Miracle-dz/UniFAR-FTUs huggingface dataset:
Operationalizing Sepsis Alert Design and Clinical Decision Support: Developing Enhanced Visual Display Models

It is vital that health care providers have the tools needed for early diagnosis and treatment of sepsis to achieve improved survival outcomes. Despite advances in early warning system technology, providers still lack responsiveness in recognizing and treating septic patients. The recently introduced Centers for Medicare and Medicaid Services early management bundle for severe/septic shock highlights the need to promote bundles of care to improve guideline compliance and lower hospital mortality. Our objective is to determine the best way to provide a sepsis alert to drive compliance in the complex cognitive system that underlies the decision-making process in the dynamic and distributed health care work environment. Alert and warning complexity is especially prevalent in health care information technology. Despite this issue, there is little consensus on how alerts and warnings should be generated and displayed to the user. Effective presentation of an alert, including how and what is displayed, may offer better cognitive support during busy patient encounters and may help providers extract information quickly. We are creating a framework to evaluate sepsis alert presentation models with enhanced visual elements integrating a textual, graphical, and figure display of the PIRO (predisposition, infection, response, organ dysfunction) classification. Our alert presentation framework is tailored to clinicians with the goal to better equip clinicians to understand their patients' data through feature extraction and visualization embedded with different asynchronous alerts.
Pharmacokinetics of Oxcarbazepine and Its Stereoselectivity

Oxcarbazepine is a new antiepileptic drug that has been approved for the treatment of partial onset seizures and generalized tonic-clonic seizures. Compared with traditional antiepileptic carbamazepine, oxcarbazepine shown an improved tolerability, a reduced propensity to cause liver enzyme induction and auto-induction. This article reviews the pharmacokinetics characters of absorption, distribution, metabolism and excretion of oxcarbazepine, the effects of age, gender, hepatic and renal dysfunction on pharmacokinetics, and the stereoselective pharmacokinetics of 10-hydroxycarbazepine, the active metabolite of oxcarbazepine, in animals and healthy subjects.
Use of Knowledge Synthesis and Translation Methodologies as the Basis of an Evidence Informed Evaluation of Mycobacterium avium ssp. paratuberculosis

USE OF KNOWLEDGE SYNTHESIS AND TRANSLATION METHODOLOGIES AS THE BASIS OF AN EVIDENCE INFORMED EVALUATION OF MYCOBACTERIUM AVIUM SSP. PARATUBERCULOSIS Lisa A. Waddell Advisors: University of Guelph, 2016 Dr. Scott A McEwen Dr. Andrijana Rajić A mixed methods approach was undertaken to develop an evidence-informed evaluation of the public health implications of Mycobacterium avium subsp. paratuberculosis. An assessment of the methodological quality of 132 literature reviews published 2000-2006 on zoonotic public health issues showed a considerable need for improvement. A scoping study on sources and routes of human exposure to M. paratuberculosis summarized 255 publications that reported prevalence or concentration of M. paratuberculosis in various sources of human exposure. Significant risk factors for developing Crohn’s disease in humans included consumption of processed meats and cheese, but not direct contact with ruminants, membership in suspected high risk occupations, milk consumption or water source. Systematic review meta-analysis on the zoonotic potential of M. paratuberculosis summarized 128 papers that examined associations with Crohn’s disease, human immunodeficiency virus infection, sarcoidosis, diabetes mellitus, multiple sclerosis and Hashimoto’s thyroiditis. There were consistent, significant positive associations with Crohn’s disease, diabetes mellitus type 1 and multiple sclerosis. A web-based survey showed that M. paratuberculosis topic specialists considered the agent likely to be a risk to human health (44.8%) and a moderate public health issue (40.1%). Topic specialists largely agreed (68.4%) that further enhancement of on-farm programs is most appropriate and further involvement by government (92%) is unnessecary given the current state of evidence. Finally, a risk profile for M. paratuberculosis was undertaken to summarize the information assembled in preceding chapters relevant to a public health evaluation of M. paratuberculosis. The evidence for the zoonotic potential of this agent is weak, but consistent across published studies, and topic specialists agree that M. paratuberculosis should be considered a moderate public health issue. However, the evidence is not yet sufficient to warrant specific risk management efforts. The existence of critical knowledge gaps and resultant uncertainties helps to explain why researchers interpret the available research differently and sometimes provide conflicting opinions and advice. While many critical knowledge gaps remain, this potential public health issue cannot be ignored and research advances and mitigation activities should continue to be monitored and periodically evaluated to re-affirm the appropriate level of action is being taken.
Hourly rounding: a strategy to improve patient satisfaction scores

MEDSURG Nursing—May/June 2010—Vol. 19/No. 3 Purpose The use of a proactive hourly rounding strategy to improve patient satisfaction is described. Inspired by the work of Meade, Bursell, and Ketelsen (2006), staff at Baltimore Washington Medical Center (BWMC) piloted hourly rounding on several units. Although results from this study are not yet available, a brief case study can demonstrate how results at BWMC may compare to the national study. The study’s purpose was to determine if patient satisfaction increases significantly as the new strategy is implemented.
Cardio-metabolic effects of anti-retroviral treatment in the Cape Winelands region of South Africa

English) 3 Background: Although highly active antiretroviral therapy (HAART) has significantly improved the survival of human immunodeficiency virus (HIV)-infected patients there are increased concerns regarding the onset of co-morbidities (e.g. cardio-metabolic complications) and mortalities. Although South Africa is burdened with the highest number of HIV-infected individuals globally, there is a relative paucity of data regarding potential links between HIV infection, HAART and cardio-metabolic risk/onset. Methods: This cross-sectional study therefore investigated the prevalence of cardio-metabolic risk factors in HIV-infected individuals within the Cape Winelands region of South Africa. Here we collected anthropometric, biochemical and lifestyle-related data for HIV-positive HAART naive (n =25) and HIVpositive individuals on HAART (n = 50) patients (20–55 years old) at the Worcester Community Day Centre (CDC) (Worcester, Western Cape, South Africa) during 2014 and 2015. Subjects on HAART were further divided into two sub-groupings, i.e. first line (n = 25) and second line treatments (n = 25). Results: Our data reveal the relatively high prevalence of traditional, cardio-metabolic lifestyle risk factors in HIV-infected individuals. There was a relatively high prevalence of smoking, i.e. 88% for the HIV-positive HAART naive group and 27% for the HIV-positive group on HAART (P = 0.001), while more than half of the HIV-positive individuals exhibited a positive history of familial cardiovascular diseases (CVD). There were no significant differences for fasting blood glucose (FBG) and insulin levels between HIV-positive HAART naive and HIV-positive on HAART. Lipid metabolite analyses (Total cholesterol [TC], low-density lipoprotein [LDL], high density lipoprotein [HDL] and triglyceride [TG]) also did not reveal significant changes when comparing HIV-positive on HAART versus HIV-positive HAART naive groups. However, additional analyses (using established cut-off values for HDL, LDL) showed a significant difference in the proportion of individuals categorized with ‘’low HDL’’ status, i.e. 68% for the HIV-positive HAART naive compared to 40% for the HIV-positive on HAART group (P = 0.022). HAART also enhanced anthropometric measures of obesity, with significant differences for Stellenbosch University https://scholar.sun.ac.za
小麦中のデオキシニバレノール，3-アセチルデオキシニバレノールおよび15-アセチルデオキシニバレノールのLC-MS/MSによる同時分析法の試験室間共同試験

: To validate an LC-MS/MS method for simultaneous determination of deoxynivalenol (DON) and its acetylated derivatives, 3-acetyl-deoxynivalenol (3ADON) and 15-acetyl-deoxynivalenol (15ADON), in wheat using a multifunctional column, an inter-laboratory study was performed in 9 laboratories using one blank wheat sample, three spiked wheat samples (10, 50, 150 µg/kg) and one naturally contaminated wheat sample. The recoveries ranged from 98.8 to 102.6% for DON, 89.3 to 98.7% for 3ADON, and from 84.9 to 90.0% for 15ADON. The relative standard deviations for repeatability (RSDR) and reproducibility (RSDR) of DON were in the ranges of 7.2-11.3% and 9.5-22.6%, respectively. For 3ADON, the RSDR ranged from 5.3 to 9.5% and the RSDR ranged from 16.1 to 18.0%, while for 15ADON, the RSDR ranged from 6.2 to 11.2% and the RSDR ranged from 17.0 to 27.2%. The HorRat values for the three analytes ranged from 0.4 to 1.2. These results validate this method for the simultaneous determination of DON and its acetylated derivatives, 3ADON and 15ADON.
Appraisal of exercise recommendations for osteoporosis treatment of current guidelines: a systematic review

International guidelines include resistance exercise as part of osteoporosis treatment, although there is no clear agreement on exercise prescription. The aim of this study was to assess methodological quality of clinical guidelines that included exercise as a therapeutic intervention for osteoporosis, in order to establish the recommendations with the best level of evidence. A systematized review on clinical guidelines for osteoporosis published between 2010 and 2014 was performed. Each guide was assessed by 4 blinded reviewer experts on osteoporosis rehabilitation. Guidelines scored 4.5 or more were selected for data extraction. Intra-class concordance coefficient was obtained for overall guideline assessment. Three guidelines fulfilled our inclusion criteria. After Appraisal of Guidelines for Research & Evaluation II (AGREE-II) assessment, 2 obtained 4.5 or more AGREE-II score. Only exercise recommendations were included. Future clinical guidelines development and updates must enhance adequate methodological quality, considering age, comorbidities and functional assessment in exercise prescription for osteoporosis treatment.
2,5,2′′,5′′‐Tetra­meth­yl‐p‐terphen­yl

The title compound, C22H22, displays no crystallographic symmetry. The central benzene ring subtends inter­planar angles of 63.00 (6) and 66.09 (6)° (in opposite senses) to the outer rings. The crystal packing involves two short C—H⋯π contacts.
Diagnostic dilemma: Mild and moderate forms of osteogenesis imperfecta

Osteogenesis imperfect (OI) is a group of genotypically and phenotypically diverse disorders of connective tissue characterized by bone fragility. The classic typing of OI includes: type I (mildest), type II (perinatally lethal), type III (most severe nonlethal) and type IV (moderate). Diagnosis and accurate typing of mild and moderate types of OI are challenging due to the heterogeneity of OI and the lack of diagnostic criteria. We did a retrospective review of 84 patient charts with a diagnosis of mild and moderate forms of OI. We report on their diagnostic experience with the goal of evaluating the role of genotyping in establishing and confirming a diagnosis of mild or moderate OI. Our analysis supports the fact that no set of clinical data is diagnostic in these cases and genetic testing has valuable utility. We further constructed a genotypephenotype map of our patient population, which can serve as an expandable tool for clinicians and families in the ongoing management of patients with mild and moderate types of O
Internet Overuse and Time Management Disposition of Middle School Students

Objective: To explore the relationship between internet overuse and time management disposition in middle school students. Methods: Using Diagnostic Questionnaire for Internet Addiction (YDQ), Time Management Disposition Scale (TMDS), we investigated 2620 middle-school students.Results:The incidence rate of internet overuse among middle school students was 2.4 %. The difference of time management disposition between internet overuse group and control group was significant(129.7±25.3/150.0±28.5,t=4.27, P0.01). Logistic analysis showed that the factor"time management behavior efficacy"had effect on internet overuse in middle school students(OR=0.78,95%CI=0.69～0.88). Conclusion:Middle school students with internet overuse have poor time management patterns ,which may be one reason of internet overuse.
THE PROTECTIVE EFFECT OF PEANUT OIL ON RISK OF CADIOVASCULAR DISEASE

Objective: To study the protective effect of peanut oil on risk of cardiovascular disease (CVD). Methods: A randomized, 4-periods crossover design (n = 65) was used to examine the effects of the low fat diet (LFD), peanut oil diet (POD), peanut oil+peanut diet (POPD) on serum lipids and lipoproteins in 65 persons aged 40-60 y. Results: Compared with the basic diet, the high-MUFA diets (POD, POPD) and the LFD lowered TC and LDL-C cholesterol by 1.95 %, 3.32%, 3.91% and 6.58%, 8.52%, 5.43% respectively. LFD lower HDL-C by 4.62% and elevated TG level by 4.02%; whereas the POD and POPD elevated HDL-C by 4.62% and 3.47% respectively and didnt elevate TG. Conclusion: Peanut oil has the protective effect on lowering hyperlipemia and reducing CVD risk.
2‐Chloro‐3‐(3‐di­methyl­amino­propyl­amino)‐1,4‐naphtho­quinone

The structure of the title compound, C15H17ClN2O2, comprises essentially planar mol­ecules slip-stacked along the a axis. The propyl chain has sufficient length to allow an intramolecular H-bond between the N—H and N(CH3)2 groups and the N—H also hydrogen bonds to the adjacent O atom, completing a three-centre association.
The effect of leptin on the Th17 correlated cytokine in ankylosing spondylitis

To understand the association of leptin and Th17 correlated cytokines with AS patients diseases activity,leptin,IL-17,TNF-α,IL-6 in synovial fluid and peripheral sera collected from 30 patients with AS and 30 healthy control were detected using sandwich ELISA and RIA methods.Results showed that the concentrations of leptin,IL-17,TNF-α,IL-6 were significantly higher in the synovial fluid and peripheral sera in AS patients than those in healthy control(P 0.01). There were obvious correlation between leptin and IL-17,IL-6 expression in the synovial fluid and peripheral sera in AS patients(P 0.01),and no correlation between leptin and TNF-α(P0.05). There were obvious correlation between the mean expression of leptin,IL-17,IL-6 and ESR,CRP,BASDAI in AS patients(P 0.01),and no correlation between TNF-α and the AS active index(P0.05). Leptin and Th17 correlated cytokines significantly increased in the synovial fluid and sera of AS patients.Leptin may play an important role in the development of AS inflammation.
On the Move and Working Alone: Policy Implications of the Experiences of Unionised Newfoundland and Labrador Homecare Workers

Abstract Homecare work is female-dominated, generally precarious, and takes place in transient and, sometimes, multiple workplaces. Homecare workers can engage in relatively complex employment-related geographical mobility to, from, and often between work locations that can change frequently and are remote from the location of their employer. Like other precarious workers, homecare workers may be more likely to experience work-related health and safety injuries and illnesses than non-precarious workers. Their complex patterns of employment-related geographical mobility may contribute to the risk of injury and illness. This paper explores patterns of employment-related geographical mobility and ways they influence the risk of injury and illness among unionised homecare workers living and working in two regions of the province of Newfoundland and Labrador, on Canada’s east coast. It uses Quinlan & Bohle’s ‘pressure, disorganisation, and regulatory failure’ model to help make sense of the vulnerability of these workers to occupational safety and health risks. The study uses a qualitative, multi-methods approach consisting of semi-structured interviews and a review of government and homecare agency policies, as well as 20 Newfoundland and Labrador homecare collective agreements. It addresses two main questions: What are the work-related health and safety experiences of interviewed unionised homecare workers in Newfoundland and Labrador? ; How do policies (government and homecare agency) and collective agreements interact with employment-related geographical mobility to mitigate or exacerbate the occupational safety and health challenges confronting these workers? Findings show that these workers experience numerous work-related health and safety issues, many of which relate to working in remote, transient and multiple workplaces. While collective agreements mitigate some health and safety issues, they do not fully address particular occupational safety and health risks associated with working alone, working remotely from employers, and working in transient workplaces, or the risks associated with commuting between workplaces. More active union engagement with these issues could be a mechanism to improve the health and safety of these and other homecare workers.
Survey of depressive and /or anxiety disorders among outpatients in general hospitals of Chengdu

Objective:To investigate the prevalence rate of depressive and anxiety disorders of outpatients in general hospitals of Chengdu.Method:A total of 1780 outpatients from departments of Neurology,Gastroenterology,Cardiology and Obstetrics and Gynecology in three general hospitals of Chengdu were screened with hospital anxiety and depression scale(HADS). The patients with the HADS score of≥8 were investigated with the mini-international neuropsychiatric interview(MINI5.0.0.),and diagnosed in terms of DSM-IV.Results:845 patients(47.47%) had a HADS score of ≥8,618 of whom were investigated with MINI5.0. 0.The lifetime adjusted prevalence rate of depressive disorders,anxiety disorders,and depressive-anxiety comorbid disorders were 24.61%,15.17%,10.11%,respectively.Conclusion:The prevalence rate of anxiety and depression disorders are quite high,but few were well-diagnosed and treated among outpatients in general hospitals of Chengdu.
Clinical features and long-term prognosis of patients suffering from myocardial infarction with premature ST segment elevation

Objective To investigate the risk factors, clinical features and prognosis of premature ST-segment elevation myocardial infarction (STEMI). Methods In this retrospective analysis, 1428 patients who were diagnosed as premature STEMI (male ≤55 years old, female ≤65) and treated with percutaneous coronary intervention (PCI), admitted to General Hospital of Shenyang Command from July 2008 to November 2012, were divided into two groups, namely the young (≤45 years old, n=381) and middle aged (>45 years old, n=1047) groups. Clinical characteristics and prognosis of the premature STEMI patients in different age groups were summarized and compared. Results The percentage of male (97.1% vs 76.7%, P<0.01), smokers (76.9% vs 65.7%, P<0.001), overweight (70.3% vs 64.9%, P=0.014), hyperlipidemia (53.3% vs 44.6%, P=0.004) were significant higher in young patients than in middle aged patients. Higher proportions of morbidities, such as hypertension (35.4% vs 43.6%, P=0.005), diabetes (14.7% vs 23.9%, P<0.001), renal insufficiency (3.4% vs 8.5%, P=0.001) and stroke (1.6% vs 5.3%, P=0.002) were found in middle aged than young patients. The incidence of multi-vessel disease was lower in young patients (47.5% vs 63.6%, P<0.001). Young patients were associated with a significantly decreased 3-year incidence of major adverse cardiovascular events compared with middle aged patients (7.1% vs 4.8%, P=0.04). Conclusion Young patients with premature STEMI is associated with less comorbidities but more controllable risk factors and worse long-term prognosis than middle aged counterparts. DOI: 10.11855/j.issn. 0577-7402.2015. 04.06
A Multivariable Model to Classify Methicillin-Resistant Staphylococcus aureus Infections as Health Care or Community Associated

Background Methicillin-resistant Staphylococcus aureus (MRSA) infections are often defined as health care (HA) or community-associated (CA) using common classification schemes involving health care risk factor, infection type, susceptibility pattern, or molecular typing. This investigation compared pulsed-field gel electrophoresis (PFGE) molecular typing results (dichotomized as HA or CA) with our new MRSA infection classification method. The goal was to develop an improved predictive model for PFGE-type based primarily on the other 3 classification variables. Methods Methicillin-resistant S. aureus infections reported to the Michigan Department of Community Health from October 2004 to December 2005 were analyzed. Patients’ demographics, risk factors, infection information, and susceptibility results were collected for 2151 cases. A subset of 244 MRSA infections with available PFGE results was analyzed. Results of logistic regression are presented using a receiver operating characteristic curve analysis. Results The multivariable models predicted the PFGE classification as HA or CA (Max-rescaled R 2 = 61%) better than health care risk factor, infection type, or susceptibility pattern alone (max-rescaled R 2 = 21%, 34%, and 46%, respectively). The best model included infection type, susceptibility pattern, age, and hospitalized during infection. Conclusions This model provides a simpler, more accurate prediction of HA or CA status, thus enhancing efforts to control MRSA infections.
A Method for Training Step-Over-Step Stair Descent Gait With Stance Yielding Prosthetic Knees: A Technical Note

ABSTRACT Limited information is available concerning stair descent training for transfemoral amputees using prosthetic knees. Literature describing stair descent training techniques are predominantly available for the step-to-step stair descent method. A thoroughly descriptive technique for training prosthetic knee users to reciprocally descend stairs, using a step-over-step pattern is not available. The purpose of this technical note is to describe a procedure for training stance-yielding prosthetic knee users how to descend stairs using a reciprocal, step-over-step pattern. The technique describes stair setup, safety considerations including hand railing, use of a gait belt, guarding techniques and a one versus two therapist technique. Nineteen subjects were initially trained in this technique, and all subjects demonstrated the ability to reciprocally descend stairs after training. Reciprocal step-over-step stair descent is not appropriate for all transfemoral amputees; however, we recommend considering the supervised, therapeutic application of this technique for all transfemoral amputees using stance yielding prosthetic knees. We suggest that practicing this technique might improve a prosthetic knee user's overall functional performance such as their ability to utilize stumble recovery during a missed step, to transition more symmetrically from stand to sit and to utilize knee flexion during the loading response of gait.