Miracle-dz/UniFAR-FTUs huggingface dataset:
Improving handoff communications in critical care: utilizing simulation-based training toward process improvement in managing patient risk.

BACKGROUND A patient admitted to the medical step-down unit experienced severe hypoglycemia due to an infusion of a higher-than-ordered insulin dose. The event could have been prevented if the insulin syringe pump was checked during the nursing shift handoff. METHODS Risk management exploration included direct observations of nursing shift handoffs, which highlighted common deficiencies in the process. This led to the development and implementation of a handoff protocol and the incorporation of handoff training into a simulation-based teamwork and communication workshop. A second round of observations took place 6 to 8 weeks following training. RESULTS The intervention demonstrated an increase in the incidence of nurses communicating crucial information during handoffs, including patient name, events that had occurred during the previous shift, and treatment goals for the next shift. However, there was no change in the incidence of checking the monitor alarms and the mechanical ventilator. CONCLUSIONS Simulation-based training can be incorporated into the risk management process and can contribute to patient safety practice.
Negotiating “Third Spaces”: EAP Apprenticeship, Academic Writing, and Chinese Students

The aims of this exploratory research on the academic writing apprenticeship of Chinese students are four-fold: (1) to determine what students thought were the purposes of academic writing, (2) to find out if students were adopting the preferred organisational patterns in writing argumentative essays, (3) to identify what their most common errors were when writing for academic purposes, and (4) to determine teacher perceptions of the academic writing program. The researcher surveyed 47 Chinese students, analysed the organisation of 31 sample essays, conducted an error analysis of 120 paragraphs, and interviewed 10 EAP writing teachers. Findings revealed that students generally associated academic writing with skills-based improvement rather than development of higher order skills as criticality; students acculturated to the preferred ways of organising essays; lexis posed the most serious issue for student writing; and teachers interviewed generally raised concerns about the effectiveness and direction of the writing program. One major consequence of globalisation is the increase in the number of extension campuses of western universities in different parts of the world. In this paper, an extension campus refers to an institution that operates as a branch of a university that is based in the west. Asia, in particular, has seen the growth of universities catering to the English language needs of students who would rather be educated on local shores, but within a generally western university model. This has been the case in China. Most extension campuses of western institutions of higher education offer degree programs featuring a final year of study in the main institution after two or three years of study in China. Studying in an institution following a Western model may pose challenges to students used to the local system of education. Challenges range from adapting to new ways of doing things to acculturating to new conventions and meeting the expectations of western education predominantly taught by an international faculty, most of whom are native English-speaking, if not educated in western countries. Language Education in Asia, 2011, 2(2), 169-184. http://dx.doi. org/10.5746/LEiA/11/V2/I2/A01/Mirador
Genetic Characterization of Protein C Deficiency in Japanese Subjects Using a Rapid and Nonradioactive Method for Single-Strand Conformational Polymorphism Analysis and a Model Building

Summary We studied the molecular basis of protein C deficiency in 28 Japanese families including 4 asymptomatic families. Two showed a decreased level of function with a normal antigen concentration consistent with type II protein C deficiency and the remaining 26 showed type I deficiency with decreases in both function and antigen level. All the exons and intron/exon junctions of the protein C gene were studied using a strategy combining polymerase chain reaction (PCR) amplification and rapid nonradioactive single-strand conformational polymorphism (SSCP) analysis. The PCR-amplified fragments with aberrant migration on SSCP analysis were sequenced. We identified 11 missense mutations, 1 nonsense mutation, 2 neutral polymorphisms, 1 frameshift deletion, 1 inframe deletion, and 1 splice site mutation. We also identified two different rare mutations in the 5-untranslated region in the protein C gene that may be responsible for the phenotype. Of these molecular defects, ten were novel. From the results of genetic analysis of 47 Japanese families with protein C deficiency reported in this and previous studies, Phel39Val and Met364Ile substitutions and a G8857 deletion were only found in Japanese subjects and seem to be a founder effect. In contrast, Argl69Trp and Val297Met substitutions, both occurring at CG dinucleotides, were commonly observed in not only Japanese but also Western populations, indicating that these are hot spots for mutation in the protein C gene. These molecular defects were found in 22 families in total, accounting for 47% of Japanese families with protein C deficiency. The structural models of the second EGF and protease domains of activated wild-type and mutant human protein C suggest a possible substrate binding exosite on two loops; one from amino acid position 349 to 357 and the other from position 385 to 388, both of which are close to each other in the three-dimensional model.
The effect of distributed series resistance on the dark and illuminated current&#8212;Voltage characteristics of solar cells

Distributed series resistance effects in solar cells are analyzed and the correctness of representing these by a lumped parameter is discussed for any conditions of bias and illumination. In addition to a general mathematical methodology, analytical expressions are derived to simplify the estimation of series resistance effects on the dark and illuminated<tex>J-V</tex>characteristics of the cell. The equivalent series resistance (r<inf>s</inf>) in the dark is found to decrease with current density<tex>J</tex>from<tex>r_{b} + r_{e}/3</tex>at small<tex>J</tex>to (<tex>r_{e} r_{b})^{1/2}</tex>at very high<tex>J</tex>, where r<inf>e</inf>and r<inf>b</inf>are the emitter layer and base region resistances, respectively. For illuminated conditions r<inf>s</inf>depends on<tex>J</tex>as well, being maximum near short-circuit and minimum near open-circuit; however, r<inf>s</inf>further depends on the photogenerated current J<inf>L</inf>: its short-circuit value increases with J<inf>L</inf>from<tex>r_{b} + r_{e}/3</tex>to<tex>r_{b} + r_{e}/2</tex>and the open-circuit value decreases with J<inf>L</inf>from<tex>r_{b} + r_{e}/3</tex>to<tex>(r_{e}r_{b})^{1/2}</tex>. The variability of r<inf>s</inf>is therefore related to the relative importance of r<inf>b</inf>and<tex>r_{e};r_{b}</tex>plays the role of attenuating this variability, a situation not well recognized previously. Previous theoretical and experimental work is critically reviewed throughout this paper.
Blood Pressure Variation and Its Correlates among Patients Undergoing Hemodialysis for Renal Failure in Benin City, Nigeria

Background: Blood pressure (BP) variation is commonly encountered during hemodialysis (HD) procedure. Both intradialysis hypotension and hypertension have implications for outcome of treatment and overall morbidity and mortality of the patients. Methodology: A retrospective study was carried out in the dialysis unit of a tertiary health institution in Benin City among patients who had HD for acute kidney injury (AKI) or chronic kidney disease (CKD) over a 3-year period. Data retrieved included age, gender, type of kidney disease, cause of kidney disease, systolic BP at onset of dialysis and at end of dialysis, and diastolic BP (DBP) at onset of and at end of dialysis. Results: Complete data were available for 217 patients. One hundred and seven patients (49.3%) had no significant change in BP; 30.9% had intradialytic hypertension (IDHT) while 19.8% had intradialytic hypotension (IDH). IDH was more prevalent among patients with diabetic kidney disease while IDHT was more common among patients with hypertensive nephropathy (P = 0.002). Female patients had higher mean BP parameters compared to male patients pre- and post-dialysis, but only changes in DBP were statistically significant (P = 0.029). Patients with CKD had higher mean BP parameters pre- and post-dialysis compared to patients with acute AKI and the differences were statistically significant. Conclusion: Females had higher mean BP parameters than males. Patients with CKD had higher mean BP parameters compared with AKI patients. IDHT is a significant problem among patients on HD in our center. Measures to curtail this trend should be instituted with the goal of reducing morbidity and mortality.
Effect of Prenatal Betamethasone/Thyrotropin Releasing Hormone Treatment on Somatosensory Evoked Potentials in Preterm Newborns

ABSTRACT: The maternal administration of betamethasone and thyrotropin releasing hormone (TRH) to accelerate the maturation of the fetus is an increasingly adopted strategy to prevent neonatal morbidity in preterm infants. The effect of this prenatal treatment on the neural maturation of the infant was assessed by measuring somatosensory evoked potentials (SEP) in preterm infants (gestational age 29–36 wk) on the 1st postnatal day, at the age of 1 wk, and before discharge. The N1 latency values of the SEP obtained in 14 infants who were exposed prenatally to betamethasone/TRH were compared with the Nl latencies measured in 12 control infants. On the 1st postnatal day, the N1 latencies in the betamethasone/ TRH-treated infants were strikingly shorter (p < 0.01) than in the controls. However, at the age of 1 wk and at discharge, the N1 latency values of both groups were similar. In conclusion, the present study provides the first solid evidence for the concept that the prenatal exposure to betamethasone/TRH accelerates the SEP-assessed neural maturation of the human fetus, that this prenatal acceleration is followed by a compensatory relative deceleration during the early neonatal period, and that the subsequent SEP-assessed neural maturation proceeds at a normal velocity.
[Study on immunoglobulin allotypes in the Chinese: a hypothesis of the origin of the Chinese nation].

This paper reports the distribution of immunoglobulin Gm and Km allotypes in 74 Chinese geographic populations. These populations are derived from 24 nationalities comprising 96.6% of the total population of China. A total of 9,560 individuals were phenotyped for Gm (1,2,3,5,21) factors and 9,611 for Km(1). Phylogenetic trees were constructed on the basis of Gm haplotype frequencies and genetic distances. The results of clustering analysis show the heterogeneity of the Chinese nation, and confirm the hypothesis that the modern Chinese nation originated from two distinct populations. One population originating in the Yellow River valley, and the other originating, in the Yangtze River valley during the early part of neolithic times (to date 3,000--7,000). Frequencies of the Gm haplotype of 74 Chinese populations were compared with those from 33 populations from major racial groups. The results suggest that during human evolution, the Negroid group and Caucasoid-Mongoloid group diverged first, followed by a divergence between the Caucasoid and Mongoloid. Interrace divergences are high in comparison with interrace divergences. There appear to be two distinct subgroups of Mongoloid, Northern and Southern Mongoloid. The Northern and Southern Mongoloid have Gm1;21 and Gm1,3;5 haplotypes as race associated markers, respectively. Furthermore, the Caucasian associated haplotype Gm3;5 was found in several of the minorities living in the northwest part of China. The amount of Caucasian admixture has been estimated. The presence of the Gm3;5 haplotype is attributed to the Caucasians living in Central Asia throughout the "Silk Road. " In contrast to the Gm haplotype distribution, Km1 gene frequencies showed a random distribution in the populations studied.
Coffin-Manson based fatigue analysis of underfilled DCAs

The continuing drive toward high-density, low-profile Integrated Circuit packaging has accelerated the spread of flip-chip technology to laminated substrates, creating direct chip attach (DCA) configurations. However, the substantial difference in the coefficients of thermal expansion (CTE) between the chip and the laminated substrates makes DCA configurations vulnerable to thermally-induced strains and the resulting solder joint fatigue. The reliability of flip-chip technology is dramatically improved by “underfilling” the gap between the chip and substrate with epoxy. The present effort is aimed at exploring the benefits of underfilling in DCA configurations. The thermo-structural behavior of an underfilled DCA is evaluated using FEM and employing an axisymmetric model of a typical DCA structure. Numerical simulations are performed for different sets of underfill material properties. The results are used to determine the parametric sensitivity of the thermal strain in the solder joints and the axial and shear stresses in the underfill material and to define the desirable range of underfill material properties. These results together with the Coffin-Manson relation are used to predict the theoretical improvement in cycles to failure. The results suggest that to minimize fatigue failure, the CTE of an underfill material should match that of solder material and its Young's Modulus should be as high as the adhesion strength of the underfill allows.
Oligomerization of EpsE Coordinates Residues from Multiple Subunits to Facilitate ATPase Activity*

EpsE is an ATPase that powers transport of cholera toxin and hydrolytic enzymes through the Type II secretion (T2S) apparatus in the Gram-negative bacterium, Vibrio cholerae. On the basis of structures of homologous Type II/IV secretion ATPases and our biochemical data, we believe that EpsE is active as an oligomer, likely a hexamer, and the binding, hydrolysis, and release of nucleotide cause EpsE to undergo dynamic structural changes, thus converting chemical energy to mechanical work, ultimately resulting in extracellular secretion. The conformational changes that occur as a consequence of nucleotide binding would realign conserved arginines (Arg210, Arg225, Arg320, Arg324, Arg336, and Arg369) from adjoining domains and subunits to complete the active site around the bound nucleotide. Our data suggest that these arginines are essential for ATP hydrolysis, although their roles in shaping the active site of EpsE are varied. Specifically, we have shown that replacements of these arginine residues abrogate the T2S process due to a reduction of ATPase activity yet do not have any measurable effect on nucleotide binding or oligomerization of EpsE. We have further demonstrated that point mutations in the EpsE intersubunit interface also reduce ATPase activity without disrupting oligomerization, strengthening the idea that residues from multiple subunits must precisely interact in order for EpsE to be sufficiently active to support T2S. Our findings suggest that the action of EpsE is similar to that of other Type II/IV secretion ATPase family members, and thus these results may be widely applicable to the family as a whole.
Comparison of Obstructive Sleep Apnea Syndrome in Children with Cleft Palate following Furlow Palatoplasty or Pharyngeal Flap for Velopharyngeal Insufficiency

Objective To evaluate the incidence and severity of obstructive sleep apnea syndrome (OSAS) in patients with cleft palate having a Furlow palatoplasty or pharyngeal flap for correction of velopharyngeal insufficiency (VPI). Patients A total of 48 nonsyndromic children with repaired cleft palate with VPI were enrolled in the study. Twenty of the children had a Furlow palatoplasty (F group) and 28 children had a pharyngeal flap (P group) for correction of VPI. Interventions An overnight polysomnography evaluation was done to evaluate the incidence and severity of OSAS 6 months or more postoperatively. Main Outcome Measures Symptoms of OSAS, respiratory disturbance index (RDI), oxyhemoglobin desaturation index (DI), and sleep stages were measured. Results In the P group, the mean percentage of stage 2 sleep was lower than the F group (p < .05). The mean RDI and DI were larger in the P group, compared with the F group (p < .001). The incidence and severity of OSAS were higher in the P group, compared with the F group (p < .001 and p = 0.05, respectively). Conclusions A Furlow palatoplasty should be used in deference to a pharyngeal flap whenever possible on the basis of the preoperative evaluation of VPI because of the decreased incidence and severity of OSAS.
Norms of data sharing in biological sciences: The roles of metadata, data repository, and journal and funding requirements

Institutional environments, comprising regulative pressures by funding agencies and journal publishers, and institutional resources, including the availabilities of data repositories and standards for metadata, function as important determinants in scientists’ data-sharing norms, attitudes and behaviours. This research investigates how these functions influence biological scientists’ data-sharing norms and how the data-sharing norms influence their data-sharing behaviours mediated by attitudes towards data sharing. The research model was developed based on the integration of institutional theory and theory of planned behaviour. The proposed research model was validated based on a total of 608 responses from a national survey conducted in the USA. The Partial Least Squares (PLS) was employed to analyse the survey data. Results show how institutional pressures by funding agencies and journals and the availabilities of data repository and metadata standards all have significant influences on data-sharing norms, which have significant influences on data-sharing behaviours, as mediated by attitudes towards data sharing.
Novel Indole-based Tambjamine-Analogues Induce Apoptotic Lung Cancer Cell Death through p38 Mitogen-Activated Protein Kinase Activation

Lung cancer has become the leading killer cancer worldwide, due to late diagnosis and lack of efficient anticancer drugs. We have recently described novel natural-derived tambjamine analogues that are potent anion transporters capable of disrupting cellular ion balance, inducing acidification of the cytosol and hyperpolarization of cellular plasma membranes. Although these tambjamine analogues were able to compromise cell survival, their molecular mechanism of action remains largely unknown. Herein we characterize the molecular cell responses induced by highly active indole-based tambjamine analogues treatment in lung cancer cells. Expression changes produced after compounds treatment comprised genes related to apoptosis, cell cycle, growth factors and its receptors, protein kinases and topoisomerases, among others. Dysregulation of BCL2 and BIRC5/survivin genes suggested the apoptotic pathway as the induced molecular cell death mechanism. In fact, activation of several proapoptotic markers (caspase-9, caspase-3, and PARP) and reversion of the cytotoxic effect upon treatment with an apoptosis inhibitor (Z-VAD-FMK) were observed. Moreover, members of the Bcl-2 protein family suffered changes after tambjamine analogues treatment, with a concomitant protein decrease towards the prosurvival members. Besides this, it was observed cellular accumulation of ROS upon compound treatment and an activation of the stress-kinase p38 MAPK route that, when inhibited, reverted the cytotoxic effect of the tambjamine analogues. Finally, a significant therapeutic effect of these compounds was observed in subcutaneous and orthotopic lung cancer mice models. Taken together, these results shed light on the mechanism of action of novel cytotoxic anionophores and demonstrate the therapeutic effects against lung cancer. Mol Cancer Ther; 16(7); 1224–35. ©2017 AACR.
Chamber-related differences in connexin expression in the human heart.

Electrical coupling in the heart is mediated by gap junctions, aggregates of cell-to-cell channels composed of connexins. The principal cardiac gap-junctional connexin, connexin43 (Cx43), is reduced in diseased human myocardium that is prone to arrhythmia. Three additional connexin isoforms, Cx40, Cx45 and Cx37, of distinctive functional capacities in vitro, are expressed in cardiovascular cells, but our knowledge of their expression patterns in the human heart is fragmentary. In the present study, we therefore applied Northern blotting, Western blotting and immunoconfocal microscopy to analyse and compare the expression of Cx43, Cx40, Cx37 and Cx45 mRNA and protein in the human left ventricle, right ventricle, left atrium and right atrium of the human heart. Cx43 was confirmed to be abundantly expressed at similar levels by myocytes in all four chambers. Cx40 levels varied between chambers in the order right atrium >left atrium >/= right ventricle approximately left ventricle. Cx37 (exclusively expressed in the endothelium) was expressed at similar overall levels in all chambers (as judged from Northern blots). Cx45 was detectable only at very low levels, with a trend toward higher levels in the atria than the ventricles in a pattern similar to Cx40. The results indicate that in humans, the ventricles and atria have distinctive connexin expression profiles, and that the atrial-type connexin profile is more pronounced in the right atrium than the left atrium. While the ventricular connexin expression pattern resembles that of other mammalian species, atrial connexin expression shows greater species variation. These differences contribute to the interpretative framework for examining the potential role of altered connexin expression in ventricular and atrial arrhythmia in the human heart.