and acceptability (discontinuation due to any adverse events during treatment). Secondary outcomes will include response rate, mean value or mean difference from baseline of surrogate indexes. We will perform the Bayesian network meta-analyses (NMA) for the most frequently reported primary or secondary outcome and the acceptability outcome, if available. Meta-regression, subgroup analyses and sensitivity analyses will be conducted based on prespecified effect modifiers to assess the robustness of the findings. Dissemination The results of this NMA will provide useful information about the effectiveness and acceptability of CHM in adults with HFrEF, which will also have implications for clinical practice and further research. Findings will be disseminated through peer-reviewed journal publication and conference presentations. PROSPERO registration number CRD42016053854.
Physical fitness interventions for nonambulatory stroke survivors: A mixed‐methods systematic review and meta‐analysis

Physical fitness training after stroke is recommended in guidelines across the world, but evidence pertains mainly to ambulatory stroke survivors. Nonambulatory stroke survivors (FAC score ≤2) are at increased risk of recurrent stroke due to limited physical activity. This systematic review aimed to synthesize evidence regarding case fatality, effects, experiences, and feasibility of fitness training for nonambulatory stroke survivors.