Miracle-dz/UniFAR-FTUs huggingface dataset:
Clinical Nurse Leader Impact on Microsystem Care Quality

Background:The current fragmented healthcare system, characterized by a lack of collaborative, patient-centered care processes, creates significant barriers to providing quality patient care. The clinical nurse leader (CNL) is theorized to provide clinical leadership at the point-of-practice to maintain cross-disciplinary collaborative processes that lead to integrated quality care. Objectives:The aim of this study was to assess the impact of CNL integration into an acute care microsystem on care quality, as measured by patient satisfaction with care. Methods:A short interrupted time series design was used to measure patient satisfaction with multiple aspects of care 10 months before and 12 months after integration of the CNL role on a progressive care unit, compared with a control unit. Data were obtained from Press Ganey surveys, and analysis was completed using a publicly available program for short time series data streams. Results:Clinical nurse leader implementation was correlated with significantly improved patient satisfaction with admission processes (r = + .63, p = .02) and nursing care (r = +.75, p = .004), including skill level (r = .83, p = .003) and keeping patients informed (r = .70, p = .003). There was no significant correlation with improved patient satisfaction with physician care (r = .31, p = .14) or discharge processes (r = .33, p = .23) postimplementation. Control data showed no significant changes in patient satisfaction measures throughout the study time frame. Discussion:The positive correlation between CNL-mediated collaborative care processes and improvements in patient satisfaction with care quality provides empirical evidence of outcomes achievable through CNL implementation. Research is needed to explore the full range of achievable outcomes and to determine the specific processes by which these outcomes are realized.
Efficacy of a single dose of furazolidone for treatment of cholera in children

To test the efficacy and safety of furazolidone given as a single dose for childhood cholera, a randomized double-blind placebo-controlled trial was carried out among 118 culture-positive dehydrated children with diarrhea. Patients were randomly assigned to one of four groups to receive medication orally in liquid suspension: furazolidone at 7 mg/kg/day once, furazolidone at 7 mg/kg/day divided into four doses for 3 days, placebo once, or placebo for 3 days. After 12 patients with furazolidone-resistant infections were excluded from the analysis of efficacy, it was determined that both groups treated with furazolidone showed significantly higher rates of bacteriologic success (stool cultures negative for Vibrio cholerae on days 2 to 4 after start of therapy) and clinical success (cessation of diarrhea within 72 h after start of therapy) than corresponding placebo groups (P less than 0.001). There were no significant differences between responses to the 3-day and single-dose regimens of furazolidone, but there was a trend toward better clinical responses in patients who received furazolidone for 3 days. No patient treated with furazolidone dropped out because of side effects. These results indicate that furazolidone, given as either a single dose or divided doses for 3 days, is effective treatment for childhood cholera.
An Experimental and Numerical Study on the Inductance Variation of HTS Magnets

Inductance is an essential parameter of a high-temperature superconducting (HTS) magnet. We have found that the inductance of HTS magnets would vary with temperatures and transport currents. The input and output properties of a magnet will change due to the variation of inductance. In this paper, an electromagnetic model has been built according to the characteristics of HTS tapes to analyze the inductance variation characteristic of HTS magnets. Four HTS coils have been made to verify this model. The result of coil and magnet experiments basically agrees with the simulation results. According to this study, the inductance variation in an HTS magnet can be attributed to the change of current density distribution in the magnet.
Cognitive profile analysis: A shared professional myth.

Interpretation of cognitive test profiles is popular in school psychological training and practice but is not supported by research evidence. This special issue contains four studies that provide additional data regarding cognitive test profiles. Consistent with the largely negative research literature, detailed analysis found all four cognitive profile reports lack­ ing reliability, validity, or diagnostic utility; even cognitive profiles composed of com­ posites were psychometrically weak. These results were not surprising because ipsative methods are inferior to normative methods in cognitive assessment. Given this consistent failure of empirical validation, belief in the utility of cognitive test profile interpretations was likened to a shared professional myth and it was recommended that psychologists es­ chew the application of cognitive test profiles for differential diagnosis and remediation.
Pinned on Karma Rock: Whitewater Kayaking as Religious Experience

This paper argues that whitewater paddling constitutes religious experience, that non-western terms often best describe this experience and that these two facts are related and have much to tell us about the nature of religious experience. That many paddlers articulate their experiences using Asian and/or indigenous religious terms suggests that this language is a form of opposition to existing norms of what constitutes religious experience. So, investigating the sport as an aquatic nature religion provides the opportunity to revisit existing categories. As a "lived religion," whitewater kayaking is a ritual practice of an embodied encounter with the sacred, and the sacred encounter is mediated through the body's performance in the water. This sacred encounter— with its risk and danger—illustrates Rudolph Otto's equation of the sacred with terrifying and unfathomable mystery and provides a counterpoint to norms of North American religiosity and related scholarship.
Multinucleated Epithelial Giant Cells in Colorectal Polyps: A Potential Mimic of Viropathic And/Or Dysplastic Changes

Multinucleated epithelial giant cells (MEG) simulating viral cytopathic effect and/or dysplasia have been reported in the esophagus in association with inflammation, but the occurrence of similar cells in the colon has not been documented. Twenty-three colon specimens (22 biopsies and 1 partial colectomy) featuring MEG from 21 patients were evaluated for a variety of histologic features and correlated with clinical, endoscopic, and follow-up data. Patients included 9 males and 12 females (mean age, 64.9 years; range, 45-86 years). Eleven cases were obtained from 10 asymptomatic patients undergoing surveillance biopsies. Presenting symptoms in the remaining patients were dyspepsia, anemia, abdominal pain, and hematochezia. Over half (13 of 23) of the specimens were from descending and rectosigmoid colon, and almost all were visualized as polyps on endoscopy. Microscopically, all but 1 of the cases featured multiple MEG (range, 6 to >50 cells per biopsy) in the base and mid crypt zones of inflamed polyps with serrated architecture. Immunohistochemical stains for CMV, HSV, adenovirus, EBV, and polyoma virus were negative and no viral particles were identified on ultrastructural examination. Nuclear staining for hMLH1 and hMSH2, markers of microsatellite instability, was similar in distribution to adjacent serrated crypts, but reduced staining intensity was noted in occasional multinucleated cells. Expression of Ki-67 and cleaved caspase 3 was consistent with a quiescent or low proliferative state. Clinical follow-up was available for 9 patients (mean duration, 22.7 months). One patient died of heart failure; all others were well at last follow-up. Bizarre MEG may occasionally be seen within the crypts of inflamed polyps with serrated architecture, raising concern for dysplasia or viral infection. Immunohistochemical and ultrastructural studies fail to establish a viral etiology, and follow-up does not indicate clinically aggressive disease. These changes appear to represent a nonspecific, possibly degenerative response to inflammation and injury, and should be distinguished from dysplasia.
Detection of chromosomal imbalances in retinoblastoma by matrix‐based comparative genomic hybridization

The genetic hallmark of retinoblastoma is mutation or deletion of the RB1 gene, whereas other genetic alterations that are also required are largely unknown. To screen for genomic imbalances on a genomewide level, we studied a series of 17 primary retinoblastomas by matrix‐based comparative genomic hybridization (matrix‐CGH). The matrix‐CGH chip contained 6,000 immobilized genomic DNA fragments covering the human genome, with an average resolution of about 500 kb. The most frequent imbalances detected were gains on chromosome arms 1q (12 of 17), 6p (10 of 17), 2p (5 of 17), and 19q (4 of 17) and loss on 16q (7 of 17). Candidate regions could be narrowed to small intervals by the identified minimally overlapping regions on 1q22, 1q32.1q32. 2, 2p24.1, and 6p21.33–p21.31. Furthermore, two as‐yet‐unknown high‐level amplifications were detected, each in a single patient, on chromosome bands 1p34.2 and 1p33. Thus, this study identified new chromosomal regions and therefore potential candidate genes that may play a role in retinoblastoma. © 2005 Wiley‐Liss, Inc.
Nucleotide sequence of human endogenous retrovirus genome related to the mouse mammary tumor virus genome

We determined the complete nucleotide sequence of the human endogenous retrovirus genome HERV-K10 isolated as the sequence homologous to the Syrian hamster intracisternal A-particle (type A retrovirus) genome. HERV-K10 is 9,179 base pairs long with long terminal repeats of 968 base pairs at both ends; a sequence 290 base pairs long, however, was found to be deleted. It was concluded that a composite genome having the 290-base-pair fragment is the prototype HERV-K provirus gag (666 codons), protease (334 codons), pol (937 codons), and env (618 codons) genes. The size of the protease gene product of HERV-K is essentially the same as that of A- and D-type oncoviruses but nearly twice that of other retroviruses. A comparison of the deduced amino acid sequences encoded by the pol region showed HERV-K to be closely related to types A and D retroviruses and even more so to type B retrovirus. It was noted that the env gene product of HERV-K structurally resembles the mouse mammary tumor virus (type B retrovirus) env protein, and the possible expression of the HERV-K env gene in human breast cancer cells is discussed.
Role of actin and myosin in the control of paracellular permeability in pig, rat and human vascular endothelium.

1. We have investigated the endothelial actomyosin system with particular emphasis on its possible role in actively opening a paracellular route for permeability. 2. Actin and myosin comprised 16% of total endothelial protein with a molar actin/myosin ratio of 16.2 which is close to the actin/myosin ratio of muscle (studies on freshly isolated pig pulmonary arterial endothelial cells, PAEC). 3. By immunocytochemistry at the light and electron microscope levels the bulk of actin and myosin was colocalized in close vicinity to the intercellular clefts of both micro‐ and macrovascular endothelial cells in situ and in vitro. 4. Calcium‐ionophore‐induced rise in permeability of human umbilical venous endothelial cells (HUVEC) and PAEC monolayers grown on filters in a two‐chamber permeability system was caused by opening of intercellular gaps. Gap formation depended on the rise in intracellular Ca2+ and could be blocked by the calmodulin‐binding drugs trifluperazine (TFP) and W7. 5. In skinned monolayers of cultured PAEC and in isolated sheets of HUVEC gap formation was shown to require ATP and occurred only when free myosin binding sites were available on endothelial actin filaments (experiments with myosin subfragment 1 modified by N‐ethylmaleimide, S1‐NEM). 6. These experiments suggest that actin and myosin in endothelial cells play a central role in regulating the width of the intercellular clefts, thereby controlling the paracellular pathway of vascular permeability.
Reevaluation of Outpatients With Streptococcus pneumoniae Bacteremia

Background. The reevaluation process for outpatients recalled for Streptococcus pneumoniae bacteremia has not been standardized. Children who return ill or with new serious focal infections require admission and parenteral antibiotic therapy. Limited data exist to guide the follow-up management of those patients identified as having occult pneumococcal bacteremia. Objectives. Characterize the outcomes of outpatients with pneumococcal bacteremia based on their evaluation at follow-up. For patients who are well-appearing without serious focal infection, propose a management scheme for reevaluation. Methods. Retrospective review of outpatients with pneumococcal bacteremia. Patients with immunocompromise, those identified with focal bacterial infection at the initial visit, or those admitted at the initial visit were excluded. Data were collected from the initial visit (when blood culture drawn) and follow-up visit with regard to clinical parameters, laboratory data, diagnoses, and any antibiotic treatment. Decision tree analysis was used to generate a model to predict children at high risk for persistent bacteremia (PB). Results. A total of 548 episodes of pneumococcal bacteremia were studied. Seventy-three children received no antibiotic, 239 oral antibiotic, and 236 parenteral antibiotic at the initial visit. Median age, temperature, and white blood cell (WBC) count were 13.5 months, 40.0°C, and 20 400/mm3. Forty-one patients had PB or new focal infections (15 with PB alone, 4 had focal infection and PB). Eight patients had meningitis at follow-up. Ninety-two percent returned because of notification of the positive blood culture result. A repeat blood culture was obtained in 92%, 23% had a lumbar puncture, 33% had a chest radiograph, and 12% were admitted. PB was associated with the antibiotic treatment group, elevation of temperature, and WBC count at follow-up. A simple management scheme using 2 sequential decision nodes of antibiotic treatment (none vs any) and then temperature at follow-up (>38.8°C) would have predicted 16/19 patients with PB (sensitivity = .84 and specificity = .86). Conclusions. All patients with pneumococcal bacteremia need prompt reevaluation. For well-appearing patients without new focal infection, the utility of diagnostic testing (specifically repeat blood cultures) and the need for admission may be determined by the use of antibiotics at the initial evaluation and the presence of fever at follow-up. The majority of patients can be managed as outpatients entirely. Patients who did not receive antibiotics at the initial evaluation and those treated with oral antibiotics but remain febrile are at the highest risk for persistent bacteremia.
Religion, synchrony, and cooperation

Shared beliefs about supernatural agents and joint engagement in ritual activities are often proposed to engender cohesion and cooperation within religious communities. We report the results of an experiment that investigated the effects of religious-concept priming and synchronous activity among Brazilian drummers. Participants were divided into two between-subjects narrative priming conditions: religious and secular. Within each priming condition, we applied a within-subjects design to investigate effects of solo, group synchronous, and group non-synchronous drumming on endorphin release and cooperation. We found an effect of priming conditions, such that there was a trend toward higher cooperation in the religiously primed group compared to the secularly primed group. We found neither a main effect of the drumming condition nor a drumming-priming interaction effect. Results suggest that behavioral synchrony alone is insufficient to increase cooperation. In light of previous findings, we propose that high levels of physical exertion or social-cognitive mechanisms, such as overlapping task-representation or intentional coordination, are also required for cooperation.
Following a wall by an autonomous mobile robot with a sonar-ring

Presents a robust method for an autonomous mobile robot with a sonar-ring to follow walls. The sonar-ring consists of multiple ultrasonic range sensors. The proposed wall-following algorithm makes a robot able to follow a wall in various shapes such as a square wall, a circular wall etc. The autonomous mobile robot "Yamabico" is used for experiments after being equipped with a 12 directional sonar-ring. The on-board controller of the robot decides its motion based on sonar-ring range data every 3 centimeters going forward. The authors carried out many experiments with this autonomous mobile robot, and investigated the validity and the limits of this method.
Prognostic value of thyroid transcription factor-1 in primary, resected, non-small cell lung carcinoma.

Thyroid transcription factor-1 (TTF-1) is a 38-kDa nuclear protein expressed in thyroid follicular cells, in human fetal lung, and, after birth, in Type II epithelial cells of alveoli and in a subset of bronchial cells. Expression of TTF-1 was documented in neoplasms arising from cells that normally produce this transcription factor. In the present study, a series of surgically resected non-small cell lung carcinomas (NSCLCs) was evaluated for the expression of TTF-1 protein, and the correlation between TTF-1 expression and patient survival was retrospectively tested. Ninety-six patients with primary NSCLC underwent surgical resection between 1987 and 1992. All of the tissue specimens from these patients were examined for TTF-1 protein expression by immunohistochemical analysis. Tumor immunoreactivity for TTF-1 was categorized into three groups (-, +, and ++), according to the percentage of reactive cells. The relationship between TTF-1 expression and postsurgical survival was analyzed for 88 patients [60 squamous cell carcinomas (SCCs) and 28 adenocarcinomas (ACs)]. TTF-1 stain was always limited to nuclei. Of the 96 specimens of NSCLC, 59 (61%) were scored as -, 20 (21%) as +, and 17 (18%) as ++. TTF-1 expression was significantly higher in ACs than in SCCs (P < .0001). Survival curves among the -, +, and ++ groups were significantly different (log rank test, P = .04). Multivariate analysis showed that NSCLCs in the ++ group were associated with a poor prognosis (P = .009), independent of node (P = .01) or stage status (P = .0006). When subsets of patients with SCC and with AC were separately analyzed, TTF-1 was found to have an independent prognostic value only in patients with SCC (P = .04). The results of this study suggest that immunoreactivity for TTF-1 in NSCLC closely relates to clinical outcome, especially in patients with SCC.
Modeling of Mutual Coupling Between Planar Inductors in Wireless Power Applications

This paper presents a compact model of mutual inductance between two planar inductors, which is essential to design and optimize a wireless power transmission system. The tracks of the planar inductors are modeled as constant current carrying filaments, and the mutual inductance between individual filaments is determined by Neumann's integral. The proposed model is derived by solving Neumann's integral using a series expansion technique. This model can predict the mutual inductance at various axial and lateral displacements. Mutual coupling between planar inductors is computed by a 3-D electromagnetic (EM) solver, and the proposed model shows good agreement with these numerical results. Different types of planar inductors were fabricated on a printed circuit board (PCB) or silicon wafer. Using these inductors, wireless power links were constructed for applications like implantable biomedical devices and contactless battery charging systems. Mutual inductance was measured for each of the cases, and the comparison shows that the proposed model can predict mutual coupling suitably.
Characteristics of hospice care discharges and their length of service: United States, 2000.

OBJECTIVE To obtain the maximum benefit from hospice, a person should receive hospice services for at least 30 days. For many Americans, this goal is not being met. This report presents data on hospice care discharges for 2000. Selected trend data are also presented. METHODS Data are from the National Home and Hospice Care Survey. The data presented are numbers and percents by selected discharge characteristics. Length of service measures include average and median length of service and length of service intervals. RESULTS AND CONCLUSIONS There were 621,100 discharges from hospice care in 2000. The typical discharge was elderly, white, lived in a private or semiprivate residence with a caregiver to whom they were related, and died while in hospice care. The primary source of payment was Medicare. Most received three or more services, were seen by three or more service providers, received help from the hospice with at least one activity of daily living (ADL), were incontinent, and had mobility limitation. Cancer is the most common primary admission diagnosis, but the proportion decreased from 75 percent in 1992 to 58 percent in 2000. Most of the discharges did not receive timely care. Sixty-three percent of discharges received hospice care for less than 30 days. The average length of service was 46.9 days, and the median length of service was 15.6 days. Shorter lengths of service occurred for those who were living in institutions, did not receive help from the agency with ADLs, had a lower level of mobility limitation, and had a primary admission diagnosis of cerebrovascular disease. Of the noninstitutionalized discharges, those whose primary caregiver was a spouse had shorter lengths of service than those who were cared for by a child.
Impact of CYP2D6 Functional Allelic Variations on Phenoconversion and Drug–Drug Interactions

We investigated whether CYP2D6 extensive metabolizers carrying a nonfunctional allele are at higher risk of phenoconversion to poor metabolizers in the presence of CYP2D6 inhibitors. Seventeen homozygous carriers of two fully‐functional alleles and 17 heterozygous carriers of one fully‐functional and one nonfunctional allele participated in this trial. Dextromethorphan 5 mg and tramadol 10 mg were given at each of the three study sessions. CYP2D6 was inhibited by duloxetine 60 mg (session 2) and paroxetine 20 mg (session 3). A higher rate of phenoconversion to intermediate metabolizers with duloxetine (71% vs. 25%, P = 0.009) and to poor metabolizers with paroxetine (94% vs. 56%, P = 0.011) was observed in heterozygous than homozygous extensive metabolizers. The magnitude of drug–drug interaction between dextromethorphan and paroxetine was higher in homozygous than in heterozygous subjects (14.6 vs. 8.5, P < 0.028). Our study suggests that genetic extensive metabolizers may not represent a homogenous population and that available genetic data should be considered when addressing drug–drug interactions in clinical practice.
Expression of vascular endothelial growth factor family members in head and neck squamous cell carcinoma correlates with lymph node metastasis

The expression of vascular endothelial growth factor (VEGF)‐A isoforms (121, 165, 189, 206), VEGF‐B, VEGF‐C and VEGF‐D in both experimental and clinical models of head and neck squamous cell carcinoma (HNSCC) was determined and correlated with conventional clinicopathologic parameters, with particular reference to cervical nodal metastasis.