Miracle-dz/UniFAR-FTUs huggingface dataset:
Standard Precautions: Occupational Exposure and Behavior of Health Care Workers in Ethiopia

Background Occupational exposure to blood and body fluids is a serious concern for health care workers, and presents a major risk for the transmission of infections such as HIV and hepatitis viruses. The objective of this study was to investigate occupational exposures and behavior of health care workers (HCWs) in eastern Ethiopia. Methods We surveyed 475 HCWs working in 10 hospitals and 20 health centers in eastern Ethiopia using a structured questionnaire with a response rate of 84.4%. Descriptive statistics and multivariate analysis using logistic regression were performed. Results Life time risks of needle stick (30.5%; 95% CI 26.4–34.6%) and sharps injuries (25.7%; 95% CI 21.8–29.6%) were high. The one year prevalence of needle stick and sharps injury were 17.5% (95% CI 14.1–20.9%) and 13.5% (95% CI 10.4–16.6%) respectively. There was a high prevalence of life time (28.8%; 95% CI = 24.7–32.9%) and one year (20.2%; 95% CI = 16.6–23.8%) exposures to blood and body fluids. Two hundred thirteen (44.8%) HCWs reported that they were dissatisfied by the supply of infection prevention materials. HCWs had sub-optimal practices and unfavorable attitudes related to standard precautions such as needle recapping (46.9%) and discriminatory attitudes (30.5%) toward HIV/AIDS patients. Conclusion There was a high level of exposure to blood and body fluids among HCWs. We detected suboptimal practices and behavior that put both patients and HCWs at significant risk of acquiring occupational infections. Health authorities in the study area need to improve the training of HCWs and provision of infection prevention equipment. In addition, regular reporting and assessment of occupational exposures need to be implemented.
Initial experiences with a new design for a preattached intravenous port device.

All available conventional ports share a common design, including catheter, locking nut, and port body, and all share two sites of structural weakness. One site is the junction between the locking nut and the proximal end of the catheter. The other site is the catheter fixation site between the locking nut and the protruding stud of the connecting tube. To overcome these shortcomings, we designed a new type of intravenous port which combines the connecting tube into one piece. The aims of this study were to test the mechanical characteristics of the new design and assess its safety in animal study. The prototype of the preattached port was manufactured from biocompatible materials, including PEEK, silicone and polyurethane. All components were assembled with biocompatible glue and mechanical and safety tests were performed to determine the mechanical strength, and tissue reaction of surrounding soft tissue and entry vessels. The mechanical tests showed the new design would not lead to catheter fracture in the oscillation test. The traction test showed significant peak load (18.75 ± 3.29 vs. 26.61 ± 1.75 N; p = 0.036) because of the difference in catheter extension capacity (26.57 ± 4.28 vs. 47.93 ± 2.45 mm; p = 0.012). Significantly smaller endurable injection pressure was identified in the prototype. (90 ± 20 vs. 177.5± 9.48 psi; p = 0.01) The safety test showed good tolerance in beagle dogs and led to no intravascular thrombus and minimal reaction in surrounding tissues. The new prototype preattached port showed good mechanical strength and overcame two potential structural weakness points. The integrated fixation design not only reduced the dimensions of the port device but also provided a greater injection area compared to current designs. It did not cause intravascular thrombosis and produced minimal tissue reaction in surrounding soft tissue, as identified by autopsy. The new design of the fixation device could serve as the basis for the next generation of intravenous ports. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 1017-1027, 2018.
Identification of C-terminal Regions in Arabidopsis thaliana Phytochelatin Synthase 1 Specifically Involved in Activation by Arsenite

Phytochelatins (PCs) are major chelators of toxic elements including inorganic arsenic (As) in plant cells. Their synthesis confers tolerance and influences within-plant mobility. Previous studies had shown that various metal/metalloid ions differentially activate PC synthesis. Here we identified C-terminal parts involved in arsenite- [As(III)] dependent activation of AtPCS1, the primary Arabidopsis PC synthase. The T-DNA insertion in the AtPCS1 mutant cad1-6 causes a truncation in the C-terminal regulatory domain that differentially affects activation by cadmium (Cd) and zinc (Zn). Comparisons of cad1-6 with the AtPCS1 null mutant cad1-3 and the double mutant of tonoplast PC transporters abcc1/2 revealed As(III) hypersensitivity of cad1-6 equal to that of cad1-3. Both cad1-6 and cad1-3 showed increased As distribution to shoots compared with Col-0, whereas Zn accumulation in shoots was equally lower in cad1-6 and cad1-3. Supporting these phenotypes of cad1-6, PC accumulation in the As(III)-exposed plants were at trace level in both cad1-6 and cad1-3, suggesting that the truncated AtPCS1 of cad1-6 is defective in PCS activity in response to As(III). Analysis of a C-terminal deletion series of AtPCS1 using the PCS-deficient mutant of fission yeast suggested important regions within the C-terminal domain for As(III)-dependent PC synthesis, which were different from the regions previously suggested for Cd- or Zn-dependent activation. Interestingly, we identified a truncated variant more strongly activated than the wild-type protein. This variant could potentially be used as a tool to better restrict As mobility in plants.
Randomized trial of oral versus intravenous acetaminophen for postoperative pain control

Purpose. Results of a study comparing pain control outcomes with preoperative oral versus intraoperative i.v. acetaminophen use in adults undergoing total hip or knee arthroplasty are reported. Methods. A single‐center, randomized, placebo‐controlled, equivalence trial was conducted. Patients were assigned (1:1) to receive 2 500‐mg capsules of acetaminophen before surgery, with an i.v. placebo infusion during surgery (the oral group), or 2 oral placebo capsules followed by an i.v. infusion of acetaminophen 1,000 mg/100 mL (the i.v. group). Patients were followed after postanesthesia care unit (PACU) admission up to 24 hours postoperatively. Results. Among 486 patients included in a modified intention‐to‐treat analysis (mean ± S.D. age, 66.3 ± 9.4 years), there were no significant differences in preoperative and intraoperative use of pain medication between the oral and i.v. groups. Postoperative opioid use in morphine milligram equivalents (MMEs) was equivalent in the oral and i.v. groups (i.e., the mean difference in median MME values was within the prespecified equivalence margin), with no significant between‐group differences in mean pain scores over 24 hours. Conclusion. In patients undergoing hip or knee arthroplasty, oral acetaminophen given preoperatively was equivalent to i.v. acetaminophen administered in the operating suite in controlling pain in the immediate postoperative period. I.V. acetaminophen was not superior to oral acetaminophen in reducing postoperative nausea and vomiting, time to ambulation, time to first dose of as‐needed pain medication, length of PACU stay, or total length of hospital stay.
Time From Smoking Cessation and Inflammatory Markers: New Evidence From a Cross-Sectional Analysis of ELSA-Brasil

Introduction The time for inflammatory markers of former smokers to revert to never smoker levels is still controversial, ranging from 5 to 20 years. We aimed to determine the time from smoking cessation for white blood cell (WBC) count and serum C-reactive protein (CRP) levels to return to those of never-smokers, after adjusting for confounding factors and for secondhand smoke (SHS) exposure among participants of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Methods Cross-sectional analysis of baseline participants of ELSA-Brasil. We used linear regression analysis and generalized linear models with gamma distribution and logarithmic link function to estimate the association of WBC count and CRP levels with time from smoking cessation. The following confounding factors were considered: sex, age, education, SHS, alcohol consumption, leisure-time physical activity, BMI, total cholesterol/HDL ratio, hypertension, diabetes, cardiovascular disease, and chronic obstructive pulmonary disease (COPD). Results: After all adjustments, time from smoking cessation <10 years remained associated with higher WBC count (eg, time from smoking cessation ≥ 5 and <10 years: β: 167.92; 95%CI: 23.52 312.31), while only time from smoking cessation <1 year remained associated with higher arithmetic mean of CRP (AMR: 1.26, 95%CI: 1.03‒1.54). Conclusions Levels of inflammatory markers were similar to those of never-smokers 1 year after smoking cessation for CRP and 10 years after for WBC. Implications The results may add to the arsenal health professionals have to encourage their patients to quit smoking, as some harms from smoking appear to revert to never-smokers' level sooner than previously reported. Longitudinal studies should confirm our findings.
Improving first‐order snow‐related deficiencies in a regional climate model

A climate version of the Regional Atmospheric Modeling System (RAMS) is used to simulate snow-related land-atmosphere interactions in the Great Plains and Rocky Mountain regions of the United States. The availability of observed snow-distribution products allow snow-water-equivalent distribution data to be assimilated directly into the RAMS simulations. By performing two kinds of model integrations, one with and one without assimilating the snow-distribution observations, the differences between the model runs are used to highlight model deficiencies and limitations and thus identify areas of possible improvement in the atmospheric model. The need to simulate subgrid snow distributions is identified and addressed by implementing a snow submodel that accounts for subgrid variations in air temperature and precipitation. This subgrid snow model is found to significantly improve the model's simulation of snow-related processes.
Adherence to oral chemotherapy medications among gastroenterological cancer patients visiting an outpatient clinic

Objective The purpose of this study was to investigate medication adherence to oral chemotherapy medications and determinants of medication non-adherence to them among gastroenterological cancer patients. Methods A cross-sectional study was conducted on 117 consecutive, consenting, eligible patients visiting an outpatient clinic of university hospital in Japan. Good medication adherence was defined as taking 100% of the prescribed dose. Medication adherence was measured via self-report. We hypothesized that there was a significant relationship between medication non-adherence and the five factors defined by the World Health Organization: patient-related, socioeconomic-related, condition-related, treatment-related, and healthcare-system/provider-related factors. Multiple logistic regression models were used to identify factors associated with oral chemotherapy medication non-adherence. Results The proportion of patients showing good medication adherence was 56.4%. The multiple logistic regression analysis revealed that the determinants of medication non-adherence to oral chemotherapy medications included having a history of patient-caused treatment interruptions due to worsening of symptoms (adjusted odds ratio [AOR] = 9.59, 95% confidence interval [CI] = 1.38-66.47), having diarrhea (AOR = 3.25, 95% CI = 1.13-9.34), experiencing pain (AOR = 0.17, 95% CI = 0.05-0.55), taking oral chemotherapy medication every 8 h (AOR = 5.52, 95% CI = 1.71-17.81), and diminished sense of priority for medication (AOR = 1.40, 95% CI = 1.21-1.63). Conclusions This study suggests that many patients with gastroenterological cancer were non-adherent to oral chemotherapy medications. It might be necessary to conduct periodic screening and connect patients at a high risk of medication non-adherence to appropriate support.
PERFORMANCE TESTING OF ASPHALT CONCRETE CONTAINING CRUMB RUBBER MODIFIER AND WARM MIX ADDITIVES

Utilisation of scrap tire has been achieved through the production of crumb rubber modified binders and rubberised asphalt concrete. Terminal and field blended asphalt rubbers have been developed through the wet process to incorporate crumb rubber into the asphalt binder. Warm mix asphalt technologies have been developed to curb the problem associated with the processing and production of such crumb rubber modified binders. Also the lowered production and compaction temperatures associated with warm mix additives suggests the possibility of moisture retention in the mix, which can lead to moisture damage. Conventional moisture sensitivity tests have not effectively discriminated good and poor mixes, due to the difficulty of simulating field moisture damage mechanisms. This study was carried out to investigate performance properties of crumb rubber modified asphalt concrete, using commercial warm mix asphalt technology. Commonly utilised asphalt mixtures in North America such as dense graded and stone mastic asphalt were used in this study. Uniaxial Cyclic Compression Testing (UCCT) was used to measure permanent deformation at high temperatures. Indirect Tensile Testing (IDT) was used to investigate low temperature performance. Moisture Induced Sensitivity Testing (MiST) was proposed to be an effective method for detecting the susceptibility of asphalt mixtures to moisture damage, as it incorporates major field stripping mechanisms. Sonnewarm™, Sasobit™ and Evotherm™ additives improved the resistance to permanent deformation of dense graded mixes at a loading rate of 0.5 percent by weight of the binder. Polymer modified mixtures showed superior resistance to permanent deformation compared to asphalt rubber in all mix types. Rediset™ WMX improves low temperature properties of dense graded mixes at 0.5 percent loading on the asphalt cement. Rediset LQ and Rediset WMX showed good anti stripping properties at 0.5 percent loading on the asphalt cement. The American Association of State Highway and Transportation Official’s Mechanistic-Empirical Pavement Design Guide (AASHTO MEPDG) software was used to predict long term low temperature performance of the mixtures in various areas of Ontario. Sasobit, Rediset LQ and Rediset WMX gave good 15 years prediction with stone mastic asphalt mixtures but the performance of dense graded mixtures was less satisfactory.
Low-dose ionizing radiation induces therapeutic neovascularization in a pre-clinical model of hindlimb ischemia

Aims We have previously shown that low-dose ionizing radiation (LDIR) induces angiogenesis but there is no evidence that it induces neovascularization in the setting of peripheral arterial disease. Here, we investigated the use of LDIR as an innovative and non-invasive strategy to stimulate therapeutic neovascularization using a model of experimentally induced hindlimb ischemia (HLI). Methods and results After surgical induction of unilateral HLI, both hindlimbs of female C57BL/6 mice were sham-irradiated or irradiated with four daily fractions of 0.3 Gy, in consecutive days and allowed to recover. We demonstrate that LDIR, significantly improved blood perfusion in the murine ischemic limb by stimulating neovascularization, as assessed by laser Doppler flow, capillary density, and collateral vessel formation. LDIR significantly increased the circulating levels of VEGF, PlGF, and G-CSF, as well as the number of circulating endothelial progenitor cells (EPCs) mediating their incorporation to ischemic muscles. These effects were dependent upon LDIR exposition on the ischemic niche (thigh and shank regions). In irradiated ischemic muscles, these effects were independent of the recruitment of monocytes and macrophages. Importantly, LDIR induced a durable and simultaneous up-regulation of a repertoire of pro-angiogenic factors and their receptors in endothelial cells (ECs), as evident in ECs isolated from the irradiated gastrocnemius muscles by laser capture microdissection. This specific mechanism was mediated via vascular endothelial growth factor (VEGF) receptor signaling, since VEGF receptor inhibition abrogated the LDIR-mediated gene up-regulation and impeded the increase in capillary density. Finally, the vasculature in an irradiated non-ischemic bed was not affected and after 52 week of LDIR exposure no differences in the incidence of morbidity and mortality were seen. Conclusions These findings disclose an innovative, non-invasive strategy to induce therapeutic neovascularization in a mouse model of HLI, emerging as a novel approach in the treatment of critical limb ischemia patients.
Exposure to airborne fungi during sorting of recyclable plastics in waste treatment facilities.

BACKGROUND In working environment of waste treatment facilities, employees are exposed to high concentrations of airborne microorganisms. Fungi constitute an essential part of them. This study aims at evaluating the diurnal variation in concentrations and species composition of the fungal contamination in 2 plastic waste sorting facilities in different seasons. MATERIAL AND METHODS Air samples from the 2 sorting facilities were collected through the membrane filters method on 4 different types of cultivation media. Isolated fungi were classified to genera or species by using a light microscopy. RESULTS Overall, the highest concentrations of airborne fungi were recorded in summer (9.1×103-9.0×105 colony-forming units (CFU)/m3), while the lowest ones in winter (2.7×103-2.9×105 CFU/m3). The concentration increased from the beginning of the work shift and reached a plateau after 6-7 h of the sorting. The most frequently isolated airborne fungi were those of the genera Penicillium and Aspergillus. The turnover of fungal species between seasons was relatively high as well as changes in the number of detected species, but potentially toxigenic and allergenic fungi were detected in both facilities during all seasons. CONCLUSIONS Generally, high concentrations of airborne fungi were detected in the working environment of plastic waste sorting facilities, which raises the question of health risk taken by the employees. Based on our results, the use of protective equipment by employees is recommended and preventive measures should be introduced into the working environment of waste sorting facilities to reduce health risk for employees. Med Pr 2017;68(1):1-9.
Surgical Management of Fifth Metatarsal Diaphyseal Fractures: A Retrospective Outcomes Study

ABSTRACT Fifth metatarsal diaphyseal fractures are a common injury treated by foot and ankle surgeons. The limited data on this specific fracture type has promoted nonoperative treatment with immobilization. The primary objective of the present study was to record the radiographic healing time of fifth metatarsal diaphyseal fractures after surgical intervention and present the specific fracture characteristics. The medical records of a series of 64 patients with surgically managed fifth metatarsal diaphyseal fractures were retrospectively reviewed. The data collected consisted of radiographic healing times, fracture characteristics, and patient demographics. The mean average age at injury was 49.23 ± 15.35 years with greatest incidence in females at 73.44%. The mean healing time was 7.73 ± 4.74 weeks, with an overall complication rate of 6.25%. The fractures were classified into 2 specific categories according to the anatomic location. Type I fractures occurred in a significantly older population, were significantly longer in length, and healed faster. The mean displacement and angulation at injury was 3.20 ± 1.22 mm, and 5.89° ± 4.60°, respectively, for all fractures. Of the 64 patients, 1 (1.56%) experienced nonunion, 2 (3.13%) delayed unions, and no malunions. One patient (1.56%) underwent repeat operation for hardware removal. One case (1.56%) of superficial postoperative infection developed and was treated with oral antibiotics. We observed good surgical outcomes with minimal postoperative complications. We also identified 2 specific entities of fifth metatarsal diaphyseal fractures. On the basis of our results, we advocate surgical intervention even for minimally displaced diaphyseal fractures to maintain even weightbearing across the metatarsal parabola.
Comparison of Superficial Surgical Site Infection Between Delayed Primary Versus Primary Wound Closure in Complicated Appendicitis

Objective: To compare superficial surgical site infection (SSI) rates between delayed primary wound closure (DPC) and primary wound closure (PC) for complicated appendicitis. Background: SSI is common in appendectomy for complicated appendicitis. DPC is preferentially used over PC, but its efficacy is still controversial. Methods: A multicenter randomized controlled trial was conducted in 6 hospitals in Thailand, enrolling patients with gangrenous and ruptured appendicitis. Patients were randomized to PC (ie, immediately wound closure) or DPC (ie, wound closure at postoperative days 3–5). Superficial SSI was defined by the Center for Disease Control criteria. Secondary outcomes included postoperative pain, length of stay, recovery time, quality of life, and cost of treatment. Results: In all, 303 and 304 patients were randomized to PC and DPC groups, and 5 and 4 patients were lost to follow-up, respectively, leaving 300 and 298 patients in the modified intention-to-treat analysis. The superficial SSI rate was lower in the PC than DPC groups [ie, 7.3% (95% confidence interval 4.4, 10.3) vs 10% (95% CI 6.6, 13.3)] with a risk difference (RD) of −2.7% (−7.1%, 1.9%), but this RD was not significant. Postoperative pain, length of stay, recovery times, and quality of life were nonsignificantly different with corresponding RDs of 0.3 (−2.5, 3.0), −0.1 (−0.5, 0.3), −0.2 (−0.8, 0.4), and 0.02 (−0.01, 0.04), respectively. However, costs for PC were 2083 (1410, 2756) Baht cheaper than DPC (∼$60 USD). Conclusions: Superficial SSI rates for the PC group were slightly lower than DPC group, but this did not reach statistical significance. Costs were significantly lower for the PC group.