Miracle-dz/UniFAR-FTUs huggingface dataset:
Incidence and Economic Burden of Injuries in the United States

Injuries are one of the most serious public health problems facing the United States today. Through premature death, disability, medical cost and lost productivity, injuries impact the health and welfare of all Americans. Deaths only begin to tell the story. Although many injuries are minor, a large proportion result in fractures, amputations, burns, or significant injuries that have far-reaching consequences. Now, for the first time in over 15 years, we have comprehensive estimates of the impact of these injuries in economic terms. This book updates a landmark Report to Congress from 1989. Since that report, no undertaking has addressed the incidence and economic burden of injuries with more timely data, despite major changes in the fields of prevention, reporting and surveillance. Since the mid-eighties, new safety technologies have been developed to prevent injuries or to decrease the severity of injuries, and new policies and laws have been enacted to promote injury prevention. Chapter topics include incidence by detailed categorisations, lifetime medical costs and productivity losses as a result of injuries, and a discussion of recent trends. Lavishly illustrated with tables and graphs, this volume is a valuable reference for public health practitioners, researchers, and students alike. Available in OSO: http://www.oxschol. com/oso/public/content/publichealthepidemiology/9780195179484/toc.html
The experience of being an older operating room nurse

THIS QUALITATIVE STUDY used a purposive sample of perioperative nurses age 50 or older to describe the experience of being an older perioperative nurse. Three themes were identified from data analysis: growing old in the OR, interpersonal and organizational concerns, and worries about the future. THESE OLDER PERIOPERATIVE NURSES still are challenged and energized by being in the OR, although they have concerns about call and scheduling and have experienced conflict with surgical technologists. THESE NURSES ALSO ARE VERY WORRIED about the future of nursing, specifically perioperative nursing. They aptly asked, "What's going to happen when the older nurses are gone and no one is here to train the new ones? " AORN J 78 (October 2003) 635-649.
Surgical options for patients with Lennox‐Gastaut syndrome

Despite ongoing investigation into pharmacologic treatments for Lennox‐Gastaut syndrome (LGS), outcomes for chronic administration of medications remain disappointing. In many instances LGS is treatment refractory, resulting in poor prognoses that include intellectual disability, persisting seizures, and psychiatric conditions. For patients with treatment resistance to other modalities for LGS, a further option is surgical intervention. Evaluation for surgery should involve interictal electroencephalogram (EEG), magnetic resonance imaging (MRI) analysis, and age‐appropriate neuropsychological/developmental assessment. Resective surgery, where seizure foci are removed, successfully controls seizures in many cases, particularly where lesionectomy or lobar resections are appropriate. Recent studies of resective surgery on individuals with LGS show promising results, with a high percentage of patients having improved seizure control. Corpus callosotomy is a palliative surgical approach that aims at controlling potentially injurious seizures, for example, atonic or drop seizures, by preventing the bilateral spread of epileptic activity. Once associated with a high risk for morbidity and mortality, microsurgical techniques and surgery limited to the anterior region of the callosum have greatly diminished complications of corpus callosotomy surgery. Vagus nerve stimulation, another palliative procedure, offers rates of seizure improvement similar to those of corpus callosotomy, with the exception of atonic seizure for which corpus callosotomy may lead to a greater reduction. Recent advances in surgical techniques offer encouraging options for treatment of LGS.
Exercise and vitamin D in fall prevention among older women: a randomized clinical trial.

IMPORTANCE While vitamin D supplementation and exercise are recommended for prevention of falls for older people, results regarding these 2 factors are contradictory. OBJECTIVE To determine the effectiveness of targeted exercise training and vitamin D supplementation in reducing falls and injurious falls among older women. DESIGN, SETTING, AND PARTICIPANTS A 2-year randomized, double-blind, placebo-controlled vitamin D and open exercise trial conducted between April 2010 and March 2013 in Tampere, Finland. Participants were 409 home-dwelling women 70 to 80 years old. The main inclusion criteria were at least 1 fall during the previous year, no use of vitamin D supplements, and no contraindication to exercise. INTERVENTIONS Four study groups, including placebo without exercise, vitamin D (800 IU/d) without exercise, placebo and exercise, and vitamin D (800 IU/d) and exercise. MAIN OUTCOMES AND MEASURES The primary outcome was monthly reported falls. Injurious falls and the number of fallers and injured fallers were reported as secondary outcomes. In addition, bone density, physical functioning (muscle strength, balance, and mobility), and vitamin D metabolism were assessed. RESULTS Intent-to-treat analyses showed that neither vitamin D nor exercise reduced falls. Fall rates per 100 person-years were 118.2, 132.1, 120.7, and 113.1 in the placebo without exercise, vitamin D without exercise, placebo and exercise, and vitamin D and exercise study groups, respectively; however, injurious fall rates were 13.2, 12.9, 6.5, and 5.0, respectively. Hazard ratios for injured fallers were significantly lower among exercisers with vitamin D (0.38; 95% CI, 0.17-0.83) and without vitamin D (0.47; 95% CI, 0.23-0.99). Vitamin D maintained femoral neck bone mineral density and increased tibial trabecular density slightly. However, only exercise improved muscle strength and balance. Vitamin D did not enhance exercise effects on physical functioning. CONCLUSIONS AND RELEVANCE The rate of injurious falls and injured fallers more than halved with strength and balance training in home-dwelling older women, while neither exercise nor vitamin D affected the rate of falls. Exercise improved physical functioning. Future research is needed to determine the role of vitamin D in the enhancement of strength, balance, and mobility. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00986466.
Risk for Clinically Relevant Adverse Cardiac Events in Patients With Chest Pain at Hospital Admission.

IMPORTANCE Patients with potentially ischemic chest pain are commonly admitted to the hospital or observed after a negative evaluation in the emergency department (ED) owing to concern about adverse events. Previous studies have looked at 30-day mortality, but no current large studies have examined the most important information regarding ED disposition: the short-term risk for a clinically relevant adverse cardiac event (including inpatient ST-segment elevation myocardial infarction, life-threatening arrhythmia, cardiac or respiratory arrest, or death). OBJECTIVE To determine the incidence of clinically relevant adverse cardiac events in patients hospitalized for chest pain with 2 troponin-negative findings, nonconcerning initial ED vital signs, and nonischemic, interpretable electrocardiographic findings. DESIGN, SETTING, AND PARTICIPANTS We conducted a blinded data review of 45,416 encounters obtained from a prospectively collected database enrolling adult patients admitted or observed with the following inclusion criteria: (1) primary presenting symptom of chest pain, chest tightness, chest burning, or chest pressure and (2) negative findings for serial biomarkers. Data were collected and analyzed from July 1, 2008, through June 30, 2013, from the EDs of 3 community teaching institutions with an aggregate census of more than 1 million visits. We analyzed data extracted by hypothesis-blinded abstractors. MAIN OUTCOMES AND MEASURES The primary outcome was a composite of life-threatening arrhythmia, inpatient ST-segment elevation myocardial infarction, cardiac or respiratory arrest, or death during hospitalization. RESULTS Of the 45,416 encounters, 11,230 met criteria for inclusion. Mean patient age was 58.0 years. Of the 11 230 encounters, 44.83% of patients arrived by ambulance and 55.00% of patients were women. Relevant history included hypertension in 46.00%, diabetes mellitus in 19.72%, and myocardial infarction in 13.16%. The primary end point occurred in 20 of the 11 230 patients (0.18% [95% CI, 0.11%-0.27%]). After excluding patients with abnormal vital signs, electrocardiographic ischemia, left bundle branch block, or a pacemaker rhythm, we identified a primary end point event in 4 of 7266 patients (0.06% [95% CI, 0.02%-0.14%]). Of these events, 2 were noncardiac and 2 were possibly iatrogenic. CONCLUSIONS AND RELEVANCE In adult patients with chest pain admitted with 2 negative findings for serial biomarkers, nonconcerning vital signs, and nonischemic electrocardiographic findings, short-term clinically relevant adverse cardiac events were rare and commonly iatrogenic, suggesting that routine inpatient admission may not be a beneficial strategy for this group.
Mapping the coherence of ictal high frequency oscillations in human extratemporal lobe epilepsy

High frequency oscillations (HFOs) have recently been recorded in epilepsy patients and proposed as possible novel biomarkers of epileptogenicity. Investigation of additional HFO characteristics that correlate with the clinical manifestation of seizures may yield additional insights for delineating epileptogenic regions. To that end, this study examined the spatiotemporal coherence patterns of HFOs (80–400 Hz) so as to characterize the strength of HFO interactions in the epileptic brain. We hypothesized that regions of strong HFO coherence identified epileptogenic networks believed to possess a pathologic locking nature in relation to regular brain activity.
Heat tolerance predicts the importance of species interaction effects as the climate changes.

SYNOPSIS Few studies have quantified the relative importance of direct effects of climate change on communities versus indirect effects that are mediated thorough species interactions, and the limited evidence is conflicting. Trait-based approaches have been popular in studies of climate change, but can they be used to estimate direct versus indirect effects? At the species level, thermal tolerance is a trait that is often used to predict winners and losers under scenarios of climate change. But thermal tolerance might also inform when species interactions are likely to be important because only subsets of species will be able to exploit the available warmer climatic niche space, and competition may intensify in the remaining, compressed cooler climatic niche space. Here, we explore the relative roles of the direct effects of temperature change and indirect effects of species interactions on forest ant communities that were heated as part of a large-scale climate manipulation at high- and low-latitude sites in eastern North America. Overall, we found mixed support for the importance of negative species interactions (competition), but found that the magnitude of these interaction effects was predictable based on the heat tolerance of the focal species. Forager abundance and nest site occupancy of heat-intolerant species were more often influenced by negative interactions with other species than by direct effects of temperature. Our findings suggest that measures of species-specific heat tolerance may roughly predict when species interactions will influence responses to global climate change.
Novel genomic determinants of apoptotic defects in acute lymphoblastic leukemia

textabstractThe treatment of pediatric acute leukemia has greatly improved over the past 4 decades, resulting in long-term disease-free survival of approximately 80% for ALL1-3 and 60% for AML.4 Despite this progress, a considerable number of children ultimately relapse with a disease that is highly refractory to further treatment. A high proportion of the contemporary treatment failures can be contributed to cellular drug resistance. However, relatively little is known about the causes of cellular drug resistance in childhood acute leukemia. In the last years it has become clear that most, if not all, chemotherapeutic agents ultimately induce programmed cell death or apoptosis in their target cells.5 Defects in the apoptosis route allow genetically instable cells to survive and are thought of as one of the major driving forces behind leukemogenesis.6,7 These observations led to the hypothesis that aberrations in the apoptosis pathway contribute to cellular drug resistance in children with acute leukemia. Therefore, a thorough knowledge of the aberrations in the apoptosis route is critical for understanding the causes of treatment failure and for a rational approach to drug design and therapy.
Risk Factors for Birth Asphyxia In Kalasin Hospital

Abstract Background Birth asphyxia is an important cause of perinatal death. The causes of birth asphyxia are mostly due to the processes during labor that may be prevented to reduce birth asphyxia and mortality of the infant Objective To determine risk factors for birth asphyxia Study design Case control study Setting Obstetric and Gynecology department of Kalasin Hospital. Subject Cases were 159 newborns with 1-minute Apgar score of 7 or less, Controls were 318 newborns with 1-minute Apgar score of more than 7,deliveried before and after each case. All babies were deliveried in Kalasin Hospital between October 2001 and December 2002. Method Socio-economic factors, antepartum factors, intrapartum factors, fetal factors, were analysed with univariate analysis and multiple logistic regression analysis. Results The incidence of birth asphyxia was 36.1 per 1000 live births. Factors significantly associated with birth asphyxia included pregnancy induced hypertension (OR 26.81, 95% CI 6.44, 111.61), breech presentation(OR 23.19, 95% CI 2.64, 203.54), abnormal of electronic fetal monitoring (OR 8.3, 95% CI 3.08, 22.34), cephalopelvic disproportion(OR 8.10, 95% CI 2.97, 22.20), gestational age 28-32 weeks(OR 5.30, 95% CI 1.32, 21.22), Cesarean section (OR 3.87, 95% CI 1.94, 7.68), gestational age 33-36 weeks (OR 3.29, 95% CI 1.13, 9.52) , birth weight less than 2500 grams (OR 3.17, 95% CI 1.25,8.06), education £ 6 th grade(OR 3.09, 95% CI 1.60, 5.95). Conclussion Risk factors for birth asphyxia included socio-economic factors, antepartum factors, intrapartum factors, fetal factors. The hospital will use this information in developing interventions to reduce birth asphyxia Key word Risk factor, birth asphyxia
A randomized, double‐blind, placebo‐controlled, multicenter, parallel‐group study to evaluate the efficacy and safety of adjunctive brivaracetam in adult patients with uncontrolled partial‐onset seizures

Brivaracetam (BRV), a selective and high‐affinity synaptic vesicle protein 2A ligand, is in development as adjunctive treatment for partial‐onset (focal) seizures (POS). This phase 3 study (N01358; NCT01261325) aimed to confirm the efficacy and safety/tolerability of BRV in adults (≥16–80 years) with POS.
The Optimal Cutoff Value of ApolipoproteinB/ApolipoproteinA-I Ratio for the Diagnosis of Metabolic Syndrome and Insulinresistance in the Population of Georgia

Studies have indicated that ApoB/ApoA-I ratio is significantly associated with MetS and IR. This study was designedto assess the optimal cutoff values of ApolipoproteinB/ApolipoproteinA-I (ApoB/ApoA-I) ratio for the diagnosis of metabolic syndrome and insulin resistance (IR) in the population of Georgia. The subjects were 1522 Georgians of Caucasian origin aged 18-80 (653 women and 869 men) without diabetes mellitus. MetS was diagnosed using the updated ATP-III definition of the metabolic syndrome. Receiver operating characteristics (ROC) curve analysis was performed to calculate the cutoff values. ROC analysis showed that areas under the curve (AUCs) of ApoB/ApoA-I ratio for the detection of MetS were 0.786±0.025 (95%CI: 0.737-0.834) in women and 0.815±0.017 (95%CI: 0.782-0.847) in men. AUCs of ApoB/ApoA-I ratio for the diagnosis of IR were 0.887±0.019 (95%CI: 0.850-0.924) in women and 0.816±0.022 (95%CI: 0.773-0.860) in men. After adjustment for age, MetS components and low-density lipoprotein cholesterol, odds ratios according to the determined cutoff values of ApoB/ApoA-I ratio were: for MetS – 1.75 in women and 1.18 in men; for IR – 13.61 in women and 7.75 in men. Study showed that in the population of Georgia optimal cutoff values of ApoB/ApoA-I ratio for the detection of MetS were 0.74 in women and 0.82 in men; for the detection of IR these values were 0.82 in women and 0.98 in men.
Involvement of GATOR complex genes in familial focal epilepsies and focal cortical dysplasia

The discovery of mutations in DEPDC5 in familial focal epilepsies has introduced a novel pathomechanism to a field so far dominated by ion channelopathies. DEPDC5 is part of a complex named GAP activity toward RAGs (GATOR) complex 1 (GATOR1), together with the proteins NPRL2 and NPRL3, and acts to inhibit the mechanistic target of rapamycin (mTOR) complex 1 (mTORC1) pathway. GATOR1 is in turn inhibited by the GATOR2 complex. The mTORC1 pathway is a major signaling cascade regulating cell growth, proliferation, and migration. We aimed to study the contribution of GATOR complex genes to the etiology of focal epilepsies and to describe the associated phenotypical spectrum.
Lack of health insurance and decline in overall health in late middle age.

BACKGROUND The number of adults in their 50s and 60s in the United States who do not have health insurance is increasing. This group may be particularly vulnerable to the ill effects of being uninsured. METHODS We conducted a prospective cohort study using files from the Health and Retirement Study, a national survey of adults who were 51 to 61 years old in 1992. We determined the risks of a major decline in overall health and of the development of new physical difficulties between 1992 and 1996 for participants who were continuously uninsured (uninsured in 1992 and in 1994), those who were intermittently uninsured (uninsured either in 1992 or in 1994), and those who were continuously insured. We used logistic regression to determine the independent effects of being uninsured on health outcomes after adjustment for base-line sociodemographic factors, preexisting medical conditions, and types of health-related behavior such as smoking and alcohol use. RESULTS We analyzed data for 7577 participants. The 717 continuously uninsured participants and the 825 intermittently uninsured participants were more likely than the 6035 continuously insured participants to have a major decline in overall health between 1992 and 1996 (21.6 percent, 16.1 percent, and 8.3 percent of the three groups, respectively; P<0.001 for both comparisons). According to a multivariate analysis, the adjusted relative risk of a major decline in overall health was 1.63 (95 percent confidence interval, 1.26 to 2.08) for continuously uninsured participants and 1.41 (95 percent confidence interval, 1.11 to 1.78) for intermittently uninsured participants, as compared with continuously insured participants. A new difficulty in walking or climbing stairs was also more likely to develop in the continuously or intermittently uninsured participants than in the continuously insured participants (28.8 percent, 26.4 percent, and 17.1 percent of the three groups, respectively; P<0.001 for both comparisons). The adjusted relative risk of such a new physical difficulty was 1.23 (95 percent confidence interval, 1.02 to 1.47) for the continuously uninsured participants and 1.26 (95 percent confidence interval, 1.01 to 1.54) for the intermittently uninsured participants. CONCLUSIONS The lack of health insurance is associated with an increased risk of a decline in overall health among adults 51 to 61 years old.
Transient and chronic seizure‐induced inflammation in human focal epilepsy

In animal models, inflammation is both a cause and consequence of seizures. Less is known about the role of inflammation in human epilepsy. We performed positron emission tomography (PET) using a radiotracer sensitive to brain inflammation in a patient with frontal epilepsy ~36 h after a seizure as well as during a seizure‐free period. When statistically compared to a group of 12 matched controls, both of the patient's scans identified a frontal (supplementary motor area) region of increased inflammation corresponding to his clinically defined seizure focus, but the postseizure scan showed significantly greater inflammation intensity and spatial extent. These results provide new information about transient and chronic neuroinflammation in human epilepsy and may be relevant to understanding the process of epileptogenesis and guiding therapy.
The ClinicalTrials.gov results database--update and key issues.

BACKGROUND The ClinicalTrials.gov trial registry was expanded in 2008 to include a database for reporting summary results. We summarize the structure and contents of the results database, provide an update of relevant policies, and show how the data can be used to gain insight into the state of clinical research. METHODS We analyzed ClinicalTrials.gov data that were publicly available between September 2009 and September 2010. RESULTS As of September 27, 2010, ClinicalTrials.gov received approximately 330 new and 2000 revised registrations each week, along with 30 new and 80 revised results submissions. We characterized the 79,413 registry and 2178 results of trial records available as of September 2010. From a sample cohort of results records, 78 of 150 (52%) had associated publications within 2 years after posting. Of results records available publicly, 20% reported more than two primary outcome measures and 5% reported more than five. Of a sample of 100 registry record outcome measures, 61% lacked specificity in describing the metric used in the planned analysis. In a sample of 700 results records, the mean number of different analysis populations per study group was 2.5 (median, 1; range, 1 to 25). Of these trials, 24% reported results for 90% or less of their participants. CONCLUSIONS ClinicalTrials.gov provides access to study results not otherwise available to the public. Although the database allows examination of various aspects of ongoing and completed clinical trials, its ultimate usefulness depends on the research community to submit accurate, informative data.
Mental Disorders among Burn Patients

49 During the two last decades, the annual number of patients requiring hospitalization because of their burn injuries in Finland has been decreasing from 1300 to 900 patients. In treatment of severe burn injuries hospitalization in specialized burn units is required. The severity of a burn injury is a function of both the characteristics of the burn injury itself and of factors related to the individual.
The training and job decisions of nurses: the first year of a longitudinal study investigating nurse recruitment and retention. CHERE Working Paper 2012/02

Understanding the employment choices and preferences of new entrants to the nursing profession is an important element in the formulation of policies for ensuring an adequate supply of nurses to meet population healthcare needs in the coming decades. A longitudinal cohort study to investigate the job preferences of nursing students and new graduates commenced in New South Wales in 2008. The study aimed to identify the relative importance of job attributes as well as factors such as age, family structure, education and health in nurses? employment choices. In addition to studying actual choices, it uses repeated discrete choice experiments (DCE) to measure preferences for job attributes and how these change after graduation and throughout the early career years. Data collection by annual online surveys commenced in September 2009 and, after one year, 530 participants had completed the first survey. This paper describes the characteristics of this cohort; it also provides an outline of the study and its methods.