Miracle-dz/UniFAR-FTUs huggingface dataset:
Profound and Multiple Handicaps: Monitoring Clients and their Parents

Techniques for assessing and monitoring development in people with profound and multiple handicaps are briefly reviewed. The procedures used to assess 90 children and adults in the follow-up study of the MENCAP Profound and Multiple Handicap Project national survey on the needs of parents and carers are described. The survey led to the identification of eight priority areas in which parents and carers indicated a need for information and assistance. Workshops on the first two areas, communication and feeding, and dental care, have been run and evaluated. The methods of evaluating these are described. Some examples of results from both the assessments of the individuals and the evaluation of the workshops are given. A few implications for changes in service provision are suggested.
Hypoxic–ischemic brain injury and neuroprotection in the newborn infant

Recent clinical trials have confirmed that in term infants with moderate-to-severe hypoxic–ischemic encephalopathy, death and severe developmental disability can be reduced by early treatment with hypothermia. However, meta-analysis of these trials has confirmed that two-thirds of the survivors remain seriously impaired. The search for new neuroprotective interventions has therefore continued. Extensive research has identified the important biochemical pathways that result in neuronal loss, and the subsequent repair and regeneration processes. The most promising neuroprotective agents that limit the former, and promote the latter, are being tested in animal models of hypoxic–ischemic brain injury and are awaiting clinical trials. It is likely that a ‘cocktail’ of agents, affecting a number of pathways, will ultimately prove to be the most effective intervention. The latest additions to a long list of proposed substances are various stem cells that promote neurogenesis by releasing trophic substances into .
Magnetic Resonance Spectroscopy in Epilepsy: Clinical Issues

Summary: Proton magnetic resonance spectroscopy (MRS) studies have shown focal reductions of N‐acetyl aspartate (NAA) signal in patients with different forms of temporal lobe epilepsy (TLE), including those with normal magnetic resonance imaging (MRI), as well as extratemporal partial epilepsies. Both single‐voxel and multivoxel 1H‐MRS have high sensitivity for detecting low NAA, indicative of neuronal dysfunction in focal epilepsies. Decreases in NAA correlate strongly with EEG abnormalities and severity of cell loss, and may be a more sensitive measure than structural MRI. However, the NAA decrease is often more widespread than the epileptogenic focus. The results of published MRS studies suggest that in patients with partial epilepsy, there is a metabolic abnormality throughout the brain, with patterns of asymmetry and focal accentuation that are useful for noninvasive localization of epileptogenic foci. A major limitation of current proton MRS studies in epilepsy is the inability to cover the entire brain in a single acquisition, thus leading to major sampling bias. The area of maximal abnormality may reside farther away, even when there is an abnormality inside of the volume of interest used for that particular examination. Decreased NAA ratios are present even in children at the onset of their epilepsy, and evidence points to a gradual and progressive course of further reduction in NAA values. Conversely, the relative NAA concentration can recover ipsilaterally and contralaterally after successful resection of a temporal lobe focus. These observations, together with the fact of the often widespread NAA abnormality, must be taken into account for the correct and adequate interpretation of proton MRS studies in the assessment of partial epilepsies.
PervasiveCrystal: Asking and Answering Why and Why Not Questions about Pervasive Computing Applications

Users often become frustrated when they are unable to understand and control a pervasive computing environment. Previous studies have shown that allowing users to pose why and why not questions about context-aware applications resulted in better understanding and stronger feelings of trust. Although why and why not questions have been used before to aid in debugging and to clarify graphical user interfaces, it is currently not clear how they can be integrated into pervasive computing systems. We explain in detail how we have extended an existing pervasive computing framework with support for why and why not questions. This resulted in PervasiveCrystal, a system for asking and answering why and why not questions in pervasive computing environments.
The Impact of Health Care Reform Initiatives on Ethical Conflict and Opportunities for Nurses to Improve Quality of Care While Enhancing Their Work Environments

Background: After more than a decade of the nursing profession contending that healthcare reform based almost exclusively on cost cutting was creating an array of serious ethical issues for nurses, healthcare organizations and other providers are now facing increasing demands primarily from payers to demonstrate improvement in both quality of care and patient experience along with continued cost reduction. Research Question: Have efforts by healthcare organizations to comply with these recently imposed requirements influenced the ethical environment faced by nurses and nurse leaders and if so, how? Materials and Methods: Data for assessing the current ethical environment was gathered with a close-ended survey mailed in October 2012 to a random sample of 3000 members of the American Organization of Nurse Executives. Results and Discussion: Statistical analysis of the data and comparison with the findings of a similar study conducted in 2000 indicated that along with five highly rated issues in the earlier study attributed largely to economic constraints imposed by healthcare organizations, the top-10 key ethical issues today included five issues primarily attributable to interprofessional conflict. Conclusion: Given the success of many ongoing efforts aimed at weakening these key sources of ethical conflict that have blocked many proposals to improve the quality of care, opportunities should arise for the nursing profession to more fully achieve its goals of improving the quality of care, safety and patient satisfaction and enhancing nurses’ work environments essential to that effort.
Targeted therapy for the post-operative conjunctiva: SPARC silencing reduces collagen deposition

Background To develop targeted antifibrotic therapy for glaucoma filtration surgery; this study determines the effectiveness of small interfering RNA (siRNA) to reduce in vivo secreted protein acidic and rich in cysteine (SPARC) expression using the mouse model of conjunctival scarring. Methods Experimental surgery was performed as described for the mouse model of conjunctival scarring. Scrambled (siScram) or Sparc (siSparc) siRNAs, loaded on layer-by-layer (LbL) nanoparticles, were injected into the conjunctiva immediately after surgery. Expression of Sparc, Col1a1, Fn1 and Mmp14 was measured by real-time PCR and immunoblotting on days 7 and 14 postsurgery. Live imaging of the operated eyes was performed using slit lamp, anterior segment-optical coherence tomography and confocal microscopy. Tissue pathology was evaluated by histochemical and immunofluorescent analyses of operated conjunctival cryosections. Tissue apoptosis was quantitated by annexin V assay. Results siSparc, delivered via expanded LbL nanoparticles, significantly inhibited Sparc transcription in both day 7 (2.04-fold) and day 14 (1.39-fold) treated tissues. Sparc suppression on day 7 was associated with a significant reduction of Col1a1 (2.52-fold), Fn1 (2.89-fold) and Mmp14 (2.23-fold) mRNAs. At the protein level, both SPARC and collagen 1A1 (COL1A1) were significantly reduced at both time points with siSparc treatment. Nanoparticles were visualised within cell-like structures by confocal microscopy, while overt tissue response or apoptosis was not observed. Conclusions SPARC targeted therapy effectively reduced both SPARC and collagen production in the operated mouse conjunctiva. This proof-of-concept study suggests that targeted treatment of fibrosis in glaucoma surgery is safe and feasible, with the potential to extend to a range of potential genes associated with fibrosis.
The risk for a cruciate ligament injury of the knee in adolescents and young adults: a population-based cohort study of 46 500 people with a 9 year follow-up

Objectives: The knee joint is the most common site for injury among younger people, the injury often resulting in expensive (surgical) treatment, long-term rehabilitation and permanent functional impairment and disability. Methods: We investigated the incidence and risk factors for a major knee-ligament injury in an adolescent Finnish population. A population-based cohort of 46 472 adolescents was followed for an average of 9 years. All patients hospitalised with the diagnosis of anterior or posterior cruciate ligament injury (ACL or PCL injury) were included in the analysis. Results: 265 (0.6%) people (194 male and 71 female subjects) from the total cohort of 46 472 were treated for a cruciate ligament injury of the knee during the follow-up period, giving an injury incidence of 60.9 (95% CI 53.6 to 68.2) per 100 000 person-years. When the socioeconomic, health and lifestyle background variables were taken into account, the adjusted hazard ratio for a cruciate ligament injury of the knee was 8.5 (95% CI 4.3 to 16.4) for female and 4.0 (95% CI 2.7 to 6.1) for male subjects who participated in organised sports ⩾4 times/week. Conclusions: The general risk for a cruciate ligament injury of the knee is relatively low among adolescents and young adults, but participation in organised sports increases the risk significantly. The risk is especially high in active young women. Preventive measures should be adopted to decrease the short-term and long-term burden of these severe injuries.
Psoas and quadratus lumborum muscle asymmetry among elite Australian Football League players

Objective In this study, asymmetry relative to the preferred kicking leg was determined if it exists for the psoas and quadratus lumborum muscles among elite Australian Football League (AFL) players. Design AFL players were assessed at three time points from 2005 to 2007 (start of preseason, end of season and end of preseason training). MRI was used to determine the cross-sectional areas (CSAs) of the psoas and quadratus lumborum muscles at the L4–L5 vertebral level (psoas) and the L3–L4 vertebral level (quadratus lumborum). Setting MRI was performed in a hospital setting. Participants 54 professional AFL players were eligible to participate in this study. The number of subjects at each of the three time points was 36 for time 1 (T1 Nov 2005), 31 for time 2 (T2 Aug 2006) and 43 for time 3 (T3 Feb Mar 2007). Risk factors The repeated measures factor in the analyses was “asymmetry”, defined as “ipsilateral” or “contralateral” to preferred kicking leg. Number of injuries (coded as 0, 1, 2 or more) was also included as a risk factor. Main outcome measurements The dependent variables were the CSAs of the psoas and quadratus lumborum muscles. Results At all three time points, the CSA of the psoas muscle was significantly greater ipsilateral to the kicking leg, while the CSA of the quadratus lumborum muscle was significantly greater on the side contralateral to the kicking leg. Asymmetry in muscle size was not related to number of injuries. Conclusions Asymmetry of the psoas and the quadratus lumborum muscles exists in elite AFL players.
Clinics in neurology and neurosurgery of sport: mass lesions. Benign brain tumours

When athletes are investigated for acute neurological symptoms a brain scan may reveal a tumour or mass lesion. Occasionally, these are incidental findings. The location of the tumour in the brain will critically affect its clinical presentation. A tumour compressing the optic nerve will result in visual loss, a tumour obstructing the cerebral aqueduct will cause hydrocephalus, and a tumour in the hippocampus may cause epilepsy. The biology of the tumour determines its growth propensity and aggressiveness. Although tectal plate glioma and glioblastoma multiforme are both classified as astrocytomas, the behaviour of each is completely different. A tectal platei glioma is a very slow-growing, indolent lesion, often remaining stable for many years without the requirement for any treatment, whereas a glioblastoma multiforme is aggressive and invasive, and can grow rapidly within a few weeks. Similarly, the classification of meningiomas includes tumours with a broad spectrum of clinical behaviour. A benign convexity meningioma grows very slowly and is cured with complete resection, whereas a skull base meningioma can invade bone, brain, vascular and neural structures. Tumour biology also affects the brain’s reaction to the tumour, such as the development of cerebral oedema surrounding the lesion. Treatment of tumours takes these and other factors into account, including patient age and functional level, comorbidity, neurological deficits and seizures. Depending on the tumour type, location and clinical presentation, treatment options include any combination of surgical resection, radiosurgery, radiotherapy, chemotherapy, and treatment of associated phenomena such as hydrocephalus and seizures. The athlete with a high-grade aggressive tumour with pronounced neurological deficit is unlikely to return to elite sport, but a sportsman with an incidental benign brain tumour will probably want to return and may be able to do so. This forum is inappropriate for a detailed discussion of the management of all brain tumours, …
Learning from past changes — Towards a learning-oriented engineering change management

Due to the complex nature of Engineering Change Management (ECM), managing knowledge and supporting an organizational as well as personal learning process is a difficult but important task to support the realization of changes. This paper presents an approach to improve ECM by applying and adapting existing knowledge management methods with the aim of supporting companies in generation, transfer and application of knowledge. The approach is based on a literature review in different research fields like organizational learning and knowledge management. Based on the findings, a framework for managing and cultivating knowledge specifically in the domain of ECM has been developed. The concept incorporates different aspects like knowledge transfer and knowledge generation from available information on an interpersonal and technical level. The developed approach aims at a continuous and eventually self-sustaining process of knowledge generation, sharing and application.
CKB - The Compound Knowledge Base: A Text Based Chemical Search System

The Compound Knowledge Base (CKB) was developed as a means of locating structures and additional relevant information from a given known structural identifier. Any of Chemical Abstracts Service Registry Number, company code (code number the producing company refers to the chemical entity internally), generic name (trivial or class name), or trade name (name under which the compound is marketed) can be provided as a query. CKB will provide the remaining available information as well as the corresponding structure for any matching compound in the database. The interface to the Compound Knowledge Base is Internet/World Wide Web-based, using Netscape Navigator and the ChemDraw Pro Plugin, which allows Merck scientists quick and easy access to the database from their desktop. The design and implementation of the database and the search interface are herein detailed.
Further Studies on the in Vitro Decalcification of Teeth

In previous papers (1, 2, 3, 4) an extension of the chemico-parasitic theory has been evolved to explain the development of caries in civilized communities and the absence of caries in primitive communities. Briefly, it is postulated that the sugars and cereal starches, as they occur in nature, are accompanied by a "protective agent"; these carbohydrates undergo acid fermentation in the crevices and pits of the teeth and, unless the "protective agent" is present, the acid thus formed produces a decalcification of the enamel, this being the first step in the formation of a caries' cavity. It is postulated that the "protective agent" is partially removed when cereal grains are converted into highly refined meal or flour, and when sugar is purified, and that this accounts for the relative scarcity of carious teeth among primitive peoples and the prevalence of decay among the civilized. In support of this it was shown that crude cereals and sugar cane juice did not cause in vitro decalcification nearly as readily as refined cereal meal or flour and refined sugar: this in spite of the occurrence of about the same degree of acid fermentation in each experiment. In attempting to discover the nature of this "protective agent", it was then shown that the in vitro decalcifying action of refined flour and sugar was strongly inhibited by certain salts of calcium and phosphorus, and the mass action law was used to show how, in acid of constant pH, the presence of calcium and phosphate ions could reduce the rate of solution of solid calcium phosphate. Since the publication of these results the present author has continued to experiment along these lines.
Why so negative about preventing cognitive decline and dementia? The jury has already come to the verdict for physical activity and smoking cessation

The world is ageing rapidly, and accompanying this demographic transition will be a significant increase in the number of people with dementia, a condition that will affect the developing world more greatly than the developed world, in both absolute numbers and proportional increase.1 The human and financial costs of this condition have, not surprisingly, been of concern to older people, their families and policy makers around the world as they grapple with what will eventually be a major cause of life years lost to disability. The search is on for safe, effective and hopefully, affordable ways to prevent this common and devastating condition of older people. Against this background, it was timely for the US Department of Health and Human Services National Institutes of Health (NIH) to host a consensus conference on ‘Preventing Alzheimer’s Disease and Cognitive Decline,'2 supported by an Evidence Based Review.3 Many of the other scourges of old age have already demonstrated a reduction in age specific incidence, and thus there is hope that similar outcomes may be achieved for dementia. For example, there has been a 25% reduction in age-adjusted stroke death rates in the USA,4 an observation confirmed in Australia where further data indicate that this is more likely to be due to a decreased incidence of stroke rather than an improvement in survival following a stroke.5 Similarly, after an earlier increase, age-adjusted female hip fracture incidence decreased between 1995 and 2005 by about 25%. 6 Therefore, prevention of these common problems of older people may be achievable and a goal for which it is worth striving. The degree of difficulty in ascertaining the population prevalence and incidence of dementia, and also the fact that many of the higher-quality studies were completed over two decades ago, makes it unlikely that …
NGR and isoDGR are separate moieties binding to different receptors.

To the editor: Bieker et al interestingly reported that NGR peptide–directed targeting of a truncated form of the human coagulation-inducing protein tissue factor (tTF-NGR) is able to induce thrombosis in the tumor vasculature of preclinical models and to inhibit tumor perfusion in humans. [1][1]
QSTR with Extended Topochemical Atom Indices. 2. Fish Toxicity of Substituted Benzenes

Considering the importance of quantitative structure-toxicity relationship (QSTR) studies in the field of aquatic toxicology from the viewpoint of ecological safety assessment, fish toxicity of various benzene derivatives has been modeled by the multiple regression technique using recently introduced extended topochemical atom (ETA) indices. The toxicity data have also been modeled using other selected topological descriptors and physicochemical variables, and the best ETA model has been compared to the non-ETA ones. Principal component factor analysis was used as the data preprocessing step to reduce the dimensionality of the data matrix and identify the important variables that are devoid of collinearities. All-possible-subsets regression was also applied on the parameters to cross-check the variable selection for the best model. Multiple linear regression analyses show that the best non-ETA model involves 1chi, ALogP98, and LUMO (energy) as predictor variables and the quality of the relation is as follows: n = 92, Q2 = 0.718, Ra2 = 0.730, R2 = 0.738, R = 0.859, F = 82.8 (df 3, 88), s = 0.340. On the other hand, the best ETA model has the following quality: n = 92, Q2 = 0.865, Ra2 = 0.876, R2 = 0.885, R = 0.941, F = 92.6 (df 7, 84), s = 0.230. The ETA relations showed positive contributions of molecular bulk (size), chloro and hydroxy substitutions in the benzene ring, and the simultaneous presence of methyl and nitro substitutions to the toxicity. Further, the presence of fluoro and ether functionality, amino or nitro functionality in an otherwise unsubstituted ring, and nitro functionality that is ortho to a chloro substituent decreases toxicity. An attempt to use non-ETA descriptors along with ETA ones did not improve the quality in comparison to the best ETA model. Interestingly, the ETA model developed presently for the fish toxicity is better than the previously reported models on the same data set. Thus, it appears that ETA descriptors have significant potential in QSAR/QSPR/QSTR studies, which warrants extensive evaluation.
Systematic reviews of t'ai chi: an overview

Several systematic reviews (SRs) have assessed the effectiveness of t'ai chi for many conditions including hypertension, osteoarthritis and fall prevention; however, their conclusions have been contradictory. The aim of this overview was to critically evaluate the SRs of t'ai chi for any improvement of medical conditions or clinical symptoms. English, Chinese and Korean electronic databases were searched for relevant articles, and data were extracted according to predefined criteria; 35 SRs met our inclusion criteria. They were related to the following conditions: cancer, older people, Parkinson's disease, musculoskeletal pain, osteoarthritis, rheumatoid arthritis (RA), muscle strength and flexibility, improving aerobic capacity, cardiovascular disease and risk factors, lowering resting blood pressure, osteoporosis or bone mineral density, type 2 diabetes, psychological health, fall prevention and improving balance, and any chronic conditions. In several instances, the conclusions of these articles were contradictory. Relatively clear evidence emerged to suggest that t'ai chi is effective for fall prevention and improving psychological health and was associated with general health benefits for older people. However, t'ai chi seems to be ineffective for the symptomatic treatment of cancer and RA. In conclusion, many SRs of t'ai chi have recently been published; however, the evidence is convincingly positive only for fall prevention and for improvement of psychological health.