Miracle-dz/UniFAR-FTUs huggingface dataset:
Preparation of multilocation reduction-sensitive core crosslinked folate-PEG-coated micelles for rapid release of doxorubicin and tariquidar to overcome drug resistance

Herein, we prepared folate-targeting core crosslinked polymeric micelles (CCL/FA) containing multiple disulfide bonds located at the interface and core of the micelles to co-deliver doxorubicin (DOX) and the P-glycoprotein (P-gp) inhibitor tariquidar (TQR) for reversing drug resistance. The stability and redox-responsive behavior of the CCL/FA micelles was evaluated through the changes in morphology, molecular weight and hydrodynamic size. On the one hand, the micelles possessed good stability, which led to the suppression of drug release from the CCL micelles in the physiological environment. On the other hand, under reductive conditions, the CCL micelles collapsed rapidly and accelerated drug release markedly. In vitro cytotoxicity measurements, combined with confocal laser scanning microscopy (CLSM) and flow cytometry, confirmed that the dual-drug-loaded micelles exhibited obviously higher cytotoxicity to MCF-7/ADR-resistant cells than free DOX · HCl, single-drug loaded CCL micelles and nontargeted CCL micelles. The results imply that co-delivering DOX and TQR by CCL/FA micelles may be a promising way of overcoming multidrug resistance in tumor treatments.
Electrical instability of high-mobility zinc oxynitride thin-film transistors upon water exposure

We investigate the effects of water absorption on the electrical performance and stability in high-mobility zinc oxynitride (ZnON) thin-film transistors (TFTs). The ZnON TFT exhibits a smaller field-effect mobility, lower turn-on voltage, and higher subthreshold slope with a deteriorated electrical stability under positive gate bias stresses after being exposed to water. From the Hall measurements, an increase of the electron concentration and a decrease of the Hall mobility are observed in the ZnON thin film after water absorption. The observed phenomena are mainly attributed to the water molecule-induced increase of the defective ZnXNY bond and the oxygen vacancy inside the ZnON thin film based on the x-ray photoelectron spectroscopy analysis.
Development of a Music Therapy Service in an Australian Public Rehabilitation Hospital

It is often challenging to find information about the details and development of clinical music therapy programs in other parts of the world. This article addresses a gap in the literature by describing the evolution of a neurological rehabilitation program over the past two years in Melbourne, Australia. After providing some local details on the development of rehabilitation music therapy in this part of the world, a brief rationale is offered for the place of music therapy in clinical rehabilitation services. This is followed by a detailed description of the implementation, operation and evaluation of the music therapy program established at the Royal Talbot Rehabilitation Centre in 2004. Music therapy in adult neurological rehabilitation is still an emerging area of practice in Australia. Although the first music therapy service for adult rehabilitation was piloted and developed here over 13 years ago, few rehabilitation facilities currently employ music therapy as a standard part of rehabilitation service. Although research and practice of music therapy in rehabilitation internationally is relatively new, it has been practiced for around 20 to 30 years in the United Kingdom and the United States of America respectively. The scarcity of music therapy positions in rehabilitation facilities in Australia is possibly a reflection of the lack of understanding of music therapy on the part of funding bodies and the shortage of rigorous music therapy research in this field. The establishment of new music therapy positions in rehabilitation facilities reflects the development of music therapy in neurorehabilitation internationally in terms of research, clinical practice and publications.
The july effect: an analysis of never events in the nationwide inpatient sample.

BACKGROUND Prior studies examining the impact of the "July effect" on in-hospital mortality rates have generated variable results. In 2008, the Centers for Medicare & Medicaid Services published a series of high-cost, high-volume, nonreimbursable hospital-acquired complications (HACs). These events were believed to be preventable and indicate deficiencies in healthcare delivery. OBJECTIVE The present study aims to investigate the impact of July admissions on patient safety in a national sample using the HACs as a metric. DESIGN/SETTING/PATIENTS Discharge data were collected from all admissions recorded in the Nationwide Inpatient Sample database from 2008 to 2011. HAC incidence was evaluated as a function of admission month, adjusting for demographic and hospital factors in multivariable analysis. MEASURES The outcome measures were HAC occurrence, prolonged length of stay (LOS), and higher inpatient costs. RESULTS A total of 143,019,381 inpatient admissions were recorded, with an overall HAC occurrence of 4.7%. July admissions accounted for 7.6% of the total number of inpatient admissions. July admissions experienced a 6% increase in likelihood of HAC occurrence (odds ratio = 1.06, 95% confidence interval: 1.06-1.07, P < 0.001) when compared to those admitted during all other months. Patients with HAC occurrence had almost 2 times increased likelihood of prolonged LOS (P < 0.001) and higher inpatient costs (P < 0.001). CONCLUSIONS July admissions are associated with increased likelihood of HAC occurrence. This trend may represent breakdowns in organization structure distinct from traditional quality measures, requiring novel transition protocols dedicated to improving HACs.
Impact of transesophageal echocardiography on clinical management of patients over age 50 with cryptogenic stroke and normal transthoracic echocardiogram.

BACKGROUND The utility of transesophageal echocardiography (TEE) subsequent to a normal transthoracic echocardiogram (TTE) in older patients with an unexplained stroke is uncertain. METHODS Two hundred sixty-three consecutive patients over the age of 50 years hospitalized with a clinical stroke confirmed with brain magnetic resonance imaging and a normal TTE were retrospectively analyzed. Patients with atrial fibrillation, atrial flutter, or any other causative reason for stroke were excluded. TEE was analyzed for findings that could explain the etiology of stroke as well as findings that would change therapy based on current guidelines. RESULTS Baseline characteristics included a mean age of 66.7 years (range, 50-91 years); 42.5% of patients were female. A possible etiology of stroke was discovered by TEE in 111 (42.2%) patients and included 1 or more of the following: complex plaque of the ascending aorta or arch, patent foramen ovale, atrial septal aneurysm, both atrial septal aneurysm and patent foramen ovale, or spontaneous contrast. Only 1 patient (0.4%) had a finding that changed immediate management, which was a thrombus in the left atrial appendage for which anticoagulation was prescribed. Follow-up was available at 6 months on 85 patients, of whom 13 (15%) had been discovered to have developed atrial fibrillation. CONCLUSION In our study population, when performed subsequent to a normal TTE in patients aged >50 years with cryptogenic stroke, TEE demonstrated a high diagnostic value, but had minimal incremental effect on patient management.
Manifest latent and congenital nystagmus waveforms in the same subject A need to reconsider the underlying mechanisms of nystagmus

We report a unique case of a horizontal manifest latent nystagmus (MLN) that is converted to a congenital nystagmus (CN) on covering the subjectþs only seeing eye. The subject is a 65-year-old female who, at five days after birth, had her right eye ennucleated. A prosthetic eye was fitted soon after. Horizontal eye movements were recorded using an IRIS (Skalar Medical) infrared system. The effect of visual feedback on primary and secondary gaze, smooth pursuit, optokinetic responses, and the role of selective attention on fixation stability were examined. On primary gaze with the left eye open and under normal viewing conditions, the patient exhibited a typical MLN waveform. The slow phase was a decreasing velocity and the fast phase beat to the left. On covering the left eye, the nystagmus slow phase immediately increased in velocity and the fast phase beat to the right. Removal of visual feedback (darkness or stabilising the retinal image) also brought about a change from MLN to CN. Both the MLN and CN .
Predictors of warfarin-associated adverse events in hospitalized patients: Opportunities to prevent patient harm.

BACKGROUND The optimum international normalized ratio (INR) monitoring frequency for hospitalized patients receiving warfarin is unknown. OBJECTIVE Assess relationship between daily versus less frequent INR monitoring and overanticoagulation and warfarin-related adverse events. DESIGN Retrospective cohort study using Medicare Patient Safety Monitoring System data. SETTING Randomly selected acute care hospitals across the United States. PATIENTS Patients hospitalized from 2009 to 2013 for pneumonia, acute cardiac disease, or surgery who received warfarin. INTERVENTIONS None. MEASUREMENTS (1) Association between frequency of INR monitoring and an INR ≥6.0 or warfarin-related adverse event. (2) Association between the rate of change of the INR and a subsequent INR ≥5.0 and ≥6.0. RESULTS Among 8529 patients who received warfarin for ≥3 days, for 1549 (18.2%) the INR was not measured on 2 or more days. These patients had higher propensity-adjusted odds ratios (ORs) of having a warfarin-associated adverse event (OR: 1.48, 95% confidence interval [CI]: 1.02-2.17) for cardiac patients and surgical patients (OR: 1.73, 95% CI: 1.20-2.48), with no significant association for pneumonia patients. Cardiac and pneumonia patients with 1 day or more without an INR measurement had higher propensity-adjusted ORs of having an INR ≥6.0 (OR: 1.61, 95% CI: 1.07-2.41 and OR: 1.92, 95% CI: 1.36-2.71, respectively). A 1-day increase in the INR of ≥0.9 occurred in 621 patients (12.5%) and predicted a subsequent INR of ≥6.0 (positive likelihood ratio of 4.2). CONCLUSION Daily INR measurement and recognition of a rapidly rising INR might decrease the frequency of warfarin-associated adverse events in hospitalized patients.
Insufficient prenatal care in Finland and Baden-Wurttemberg characteristics of women and infant outcome

The amount of prenatal care and the relationship between insufficient prenatal care, mothers' characteristics and infant outcome were studied in Finland and in Baden-Wurttemberg, Germany. The main sources of data were the Finnish Medical Birth Register (N=193,659) and the Perinatal Survey of Baden-Wurttemberg (N=307,152) in 1991–1993. Insufficient prenatal care was defined as no visits, 1 or 2 visits or late attendance. Most of the women - also those in the risk groups for low use of care (foreigners, young mothers, grand multiparas, single mothers and women with a poor social status) - were using prenatal care extensively. The proportion of women having insufficient care was 3.4% in Finland and 8.1% in Baden-Wurttemberg, most of them being late attenders. Among women with insufficient care, 39% in Finland and 55% in Baden-Wurttemberg were from the risk groups identified. Foreign nationals contributed 10% of the women with insufficient care in Finland and 44% in Baden-Wurttemberg. The group of women with insufficient prenatal care was heterogeneous and it could not be defined by using traditional risk factors only. Infants of mothers with few prenatal visits had poorer outcomes, but the attributable proportion of insufficient prenatal care to infant outcome was small.
A comparison of plasmid DNA delivery efficiency and cytotoxicity of two cationic diblock polyoxazoline copolymers

Cationic polymers as non-viral gene delivery carriers are widely used because of their strong condensing properties and long-term safety, but acute cytotoxicity is a persistent challenge. In this study, two types of polyplexes were prepared by co-formulating plasmid DNA and two cationic diblock copolymers PABOXA5-b-PMOXA33-PA (primary amine) and PABOXA5-b-PMOXA33-TA (tertiary amine) to check their transfection efficacies in HeLa cells and HEK293T cells, respectively. The plasmid DNA/PABOXA5-b-PMOXA33-PA polyplex showed higher transfection efficacy compared to the plasmid DNA/PABOXA5-b-PMOXA33-TA polyplex under an N/P ratio of 40. Both polymers exhibited low toxicity, attributed to the shielding effect of a hydrophilic, noncharged block. Mechanistic insight into differential transfection efficiencies of the polymers were gained by visualization and comparison of the condensates via transmission electron and atomic force microscopy. The results provide information suited for further structure optimization of polymers that are aimed for targeted gene delivery.
Structure and outcomes of interdisciplinary rounds in hospitalized medicine patients: A systematic review and suggested taxonomy.

BACKGROUND Interdisciplinary rounds (IDR) have been described to improve outcomes. However, there is limited understanding of optimal IDR design. PURPOSE To systematically review published reports of IDR to catalog types of IDR and outcomes, and assess the influence of IDR design on outcomes. DATA SOURCES Ovid MEDLINE, Ovid MEDLINE In-Process & Other Non-Indexed Citations, Journals Ovid, Cumulative Index to Nursing and Allied Health Literature (EBSCOhost), and PubMed from 1990 through December 2014, and hand searching of article bibliographies. STUDY SELECTION Experimental, quasiexperimental, and observation studies in English-language literature where physicians rounded with another healthcare professional in inpatient medicine units. DATA EXTRACTION Studies were abstracted for study setting and characteristics, and design and outcomes of IDR. DATA SYNTHESIS Twenty-two studies were included in the qualitative analysis. Many were of low to medium quality with few high-quality studies. There is no clear definition of IDR in the literature. There was wide variation in IDR design and team composition across studies. We found three different models of IDR: pharmacist focused, bedside rounding, and interdisciplinary team rounding. There are reasonable data to support an association with length of stay and staff satisfaction but little data on patient safety or satisfaction. Positive outcomes may be related to particular components of IDR design, but the relationship between design and outcomes remains unclear. CONCLUSIONS Future studies should be more deliberately designed and fully reported with careful attention to team composition and features of IDR and their impact on selected outcomes. We present a proposed IDR definition and taxonomy for future studies. Journal of Hospital Medicine 2016;11:513-523. © 2016 Society of Hospital Medicine.
Revolution in Science

ABSTRACT The distinguished professor emeritus of the History of Science at Harvard offers here a distillate of a career of research, reading, and reflection on revolutions in science. Distillate may seem an odd term for a book whose 30 chapters and 472 pages of text are supplemented by nearly 100 pages in small print of glosses and documented by more than 100 further pages of notes and bibliography. Cohen's wide-ranging encyclopedic scope encompasses Newton, Lavoisier, Kant, Darwin, Marx, Freud, Einstein, and many others. There is a mine of information for lay and professional readers and students of history. Yet, as a survey of case histories of major revolutions in science, the book presents little in the way of detailed analysis or broad interpretation that will seem new to historians of science in their respective areas of research interest.Cohen seeks to show that revolutions in science generally develop in four stages,
Toward structural/chemical cotailoring of phase‐change Ge–Sb–Te in a transmission electron microscope

Ge2Sb2Te5, as the prototype material for phase‐change memory, can be transformed from amorphous phase into nanoscale rocksalt‐type GeTe provided with an electron irradiation assisted by heating to 520°C in a 1250 kV transmission electron microscope. This sheds a new light into structural and chemical cotailoring of materials through coupling of thermal and electrical fields.
Photoresponsive lipid-polymer hybrid nanoparticles for controlled doxorubicin release

Currently, photoresponsive nanomaterials are particularly attractive due to their spatial and temporal controlled drug release abilities. In this work, we report a photoresponsive lipid-polymer hybrid nanoparticle for remote controlled delivery of anticancer drugs. This hybrid nanoparticle comprises three distinct functional components: (i) a poly(D,L-lactide-co-glycolide) (PLGA) core to encapsulate doxorubicin; (ii) a soybean lecithin monolayer at the interface of the core and shell to act as a molecular fence to prevent drug leakage; (iii) a photoresponsive polymeric shell with anti-biofouling properties to enhance nanoparticle stability, which could be detached from the nanoparticle to trigger the drug release via a decrease in the nanoparticle’s stability under light irradiation. In vitro results revealed that this core–shell nanoparticle had excellent light-controlled drug release behavior (76% release with light irradiation versus 10% release without light irradiation). The confocal microscopy and flow cytometry results also further demonstrated the light-controlled drug release behavior inside the cancer cells. Furthermore, a CCK8 assay demonstrated that light irradiation could significantly improve the efficiency of killing cancer cells. Meanwhile, whole-animal fluorescence imaging of a tumor-bearing mouse also confirmed that light irradiation could trigger drug release in vivo. Taken together, our data suggested that a hybrid nanoparticle could be a novel light controlled drug delivery system for cancer therapy.
Maternal blood vascular architecture of the dog placenta during the second half of pregnancy.

The maternal vascular architecture of the dog girdle placenta from 30 to 63 (full term) days of pregnancy was investigated on corrosion casts by means of scanning electron microscopy.Each zone in the zonary girdle of the dog placenta was supplied by the radial arteries which were emitted from the arcuate arteries. The radial arteries branched three to five times giving off arterioles in the middle of the labyrinth which reached the allantochorionic side of the labyrinth. Subsequently, the arterioles emitted capillaries which formed a network in the labyrinthine zone. The capillary network was oriented in feto-maternal direction. Venules originating from the network converged into the radial veins near the junctional zone. Finally the radial veins joined the arcuate veins.At 30 days of pregnancy, the capillary network of the labyrinthine zone had a basic architecture. It developed remarkably in quantity from 30 to 45 days of pregnancy, with prominent development from 40 to 45 days. Though the network continuously developed from 45 days onward, the rate of development was lower than before. In the placenta of 45 days, the capillary network of the labyrinthine zone completed its development as well as its arrangement.
A hospitalist-run short-stay unit: features that predict length-of-stay and eventual admission to traditional inpatient services.

BACKGROUND Short-stay units (SSUs) provide an alternative to traditional inpatient services for patients with short anticipated hospital stays. Yet little is known about which patient types predict SSU success. OBJECTIVE To describe patients admitted to our hospitalist-run SSU and explore predictors of length-of-stay (LOS) and eventual admission to traditional inpatient services. DESIGN Prospective observational cohort study. SETTING Large public teaching hospital. PATIENTS Consecutive admissions (n = 755) to the SSU over 4 months. INTERVENTION Hospitalist attending physicians prospectively collected data from patients' histories, physical exams, and medical records upon admission and discharge. MEASUREMENTS Risk assessments were made for patients with our most common provisional diagnoses: possible acute coronary syndrome (ACS) and heart failure. Patient stays were considered successful when LOS was less than 72 hours and eventual admission to traditional inpatient services was not required. RESULTS Of 738 eligible patients, 79% (n = 582) had successful SSU stays. In a multivariable model, the provisional diagnosis of heart failure predicted stays longer than 72 hours (P = 0.007) but risk assessments were unimportant. Patients who received specialty consultations were most likely to need eventual admission (odds ratio [OR], 13.1; 95% confidence interval [CI], 6.9-24.9), and the likelihood of long stays was inversely proportional to the accessibility of diagnostic tests. CONCLUSIONS In our hospitalist-run SSU, the inaccessibility of diagnostic tests and the need for specialty consultations were the most important predictors of unsuccessful stays. Designs for other SSUs that care for mostly low-risk patients should focus on matching patients' diagnostic and consultative needs with readily accessible services.
Fistula Fiberscope–assisted Percutaneous Glue Sealing for Enterocutaneous Fistulas: A Case Report

Endoscopic therapy is a valuable option for glue sealing in fistula patients with low-output volume to enable more complete filling of internal openings. However, no special endoscopes were designed and made for fistula tracts. This brief report concerns about the application of an autologous platelet-rich fibrin sealant through a refined fistula fiberscope. Symptoms achieved resolutions and the follow-up computed tomography scans revealed no intestinal fluid leakage. To our knowledge, this is the first report on this percutaneous endoscope-assisted glue procedure.
Mental Health and Mental Illness: Out of the Closet?

The extensive changes in mental health services over the past 25 years negate the possibility of an overall research summary. Instead, we identify six pivotal topics to explore in depth: (1) the paradigm shift to a biopsychosocial mental illness etiology, (2) the organization and financing of mental health care, (3) community‐based programs for adults with serious mental illness, (4) the role of families and consumers, (5) services for children and adolescents with serious emotional or mental disturbances, and (6) the interface with criminal justice. The article concludes with a discussion of future issues in mental health services research and the role of social work researchers.
Automatic thresholding from the gradients of region boundaries

We present an approach for automatic threshold segmentation of greyscale images. The procedure is inspired by a reinterpretation of the strategy observed in human operators when adjusting thresholds manually and interactively by means of ‘slider’ controls. The approach translates into two methods. The first one is suitable for single or multiple global thresholds to be applied globally to images and consists of searching for a threshold value that generates a phase whose boundary coincides with the largest gradients in the original image. The second method is a variation, implemented to operate on the discrete connected components of the thresholded phase (i.e. the binary regions) independently. Consequently, this becomes an adaptive local threshold procedure, which operates relative to regions, rather than to local image subsets as is the case in most local thresholding methods previously published. Adding constraints for specifying certain classes of expected objects in the images can improve the output of the method over the traditional ‘segmenting first, then classify’ approach.