Miracle-dz/UniFAR-FTUs huggingface dataset:
Factors that shape the development of interprofessional improvement initiatives in health organisations

Background Quality and safety improvement programmes advance the standard of care delivered by health organisations but have been shown to be less effective than anticipated. Implementing improvement programmes require a greater understanding of the impact of the social context and strategies that engage staff. Objective To investigate factors that shaped the development of interprofessional improvement initiatives in a health organisation. Methods Data are drawn from a large-scale longitudinal action research study examining interprofessional learning and practice. The setting is an autonomous bounded health jurisdiction in Australia. Within the study, health professionals have conceptualised more than 111 interprofessional improvement projects, of which 76 have evolved into ongoing activities. Textual data were analysed using emergent coding and descriptive statistics. Results Initiatives were shaped by six determinants: site receptivity; team issues; leadership; impact on healthcare relations; impact on quality and safety issues; and extent to which the projects became institutionally embedded. Initiatives that engaged participants and progressed were characterised by and displayed flexible leadership, and ongoing refinement and maturity over time. The local organisational context and initiatives coevolved. Conclusions Improvement initiatives are necessary for improved quality of care and patient safety but are difficult to implement and sustain. The factors identified to develop them are constantly under challenge in health services. Improving healthcare quality will, in part, depend upon the ability to provide more flexible and supportive social contexts.
A review of the information and support needs of family carers of patients with chronic obstructive pulmonary disease.

AIMS AND OBJECTIVES The objectives of this narrative review were to identify: (1) The information and support needs of carers of family members with chronic obstructive pulmonary disease; (2) appropriate interventions to support carers in their caregiving role; (3) information on carers' needs as reported in studies of patients living with COPD in the community. BACKGROUND Chronic obstructive pulmonary disease is a major health problem in the UK resulting in significant burden for patients, families and the health service. Current National Health Service policies emphasise, where medically appropriate, early discharge for acute exacerbations, hospital-at-home care and other models of community care to prevent or reduce re-hospitalisations of people with chronic conditions. Understanding carers' needs is important if health care professionals are to support carers in their caregiving role. DESIGN A narrative literature review. METHODS Thirty five papers were reviewed after searching electronic databases. RESULTS Few studies were identified which addressed, even peripherally, carers' needs for information and support, and no studies were found which described and evaluated interventions designed to enhance caregiving capacity. Several studies of hospital-at-home/early discharge, self care and home management programmes were identified which included some information on patients' living arrangements or marital status. However, there was little or no detail reported on the needs of, and in many cases, even the presence of a family carer. CONCLUSIONS This review highlights the dearth of information on the needs of carers of chronic obstructive pulmonary disease patients and the need for future research. RELEVANCE TO CLINICAL PRACTICE There is little research based knowledge of the needs of carers of chronic obstructive pulmonary disease patients and interventions to assist them in providing care. This knowledge is critical to ensure that carers receive the information they need to carry out this role while maintaining their own physical and emotional health.
The radiation response of cells from 9L gliosarcoma tumours is correlated with [F18]-EF5 uptake

Purpose: Tumour hypoxia affects cancer biology and therapy-resistance in both animals and humans. The purpose of this study was to determine whether EF5 ([2-(2-nitro-1-H-imidazol-1-yl)-N-(2,2,3,3,3-pentafluoropropyl)-acetamide]) binding and/or radioactive drug uptake correlated with single-dose radiation response in 9L gliosarcoma tumours. Materials and methods: Twenty-two 9L tumours were grown in male Fischer rats. Rats were administered low specific activity 18F-EF5 and their tumours irradiated and assessed for cell survival and hypoxia. Hypoxia assays included EF5 binding measured by antibodies against bound-drug adducts and gamma counts of 18F-EF5 tumour uptake compared with uptake by normal muscle and blood. These assays were compared with cellular radiation response (in vivo to in vitro assay). In six cases, uptake of tumour versus muscle was also assayed using images from a PET (positron emission tomography) camera (PENN G-PET). Results: The intertumoural variation in radiation response of 9L tumour-cells was significantly correlated with uptake of 18F-labelled EF5 (i.e., including both bound and non-bound drug) using either tumour to muscle or tumour to blood gamma count ratios. In the tumours where imaging was performed, there was a significant correlation between the image analysis and gamma count analysis. Intertumoural variation in cellular radiation response of the same 22 tumours was also correlated with mean flow cytometry signal due to EF5 binding. Conclusion: To our knowledge, this is the first animal model/drug combination demonstrating a correlation of radioresponse for tumour-cells from individual tumours with drug metabolism using either immunohistochemical or non-invasive techniques.
An anatomic basis for spinal instability: A porcine trauma model

To determine the anatomic basis for spinal instabilities, 16 porcine cervical spine specimens were subjected to a well‐defined sagittal plane trauma. The multidirectional instability of each specimen was measured before and after trauma. Detailed anatomic dissections were performed on each traumatized specimen to quantitate the extent of injury to several distinct anatomic structures and columns. Multiple regression models were constructed to determine which anatomic structures and columns correlated best with each multidirectional instability. Flexion instability correlated best with injury to the interspinous/supraspinous ligaments and the ligamentum flavum. Extension instability correlated best with anterior longitudinal ligament and pedicle injury. Axial rotation instability correlated best with anterior disc–end‐plate and capsular ligament injuries, while lateral bending instability correlated best with posterior disc–end‐plate injuries. Anterior column injuries correlated best with extension, axial rotation, and lateral bending instabilities, while posterior column injuries correlated best with flexion instability. Finally, individual anatomic structural injuries had higher correlations with multidirectional instabilities than did the injuries defined by the anatomic columns.
Preschool children use linguistic form class and pragmatic cues to interpret generics.

Generic noun phrases (e.g., "Bats live in caves") are important for expressing knowledge about abstract kinds. Past work has found that parents frequently use generic noun phrases in their speech to young children. However, little is known regarding how children understand these expressions, nor which cues signal generic meaning. The present set of 5 studies examined the influence of linguistic form class (e.g., "What color are dogs? " [generic] versus "What color are the dogs? " [nongeneric]) and of pragmatic context (e.g., "What color are they? " in the presence of either a single exemplar [generic] or multiple exemplars [nongeneric]). Participants were 2-year-olds (N = 42), 3-year-olds (N = 40), 4-year-olds (N = 40), and adults (N = 51). The data indicate that by 2 years of age, children use linguistic form class, and by 3 years of age, children use pragmatic context. These findings demonstrate that young children have begun to understand the distinction between generic and nongeneric noun phrases from a very young age, and that identification of generics is signaled not by formal or pragmatic cues alone, but by a combination of information from both language form and pragmatic context. It is suggested that children make use of multiple linguistic and conceptual cues to acquire and interpret generics.
The Platelet Function Analyzer (PFA‐100®): a novel in‐vitro system for evaluation of primary haemostasis in children

The PFA‐100® system provides an in‐vitro method of assessing primary platelet‐related haemostasis by measuring the time (the closure time, or CT) taken for a platelet plug to occlude a microscopic aperture cut into a membrane coated with collagen and either epinephrine or ADP. We used the system to establish normal ranges for CTs in healthy children, adults and neonates. Mean CTs of healthy children were independent of the needle gauge used (21G or 23G) for blood sampling; they were very similar to the mean CTs of healthy adults, but longer than mean CTs of healthy neonates. Although children with haemophilia had normal CTs, the PFA‐100 system was found to be potentially useful in screening for von Willebrand disease in children.
The detection of monkeypox in humans in the Western Hemisphere.

BACKGROUND During May and June 2003, an outbreak of febrile illness with vesiculopustular eruptions occurred among persons in the midwestern United States who had had contact with ill pet prairie dogs obtained through a common distributor. Zoonotic transmission of a bacterial or viral pathogen was suspected. METHODS We reviewed medical records, conducted interviews and examinations, and collected blood and tissue samples for analysis from 11 patients and one prairie dog. Histopathological and electron-microscopical examinations, microbiologic cultures, and molecular assays were performed to identify the etiologic agent. RESULTS The initial Wisconsin cases evaluated in this outbreak occurred in five males and six females ranging in age from 3 to 43 years. All patients reported having direct contact with ill prairie dogs before experiencing a febrile illness with skin eruptions. We found immunohistochemical or ultrastructural evidence of poxvirus infection in skin-lesion tissue from four patients. Monkeypox virus was recovered in cell cultures of seven samples from patients and from the prairie dog. The virus was identified by detection of monkeypox-specific DNA sequences in tissues or isolates from six patients and the prairie dog. Epidemiologic investigation suggested that the prairie dogs had been exposed to at least one species of rodent recently imported into the United States from West Africa. CONCLUSIONS Our investigation documents the isolation and identification of monkeypox virus from humans in the Western Hemisphere. Infection of humans was associated with direct contact with ill prairie dogs that were being kept or sold as pets.
2011 colposcopic terminology of the International Federation for Cervical Pathology and Colposcopy.

New colposcopy terminology was prepared by the Nomenclature Committee of the International Federation of Cervical Pathology and Colposcopy after a critical review of previous terminologies, online discussions, and discussion with national colposcopy societies and individual colposcopists. This document has been expanded to include terminology of both the cervix and vagina. The popular terms "satisfactory colposcopy" and "unsatisfactory colposcopy" have been replaced. The colposcopic examination should be assessed for three variables: 1) adequate or inadequate, with the reason given; 2) squamocolumnar junction visibility; and 3) transformation zone type. Other additions were the localization of the lesion to either inside or outside the transformation zone and determinants of size as well as location of cervical lesions. Two new signs were included in the terminology-the "inner border sign" and "ridge sign. " The following definitions have been added: congenital transformation zone, polyp (ectocervical or endocervical), stenosis, congenital anomaly, and posttreatment consequence. In addition, the terminology includes standardization of cervical excision treatment types and cervical excision specimen dimensions. The International Federation of Cervical Pathology and Colposcopy recommends that the 2011 terminology replace all others and be implemented for diagnosis, treatment, and research.
Stress reactivity: biological and subjective responses to the cold pressor and Trier Social stressors

The cold pressor test (CPT) and Trier Social Stress Test (TSST) have been shown to reliably increase HPA activity; however, little research has compared responses to these stressors. In this study, biological (plasma cortisol and ACTH levels) and subjective (e.g., stress and mood) responses were compared in 31 subjects administered both the CPT and TSST. Subjects were diagnosed with alcohol dependence and post‐traumatic stress disorder (PTSD) (n = 11), alcohol dependence without PTSD (n = 10), PTSD without alcohol use disorder (n = 4), and neither PTSD nor alcohol use disorder (n = 6). All subjects completed both the CPT and TSST. In all groups, the TSST elicited higher levels of ACTH and cortisol than the CPT, and the response time course differed between tasks. The TSST also produced lower mood ratings than the CPT. A comparison of all diagnosed groups with normal controls revealed group differences in ACTH responding for the CPT but not the TSST. The results suggest that the TSST results in a greater HPA response than the CPT; however, the CPT may have utility in diagnostically heterogeneous patients. Copyright © 2006 John Wiley & Sons, Ltd.
Deciphering AP-1 Function in Tumorigenesis: Fra-ternizing on Target Promoters

Multi-gene families of transcription factors pose a formidable challenge to molecular and functional analysis. Dissecting distinct functions for individual family members requires a combination of approaches in different cellular and animal models. The AP-1 transcription factor complex serves as a paradigm for understanding the dynamics of transcriptional regulation. Knockout, knockdown and transgenic strategies, inducible alleles, mutational analysis, chemical genetics, etc.; researchers have applied all the tricks of the trade to understand how AP-1 works. AP-1 refers to a mixture of dimers formed between members of the Jun, Fos and ATF families. The complexity of the AP-1 biological functions reflects the wide combinatorial diversity of its components.1 AP-1 has been linked to cancer and neoplastic transformation ever since the first jun and fos genes were cloned as cellular homologues of viral oncogenes twenty years ago. Because of the oncogenic or tumor suppressive activity exhibited by distinct Jun and Fos nuclear proteins depending on the cell context and the genetic background of the tumor, the AP-1 complex has been called a “double-edged sword” in tumorigenesis.2 The cumulating results over the last decade are finally leading to the identification of specific functions for individual AP-1 components and their contribution to neoplastic disease. Here, we focus on the Fra-1 protein in tumorigenesis, which offers an illustrative example of this helter-skelter voyage.
[Clinical observation on ankylosing spondylitis treated with acupoint catgut embedding combined vessel pricking therapy].

OBJECTIVE To explore the efficacy and safety of acupoint catgut embedding combined with vessel pricking therapy for ankylosing spondylitis (AS). METHODS Eighty-six cases of AS were randomly divided into an acupoint catgut embedding combined vessel pricking group (group A) and a medication group(group B), 43 cases in each group. In the group A, acupoint catgut embedding combined with vessel pricking therapy were applied at Shenshu(BL 23), Dazhu (BL 11) and Jiaji (EX-B 2) etc. The group B was treated with oral administration of Sulfasalazine (SASP). The treatment lasted for 8 weeks. Symptom score, Visual Analogue Scale(VAS), the indices of morning stiff duration, Schober test, occiput to wall distance, chest expansion, erythrocyte sedimentation rate (ESR) and C-response protein (CRP) were compared before and after treatment between two groups. RESULTS After treatment, the total effective rate was 83.7% (36/43) in the group A, which was superior to that of 70.0% (28/40) in the group B (P < 0.05). The improvements of all indices in two groups were more significant than those before treatment (all P < 0.01), and symptom score, Schober test score and VAS score in group A were superior to those in the group B (P < 0.01, P < 0.05). No adverse reaction occurred in the group A. CONCLUSION The therapeutic effect of acupoint catgut embedding combined with vessel pricking therapy for AS is preferable without any adverse effects, which is superior to that of oral administration of SASP.
Effect of myoplasmic pH on excitation‐contraction coupling in skeletal muscle fibres of the toad.

1. The effect of pH on excitation‐contraction coupling in skeletal muscle of the toad was examined using a skinned fibre preparation which gives ready access to the intracellular environment while still allowing stimulation of Ca2+ release by the normal voltage‐sensor mechanism. 2. In each fibre, depolarization‐induced responses (produced by changing the ions in the bathing solution) were examined first at pH 7.1, and then at another pH between 6.1 and 8.0. At all pH levels examined, the first depolarization elicited a large response which was slightly greater (pH 7.6 and 8.0) or smaller (pH 6.6 and 6.1) than that at pH 7.1. The size of the first depolarization‐induced response varied with pH in almost exactly the same manner as did the maximum Ca(2+)‐activated response. The duration of the depolarization‐induced response at all other pH levels was longer than at pH 7.1. 3. Repeated depolarizations (30 s or more apart) produced similar responses at pH 7.1, but at all other pH levels examined the second and subsequent responses became progressively smaller. The reasons for this decrease were different at low and high pH. 4. Examination of the size of the depolarization‐induced response after reloading the depleted sarcoplasmic reticulum (SR) with Ca2+ in solutions at various pH levels, indicated that the SR Ca2+ pump operated more poorly at pH 6.6 and 6.1 than at pH 7.1. This can account for the wide and successively smaller depolarization‐induced responses at acidic pH. 5. Examination of the size of the depolarization‐induced response after 5 min bathing without stimulation in a very low [Ca2+] solution (‐log10[Ca2+] (pCa) greater than 8.0, 1 mM‐BAPTA (1,2‐bis(O‐aminophenoxy)ethane‐N,N,N’,N'‐tetraacetic acid), indicated that the sarcoplasmic reticulum (SR) lost far more Ca2+ at pH 7.6 and 8.0 than at pH 7.1 or 6.1. This indicates that SR is ‘leakier’ at alkaline pH. 6. Exposure of fibres heavily loaded with Ca2+ to solutions at pH 8.0 invariably induced a large response within 1‐6 s. This response was unaffected by inactivation of the voltage sensors and was blocked completely by 2 microM‐Ruthenium Red. This response and the ‘leak’ at alkaline pH are consistent with previous studies of the pH dependence of Ca(2+)‐activated opening of single Ca2+ release channels in lipid bilayers. 7. These findings indicate that depolarization can induce massive Ca2+ release at both acidic and alkaline pH, provided that the SR is normally loaded with Ca2+, and give further insight into the intracellular events underlying fatigue in skeletal muscle.
Cardiorespiratory fitness as a quantitative predictor of all-cause mortality and cardiovascular events in healthy men and women: a meta-analysis.

CONTEXT Epidemiological studies have indicated an inverse association between cardiorespiratory fitness (CRF) and coronary heart disease (CHD) or all-cause mortality in healthy participants. OBJECTIVE To define quantitative relationships between CRF and CHD events, cardiovascular disease (CVD) events, or all-cause mortality in healthy men and women. DATA SOURCES AND STUDY SELECTION A systematic literature search was conducted for observational cohort studies using MEDLINE (1966 to December 31, 2008) and EMBASE (1980 to December 31, 2008). The Medical Subject Headings search terms used included exercise tolerance, exercise test, exercise/physiology, physical fitness, oxygen consumption, cardiovascular diseases, myocardial ischemia, mortality, mortalities, death, fatality, fatal, incidence, or morbidity. Studies reporting associations of baseline CRF with CHD events, CVD events, or all-cause mortality in healthy participants were included. DATA EXTRACTION Two authors independently extracted relevant data. CRF was estimated as maximal aerobic capacity (MAC) expressed in metabolic equivalent (MET) units. Participants were categorized as low CRF (< 7.9 METs), intermediate CRF (7.9-10.8 METs), or high CRF (> or = 10.9 METs). CHD and CVD were combined into 1 outcome (CHD/CVD). Risk ratios (RRs) for a 1-MET higher level of MAC and for participants with lower vs higher CRF were calculated with a random-effects model. DATA SYNTHESIS Data were obtained from 33 eligible studies (all-cause mortality, 102 980 participants and 6910 cases; CHD/CVD, 84 323 participants and 4485 cases). Pooled RRs of all-cause mortality and CHD/CVD events per 1-MET higher level of MAC (corresponding to 1-km/h higher running/jogging speed) were 0.87 (95% confidence interval [CI], 0.84-0.90) and 0.85 (95% CI, 0.82-0.88), respectively. Compared with participants with high CRF, those with low CRF had an RR for all-cause mortality of 1.70 (95% CI, 1.51-1.92; P < .001) and for CHD/CVD events of 1.56 (95% CI, 1.39-1.75; P < .001), adjusting for heterogeneity of study design. Compared with participants with intermediate CRF, those with low CRF had an RR for all-cause mortality of 1.40 (95% CI, 1.32-1.48; P < .001) and for CHD/CVD events of 1.47 (95% CI, 1.35-1.61; P < .001), adjusting for heterogeneity of study design. CONCLUSIONS Better CRF was associated with lower risk of all-cause mortality and CHD/CVD. Participants with a MAC of 7.9 METs or more had substantially lower rates of all-cause mortality and CHD/CVD events compared with those with a MAC of less 7.9 METs.
Remark on ordinary and Randić energy of graphs

Let G be an undirected simple graph with n vertices and m edges. Denote with |λ1| |λ2| · · · |λn| and |ρ1| |ρ2| · · · |ρn| absolute eigenvalues and Randić eigenvalues of G arranged in non-increasing order, respectively. Upper bound of graph invariant E(G) = ∑i=1 |λi| , and lower and upper bounds of invariant RE(G) = ∑i=1 |ρi| are obtained in this paper.
Introduction: Air Pollution in China

Abstract This introduction provides an overview and analysis of key scientific data regarding air pollution in China. It constitutes a reference for understanding how policymakers, media and population in China make sense of and deal with air pollution, as discussed in the other articles of the section. We summarize the major characteristics and trends regarding air pollution in China, including its main sources and composition, levels of population exposure across the country, attributable mortality, and mitigation efforts. We also compare current levels of air pollution in China with other parts of the world and in a historical perspective. While the situation remains dire in many regions, particularly the Northeast, we conclude that there are signs of relief, or at least a halt to the increase in ambient air pollution levels. At the same time, critical issues regarding unequal levels of exposure remain, and health damaging levels of air pollution in cities will undoubtedly remain high for a long time to come. The rural population residing in areas close to industry and polluted cities and still depending on solid household fuels will likely be the worst off when it comes to air pollution exposure.