Miracle-dz/UniFAR-FTUs huggingface dataset:
Outcome Indicators on Interprofessional Collaboration Interventions for Elderly

Background: Geriatric care increasingly needs more multidisciplinary health care services to deliver the necessary complex and continuous care. The aim of this study is to summarize indicators of effective interprofessional outcomes for this population. Method: A systematic review is performed in the Cochrane Library, Pubmed (Medline), Embase, Cinahl and Psychinfo with a search until June 2014. Results: Overall, 689 references were identified of which 29 studies met the inclusion criteria. All outcome indicators were summarized in three categories: collaboration, patient level outcome and costs. Seventeen out of 24 outcome indicators within the category of ‘collaboration’ reached significant difference in advantage of the intervention group. On ‘patient outcome level’ only 15 out of 32 outcome parameters met statistical significance. In the category of ‘costs’ only one study reached statistical significance. Discussion and conclusion: The overall effects of interprofessional interventions for elderly are positive, but based on heterogeneous outcomes. Outcome indicators of interprofessional collaboration for elderly with a significant effect can be summarized in three main categories: ‘collaboration’, patient level’ and ‘costs’. For ‘collaboration’ the outcome indicators are key elements of collaboration, involved disciplines, professional and patient satisfaction and quality of care. On ‘patient level’ the outcome indicators are pain, fall incidence, quality of life, independence for daily life activities, depression and agitated behaviour, transitions, length of stay in hospital, mortality and period of rehabilitation. ‘Costs’ of interprofessional interventions on short- and long-term for elderly need further investigation. When organizing interprofessional collaboration or interprofessional education these outcome indicators can be considered as important topics to be addressed. Overall more research is needed to gain insight in the process of interprofessional collaboration and so to learn to work interprofessionally.
A Full Phenotype of Paraganglioma Linked to a Germline SDHB Mosaic Mutation.

CONTEXT Heterozygous germline pathogenic variants found in succinate dehydrogenase (SDH) complex genes predispose to hereditary paraganglioma (PGL) syndromes. No mosaicism has yet been reported in this setting. DESIGN AND PARTICIPANT We describe the clinical history of a case of SDH complex, subunit B (SDHB) mosaicism. A 24-year-old woman who developed a cardiogenic shock during dental surgery was diagnosed with a functional para-aortic PGL, which produced predominantly norepinephrine and its metabolites. The tumor was removed and showed a loss of SDHB expression by immunohistochemistry. Four years after initial laparotomy, the patient had a rapid cardiac decompensation during her second pregnancy, despite negative imaging 10 months before. Two recurrent functional PGLs were found and surgically removed. Initial genetic analysis performed by Sanger sequencing did not reveal any germline pathogenic variant in SDHB, VHL, SDHD, SDHC, SDHAF2, RET, MAX, and TMEM127. Next-generation sequencing performed on tumor- and blood-extracted DNAs highlighted the presence of a mosaic rare variant in SDHB (c.557G>A, p.Cys186Tyr) with an allelic ratio of 15% in the blood DNA. CONCLUSIONS We report the full clinical description of a proband with SDHB mosaicism associated with a functional, recurrent PGL. This case strengthens the necessity to complete the genetic analysis with methodologies able to identify germline mosaicism, especially in the case of early disease onset.
The effects of quantization noise and sensor nonideality on digital differentiator-based rate measurement

This paper focuses on the nature of the rate error which arises when a first-order digital differentiator is applied to the output of a uniform quantizer for the purpose of rate estimation. The quantizer input is assumed to be a constant-rate signal which is subject to a uniformly distributed noise source. New formulae are presented for the corresponding rms and spectral error characteristics. The results are applicable to the signal processing of sensor outputs, exemplified by the shaft encoder-based velocity estimation of an almost uniformly rotating mass. Both computer-generated finite data sets and experimental data derived from encoder-based shaft velocity measurements are utilized to verify the theoretical results. The results described are also applicable to a more general class of systems which involve the digital differentiation of quantized, noise-affected signals, such as first-order sigma-delta modulators with nominally constant input.
Impact of Stimulus Polarity on oVEMP Response Using the Belly-Tendon Electrode Montage

Abstract Background: One stimulus parameter not well established with respect to the ocular vestibular evoked myogenic potential (oVEMP) is stimulus polarity. Many research studies traditionally record oVEMPs using alternating polarity primarily. Purpose: The purpose of this study was to evaluate the effects of stimulus polarity on the oVEMP response under three different conditions (condensation, rarefaction, and alternating) with updated but established recording procedures—the belly-tendon electrode montage. Research Design: oVEMPs were assessed with changes in stimulus polarity in the seated upright position. Study Sample: Thirty otologically normal participants (60 ears) with no history of hearing or balance disorders and normal middle ear function. Data Collection and Analysis: Five hundred–hertz air-conducted tone bursts at 95-dB nHL were used to evoke the oVEMP response while recordings were made from the contralateral eye to acoustical stimulation using the belly-tendon electrode montage. Measurements were made using three polarities: alternating, condensation, and rarefaction. Natus Bio-logic AEP hardware and software was used for all data collection and analysis. Results: Condensation stimulus phase provided the largest response amplitude compared with alternating and/or rarefaction. Rarefaction provided the earliest latency among stimulus polarities. Conclusions: Condensation is a more effective stimulus polarity regarding response amplitude when recording the oVEMP. This study further supports the use of the belly-tendon electrode montage for recording the oVEMP response.
Demonstration of a capsule plasmid in Bacillus anthracis

Virulent and certain avirulent strains of Bacillus anthracis harbor a plasmid, designated pXO2, which is involved in the synthesis of capsules. Two classes of rough, noncapsulated (Cap-) variants were isolated from the capsule-producing (Cap+) Pasteur vaccine strains ATCC 6602 and ATCC 4229. One class was cured of pXO2, and the other class still carried it. Reversion to Cap+ was demonstrable only in rough variants which had retained pXO2. Proof that pXO2 is involved in capsule synthesis came from experiments in which the plasmid was transferred by CP-51-mediated transduction and by a mating system in which plasmid transfer is mediated by a Bacillus thuringiensis fertility plasmid, pXO12. Cells of Bacillus cereus and a previously noncapsulated (pXO2-) strain of B. anthracis produced capsules after the acquisition of pXO2.
Missense mutation (R15W) of the connexin32 gene in a family with X chromosomal Charcot-Marie-Tooth neuropathy with only female family members affected

A small family with sensorimotor neuropathy of dominant inheritance was examined. All three affected members were female. They had unusually severe symptoms and pronounced reduction of motor nerve conduction velocities with absent sensory nerve action potentials. Molecular genetic analysis disclosed a missense mutation in the connexin32 gene in codon 15 (Arg15Trp) which predicts the replacement of a basic amino acid to a non-polar amino acid in the first cytoplasmic loop of the protein. This report illustrates that in small pedigrees in which only women are affected, and which show a severe clinical phenotype, X chromosomal Charcot-Marie-Tooth neuropathy should be considered as differential diagnosis.
Effect of different doses of intravenous oxycodone and fentanyl on intubation-related hemodynamic responses

Background: Intubation using direct laryngoscopy is a risky and painful procedure that is associated with undesirable hemodynamic changes such as tachycardia, hypertension, and arrhythmia. Recently, intravenous oxycodone was introduced and used for the control of acute postoperative pain and to attenuate intubation-related hemodynamic responses (IRHRs), but there is insufficient information regarding its proper dosage. We investigated the attenuating effects of different doses of oxycodone and fentanyl on IRHRs. Methods: For calculating oxycodone effective dose (ED95), which attenuated all IRHR changes to less than 20% over baseline values in 95% of male patients at 1 minute after intubation, oxycodone 0.1 mg/kg was injected for the first patient 1 hour before intubation, and the next dose for each subsequent patient was determined by the response of the previous patient using Dixon up-and-down method with an interval of 0.01 mg/kg. After obtaining the predictive oxycodone ED95, 148 patients were randomly allocated to groups receiving normal saline (group C), oxycodone ED95 (group O1), oxycodone 2 × ED95 (group O2), or fentanyl 2 &mgr;g/kg (group F). We recorded the incidence of “success” as a less than 20% change from baseline values in all IRHRs 1 minute after intubation. Results: The predictive oxycodone ED95 was 0.091 (0.081–0.149) mg/kg. The incidence of “success” was highest in group O2 (75.7%), followed by group O1 (62.2%) and group F (45.9%) with significant differences between the groups (P < .001). The systolic, diastolic, mean arterial pressure, and heart rate were not significantly different among groups after administration of either oxycodone or fentanyl. The percentage hemodynamic changes of the group O2 were significantly lower than those of groups F and O1, but the absolute percentage hemodynamic changes were not significantly different among groups F, O1, and O2. The recalculated oxycodone ED95 with probit analysis (0.269 mg/kg) was needed to prevent any arterial pressure and heart rate changes. Conclusions: Oxycodone 0.182 mg/kg is more effective in attenuating all IRHRs than fentanyl 2 &mgr;g/kg with safe hemodynamic changes. Further research is required to determine if the recalculated oxycodone ED95 (0.269 mg/kg) is also effective and hemodynamically safe for preventing all IRHRs.
The future of keratoplasty: cell-based therapy, regenerative medicine, bioengineering keratoplasty, gene therapy.

PURPOSE OF REVIEW To provide an update on the state of development of novel therapeutic modalities for the treatment of corneal diseases. RECENT FINDINGS Novel corneal therapeutics may be broadly classified as cell therapy, regenerative medicine, bioengineered corneal grafts and gene therapy. Cell therapy encompasses cultivation of cells, such as corneal endothelial cells (CECs) and keratocytes to replenish the depleted native cell population. Regenerative medicine is mainly applicable to the corneal endothelium, and is dependent on the ability of native, healthy CECs to restore the corneal endothelium following trauma or descemetorhexis; this approach may be effective for the treatment of Peter's anomaly and Fuchs endothelial corneal dystrophy (FECD). Bioengineered corneal grafts are synthetic constructs designed to replace cadaveric corneal grafts; tissue-engineered endothelial-keratoplasty grafts and bioengineered stromal grafts have been experimented in animal models with favourable results. Gene therapy with antisense oligonucleotide and CRISPR endonucleases, including deactivated Cas9, may potentially be used to treat FECD and TGFBI-related corneal dystrophies. SUMMARY These novel therapeutic modalities may potentially supersede keratoplasty as the standard of care in the future.
Circadian characteristics of urinary epinephrine and norepinephrine from healthy young women in Japan and U.S.A.

Clinically healthy diurnally active young adult women were studied during the same season (March) at the Universities of Kyushu (Fukuoka City, Japan) and of Minnesota (Minneapolis, U.S.A.), under comparable conditions, except that the habitual diets were not changed. The subjects (20 Japanese and 16 Americans of mixed Caucasian background) were studied over a single 24-hr span. Urine was collected at 4-hr intervals. A circadian rhythm in total urinary norepinephrine excretion showed similar characteristics in Japanese and Americans. In epinephrine excretion, the Japanese women showed a statistically significantly higher amplitude with higher peak values, but no statistically significant difference in the rhythm-adjusted mean. This intergroup difference is strictly time dependent; it does not come to the fore in urine samples covering the nocturnal rest span of the subjects.
Over-Expression of OsHOX24 Confers Enhanced Susceptibility to Abiotic Stresses in Transgenic Rice via Modulating Stress-Responsive Gene Expression

Homeobox transcription factors play critical roles in plant development and abiotic stress responses. In the present study, we raised rice transgenics over-expressing stress-responsive OsHOX24 gene (rice homeodomain-leucine zipper I sub-family member) and analyzed their response to various abiotic stresses at different stages of development. At the seed germination stage, rice transgenics over-expressing OsHOX24 exhibited enhanced sensitivity to abiotic stress conditions and abscisic acid as compared to wild-type (WT). OsHOX24 over-expression rice seedlings showed reduced root and shoot growth under salinity and desiccation stress (DS) conditions. Various physiological and phenotypic assays confirmed higher susceptibility of rice transgenics toward abiotic stresses as compared to WT at mature and reproductive stages of rice development too. Global gene expression profiling revealed differential regulation of several genes in the transgenic plants under control and DS conditions. Many of these differentially expressed genes were found to be involved in transcriptional regulatory activities, besides carbohydrate, nucleic acid and lipid metabolic processes and response to abiotic stress and hormones. Taken together, our findings highlighted the role of OsHOX24 in regulation of abiotic stress responses via modulating the expression of stress-responsive genes in rice.
Advances in Brief Overexpression of Bcl-xs Sensitizes MCF-7 Cells to Chemotherapy-induced Apoptosis 1

Resistance to apoptosis plays an important role in tumors that are refractory to chemotherapy. We report that Bcl-x,, which functions like Bcl-2 to inhibit apoptosis, is highly expressed in MCF-7 human breast carcinoma cells. We used Bcl-xs, a dominant negative inhibitor of Bcl-2 and Bcl-x,, to demonstrate the role of these genes in modulating chemo therapy-induced apoptosis. Bcl-xs overexpressed in MCF-7 cells by stable transfection does not affect viability by itself but induces a marked increase in chemosensitivity to VP-16 or taxol. Using an ELISA assay which quantitates DNA damage, we demonstrate that this sensitization is due to apoptosis, suggesting the therapeutic utility of targeting this pathway.
Determinants of disability pension applications and awarded disability pensions in Finland, 2009 and 2014

Aims: Examining the non-medical determinants of applying for and being awarded disability pension is important for assessing the functionality of the disability pension system. We examined how demographic and socioeconomic factors as well as factors related to the disability process associate with the probability of applying for disability pension and the probability of applicants being awarded pension in 2009 and 2014. Methods: 70% random samples of Finnish non-retired residents aged 18–64 in 2009 (n = 2,076,881) and in 2014 (n = 2,097,790) were analysed with logistic regression analysis. The application rates were 0.9% in 2009 and 0.7% in 2014, and the rates of awarded pensions were 80.6% in 2009 and 72.2% in 2014. Results: Being an upper-level non-manual employee and having more employment during the preceding four calendar years decreased the odds of applying for disability pension but increased the odds of being awarded one. Older age increased the odds of both applying for and being awarded pension. Compared to applications based on mental disorders, those applying due to neoplasms and diseases of the circulatory system had increased odds of being awarded pension whereas those applying due to musculoskeletal diseases or injuries had decreased odds. Only minor temporal changes were found in the determinants of applying for or being awarded disability pension. Conclusions: With a greater probability of disability pension applications but also a lower probability of being awarded pension, the occupational disability process involves a comprehensive disadvantage for lower socioeconomic status groups.
Genetic Determinants of Self Identity and Social Recognition in Bacteria

The bacterium Proteus mirabilis is capable of movement on solid surfaces by a type of motility called swarming. Boundaries form between swarming colonies of different P. mirabilis strains but not between colonies of a single strain. A fundamental requirement for boundary formation is the ability to discriminate between self and nonself. We have isolated mutants that form boundaries with their parent. The mutations map within a six-gene locus that we term ids for identification of self. Five of the genes in the ids locus are required for recognition of the parent strain as self. Three of the ids genes are interchangeable between strains, and two encode specific molecular identifiers.
Automatic and robust 3D face registration using multiresolution Spherical Depth Map

Face registration is a necessary preprocessing step for 3D face recognition. An entirely automatic method for 3D face registration is proposed in this paper with high accuracy and good robustness to pose and facial expression variations. Our method consists of the following three stages. Firstly, the face shape is represented by Fitting Sphere Representation (FSR). Secondly, generate the Spherical Depth Map (SDM) of face shape which is normalized roughly to a similar pose. Finally, accurately localize the nose tip using multiresolution SDM by a coarse-to-fine method. Then, in conjunction with the face orientation figured out by linear fitting and the center of fitting sphere, face can be registered completely. Extensive experiments are conducted on five popular 3D face databases. The registration accuracy is near 100 percent. Experimental results demonstrate the high robustness of the proposed methods to pose and expression variations.
Clinical characterization of icotinib-induced chemoresistance in erlotinib-treated lung adenocarcinoma patient with EGFR mutations

Rationale: Mounting evidences reveal that mutation of epidermal growth factor receptor (EGFR) may induce the resistance of tyrosine kinase inhibitors (TKIs). TKI-resistant lung cancer cells are sensitive to inhibition of the EGFR pathway. This case report aimed to characterize the therapeutic benefits of erlotinib, a targeted drug, on an advanced lung cancer patient with somatic EGFR mutation. Patient concerns: A 52-year-old non-smoking Chinese woman was suffered from pneumonia-based chest pains, and the patient was diagnosed as advanced lung cancer through medical imaging, thoracoscopy, and pathological examination. Diagnoses: Blood tests, pathological examination, thoracoscopy, computed tomography (CT)/positron emission computed tomography (PET) scans, next-generation sequencing (NGS) testing were subjected to the patient's samples before and after targeted drug treatments. Interventions: After icotinib-induced resistance, the chemoresistance mechanism was involved in EGFR mutations before being prescribed with erlotinib. Outcomes: The therapeutic effectiveness of icotinib for 4-month showed undetected carcinomatous metastasis. The lung tumor sizes were reduced, and improved quality of life (QOL) was described by the patient. Followed by monotherapy with erlotinib for 1.5-year, the icotinib-resistant patient benefited from longer survival rate without tumor enlargement and neoplastic metastasis. In therapeutic duration of erlotinib, T790M mutation of EGFR, R248W mutation of tumor protein p53 (TP53), K844S mutation of retinoblastoma protein 1 (RB1) were identified through NGS test. Lessons: In conclusion, the anti-cancer benefits of icotinib and erlotinib against advanced lung cancer may contribute to suppress neoplastic growth and metastasis. Further, erlotinib exerts potent efficacy for extended survival rate of patient because detectable mutations may not or limitedly induce erlotinib-resistance. In addition, reduced circulating hormones by menopause may enhance the therapeutic effectiveness of erlotinib.
Association of Preoperative Functional Performance With Outcomes After Surgical Treatment of Head and Neck Cancer: A Clinical Severity Staging System.

Importance Patients with head and neck cancers have comorbidities and other constitutional symptoms known to be associated with adverse postoperative outcomes, but the role of functional performance is not well studied. Objective To explore the addition of functional performance to other clinical factors for association with 3 patient outcomes: 30-day unplanned readmission (UR), 90-day medical complications, and overall survival (OS). Design, Setting, and Participants This retrospective cohort study was conducted in a single tertiary care center with patients surgically treated for squamous cell cancer of the lip, oral cavity, pharynx, or larynx from January 2012 to December 2016. All analysis took place between January 2018 and November 2018. Data from 2 registries were analyzed, supplemented with medical record review. Logistic regression analysis was used to explore association of preoperative functional performance with outcomes. Conjunctive consolidation was used to create a useful clinical severity staging system, which included functional performance (estimated from metabolic equivalent [MET] score: <4, light-intensity activities; ≥4 at least moderate-intensity activities); overall comorbidity severity; preoperative weight loss; and TNM tumor staging. Logistic regression was used to assess the prognostic accuracy of the clinical severity staging system for 30-day UR and 90-day complications, and Cox proportional hazard regression for OS. Exposures All patients underwent surgical treatment for head and neck cancer. Main Outcomes and Measures The primary outcomes were 30-day UR and 90-day complications; the secondary outcome was OS. Results For the 657 patients included, the mean (SD) age was 62.0 (11.3) years; 73% were men (n = 477), and 88% were white (n = 580). A total of 75 (11%) had a 30-day UR; 204 (31%) developed a 90-day complication; and 127 (19%) patients died during the observation period. Individually, poor functional performance (<4 METs), high comorbidity burden, preoperative weight loss, and advanced TNM stage were associated with all 3 outcomes; the increased risk for each outcome ranged from 1.5 to 3.0 times the reference range. Using these 4 variables in combination, the 4-category clinical severity staging system demonstrated a strong association between severity stage and all 3 adverse outcomes: 30-day UR (C statistic, 0.63), 90-day complications (C statistic, 0.63), and OS (C statistic, 0.68). Conclusions and Relevance Poor preoperative functional performance, high comorbidity burden, preoperative weight loss, and advanced tumor stage were all associated with worse patient outcomes after head and neck cancer surgery. The model incorporating all 4 of these factors developed in this study may facilitate patient-centered risk assessment and patient-physician shared preoperative decision making.