Miracle-dz/UniFAR-FTUs huggingface dataset:
In-hospital delirium risk assessment, diagnosis and management; medications to avoid

Background: Delirium is a common, but potentially preventable complication of acute illness that is associated with important adverse outcomes including increased length of hospital admission, risk of dementia and admission to long-term care. In-hospital risk assessment and diagnosis: Age over 65, severe illness, current hip fracture and presence of cognitive impairment or dementia are important risk factors for delirium. Assess people with any of these risk factors for recent changes or fluctuations in behaviour that might indicate delirium. If any indicators are present, complete a full cognitive assessment to confirm the diagnosis of delirium. In-hospital risk management: Multicomponent delirium prevention interventions can reduce the incidence of delirium in hospital by around one third and should be provided to people with any of the important risk factors that do not have delirium at admission. A medication review that considers both the number and type of prescribed medications is an important part of the multicomponent delirium prevention intervention. Which medications to avoid in people at risk of delirium: For people at risk of delirium, avoid new prescriptions of benzodiazepines or consider reducing or stopping these medications where possible. Opioids should be prescribed with caution in people at risk of delirium but this should be tempered by the observation that untreated severe pain can itself trigger delirium. Caution is also required when prescribing dihydropyridines and antihistamine H 1 antagonists for people at risk of delirium and considered individual patient assessment is advocated. Conclusion: Delirium is common, distressing to patients, relatives and carers and is associated with important adverse outcomes. Multicomponent delirium prevention interventions can reduce the incidence of delirium by approximately one third and usually incorporate a medication review. Identification of which medications to avoid in people at risk of delirium will help guide evidence-based decision making.
Spore morphology and ultrastructure of the tropical moss Helicophyllum torquatum (Hook.) Brid. (Helicophyllaceae) in relation to systematics and evolution

Spores of Helicophyllum torquatum (Hook.) Brid. (Helicophyllaceae, a monotypic family of tropical mosses) were studied by means of TEM, SEM, and LM. Different techniques of staining were employed to reveal the sporoderm structure. The spores are isomorphic, medium-sized (ranging from 26.40 to 41.80 μm), heteropolar, subcircular amb, plane-convex, catatremate, the surface consists of granules and gemmae. The systematic significance of spore morphology of this species are being considered here for the first time. Spore characteristics are congruent with the hypothesis of an affinity of the Helicophyllaceae with acrocarpous lineages.
Assessment of genomic diversity of cotton (Gossypium hirsutum) genotypes using simple sequence repeats markers through genetic analysis software.

The present study was designed to evaluate genetic diversity among twenty cotton genotypes by employing thirty one SSR markers that were reported from Brookheaven National Laboratories. Out of thirty-one primers, six SSR primers were found polymorphic at different SSR loci. Maximum number of loci (33), were amplified by MNH-93, while minimum (22) by 238F. Total percentage of informative loci was 36.8%. Genetic diversity matrix of these genotypes was calculated by NTSYS-pc 2.2 software. Genetic similarity coefficients ranged from 0.474 to 0.974. The highest dissimilarity (0.474) was observed between genotype 298-F and CIM-496. Cluster analysis as performed using un-weighted pair group method of arithmetic average algorithm showed that Nei and Li's coefficients ranged from 0.63 to 0.97. The dendrogram of cotton lines showed two major clusters except 238-F forming an out-group from other genotypes, thus showing maximum dissimilarity. Genotypes MNH-93 and K-68/9 showed maximum similarity coefficient of 0.97. Information obtained from the present study can be used to select divergent parents for future breeding programs. © 2013 Friends Science Publishers
Propagation of Cleome spinosa Jacq. through tissue culture.

The tissue culture and rapid propagation of Cleome spinosa Jacq. was explored by investigating the effects of different plant growth regulators on callus induction, bud differentiation, and root formation of three types of explants. The results showed that hypocotyls and stem segments regenerated buds directly on growth regulator-free Murashige and Skoog (MS) medium. The highest callus induction rates of hypocotyls, stem segments, and leaves reached 100% and were obtained on the culture medium of MS + (1.0 to 2.0) mg/L kinetin (KT) + 0.02 mg/L α-naphthalene acetic acid (NAA), on which the leaves produced the best quality of calluses. The leaf-derived calluses were subcultured on MS + 0.5 mg/L KT +0.5 mg/L 6-benzylaminopurine (BAP) and achieved the highest differentiation rate of 100%, producing an average of 7.5 buds per explant. Inoculation with MS + 0.5 mg/L indole-3butyric acid (IBA) resulted in the production of a number of thick roots by 66.7% of the regenerated buds. After transplanting, plantlets with more roots survived easily and grew well.
Is internet hampering mental health of medical students: a cross sectional study

In the new generation, the Internet has become an important tool for education, entertainment, communication, and information-sharing. Easy access and social networking are two of the several aspects of the Internet fostering addictive behaviour. Internet usage among medical students is high. Smart phones as a self learning tool providing sleek connectivity are essential. Their benefits lead to overuse resulting in addiction or nomophobia. Increased awareness generation is needed among the youth regarding nomophobia. Standardized measures for identification and appropriate psychobehavioral therapy for those seeking help might alleviate the problem. Internet addiction commonly refers to an individual’s inability to control his or her use of the Internet (including any online-related, compulsive behaviour), which eventually causes one’s marked distress and functional impairment in daily life. Research ABSTRACT
In situ-generated thrombin is the only enzyme that effectively activates factor VIII and factor V in thromboplastin-activated plasma

We investigated the activation of the nonenzymatic protein cofactors factor VIII and factor V in plasma when coagulation was initiated by thromboplastin. With sensitive bioassays, we were able to measure specifically the generation of activated factor VIII and activated factor V in plasma. Our results showed that when plasma was triggered with a relatively high concentration of thromboplastin, factor VIII and factor V were completely activated at the clotting time of plasma. However, when the generation of thrombin, but not that of factor Xa, was delayed by addition of hirudin to the plasma, factor Va was generated only at the time thrombin generation overcame the hirudin inhibition. In addition, generation of factor VIIIa correlated with thrombin generation and not with factor Xa generation. Furthermore, addition of large amounts of factor Xa to hirudinized plasma did not show detectable factor VIII or factor V activation. We concluded that in plasma activated with thromboplastin the enzyme responsible for activation of factor V and factor VIII is thrombin, not factor Xa.
Arbitrage d’une controverse de politique de santé : application d’une démarche délibérative au Financement basé sur la Performance en Afrique subsaharienne

Objectifs : Cet article s’interesse a la controverse autour du financement base sur la performance (FBP) dans sa reforme des systemes de sante. Il vise une analyse objective des differentes opinions autour de l’approche de maniere a contribuer a une meilleure structuration du debat. Methodes : Notre demarche deliberative structurante a consiste a organiser un dialogue indirect entre experts critiques et partisans du FBP sur base d’une grille d’analyse concue par Norman Daniels et coll. ; grille non partisane et comportant des criteres clairs et objectifs. Executes en deux tours (critiques ensuite partisans), les interviews ont ete analyses et des segments de reponses ont ete regroupes, selon les thematiques sectorielles les plus reprises et faisant ressortir les grandes tendances de la controverse. Resultats : Les interviews ont permis de degager des pistes de convergence autour du FBP, vu comme une strategie complementaire a d’autres, notamment celle visant a l’amelioration de l’accessibilite financiere de la population aux soins de sante. Elle a degage des desaccords relevant soit de malentendus sur les pretentions accordees au FBP, soit d’une absence de donnees probantes suffisantes, soit encore d’une asymetrie informationnelle entre experts. Conclusions : Les discussions autour du FBP se polarisent autour de plusieurs questions. Mais une meilleure structuration des arguments convergents et divergents devrait rendre une certaine synthese possible. Pour un plus grand benefice des populations, il incombe aux experts d’adopter une demarche objective avec des criteres acceptes par tous.
Motivational Strategies for Stroke Rehabilitation: A Delphi Study

Background and Purpose: Although various strategies are used to motivate patients during rehabilitation, consensus regarding the optimal motivational strategies for stroke rehabilitation has not been established. Expert consensus may aid rehabilitation professionals in effectively utilizing motivational strategies to produce the most beneficial outcome for their patients. The primary purpose of this study was to provide a comprehensive list of effective motivational strategies based on consensus among rehabilitation experts, generated using the Delphi technique. In addition, we sought to identify the types of information that are important when selecting motivational strategies. Methods: A total of 198 rehabilitation experts participated in a three-round Delphi survey. The rehabilitation experts included physicians, physical therapists, occupational therapists, and speech-language-hearing therapists who had worked in stroke rehabilitation for at least five years. Panelists were asked to rate the effectiveness of motivational strategies and to rate the importance of different types of information using a 5-point Likert scale. Consensus was defined as having been reached for items with an interquartile range of 1 or less. Results: A total of 116 experts (58.6%) completed the third round of the Delphi survey. Consensus was reached on all of the 26 presented strategies. Seven strategies, such as control of task difficulty and goal setting, were considered to be very effective in increasing patient motivation. In addition, all 11 of the presented types of information were deemed very important or important in determining which motivational strategies to use. Conclusions: We generated a list of effective motivational strategies for stroke rehabilitation based on expert consensus. Our results suggest that experts consider a comprehensive range of patient information when choosing motivational strategies. These findings represent a group of consensus-based recommendations for increasing patient adherence to stroke rehabilitation programs, which may be beneficial to many medical professionals working in stroke rehabilitation.
Modifiable Lifestyle Factors and Risk of Stroke

Aims: Assessing whether modifiable risk factors are causally associated with reduced stroke risk is important in planning public health measures, but determining causality can be difficult in epidemiological data. Leveraging large-scale genetic data in a technique known as Mendelian randomisation, we aimed to determine whether modifiable lifestyle factors including educational attainment, smoking, and body mass index are causal risk factors for ischaemic stroke and its different subtypes and haemorrhagic stroke. Methods and Results: We performed two-sample and multivariable Mendelian randomization to assess the causal effect of twelve lifestyle factors on risk of stroke and whether these effects are independent. We found genetic predisposition to increased number of years of education to be inversely associated with ischaemic, large-artery, and small-vessel stroke, as well as with intracerebral haemorrhage. Genetic predisposition to ever smoking regularly, higher body mass index (BMI), and higher waist-hip ratio are also associated with ischaemic and large-artery stroke. Additionally, we found that the effects of education, BMI, and smoking on ischaemic stroke to be independent of each other. Conclusion: Genetic predisposition to higher educational attainment can reduce the risk of ischaemic, large-artery, and small-vessel stroke, while genetic predisposition to smoking and higher anthropometry measures can increase the risk of these stroke subtypes. This suggests that lifestyle modification addressing these risk factors will reduce stroke risk.
Impact of time and temperature on gut microbiota and SCFA composition in stool samples

Gut dysbiosis has been implicated in the pathophysiology of a growing number of non-communicable diseases. High through-put sequencing technologies and short chain fatty acid (SCFA) profiling enables surveying of the composition and function of the gut microbiota and provide key insights into host-microbiome interactions. However, a methodological problem with analysing stool samples is that samples are treated and stored differently prior to submission for analysis potentially influencing the composition of the microbiota and its metabolites. In the present study, we simulated the sample acquisition of a large-scale study, in which stool samples were stored for up to two days in the fridge or at room temperature before being handed over to the hospital. To assess the influence of time and temperature on the microbial community and on SCFA composition in a controlled experimental setting, the stool samples of 10 individuals were exposed to room and fridge temperatures for 24 and 48 hours, respectively, and analysed using 16S rRNA gene amplicon sequencing, qPCR and nuclear magnetic resonance spectroscopy. To best of our knowledge, this is the first study to investigate the influence of storage time and temperature on the absolute abundance of methanogens, and of Lactobacillus reuteri. The results indicate that values obtained for methanogens, L. reuteri and total bacteria are still representative even after storage for up to 48 hours at RT (20 {degrees}C) or 4 {degrees}C. The overall microbial composition and structure appeared to be influenced more by laboratory errors introduced during sample processing than by the actual effects of temperature and time. Although microbial activity was demonstrated by elevated SCFA at both 4 {degrees}C and RT, SCFAs ratios were more stable over the different conditions and may be considered as long as samples are come from similar storage conditions.
Can Envelope Following Responses Be Used to Estimate Level Compression in the Auditory System?

The ability to compress the large level range of incoming sounds into a smaller range of vibration amplitudes on the basilar membrane (BM) is an important property of the healthy auditory system. Sensorineural hearing impairment typically leads to a decrease in sensitivity to sound and a reduction of the amount of compression observed in BM input-output functions. While sensitivity loss can be measured efficiently via audiometry, no measure has yet been provided that represents fast and reliable compression estimates in the individual listener. In the present study, magnitude-level functions obtained from envelope following responses (EFR) to four simultaneously presented amplitude modulated tones were measured in normal-hearing (NH) and sensorineural hearing-impaired (HI) listeners. The slope of part of the EFR magnitude-level function was used to estimate level compression. The median values of the compression estimates in the group of NH listeners were found to be consistent with previously reported group-averaged compression estimates based on psychoacoustical measures and group-averaged distortion-product otoacoustic emission magnitude-level functions in human listeners, and similar to BM compression values measured invasively in non-human mammals. The EFR magnitude-level functions for the HI listeners were less compressive than those for the NH listeners, consistent with a reduction of BM compression in HI listeners. A computer model of the auditory nerve (AN) was used to simulate EFR magnitude-level functions at the level of the AN. The recorded EFRs at the chosen amplitude modulation rates (81-98 Hz) were considered to represent neural activity originating from the auditory brainstem and midbrain rather than a direct measure of AN activity. Nonetheless, the AN model simulations could account for the main trends observed in the recorded data. The model simulations suggested that the growth of the EFR magnitude-level function is highly influenced by contributions from off-frequency neural populations, which compromises the possibility to estimate local (i.e., frequency specific) compression with EFRs. Furthermore, the model showed that while the slope of the EFR magnitude-level function is sensitive to the loss of compression observed in HI listeners due to outer hair cell dysfunction, it is also sensitive to inner hair cell dysfunction. Overall, it is concluded that EFR magnitude-level functions do not represent frequency specific level compression in the auditory system.
Development and validation of a transcriptional signature for the assessment of fibrosis in organs

Background: Fibrosis in most organs has proven to be an critical factor related to high risk of morbidity and mortality, but an adequate assessment of fibrosis severity is still challenging. This study tried to evaluate fibrosis severity through a fibrosis transcriptional signature. Methods: A fibrosis transcriptional signature was developed through an integrated analysis of multiple expression profiling datasets of human organs with fibrosis-related diseases. A fibrosis severity score for each sample was the calculated through gene set variation analysis (GSVA), and its role in evaluating fibrosis severity was then analyzed. Results: Ten expression profiling datasets of human tissues with organ failure were integrated with robust rank aggregation method, and a fibrosis severity score consisting of 149 genes. Most of those included genes were involved in fibrogenic pathways. GSEA analysis revealed that fibrosis transcriptional signature was significantly enriched in the fibrogenic tissues. Additionally, we found that fibrosis transcriptional signature could effectively differentiate fibrosis tissues and non-fibrosis tissues. Conclusion: This study developed an useful fibrosis transcriptional signature involved in fibrosis-related diseases. This fibrosis transcriptional signature is helpful in precisely evaluating the fibrosis severity in common organs at the transcriptional level.
Analysis of Effective Dose at Computed Tomography in a Modern 64 slice Multidetector CT System in an Irish Tertiary Care Centre with Local and International Reference Standards

Diagnostic Reference Levels (DRLs) are used to establish if local imaging protocols have been optimised. This study examines a modern multi-detector 64 slice CT (MDCT) system for four commonly performed examinations in a large tertiary care centre by comparison with current international reference standards. Effective dose (ED) was calculated using dose-length product conversion coefficients for all patients and compared to Irish national and local DRLs, and published international point values. ED at CT abdomen-pelvis was 28.5% above the national DRL and 26% above the local DRL. ED at CT thorax was 3.5% greater than local DRL and 42.5% greater than the national DRL. ED at CT brain was 100% above both the local and national DRLs. CT cervical spine ED was 79% greater than the local and 100% greater than the national DRL.A review of study protocols is necessary to facilitate optimisation of total study radiation dose.
Prism adaptation treatment for upper-limb complex regional pain syndrome: a double-blind randomized controlled trial

Initial evidence suggested that people with Complex Regional Pain Syndrome (CRPS) have reduced attention to the affected side of their body and the surrounding space, which might be related to pain and other clinical symptoms. Three previous unblinded, uncontrolled studies showed pain relief following treatment with prism adaptation, an intervention that has been used to counter lateralised attention bias in brain-lesioned patients. To provide a robust test of its effectiveness for CRPS, we conducted a double-blind randomized controlled trial of prism adaptation for unilateral upper-limb CRPS-I. Forty-nine eligible adults with CRPS were randomized to undergo two-weeks of twice-daily home-based prism adaptation treatment (n = 23) or sham treatment (n = 26). Outcomes were assessed in person four weeks prior to and immediately before treatment, and immediately after and four weeks post-treatment. Long-term postal follow-ups were conducted three and six months after treatment. We examined the effects of prism adaptation versus sham treatment on current pain intensity and CRPS symptom severity score (primary outcomes); as well as sensory, motor, and autonomic functions, self-reported psychological functioning, and experimentally tested neuropsychological functions (secondary outcomes). Primary and secondary outcomes did not differ between the prism adaptation and sham treatment groups when tested at either time point following treatment. Overall, CRPS severity significantly decreased over time for both groups, but we found no benefits of prism adaptation beyond sham treatment. Our findings do not support the efficacy of prism adaptation treatment for relieving upper-limb CRPS-I. This trial was prospectively registered (ISRCTN46828292).
Orbitofrontal-striatal structural alterations linked to negative symptoms at different stages of the schizophrenia spectrum

Among the most debilitating manifestations of schizophrenia are negative symptoms such as anhedonia and apathy. Imaging studies have linked these symptoms to morphometric abnormalities in two brain regions implicated in reward and motivation: the orbitofrontal cortex (OFC) and ventral striatum. Negative symptoms generally are associated with reduced OFC thickness, while apathy specifically maps to reduced striatal volume. However, it remains unclear whether these tissue losses are a consequence of chronic illness and its treatment, or an underlying phenotypic trait. Here we use multicentre MRI data to investigate orbitofrontal-striatal abnormalities across the schizophrenia-spectrum from healthy populations with schizotypy, to unmedicated and medicated first-episode psychosis patients, and patients with chronic schizophrenia. Striatal volumes and OFC thickness were estimated from T1-weighted images acquired in all three diagnostic groups and controls from four sites (n=337). Results were first established in one test cohort ( Zurich sample) and replicated in three independent samples. There was a correlation between apathy and striatal volume only in healthy individuals with schizotypy; however, medicated patients exhibited larger striatal volumes, which appears to be a consequence of antipsychotic medications. The association between reduced OFC thickness and negative symptoms generally also appeared to vary along the disease course, being significant only in first-episode psychosis patients. In schizotypy there was increased OFC relative to controls. Our findings suggest that negative symptoms associate with a temporal continuum of orbitofrontal-striatal abnormalities that may predate the occurrence of schizophrenia. Thicker OFC in schizotypy may represent either compensatory or pathological mechanisms prior to disease-onset.