Miracle-dz/UniFAR-FTUs huggingface dataset:
Analysis of influenza vaccination coverage among the elderly in Genoa (Italy) based on a deprivation index, 2009-2013

Summary Introduction The elderly suffer the most influenza-related complications, and 90% of deaths due to influenza occur in older subjects. Consequently, the elderly are among the main targets of influenza vaccination campaigns. The use of deprivation indexes can help to identify subgroups with lower vaccination uptake. This study analyzed influenza vaccination coverage in elderly persons living in Genoa (Italy) in relation to a local Index of Socio-Economic and Health Deprivation (SEHDI) in order to identify population subgroups needing specific intervention to improve vaccination coverage. Methods The study targeted subjects aged ≥ 65 years living in Genoa in the period 2009-2013. Information on vaccination coverage was provided by general practitioners and Local Health Units. A combination of linear regression, factor analysis and cluster analysis was used to construct the SEHDI at Census Tract (CT) level, on the basis of data from the 2011 Italian census. Results In 2011, people aged ≥ 65 years accounted for the 27.7% of the population of Genoa. Most elderly subjects were assigned to either the medium (45.3%) or medium-high (32%) deprivation groups, while the percentages in the extreme tails were low (3.6% high deprivation; 1.3% low deprivation). Significant, non-linear (p < 0.05 NL) relationships were observed in both sexes with regard to mortality due to all respiratory diseases (RD) and chronic obstructive pulmonary disease (COPD), with the highest Standardized Mortality Ratio (SMR) values in women in the high deprivation group of women (1.81, p < 0.05 RD; 1.79, p < 0.05 COPD). The SMRs for influenza and pneumonia showed a positive linear trend in women (p < 0.05) with the highest value in the high deprivation group (1.97, p < 0.05), while in men the trend was NL (p < 0.05). A positive linear trend (p < 0.05) was found with regard to vaccination coverage, which grew weakly as deprivation increased, up to the medium-high deprived group (from 34.6% to 44.4%). However, the high deprivation group showed the lowest value (33.3%). Conclusions The results revealed a relationship between deprivation and influenza vaccination coverage in the elderly. This finding should be taken into account in the organization of vaccination campaigns and should prompt differentiated intervention in each local area.
Echinocandins versus Amphotericin B Against Candida tropicalis Fungemia in Adult Hematological Patients with Neutropenia: A Multicenter Retrospective Cohort Study

Background Candida tropicalis is the most common non-albicans Candida species identified in immunocompromised patients, which often appears with high mortality. However, data on the outcomes of treatment for Candida tropicalis fungemia in patients with neutropenia remain limited. Methods In the present study, 90 neutropenic adult patients with proven Candida tropicalis fungemia, who received initial antifungal therapy, were retrospectively analyzed. Results These results revealed that the overall 8-day and 30-day mortality among patients in the entire data set were 22.2% and 33.3%, respectively. However, there was no significant difference between the survival and death group, in terms of baseline characteristics. The univariate analysis of risk factors identified the treatment with azole as a predictor of mortality, while treatments that containing amphotericin B were associated with reduced mortality. In addition, the survival rate on day 30 was observed in 60.7% (17/28) of patients who were initially treated with echinocandins, while this was observed in 86.4% (19/22, P=0.039) and 100% (13/13, P=0.024) of patients treated with amphotericin B plus echinocandins and amphotericin B, respectively. Conclusion These data indicate for the first time that the initial therapy with amphotericin B-based agents was associated with a better survival rate and could be assessed as the optimal strategy for the treatment of Candida tropicalis fungemia in patients with neutropenia.
Association between Electronic Medical Records and Healthcare Quality

Abstract The implementation of electronic medical records (EMRs) has generally been thought to improve medical efficiency and safety, but consistent evidence of improved healthcare quality due to EMRs in population-based studies is lacking. We assessed the relationship between the degree of EMR adoption and patient outcomes. We performed an observational study using discharge data from Tri-service General Hospital from 2013 to 2018. The levels of EMR utilization were divided into no EMRs, partial EMRs and full EMRs. The primary healthcare quality indicators were inpatient mortality, readmission within 14 days, and 48-hour postoperative mortality. We performed a Cox proportional hazards regression analysis to evaluate the relationship between the EMR utilization level and healthcare quality. In total, 262,569 patients were included in this study. Compared with no EMRs, full EMR implementation led to lower inpatient mortality [adjusted hazard ratio (HR) 0.947, 95% confidence interval (CI): 0.897–0.999, P = . 049] and a lower risk of readmission within 14 days (adjusted HR 0.627, 95% CI: 0.577–0.681, P < .001). Full EMR implementation was associated was a lower risk of 48-hour postoperative mortality (adjusted HR 0.372, 95% CI: 0.208–0.665, P = .001) than no EMRs. Partial EMR implementation was associated with a higher risk of readmission within 14 days than no EMRs (HR 1.387, 95% CI: 1.298–1.485, P < .001). Full EMR adoption improves healthcare quality in medical institutions treating severely ill patients. A prospective study is needed to confirm this finding.
Sacral and Rectal Necrosis after Carbon Ion Radiotherapy Reconstructed with Transpelvic Rectus Abdominis Flap

Summary: Carbon ion radiotherapy (CIRT) has been used for malignant tumors that are difficult to excise surgically, such as sacral chordoma, and the success of its outcomes is attributable to the high dose concentration and biological effects. CIRT has produced successful clinical outcomes, and it is considered to have fewer adverse effects on surrounding normal tissues; moreover, complications have been rarely reported. We describe a 75-year-old woman with a full-thickness sacral defect, who had received CIRT for sacral chordoma 3 years earlier. Computed tomography showed sacral bone destruction, and a colonoscopy revealed rectal necrosis. Rectectomy in addition to sacral bone resection was necessary, which resulted in a huge sacral defect of slightly anxious viability. We performed reconstruction of the sacral defect by using pedicled vertical rectus abdominis myocutaneous (VRAM) flap, obliterating sacral defects and intrapelvic dead space that occurred after rectectomy. Six months after surgery, the wound had healed well, and no complication was observed. Sacral complications after CIRT may affect surrounding normal tissues such as the rectum, and it would be difficult to reconstruct the resulting complications. The vertical rectus abdominis myocutaneous flap is considered useful for the simultaneous obliteration of sacral defects and intrapelvic dead space after CIRT.
Association between Vitamin B12 levels and cognitive function in the elderly Korean population

Abstract Vitamin B12 (B12), also known as cobalamin, is a water-soluble vitamin. It is a cofactor in DNA synthesis and is involved in the metabolism of every cell of the human body, including the central nervous system. Those with a deficiency of B12 can present with peripheral neuropathy, pernicious anemia, or a cognitive disorder. Previous studies have revealed that a deficiency of B12 is associated with cognitive decline or Alzheimer disease. The data of 2991 people were evaluated from 2 years of the Korean Frailty and Aging Cohort Study, a nationwide multicenter survey. To assess cognitive function, a short form of the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD-K) was used. Of the CERAD-K tests, we included the Mini-Mental State Examination in the Korean version of the CERAD assessment packet (MMSE-KC), the word list: memory/recall/recognition, digit span (forward, backward), trail making test-A, and the frontal assessment battery. B12 concentrations were classified into clinically relevant categories, insufficient (<350 pg/mL) and sufficient (≥350 pg/mL). A linear regression analysis was used to evaluate the relationship between cognitive function and B12 levels. The mean age of the 2991 participants was 76.4 ± 3.9 years old. Overall, 414 (13.8%) were classified as B12 insufficient, and 2577 (86.2%) as B12 sufficient. The sufficient B12 group performed better in the MMSE-KC, Wordlist: memory, Wordlist: recognition, TMT-A test, digit span, and FAB tests. This was statistically significant (P < .05). However, in the multivariable linear regression analysis, after adjusting for age, sex, education period, marriage, smoking and drinking habits, and comorbidities, the association between the B12 group and cognitive function was not statistically significant. Although our study does not show that B12 insufficiency is a direct risk factor to cognitive decline, B12 levels could be a contributing factor to cognitive function. Our results suggest that cognition was affected by the B12 levels, along with demographic and sociological variables.
Tanshinone IIA Promotes Axonal Regeneration in Rats with Focal Cerebral Ischemia Through the Inhibition of Nogo-A/NgR1/RhoA/ROCKII/MLC Signaling

Purpose The aim of this study was to evaluate the neuroprotective effect of tanshinone IIA (TSA) on focal cerebral ischemia in rats and to investigate whether it was associated with Nogo-A/NgR1/RhoA/Rho-associated protein kinase 2 (ROCKII)/myosin light chain (MLC) signaling. Methods In this study, focal cerebral ischemia animal model was used. Neurological deficit scores and infarction volume were investigated to evaluate the neuroprotection of TSA. Hematoxylin-eosin staining, Nissl staining, and immunofluorescence staining were conducted to detect ischemic changes in brain tissue and changes in neurofilament protein 200 (NF200) and growth-associated protein-43 (GAP-43) expression, respectively. Western blotting and qRT-PCR analyses were used to detect the expression levels of NF200, GAP-43 and Nogo-A/NgR1/RhoA/ROCKII/MLC pathway-related signaling molecules. Results TSA treatment can improve the survival rate of rats, reduce the neurological score and infarct volume, and reduce neuron damage. In addition, TSA also increased axon length and enhanced expression of NF200 and GAP-43. Importantly, TSA significantly attenuated the expression of Nogo-A, NgR1, RhoA, ROCKII, and p-MLC, and thus inhibiting the activation of this signaling pathway. Conclusion TSA promoted axonal regeneration by inhibiting the Nogo-A/NgR1/RhoA/ROCKII/MLC signaling pathway, thereby exerting neuroprotective effects in cerebral ischemia rats, which provided support for the clinical application of TSA in stroke treatment.
Home-Based Cognitively Assistive Robots: Maximizing Cognitive Functioning and Maintaining Independence in Older Adults Without Dementia

Abstract Promoting health and prolonging independence in the home is a priority for older adults, caregivers, clinicians, and society at large. Rapidly developing robotics technology provides a platform for interventions, with the fields of physically and socially assistive robots expanding in recent years. However, less attention has been paid to using robots to enhance the cognitive health of older adults. The goal of this review is to synthesize the current literature on home-based cognitively assistive robots (CAR) in older adults without dementia and to provide suggestions to improve the quality of the scientific evidence in this subfield. First, we set the stage for CAR by: a) introducing the field of robotics to improve health, b) summarizing evidence emphasizing the importance of home-based interventions for older adults, c) reviewing literature on robot acceptability in older adults, d) highlighting important ethical issues in healthcare robotics, and e) reviewing current findings on socially assistive robots, with a focus on translating findings to the CAR context. With this foundation in place, we then review the literature on CAR, identifying gaps and limitations of current evidence, and proposing future directions for research. We conclude that CAR is promising and feasible and that there is a need for more methodologically rigorous evaluations of CAR to promote prolonged home-based independence in older adults.
Impacts of extreme climatic events on competition during grassland invasions

Phytometers of five C3 and five C4 species were transplanted into three different grasslands to study the effects of extreme climatic events on community invasibility and competition. Single extreme heating (eight hours at 52.5 °C) and rainfall (the equivalent of 100 mm) events in factorial combinations were superimposed on the grassland communities. A novel technique involving portable computer‐controlled chambers was used to create the heating events. In order to generate predictions of response to the extreme climatic events, the 10 phytometer species were categorized on the basis of 12 key plant functional traits. Using principal component analysis, two functional types (FTs) were identified as most likely to be advantaged (FT1, fast‐growing C4 annuals) and disadvantaged (FT2, slower‐growing C3 perennials) by an extreme climatic event. Competition between the resident vegetation and FT1 plus other C4 phytometers was consistently more intense within the exclusively C3 community compared to the dry C3/C4 community or moist C3/C4 community. The single extreme heating event had the greatest impact on competition, lowering the intensity of competition between the phytometers and resident vegetation. Our results indicate that competition is highly important in limiting the invasion of C3 grasslands by C4 species. The FT1 and FT2 responses confirmed predictions based on plant functional traits, whether growing as phytometers or as part of the resident vegetation. Future increases in climatic variability and the incidence of extreme climatic events are expected to suppress C3 competitive dominance and promote invasion of C4 species, in particular, the FT1 species.
Characterizing the Cantor bi-cube in asymptotic categories

We present the characterization of metric spaces that are micro-, macro- or bi-uniformly equivalent to the extended Cantor set $\{\sum_{i=-n}^\infty\frac{2x_i}{3^i}:n\in\IN ,\;(x_i)_{i\in\IZ}\in\{0,1\}^\IZ\}\subset\IR$, which is bi-uniformly equivalent to the Cantor bi-cube $2^{<\IZ}=\{(x_i)_{i\in\IZ}\in \{0,1\}^\IZ:\exists n\;\forall i\ge n\;x_i=0\}$ endowed with the metric $d((x_i),(y_i))=\max_{i\in\IZ}2^i|x_i-y_i|$. Those characterizations imply that any two (uncountable) proper isometrically homogeneous ultrametric spaces are coarsely (and bi-uniformly) equivalent. This implies that any two countable locally finite groups endowed with proper left-invariant metrics are coarsely equivalent. For the proof of these results we develop a technique of towers which can have an independent interest.
Wolf Depredation Trends and the Use of Fladry Barriers to Protect Livestock in Western North America

Abstract: In Alberta, Canada (1982–2001), and in Idaho, Montana, and Wyoming, United States (1987–2001), wolves (Canis lupus) killed various domestic animals, among which the major prey were sheep in the United States (68%,n =494) and cattle in Canada (95%;n =1633). Under recovery programs, the wolf population increased in the United States, and depredation events increased proportionately. In both countries, the number of domestic animals killed each year was correlated with the number of wolves killed by government authorities for depredation management. We tested the ability of antiwolf barriers made of flags hanging from ropes to impede wolf access to food and livestock. In 18 experiments, barriers prevented captive wolves(n =9)from accessing food for up to 28 hours and allowed daily separation of wolves to administer contraceptive pills to a female wolf. Barriers prevented access by wild wolves to 100‐m2 baited sites during two 60‐day tests. We also set barriers around three cattle pastures. In Alberta during two 60‐day trials on 25‐ha pastures, wolves approached barriers on 23 occasions but did not cross them, and no cattle were killed. Wolves killed cattle on neighboring ranches during the trials and before and after the trials on the tested ranches. In Idaho four radiocollared wolves crossed barriers and killed cattle in a 400‐ha ranch after 61 days of barrier exposure. Our results suggest that antiwolf barriers are effective in deterring captive and wild wolves for >1 and ≥60 days, respectively, and that wild wolves switch to alternative livestock when excluded from one herd of livestock. Our depredation data indicate that protecting livestock from wolves reduces the necessity for killing wolves. Barriers could play a role among the limited set of preventive measures available and offer a cost‐effective mitigation tool for the problem of livestock depredation on a local scale.
Propension à fournir des données personnelles mensongères sur Internet : une étude exploratoire

The rise of consumer data-gathering requests has each day forced more consumers to adopt privacy protection strategies, and more specifically since the arrival of the Internet. Some people choose not to answer the requests; others sometimes prefer to provide inaccurate data. Why do some individuals choose to lie? In spite of academic and managerial interest, there is little if no answer to this question. This research contributes to fill this gap by studying the propensity of Net surfers 1) to answer a request for on line personal data and 2) to (or not to) provide untrue data. Three categories of antecedents – individual, beliefs and situational – to both behaviors are identified and integrated within the model. So as to test it, 252 Net surfers panelists were subjected to an experimental process consisting in filling out a form with more or less sensitive data. Our results come to enrich and/or confirm the literature in a French context. The perceived value in this exchange – seldom introduced into the existing models – influences both the probability of filling out the form and of providing untrue data. We also prove that a request of sensitive data, a strong consumer privacy concern and being a male result in a strong probability of lying. Lastly, the privacy concern would have a moderating role – which the literature does not evoke – on the link between the sensitivity of the form and the intention to answer it. Our results have interesting implications for both the researchers and the organizations wishing to improve their consumer data-gathering procedures.
Neighborhood predictors of interspecific competition in young Douglas-fir plantations

Neighborhood models describing the effect of interspecific competition on the height and stem diameter of 4- to 9-year-old saplings of Douglas-fir (Pseudotsugamenziesii (Mirb.) Franco) were developed from site-preparation experiments in the Oregon Coast Range. The influence of abundance measures, height, distance, arid spatial arrangement of nonconiferous woody plants surrounding individual saplings was examined. Optimum neighborhood heights and radii were defined. The best interspecific competition index for predicting Douglas-fir height and stem diameter was total percent cover for all woody species within a 2.1-m radius. Visual estimates of neighbor cover were superior to objective measures of crown area. The cover of woody species equalling or exceeding the height of the tree provided the best prediction for tree height. Woody species cover equalling or exceeding one-half the height of the tree provided the best index for predicting stem diameter. Accounting for the spatial arrangement of neighboring .
The assessment of outcome for musculoskeletal shoulder pain: a mixed methods study

--------------------------------------------------------------I PRESENTATIONS ---------------------------------------------------------------II ACKNOWLEDGEMENTS ---------------------------------------------------------------III TABLE OF CONTENTS ---------------------------------------------------------------IV LIST OF ABBREVIATIONS ---------------------------------------------------------------IX LIST OF TABLES ---------------------------------------------------------------X LIST OF FIGURES ---------------------------------------------------------------XI LIST OF IMAGES ---------------------------------------------------------------XIII LIST OF APPENDICES ---------------------------------------------------------------XIV CHAPTER ONE INTRODUCTION 1.0 Introduction -------------------1 1.1 Morbidity of musculoskeletal shoulder pain -------------------1 1.2 Implementation of evidence based practice for MSP -------------------1 1.3 Importance of gaining the patient’s perspective -------------------2 1.4 Patient reported outcome measures for MSP -------------------2 1.5 The ICF model of disability and health -------------------3 1.6 The purpose of the research -------------------3 1.6. 1 The overarching research question -------------------3 1.6. 2 The component research questions -------------------4 1.7 The structure of the thesis -------------------4 CHAPTER TWO IMPORTANCE OF PATIENT REPORTED OUTCOME MEASURES IN THE EVIDENCE BASED MANAGEMENT OF MUSCULOSKELETAL SHOULDER PAIN 2.0 Introduction -------------------6 2.1 Function of the shoulder -------------------6 2.2 Musculoskeletal shoulder pain -------------------7 2.3 Prevalence of musculoskeletal shoulder pain -------------------7 2.4 Morbidity of musculoskeletal shoulder pain -------------------8 2.5 Societal cost of musculoskeletal shoulder pain -------------------8 2.6 Referral rates for specialist opinion -------------------8 2.7 Management of musculoskeletal shoulder pain -------------------8 2.7. 1 Implementation of evidence based practice -------------------9 2.7. 2 Changes in healthcare policy -------------------10 2.7. 3 Measurement of health outcomes -------------------11 2.7. 4 Provision of patient-centred healthcare -------------------11 2.8 Outcome measures -------------------12 2.8. 1 Types of outcome measures -------------------13 2.8. 2 Patient reported outcome measures -------------------14 2.8. 3 Patient involvement in development of PROMs -------------------15 2.8. 4 Specific applications of PROMs -------------------16 2.8. 5 Types of PROMs -------------------17 2.9 Measurement properties of PROMs -------------------19 2.9. 1 Validity -------------------19 2.9. 1.1 Content validity -------------------19 2.9. 1.2 Construct validity -------------------21 2.9. 2 Reliability -------------------22 2.9. 2.1 Test-retest reliability -------------------22 2.9. 2.2 Standard error of measurement -------------------23 2.9. 2.3 Internal consistency -------------------23 2.9. 3 Responsiveness -------------------23