Miracle-dz/UniFAR-FTUs huggingface dataset:
Reduce falls through tests of change

NURSES ARE DEDICATED to keeping patients safe and having the foresight to avoid adverse events such as falls. According to the CDC, falls are the leading cause of fatal and nonfatal injuries among adults age 65 and older in the United States. Severe injuries associated with falls include hip fractures and traumatic brain injury. Patients with advanced illness are especially vulnerable to falling. Because many of these patients are in hospice settings, hospice patients are more likely to fall than patients who aren’t receiving hospice care. This article provides an overview for creating a successful falls reduction program in a hospice setting.
Pain induced by injection of hypertonic saline into the infrapatellar fat pad and effect on coordination of the quadriceps muscles.

OBJECTIVE Musculoskeletal conditions of the knee involve changes in sensorimotor function, but it is unclear whether these changes are a cause or result of pain. Induction of experimental pain may help solve this issue. Although this is commonly achieved by injection of hypertonic saline into muscle, muscle is commonly not the source of pain. This study investigated whether pain induced by injection of saline into the infrapatellar fat pad changes motor control of the quadriceps muscles of the knee. METHODS Ten participants performed a standardized task involving ascending and descending a series of steps. Electromyographic activity (EMG) of vastus medialis obliquus (VMO) and vastus lateralis (VL) was recorded with surface electrodes. Trials were conducted without pain, with anterior knee pain induced by injection (0.25 ml) of hypertonic saline (5%) into the infrapatellar fat pad, with anticipation of pain associated with unpredictable electrical shocks to the knee, and 20 minutes after pain cessation. EMG onset and amplitude were analyzed. RESULTS When participants ascended the steps with pain, the onset of VMO EMG was delayed relative to that of VL, in contrast to simultaneous or earlier activation of VMO EMG in the pre- and postpain trials. VL EMG amplitude was decreased significantly from the control condition. CONCLUSION These data show that alterations in coordination of knee muscle activity can be caused by pain, even when it is of nonmuscle origin. Treatment of pain is therefore important to facilitate performance of the quadriceps muscles, which are essential for locomotor and functional tasks as well as for knee stability.
The FLUIDHAND III: A Multifunctional Prosthetic Hand

The third generation of the FLUIDHAND is an updated version of the previous models containing enhanced functionality, cosmesis, enable secure, and adaptive grasping while maintaining an aesthetic appeal. The combination of flexible fluidic actuators and soft passive elements reduces the required grasping force for a wide range of objects. At the same time, the enhanced actuator system allows high grasping forces if necessary. Two myoelectrodes in the socket together with the developed controller board and software enable quick selection of the most important grasping patterns. Vibrotactile force feedback and wireless programming and control options complete the characteristics of the FLUIDHAND III.
Über das relative postnatale Wachstum der Bodenregionen der Fossae craniales

: The relative postnatal growth of the bony floor parts was calculated from previous measurements and planimetrically determined on 21 adults and 13 skulls of children. As expected 1) the percentage rise in length and breadth values was lower than that of the area values. 2) The greatest postnatal area rise (63%) was determined in the hypophyseal region. 3) The growth of the individual skull areas terminates at a variable period after birth, e.g. a) between the foramen caecum and the tuberculum sellae in the 8th year of life; the planum sphenoidale, however, grows after the 9th year of life by approx. 27%! b) In children of 8 years of age, the lateral length of the middle cranial fossa is about 98% of the adult value. c) Between the 6th year of life and adult age a length increase of 18.5% takes place (tuberculum sellae--dorsum sellae). d) In 5-year old children the lateral length of the posterior cranial fossa is 97.5%, in 8-year-olds 99.9% of the adult value. e) After the 8th year of life the breadth increase is e.g. 6.4% in the region of the anterior cranial fossa, 3.5% in the middle fossa, and 10% in the pituitary region.
Effect of fluvastatin on cardiac outcomes in kidney transplant patients with systemic lupus erythematosus: a randomized placebo-controlled study.

OBJECTIVE Patients with systemic lupus erythematosus (SLE), with or without end-stage renal failure, are at increased risk of premature cardiovascular disease. Although statin therapy has been found to reduce cardiovascular risk in the general population, its effectiveness in kidney transplant recipients with SLE has not been examined. This study was undertaken to investigate the effect of fluvastatin on cardiac end points in a randomized controlled trial of renal transplant patients with SLE. METHODS Patients with SLE were identified from among participants in the Assessment of Lescol in Renal Transplantation trial, a randomized, double-blind, placebo-controlled study of the effect of fluvastatin (40-80 mg/day) on cardiovascular outcomes in renal transplant recipients. Patients were randomized to either a group receiving fluvastatin or a placebo group for the duration of the 5-6-year trial, and then invited to continue in a 2-year open-label extension during which all participants, regardless of original group, received fluvastatin. Patients were followed up for a total of 7-8 years for assessment of the primary end point of major cardiac events, comprising nonfatal myocardial infarction, cardiac death, and coronary intervention procedures. RESULTS Fluvastatin reduced low-density lipoprotein cholesterol levels by 29.2% (95% confidence interval [95% CI] 18.3-40%), from a mean +/- SD of 4.0 +/- 0.9 mmoles/liter to 2.8 +/- 1.1 mmoles/liter, and total cholesterol by 19.6% (95% CI 11.7-27.5%), from 6.4 +/- 0.9 mmoles/liter to 5.1 +/- 1.1 mmoles/liter. Compared with placebo-treated patients, patients randomized to receive fluvastatin exhibited a 73.4% reduction in the risk of major cardiac events (relative risk 26.6 [95% CI 5.9-119.4], P = 0.064). CONCLUSION Our results indicate that the effect of fluvastatin on cardiac events in renal transplant recipients with SLE is similar to that observed with statin therapy in the renal transplant population as a whole.
Nutritional Management of Gastroparesis in People With Diabetes

Gastroparesis, or slow emptying of the stomach, is a debilitating disease process that affects an estimated 4% of the population.1 The most common etiologies preceding the development of gastroparesis symptoms are diabetes (50%), status post vagotomy or gastric resection, and a viral episode before symptom development. Before the diagnosis can be made, however, mechanical or structural disorders of the gastrointestinal tract must be ruled out. Clinically, patients with gastroparesis are at risk for fluid, electrolyte, and nutrient deficits and, in patients with diabetes, erratic glycemic control. Treatment is targeted at correcting fluid, electrolyte, and nutritional deficiencies, reducing symptoms, and correcting the precipitating cause of gastroparesis, if possible. Although the mainstay of treatment for gastroparesis is anti-emetic and prokinetic therapy,1 this article will focus on nutrition interventions. Stratifying the nutrition status of patients with gastroparesis into mild, moderate, or severe malnutrition is an important first step in the treatment of gastroparesis. This will help identify those who need aggressive nutritional support early on versus those who might benefit from some initial adjustments in oral food selections. Unintentional weight loss over time is one of the first and most important parameters to assess regardless of the patient's overall appearance. A 5–10% unintentional loss of weight over a 3- to 6-month period signifies severe malnutrition.2 Most guidelines identify patients at nutritional risk if they: 1. Are < 80% of ideal weight 2. Have a BMI < 20 kg/m2 3. Have lost 5 lb or 2.5% of baseline weight in 1 month 4. Have lost 10 lb or 10% of usual body weight in 6 months One often-overlooked population includes patients requiring hemodialysis. Given the percentage of hemodialysis patients who have a long-standing history of diabetes, gastroparesis can frequently be found if clinicians know what to look for.3,4Because of the …
Children caring for their ill parents with HIV/AIDS

Abstract Children orphaned by HIV/AIDS experience not only the trauma of a parent's death, but the stress of living with and often caring for an ill and dying parent. We interviewed 50 mothers ill from HIV/AIDS in both Mutare, Zimbabwe and New York, USA, and one child of each aged 8–16 about personal assistive care the child provided; other household responsibilities; hours/day children spent on chores; and parental/child mental health. Children provided substantial amounts of personal care; took responsibility for cooking, cleaning, shopping and other household tasks; and some were their parents' confidants. The amount of care provided was related to maternal disability, not child age, gender, or presence of other adults/siblings. Children reported performing more tasks than their mothers reported. Almost half of New York and 80% of Mutare children said they had too much responsibility, and most reported reduced after-school and peer activities. Both children and parents felt children were more capable because of their responsibilities. Depression rates in New York and Mutare children were high but Mutare children were extremely vulnerable; two-thirds had depression scores in the clinically significant range. However, child caregiving was unrelated to depression. Research to better understand the role of child caregivers is still needed.
Dynamic leaders’ containment control of high-order multi-agent systems with state time-delay: an LMI approach

ABSTRACT This paper addresses the containment control of a multi-agent system with dynamic leaders while considering the state time-delay and time-varying input disturbances. The agents dynamics are assumed to be high-order integrals and an unkown state time-delay with a known upper bound is considered. In order to deal with dynamic leaders and time-varying input disturbances, an appropriate distributed PIp-type-based control protocol is proposed in this study. Thereafter, utilising the Lyapunov–Krasovskii stability theorem and based on LMI (Linear Matrix Inequality) approach, two theorems are proved which guarantee asymptotically stability of the multi-agent system with fixed and switching networks. In addition to stability assurance, the gains of the proposed protocol are achieved through solving the LMI. Finally, some numerical examples are given to demonstrate the validity of the theoretical results.
The social, physical and temporal characteristics of primary school dining halls and their implications for children's eating behaviours

Purpose – Social, physical and temporal characteristics are known to influence the eating experience and the effectiveness of nutritional policies. As the school meal service features prominently in UK nutritional and health promotion policy, the paper's aim is to investigate the characteristics of the primary school dining context and their implications for eating behaviours.Design/methodology/approach – A case study of one local authority in Wales was conducted involving 11 primary schools stratified into socio‐economic quartiles. Focussed observations were carried out over two to three lunchtimes per school to explore their social, physical and temporal characteristics. These were supplemented by semi‐structured interviews with catering staff and midday supervisors.Findings – The dining halls had numerous generic attributes (e.g. accommodation, equipment, length of lunchtime, social actors). These interacted to have a direct, but not necessarily positive, bearing on food choice and consumption. Overcro.
Nurses' most important role this flu season: Get vaccinated.

58 l Nursing2016 l Volume 46, Number 10 www.Nursing2016. com FLU SEASON has ethical implications for nurses, who have a duty to keep patients safe from avoidable complications. No matter where they work, nurses are in direct contact with vulnerable patients every day. Some patients may be at high risk for influenza infection because they have an autoimmune disorder, or are receiving chemotherapy or have received an organ transplant requiring immunosuppressant therapy. Infants, children, pregnant women, people with specific chronic illnesses, and adults age 65 and older are also especially vulnerable.1 What can nurses do to keep their patients safe from influenza infection and influenza-related complications? This article will explain nurses’ important role in herd immunity and their ethical duty during flu season.
Levels of Alpha-Fetoprotein During Pregnancy and Early Infancy in Normal and Disease States

Alpha-fetoprotein (AFP) was 1 of the first serum protein markers to serve in the dual capacities of tumor marker and fetal defect marker, ie, an oncofetal protein, in the clinical laboratory. Although the serum-marker capacity of AFP has long been used, less is known of the fluid compartments of this oncofetal protein during fetal and perinatal development. In this review, the biologic activities of AFP are discussed in light of its presence in the various biologic fluid compartments: fetal serum, amniotic fluid, cord blood, urine, and maternal serum. AFP concentrations within the biologic fluids are considered in the context of gestational age, sex, body weight, and anatomic location. Discussion follows concerning the relationships and roles of AFP in various developmental disorders such as hypothyroidism, folate deficiencies, autoimmune disorders, acquired immunodeficiency disorder (AIDS), congenital heart defects, cystic fibrosis, preeclampsia/hypertension, and platelet aggregation disorders. Based on its presence in so many types of birth defects, malformations, and congenital anomalies, AFP can be seen to serve as a form of molecular “duct tape” during pregnancy and postnatal development. Target Audience Obstetricians & Gynecologists, Family Physicians Learning Objectives After completion of this article, the reader should be able to outline the potential physiologic roles of AFP in the regulation of fetal growth and differentiation, to list the fetal defects associated with elevated and now levels of AFP, and to summarize the biology of AFP during growth and development.
Disestesia peri-incisional após reconstrução do ligamento cruzado anterior com terço central do tendão patelar

OBJECTIVE: To evaluate the prevalence and type of dysesthesia around the incision used to obtain the patellar tendon for anterior cruciate ligament (ACL) reconstruction surgery. METHODS: Out of a population of 1368 ACL reconstructions using the central third of the patellar tendon, 102 patients (111 knees) were evaluated by means of telephone interview. RESULTS: The mean follow-up was 52 months (ranging from 12 to 88 months). The patients' ages ranged from 16 to 58 years (mean: 34.7 years). There was some degree of peri-incisional dysesthesia in 66 knees (59.46%). In 40.54% of the knees, this condition was not found. In all the cases of dysesthesia, the type encountered was Highet's type II. CONCLUSION: Peri-incisional dysesthesia following ACL reconstruction using the central third of the patellar tendon is highly prevalent. It affected more than half of the cases in this series.
Comparison of Acute and Subclinical Pelvic Inflammatory Disease

Objective: The objective of this study was to compare the demographic, clinical, and microbiologic findings in women with subclinical pelvic inflammatory disease (PID) and women with acute PID. Study: A cross-sectional study was performed using cohorts from 2 separate studies of 1293 women at risk for PID. Most participants were recruited from emergency departments, sexually transmitted disease clinics, and family planning clinics in metropolitan centers. We compared demographic, clinical, and microbiologic findings among women with acute PID, women with subclinical PID, and women without endometritis (controls). Statistical analyses included chi-square for categorical variables, calculation of odds ratio and 95% confidence intervals, and polychotomous logistic regression when appropriate. Results: Similar proportions of women with acute and subclinical PID tested positive for cervical Chlamydia trachomatis (odds ratio [OR], 1.1; 95% confidence interval, 0.6–2.0) and had bacterial vaginosis (OR, 0.7; 95% CI, 0.2–1.8). The rate of cervical Neisseria gonorrhoeae infection in women with subclinical PID was intermediate between the rates in women with acute PID and controls (21% vs. 49% vs. 7%, respectively, P <0.001, test for trend). Endometrial recovery of N. gonorrhoeae and C. trachomatis in women with subclinical PID was also seen at intermediate levels. Similar distributions of teenagers, women who smoked or used illicit drugs, and women engaging in sexual intercourse during menses were found in each group. Proportions of women with subclinical PID who were black and with lower education levels were intermediate between the proportions of these characteristics in women with acute PID and controls. Conclusion: Demographic and microbiologic characteristics of women with subclinical and acute PID are comparable. These findings suggest that the pathophysiological mechanisms of acute and subclinical PID are similar.
Analysis of HIV Testing Acceptance and Risk Factors of an Adolescent Cohort Using Emergency Department–Based Multimedia HIV Testing and Counseling

Background The social environment in the Bronx, NY, has led to HIV infection rates among young people that are much higher than the national average. Methods A prospective observational study on a convenience sample of medically stable emergency department (ED) patients was conducted from October 1, 2005, to August 31, 2012. Acceptability of the tested model was determined by assessing the number of patients tested and identified HIV infections. Data were compared with data from the rest of the ED that tested for HIV. Results A total of 10,149 adolescents were approached during this period, of which 9.5% refused or were ineligible to test. Of those approached, 38.9% of patients were male, 59.7% were Hispanic, and 33.6% were black. The mean age was 19.4 ± 1.4 years, and 8.2% of patients were men who have sex with men. For risk behavior profiles, 24.3% never used condoms in the past 3 months. Incidence of HIV was less than 1%, and 92.6% of HIV-positive patients were linked to care. Of the patients who completed a postsatisfaction survey, 82.4% felt influenced to change their sexual practices. A smaller percentage of adolescent had tested previously for HIV compared with nonadolescents (67.7% vs. 80.6%). There was a slightly larger percentage of adolescents that accepted HIV testing compared with nonadolescents (95.4% vs. 90.8%). Adolescents who were positive for HIV were tested earlier in the progression of the disease, with higher median CD4 cell counts and lower viral loads compared with nonadolescents. Conclusions Adolescents were highly receptive to a multimedia-integrated ED-based HIV testing program, as indicated by their high uptake of testing.
Interleukin-6 and the Hypothalamic-Pituitary-Adrenal Activation in a Tumor Bearing Mouse

Tumor derived cytokines have been suggested to activate the hypothalamic-pituitary-adrenal (HPA) axis; that is, increase the hypothalamic releases of corticotropin-releasing hormone (CRH) and adrenocorticotrophic hormone. The authors previously reported that tumor mice bearing a human oral squamous cell carcinoma exhibit an anorectic phenotype with increased expression of CRH mRNA in their hypothalamic paraventricular nuclei. This study examined the plasma levels of tumor-derived cytokines, such as interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α), in order to determine potential mediator(s) implicated in CRH expression in this tumor mouse model. Plasma corticosterone levels were assayed as well to confirm the HPA activation. In the results, plasma levels of IL-6, but not TNF-α, were increased significantly in the tumor mice compared with age-matching non-tumor controls. Plasma corticosterone levels were also increased in the tumor mice. These results together with the previous findings suggest IL-6 as a potential mediator in the control of hypothalamic CRH expression in the authors’ tumor mouse model.
TRAF1 polymorphisms associated with rheumatoid arthritis susceptibility in Asians and in Caucasians.

OBJECTIVE Recent genome-wide association scans and replication studies of European populations have disclosed several single-nucleotide polymorphisms (SNPs) associated with rheumatoid arthritis (RA) susceptibility. The aim of this study was to evaluate the RA-associated loci by genotyping previously reported SNPs and additional tag SNPs in a Korean population. METHODS A total of 1,316 unrelated RA patients and 1,006 controls were genotyped for 12 SNPs identified in genome-wide scans and for 12 additional tag SNPs in IL2RB, OLIG3-TNFAIP3, PTPN22, and TRAF1-C5, and the findings were statistically compared. RESULTS None of the SNPs tested was associated with RA susceptibility, except rs7021206 in TRAF1 intron 3 (P = 0.0032) and, among the SNPs previously reported, rs6457617 in HLA (P = 4.6 x 10(-35)). The association of rs7021206 was positive in patients who were seropositive for rheumatoid factor (P = 0.0051) or for anti-cyclic citrullinated peptide autoantibodies (P = 0.0062). However, Korean patients were negative for the association of rs3761847 in the TRAF1-C5 intergenic region previously reported in Caucasians. Linkage disequilibrium between rs3761847 and rs7021206 was not as high in Koreans (r(2) = 0.37) as in Caucasians (r(2) = 0.67), which explains the lack of association of rs3761847 in Koreans. Accordingly, RA susceptibility was localized to an extended haplotype marked by rs7021206 rather than rs3761847, and SNPs highly correlated with rs7021206 (r(2) > or = 0.81) extended from rs1953126 in the PHF19-TRAF1 intergenic region to rs2900180 in the TRAF1-C5 intergenic region, spanning 66 kb. CONCLUSION Our results demonstrate that within and around TRAF1, excluding PHF19 and C5, SNPs highly correlated with rs7021206, but not those correlated with rs3761847, are associated with RA in both Asians and Caucasians and are possibly correlated with causative variations.
Outpatient titration of carbidopa/levodopa enteral suspension (Duopa)

Carbidopa/levodopa enteral suspension (CLES; Duopa) is a suspension or gel formulation of carbidopa/levodopa that is approved by the USA Food and Drug Administration for the treatment of advanced Parkinson's disease patients with motor fluctuations. CLES is delivered at a constant rate continuously throughout the day into the jejunum through an infusion pump via a PEG-J tube implanted surgically. The efficacy of CLES was established in the USA based on a randomized, double-blind, double-dummy, active controlled, parallel group and 12-week study, in which mean daily OFF time was reduced by 4.0 h, compared to 1.9 h with oral immediate release carbidopa/levodopa. The CLES hardware consists of a cassette containing the drug, a pump to deliver the drug and tubing to connect the PEG-J to the pump. It is critical to understand the appropriate conversion of the carbidopa/levodopa daily dosages to the CLES dosage and how to program the pump and titrate CLES to achieve the most effective dose. We describe one methodology for patient selection, outpatient titration and pump programming.