Miracle-dz/UniFAR-FTUs huggingface dataset:
Prevalence of nursing assistant training and certification programs within nursing homes, 1997-2007.

PURPOSE The purpose of this study was to describe how the prevalence of nurse aide training and competency evaluation programs (NATCEPs) provided in the nursing home (NH) setting changed between 1997 and 2007, to explore the environmental factors that may be influencing the prevalence of these programs, and to examine how the changing prevalence of NH-based NATCEPs may be affecting those considering certified nursing assistant (CNA) work. METHODS We used the Online Survey Certification and Reporting (OSCAR) data to generate descriptive statistics for 3 groups of NHs from 1997 to 2007: NHs that never provided an NATCEP, those that provided the program throughout the study period, and those that provided the program intermittently. We gathered information on states' policies regarding CNA training by telephone and Internet. Data from the National Nursing Assistant Survey were also utilized to describe where CNAs are receiving their training and what proportion of costs they are paying. RESULTS Prevalence of NH-based programs dropped throughout the study period. It is likely that most CNAs are now receiving their preemployment training outside the NH setting and paying a greater share of their training costs. IMPLICATIONS The shifting of CNA training to venues other than NHs raises important questions about the quality of training and states' ability to monitor training programs. In addition, CNAs receiving training outside NHs pay a greater share of their training costs, possibly creating a disincentive to enter the field.
PROTECTIVE EFFECT OF HEAT PRECONDITIONING OF RAT LIVER GRAFT RESULTING IN IMPROVED TRANSPLANT SURVIVAL1

Background. The protective effect of heat preconditioning of the liver against ischemia-reperfusion injury has been reported mostly in models of transient ischemia in relation to heat shock protein 70 (HSP70). We estimated the effect of heat preconditioning of liver grafts on the transplant survival rate and on apoptosis of sinusoidal endothelial cells (SEC) as well as hepatocytes in a rat model of liver transplantation. Methods. Donor rats of the heat shock (HS) group were subjected to heat preconditioning 48 hr before graft harvest, and HSP70 levels were estimated by Western blot analysis and immunohistochemistry. The liver isografts from the HS group and control (C) group were preserved in Euro-Collins solution for 6 or 8 hr and transplanted orthotopically. Serum hyaluronic acid and alanine aminotransferase were measured, and apoptosis of the SEC and hepatocytes was analyzed by terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end-labeling staining and electron microscopy. Results. HSP70 expression was detected not only in hepatocytes but also in SEC. In the 8-hr preservation model, the 1-week survival rate was 60% in the HS group and 0% in the C group. Serum hyaluronic acid and alanine aminotransferase levels in the HS group were significantly lower than those in the C group at 3 hr after reperfusion, and the number of terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end-labeling–positive SEC in the C group (35.2%) was markedly increased compared with the HS group (10.1%). Electron microscopic examination confirmed the features of apoptosis of SEC. Conclusions. Heat preconditioning of the graft improved the survival rate of the liver transplants. Induction of HSP70 in SEC as well as in hepatocytes might attenuate preservation-reperfusion injury by inhibiting apoptosis of SEC.
A Multiagent Based Approach to Money Laundering Detection and Prevention

The huge amount of bank operations that occur every day makes it extremely hard for financial institutions to spot malicious money laundering related operations. Although some predefined heuristics are used they arenât restrictive enough, still leaving to much work for human analyzers. This motivates the need for intelligent systems that can help financial institutions fight money laundering in a diversity of ways, such as: intelligent filtering of bank operations, intelligent analysis of suspicious operations, learning of new detection and analysis rules. In this paper, we present a multiagent based approach to deal with the problem of money laundering by defining a multiagent system designed to help financial institutions in this task, helping them to deal with two main problems: volume and rule improvement. We define the agent architecture, and characterize the different types of agents, considering the distinct roles they play in the process.
Ovary and ovulation: Low temperature storage and grafting of human ovarian tissue

Ovarian tissue storage at low temperatures is a promising new method for protecting young cancer patients from the sterilizing effects of chemotherapy and/or radiotherapy. Tissue can be stored and returned to the body in due course as a thin cortical graft since the primordial follicles are distributed peripherally and are relatively resistant to ischaemia. Slices of tissue donated by healthy patients were trimmed to a uniform size and preserved by slow freezing to liquid nitrogen temperatures for up to 2 months in one of the following cryoprotectants: dimethylsulphoxide, ethylene glycol, glycerol, propylene glycol. Their viability was assessed by counting follicles in histological sections 18 days after grafting under the kidney capsules of severe combined immunodeficiency (SCID) mice, and the results were expressed as percentages of the numbers in comparable pieces of ungrafted tissue. While only 10% of the total number of follicles was found in the glycerol group compared to controls, significantly higher percentages (44-84%) survived cryopreservation in the other media. The tissues were sterile when frozen and thawed without a cryoprotectant. These results suggest that if comparable results could be achieved by autografting, a patient's fertility should be safeguarded from cytotoxic treatment.
What does it mean to be green?

Today a company is not considered environmentalist unless it moves beyond mere compliance with government regulations to behavior its competitors, and even customers, do not expect. How should it set its agenda? Author Art Kleiner proposes that, to be green, a company must ask three questions: What products should we bring to market? How much disclosure of pollution information should we support? And how can we reduce waste at its source? These questions can't be answered, Kleiner says, unless managers insist on sustainable growth. In this sense, a big investment in environmentalism is like a big one in R&D--both presuppose patient capital and managerial maturity. What are green products? Kleiner cautions against giving in to misinformed public opinion--as McDonald's did in giving up its styrene "clamshells," which were more recyclable than the composite papers it switched to. Rather, companies should rely on literature that analyzes the product life cycle. As for public disclosure, the benefits may be unexpected. Federal legislation requiring companies to report the emission of potentially hazardous waste to a central data bank has not made environmentalists attack them. Rather, it has forced companies to learn what chemicals they inadvertently produce and how much--knowledge that helps them improve production processes. Sharing it helps ecological researchers study the combined effects of plant emissions. As for pollution prevention, Kleiner notes the analogy to quality and observes that it is better to design harmful waste products out of the system than catch them at the end of the line. (ABSTRACT TRUNCATED AT 250 WORDS)
A Brief Culturally Tailored Intervention for Puerto Ricans With Type 2 Diabetes

The information—motivation—behavioral skills (IMB) model of health behavior change informed the design of a brief, culturally tailored diabetes self-care intervention for Puerto Ricans with type 2 diabetes. Participants (n = 118) were recruited from an outpatient, primary care clinic at an urban hospital in the northeast United States. ANCOVA models evaluated intervention effects on food label reading, diet adherence, physical activity, and glycemic control (HbA1c). At follow-up, the intervention group was reading food labels and adhering to diet recommendations significantly more than the control group. Although the mean HbA1c values decreased in both groups (Intervention: 0.48% vs. Control: 0.27% absolute decrease), only the intervention group showed a significant improvement from baseline to follow-up (p < .008), corroborating improvements in diabetes self-care behaviors. Findings support the use of the IMB model to culturally tailor diabetes interventions and to enhance patients’ knowledge, motivation, and behavior skills needed for self-care.
Furosemide/Fludrocortisone Test and Clinical Parameters to Diagnose Incomplete Distal Renal Tubular Acidosis in Kidney Stone Formers.

BACKGROUND AND OBJECTIVES Incomplete distal renal tubular acidosis is a well known cause of calcareous nephrolithiasis but the prevalence is unknown, mostly due to lack of accepted diagnostic tests and criteria. The ammonium chloride test is considered as gold standard for the diagnosis of incomplete distal renal tubular acidosis, but the furosemide/fludrocortisone test was recently proposed as an alternative. Because of the lack of rigorous comparative studies, the validity of the furosemide/fludrocortisone test in stone formers remains unknown. In addition, the performance of conventional, nonprovocative parameters in predicting incomplete distal renal tubular acidosis has not been studied. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS We conducted a prospective study in an unselected cohort of 170 stone formers that underwent sequential ammonium chloride and furosemide/fludrocortisone testing. RESULTS Using the ammonium chloride test as gold standard, the prevalence of incomplete distal renal tubular acidosis was 8%. Sensitivity and specificity of the furosemide/fludrocortisone test were 77% and 85%, respectively, yielding a positive predictive value of 30% and a negative predictive value of 98%. Testing of several nonprovocative clinical parameters in the prediction of incomplete distal renal tubular acidosis revealed fasting morning urinary pH and plasma potassium as the most discriminative parameters. The combination of a fasting morning urinary threshold pH <5.3 with a plasma potassium threshold >3.8 mEq/L yielded a negative predictive value of 98% with a sensitivity of 85% and a specificity of 77% for the diagnosis of incomplete distal renal tubular acidosis. CONCLUSIONS The furosemide/fludrocortisone test can be used for incomplete distal renal tubular acidosis screening in stone formers, but an abnormal furosemide/fludrocortisone test result needs confirmation by ammonium chloride testing. Our data furthermore indicate that incomplete distal renal tubular acidosis can reliably be excluded in stone formers by use of nonprovocative clinical parameters.
A Practical Method to Calibrate Self-Reported Adherence to Antiretroviral Therapy

Objective:Self-report of antiretroviral medications adherence is inexpensive and simple to use in clinical settings but grossly overestimates adherence. We investigated methods to calibrate patients' self-reported adherence to match objectively measured adherence more closely for the purpose of developing a practical and more accurate self-reported adherence measure. Design:Longitudinal cohort design. Methods:Using data from 2 prospective longitudinal clinical investigations conducted at 5 HIV clinics, we examined the discrepancy between self-reported adherence and objectively measured adherence. We evaluated the relation between attitudinal measures and the degree of discrepancy and used a cross-validation approach to propose candidate items to improve adherence survey methodology. Results:Among 330 patients, self-reported adherence was consistently higher than objectively measured adherence. The best calibration models included the patient's self-reported adherence, duration of the antiretroviral regimen, and attitudinal measures (ability to take medication as instructed, believing medication can help one to live longer, whether or not it is too troublesome to take antiretrovirals, and feeling things are going the right way). Conclusion:The method efficiently identified survey items to improve self-reported adherence measurement. The calibrated measure more closely approximates objectively measured adherence and is more sensitive for detecting nonadherence. These models merit evaluation in other settings.
Improving accrual of older persons to cancer treatment trials: a randomized trial comparing an educational intervention with standard information: CALGB 360001.

PURPOSE To design and test a geriatric educational intervention to improve accrual of cancer patients age 65 years and older to cooperative group-sponsored treatment trials. METHODS Main member institutions of the Cancer and Leukemia Group B (CALGB) and its affiliates were randomly assigned to receive standard information (n = 73) or educational intervention (n = 53). Standard information included CALGB Web site access and periodic notification about existing trials. The geriatric educational intervention included standard information plus: (1) an educational seminar; (2) educational materials; (3) a list of available protocols for use on charts; (4) a monthly e-mail and mail reminders for 1 year; and (5) a case discussion seminar. The main outcome was percentage of accrual of older persons to phase II and III treatment protocols after study initiation compared with baseline. RESULTS There were 3,032 patients entered onto trials in the baseline year, and 2,160 and 1,239 during the 2 years postintervention, respectively. Overall percentage of accrual of older patients was 37% at baseline, and 33% and 31% during the first and second years after intervention. There was no improvement in accrual in the intervention versus control arm: 36% v 32% in the first year and 31% v 31% in the second year. CONCLUSION Accrual of older patients was not increased by this intervention. Reasons for lack of effect include low intervention intensity, high baseline accrual rates, and closure of several high-accruing protocols during the study. More intense and multifaceted approaches will be needed to change physician (and patient) behavior and to increase accrual of older persons to clinical trials.
Deformity correction by Ilizarov distraction osteogenesis after distal radius physeal arrest.

OBJECTIVE The aim of this study was to evaluate the results of osteotomy and distraction osteogenesis using Ilizarov circular external fixator to treat radial shortening and severe wrist deformity due to neglected post-traumatic distal radius physeal arrest. METHODS The study retrospectively reviewed 4 patients (4 males; average age: 16 years; range: 14 to 19 years) who underwent osteotomy and distraction osteogenesis to treat radial shortening and severe wrist deformity due to neglected distal radius physeal arrest. Mean interval between trauma and surgical intervention was 8 (range: 4 to 12) years and mean follow-up time was 83 (range: 40 to 126) months. Patients were evaluated with radiographic measurements (shortening and lengthening ratio, radioulnar joint leveling, distal radioulnar joint congruency), objective functional measurements (grip and pinch strength, range of motion measurements [ROM]) and subjective functional measurements (Disabilities of the Arm, Shoulder and Hand [DASH] questionnaire and Mayo wrist score). Statistical analysis was made using the Mann-Whitney U non-parametric test. RESULTS Radiographic measurements were obtained preoperatively and at the final follow-up. The mean shortening ratio of the radius was 14.6% (range: 9.3% to 18.7%) and mean lengthening ratio was 15.9% (range: 13.2% to 18.3%). Normal distal radioulnar joint leveling and distal radioulnar congruency resembling a joint was established in all but one patient with four millimeters of ulna plus deformity. According to the Mann-Whitney U non-parametric test, there was no statistical difference in grip and pinch power, ROM on flexion/extension, and ulnar/radial deviation axis between the operated and non-operated sides. There was statistically significant pronation/supination restriction between the operated and non-operated sides (p<0.04). Mean DASH score was 2.07 (range: 0.0 to 8.3) and the mean Mayo wrist score was 89 (range: 75 to 100) points. According to the Mayo wrist score, results were excellent in one patient, good in two patients, and satisfactory in one patient. CONCLUSION The use of distal metaphyseal osteotomy and Ilizarov distraction osteogenesis is a viable treatment method for neglected physeal fractures of the distal radius as it establishes acceptable deformity correction and a functional wrist joint.
FTY720 Pretreatment Reduces Warm Hepatic Ischemia Reperfusion Injury Through Inhibition of T‐Lymphocyte Infiltration

Ischemia and reperfusion (IR) injury remains a significant problem in clinical liver transplantation. We investigated the effects of lymphocyte depletion with FTY720 in models of warm hepatic IR. Using 60‐min partial warm hepatic IR, three groups of rats were studied: Sham – laparotomy alone; Control – water p.o. × 3 d before ischemia; Treatment – FTY720 p.o. × 3 d before ischemia. Animals were sacrificed for analysis at 6 h and 24 h post reperfusion. The effect of FTY720 pretreatment on survival was also studied using 150 min total hepatic IR with portojugular shunt. FTY720 treatment significantly reduced serum glutamic pyruvic transaminase and peripheral blood lymphocytes compared to controls at 6 h and 24 h (p < 0.0005). Histological grade was significantly improved in treated livers vs. controls (p < 0.05). CD3 immunocytochemical analysis revealed a significant reduction in T‐cell infiltration in FTY720‐treated livers (p < 0.0002). No difference in tissue myeloperoxidase levels was observed. Seven‐day survival was significantly improved in treated rats vs. controls following total hepatic ischemia (p < 0.05). In conclusion, FTY720 ameliorates the biochemical and histological manifestations of hepatic IR by preventing T‐lymphocyte infiltration and prolongs survival following a more severe ischemic insult. Myeloperoxidase data suggest this mechanism is independent of neutrophil activation. These results indicate that T lymphocytes are pivotal mediators in hepatic IR and may have important implications in liver transplantation.
P2Y6 Receptor Antagonist MRS2578 Inhibits Neutrophil Activation and Aggregated Neutrophil Extracellular Trap Formation Induced by Gout-Associated Monosodium Urate Crystals

Human neutrophils (polymorphonuclear leukocytes [PMNs]) generate inflammatory responses within the joints of gout patients upon encountering monosodium urate (MSU) crystals. Neutrophil extracellular traps (NETs) are found abundantly in the synovial fluid of gout patients. The detailed mechanism of MSU crystal–induced NET formation remains unknown. Our goal was to shed light on possible roles of purinergic signaling and neutrophil migration in mediating NET formation induced by MSU crystals. Interaction of human neutrophils with MSU crystals was evaluated by high-throughput live imaging using confocal microscopy. We quantitated NET levels in gout synovial fluid supernatants and detected enzymatically active neutrophil primary granule enzymes, myeloperoxidase, and human neutrophil elastase. Suramin and PPADS, general P2Y receptor blockers, and MRS2578, an inhibitor of the purinergic P2Y6 receptor, blocked NET formation triggered by MSU crystals. AR-C25118925XX (P2Y2 antagonist) did not inhibit MSU crystal–stimulated NET release. Live imaging of PMNs showed that MRS2578 represses neutrophil migration and blocked characteristic formation of MSU crystal–NET aggregates called aggregated NETs. Interestingly, the store-operated calcium entry channel inhibitor (SK&F96365) also reduced MSU crystal–induced NET release. Our results indicate that the P2Y6/store-operated calcium entry/IL-8 axis is involved in MSU crystal–induced aggregated NET formation, but MRS2578 could have additional effects affecting PMN migration. The work presented in the present study could lead to a better understanding of gouty joint inflammation and help improve the treatment and care of gout patients.
Scale-Invariance of Normalized Yearly Mean Grain Yield Anomaly Series

In crop science, tools of non-linear dynamics, fractals, chaos, intermittency and self-organized criticality may be employed and applied to the analysis of spatial variability and temporal behavior of agro-meteorological variables, soil properties, plant attributes, commercial yields, and prices of the agricultural products in order to gain knowledge about underlying complex processes. A search on the occurrence of particular scaling laws in Mexico's normalized yearly mean grain yield anomaly series of maize (Zea mays L.), beans (Phaseolus vulgaris L.), wheat (Triticum aestivum L.) and rice (Oriza sativa L.), using a variography approach is reported in this work. Additionally, power spectrum determination, time-frequency analysis, and estimation of Lyapunov exponent were performed for each profile in order to obtain useful information on the frequency contents and signs at which important frequencies occur as well as to determine their sensitivity to initial conditions. Fractal analysis gives us the order maize
Ranolazine improves autonomic balance in heart failure when added to guideline-driven therapy

Background The effect of ranolazine (RAN) on cardiac autonomic balance in congestive heart failure (CHF) was studied. Methods Fifty-four CHF patients were randomized to (1) open-label RAN (RANCHF) added to usual therapy vs. (2) usual therapy (NORANCHF). Parasympathetic and sympathetic (P&S) measurements were taken at baseline and at 12 months. Results A total of 16/27 (59%) patients in both groups had initially abnormal P&S measures, including high sympathovagal balance (SB), cardiovascular autonomic neuropathy (CAN) or both. High SB normalized in 10/12 (83%) RANCHF patients vs. 2/11 (18%) NORANCHF patients. SB became high in 5/11 (45%) NORANCHF vs. 1/11 (9%) RANCHF patients. CAN improved in 4/6 (67%) RANCHF patients vs. 5/7 (45%) NORANCHF patients. CAN developed in 1/11 (9%) RANCHF vs. 4/11 (36%) NORANCHF patients. Since improved P&S in RANCHF patients seemed independent of improved brain natriuretic peptide and impedance cardiography (BioZ) measurements, 5 day RAN was given to 30 subjects without CHF but with high SB or CAN. P&S improved in 90% of these subjects. Conclusions RAN improves unfavorable P&S activity in CHF possibly by a direct effect upon autonomic sodium channels.
Molecular Diagnosis of Toxoplasmosis in Non Immune Pregnant Females

Abstract BACKGROUND AND AIM: Infection with the protozoan parasite Toxoplasma gondii has a worldwide distribution. Congenital infection is the most important part of the disease burden due to Toxoplasma infection in humans. Early diagnosis of maternal infection helps to prevent severe complications of toxoplasmosis. In the present study, three PCR assays (conventional, nested & quantitative) were evaluated for diagnosis of recent toxoplasmosis based on detection of Toxoplasma B1 gene. MATERIAL AND METHODS: The present study was carried out on 150 pregnant females who were serologically negative for anti-Toxoplasma IgG and IgM antibodies. RESULTS: The results revealed that out of 12 true positive cases (by 2 out of the 3 PCR protocols), 8 cases were positive by cPCR, 11 cases were positive by nPCR and 12 cases were positive by qPCR. Accurate estimation of genomic Toxoplasma DNA in positive samples was achieved by qPCR. In general, PCR assays offer a sensitive alternative of serological methods for diagnosis of recent maternal toxoplasmosis. In addition, qPCR decreases the risk of contamination of PCR products being a closed tube method and helps in estimation of infection load. CONCLUSIONS: We recommend screening of high-risk pregnant women by qPCR for early diagnosis of toxoplasmosis and proper management.