Miracle-dz/UniFAR-FTUs huggingface dataset:
Establishing the minimal number of virtual reality simulator training sessions necessary to develop basic laparoscopic skills competence: evaluation of the learning curve.

INTRODUCTION Medical literature is scarce on information to define a basic skills training program for laparoscopic surgery (peg and transferring, cutting, clipping). The aim of this study was to determine the minimal number of simulator sessions of basic laparoscopic tasks necessary to elaborate an optimal virtual reality training curriculum. MATERIALS AND METHODS Eleven medical students with no previous laparoscopic experience were spontaneously enrolled. They were submitted to simulator training sessions starting at level 1 (Immersion Lap VR, San Jose, CA), including sequentially camera handling, peg and transfer, clipping and cutting. Each student trained twice a week until 10 sessions were completed. The score indexes were registered and analyzed. The total of errors of the evaluation sequences (camera, peg and transfer, clipping and cutting) were computed and thereafter, they were correlated to the total of items evaluated in each step, resulting in a success percent ratio for each student for each set of each completed session. Thereafter, we computed the cumulative success rate in 10 sessions, obtaining an analysis of the learning process. By non-linear regression the learning curve was analyzed. RESULTS By the non-linear regression method the learning curve was analyzed and a r2 = 0.73 (p < 0.001) was obtained, being necessary 4.26 (∼five sessions) to reach the plateau of 80% of the estimated acquired knowledge, being that 100% of the students have reached this level of skills. From the fifth session till the 10th, the gain of knowledge was not significant, although some students reached 96% of the expected improvement. CONCLUSIONS This study revealed that after five simulator training sequential sessions the students' learning curve reaches a plateau. The forward sessions in the same difficult level do not promote any improvement in laparoscopic basic surgical skills, and the students should be introduced to a more difficult training tasks level.
Use of real-time ultrasound to evaluate live animal carcass traits in young performance-tested beef bulls.

Young bulls were ultrasonically scanned to 1) study breed differences for 12th rib fat depth (USFAT) and longissimus muscle area (USREA), 2) evaluate the nature and predictability of USFAT and USREA development, and 3) determine the effect of age (YFAT and YREA, respectively) or weight (WREA) adjustments on USFAT and USREA. Angus (AA), Charolais (CH), Hereford (HH), Shorthorn (SS), and Simmental (SM) bulls (n = 886) were studied in 2 yr at two stations. Breed differences were observed for end of test USFAT (AA = SS > HH > CH = SM, P < .05) and USREA (CH = SM > SS = AA > HH, P < .05). Within-breed coefficients of variation were 29.8 to 48.4% for end of test USFAT and from 9.0 to 10.8% for end of test USREA. In most bulls, USFAT development was neither linear nor quadratic (P > .05), but USREA development was linear (P < .05). Prediction equations were characterized by low r2 and high residual standard deviation (RSD) values, although those for d-84 USREA had r2 values from . 63 to . 70 and RSD values from 4.09 to 5.80 cm2. High associations were obtained between end of test USFAT with YFAT (r = .83 to .91, P < .05) and USREA with YREA (r = .74 to .84, P < .05) but not for end of test USREA with WREA (r = .31 to .56, P < .05). These results indicate that end of test ultrasound measurements may be a useful addition to performance testing programs.
Decrease in antibiotic use among children in the 1990s: not all antibiotics, not all children

Background: Decreases in antibiotic use were widely reported in the 1990s. This study was undertaken to determine trends in the use of antibiotics from fiscal year (FY) 1995 (April 1995 to March 1996) to FY 2001 in a complete population of Manitoba children. Methods: Using Manitoba's health care databases, we determined annual population-based rates of antibiotic prescription among children by antibiotic class (narrow-spectrum and broader-spectrum antibiotics), age group, physician diagnosis (e.g., otitis media or bronchitis) and neighbourhood income in urban areas (derived from the 1996 census). Antibiotic prescription rates were generated within a generalized linear model framework with general estimating equations, and differences between FY 2001 and FY 1995 were tested. Differences in antibiotic use over time were compared across antibiotic classes, age groups, diagnoses and income neighbourhoods. Results: The overall antibiotic prescription rate decreased by almost one-third, from 1.2 prescriptions per child in FY 1995 to 0.9 prescriptions in FY 2001. Total antibiotic use declined for all respiratory tract infections; decreases were greatest for the sulfonamides (decrease to less than one-third the FY 1995 rate) and narrow-spectrum macrolides (decrease to less than half the FY 1995 rate). In contrast, the FY 2001 rate for broader-spectrum macrolides was as much as 12.5 times the FY 1995 rate. Otitis media accounted for one-quarter of the use of the latter agents. Preschool children and low-income children received the greatest number of antibiotic prescriptions. Declines in antibiotic prescriptions were of a lesser magnitude for low-income children (for whom rates in FY 2001 were four-fifths the rates in FY 1995) than for higher-income children (for whom rates in FY 2001 were about two-thirds the rates in FY 1995). Interpretation: Overall, antibiotic use declined over the late 1990s in this population of Canadian children, but the increasing use of broader-spectrum macrolides and higher rates of antibiotic use among preschool and low-income children may have implications for antibiotic resistance.
Hypoglycemic effect of aqueous extract of seabuckthorn (Hippophae rhamnoides L.) seed residues in streptozotocin‐induced diabetic rats

An extract of seabuckthorn (Hippophae rhamnoides L.) seed residues has been shown to possess hypoglycemic and hypolipidemic properties in normal mice. The present study investigated the effects of an aqueous extract of seabuckthorn seed residues (ASSR) on serum glucose, lipid profiles and antioxidant parameters in streptozotocin‐induced diabetic rats. Male Sprague‐Dawley rats were divided into four groups: a normal control group; diabetic control group; diabetic groups supplemented with 5 mg/kg body weight glibenclamide (reference drug) and 400 mg/kg body weight ASSR. Diabetes in rats was induced by intraperitoneal injection of streptozotocin (45 mg/kg body weight). Vehicle (distilled water), glibenclamide and ASSR were administered orally to normal and diabetic rats once a day lasting for 4 weeks. The data showed that administration of ASSR significantly lowered the serum glucose, triglyceride and nitric oxide levels in diabetic rats. Moreover, ASSR treatment also increased serum superoxide dismutase activity and glutathione level markedly. These results show that ASSR has hypoglycemic, hypotriglyceridemic and antioxidant effects in streptozotocin‐induced diabetic rats, suggesting that ASSR supplementation can be useful in preventing diabetic complications associated with hyperlipidemia and oxidative stress. Copyright © 2009 John Wiley & Sons, Ltd.
Norepinephrine or Dopamine for Septic Shock

Received July 30, 2010, and in revised form September 14, 2010. Accepted for publication September 20, 2010. Background: There is debate as to the vasopressor agent of choice in patients with septic shock. According to current guidelines either dopamine or norepinephrine may be considered as the first-line agent for the management of refractory hypotension of septic shock. Objective: The aim of this systematic review was to evaluate randomized clinical trials which compared norepinephrine versus dopamine in critically ill patients with septic shock or in a population of critically ill patients with shock predominantly secondary to sepsis. Data Sources: MEDLINE, Embase, Scopus, Cochrane Register of Controlled Trials and citation review of relevant primary and review articles. Study Selection: Randomized clinical trials that compared norepinephrine with dopamine in critically ill adults with sepsis and reported the 28-day or in-hospital mortality. Data Extraction: We abstracted data on study design, study setting, patient population, 28-day mortality or in-hospital mortality, rate of arrhythmias, hospital length of stay, and ICU length of stay. Data Synthesis: Six studies met our inclusion criteria. These studies included a total of 2043 participants, with 995 in the norepinephrine and 1048 in the dopamine groups. There were 479 (48%) deaths in the norepinephrine group and 555 (53%) deaths in the dopamine group. There was statistically significant superiority of norepinephrine over dopamine for the outcome of in-hospital or 28-day mortality: pooled RR: 0.91 (95% CI 0.83 to 0.99; P = .028). We also found a statistically significant decrease in the rate of cardiac arrhythmias in the norepinephine group as compared to the dopamine group: pooled RR: 0.43 (95% CI 0.26 to 0.69; P ≤ .001). A subgroup analysis that pooled studies in which all the randomized patients had septic shock demonstrated that norepinephrine improved in-hospital or 28-day mortality; however, the results were no longer statistically significant. Conclusions: The analysis of the pooled studies that included a critically ill population with shock predominantly secondary to sepsis showed superiority of norepinephrine over dopamine for in-hospital or 28-day mortality.
Prevalence and molecular characterization of carbapenemase-producing gram-negative bacteria from a university hospital in China

Abstract Background: The increasing emergence of carbapenem resistance in gram-negative bacteria associated with carbapenemase prompted the initiation of this study. Methods: A total of 3139 gram-negative bacteria were recovered from a 3380-bed university hospital in Wenzhou during 2008 and 2012. Antimicrobial susceptibility was determined using the VITEK2 Compact System and agar dilution method. The phenotype and genotype of carbapenemase were demonstrated using the modified Hodge test, PCR and sequencing. A conjugation experiment was performed to reveal the transferability of resistant genes. The location of the carbapenemase gene was studied by plasmid analysis and southern blot hybridization. Clonal relatedness of the isolates was investigated by pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). Results: Overall, 751 of 3139 isolates (71/2055 Enterobacteriaceae, 510/620 Acinetobacter baumannii and 170/464 Pseudomonas aeruginosa) exhibited resistance to carbapenem. Carbapenemase-encoding genes were detected in 70.4% (50/71) of carbapenem-resistant Enterobacteriaceae, including blaKPC (80%) and blaIMP (20%). All A. baumannii subjected to genotype analysis were positive for blaOXA-51-like and co-harboured blaOXA-23-like (80.4%) and blaIMP (7.8%). ISAba1 was found upstream of blaOXA-23-like and blaOXA-51-like. Eight and seven strains of 170 P. aeruginosa carried blaIMP and blaVIM, respectively. PFGE analysis identified at least one dominant genotype in certain species. Four KPC-2-producing Klebsiella pneumoniae belonged to the same sequence type ST11. The plasmids carrying blaKPC were successfully transferred into recipient strains. Conclusion: This study highlights the challenge of increasing prevalence of carbapenem resistance associated with carbapenemase genes and dissemination of epidemic clones in Wenzhou, China.
A spatial temporal analysis of the Fusarium graminearum transcriptome during symptomless and symptomatic wheat infection

Summary Fusarium head blight of wheat is one of the most serious and hazardous crop diseases worldwide. Here, a transcriptomic investigation of Fusarium graminearum reveals a new model for symptomless and symptomatic wheat infection. The predicted metabolic state and secretome of F. graminearum were distinct within symptomless and symptomatic wheat tissues. Transcripts for genes involved in the biosynthesis of the mycotoxin, deoxynivalenol, plus other characterized and putative secondary metabolite clusters increased in abundance in symptomless tissue. Transcripts encoding for genes of distinct groups of putative secreted effectors increased within either symptomless or symptomatic tissue. Numerous pathogenicity‐associated gene transcripts and transcripts representing PHI‐base mutations that impacted on virulence increased in symptomless tissue. In contrast, hydrolytic carbohydrate‐active enzyme (CAZyme) and lipase gene transcripts exhibited a different pattern of expression, resulting in elevated transcript abundance during the development of disease symptoms. Genome‐wide comparisons with existing datasets confirmed that, within the wheat floral tissue, at a single time point, different phases of infection co‐exist, which are spatially separated and reminiscent of both early and late infection. This study provides novel insights into the combined spatial temporal coordination of functionally characterized and hypothesized virulence strategies.
Neutrophil Depletion Suppresses Pulmonary Vascular Hyperpermeability and Occurrence of Pulmonary Edema Caused by Hantavirus Infection in C.B-17 SCID Mice

ABSTRACT Hantavirus infections are characterized by vascular hyperpermeability and neutrophilia. However, the pathogenesis of this disease is poorly understood. Here, we demonstrate for the first time that pulmonary vascular permeability is increased by Hantaan virus infection and results in the development of pulmonary edema in C.B-17 severe combined immunodeficiency (SCID) mice lacking functional T cells and B cells. Increases in neutrophils in the lung and blood were observed when pulmonary edema began to be observed in the infected SCID mice. The occurrence of pulmonary edema was inhibited by neutrophil depletion. Moreover, the pulmonary vascular permeability was also significantly suppressed by neutrophil depletion in the infected mice. Taken together, the results suggest that neutrophils play an important role in pulmonary vascular hyperpermeability and the occurrence of pulmonary edema after hantavirus infection in SCID mice. IMPORTANCE Although hantavirus infections are characterized by the occurrence of pulmonary edema, the pathogenic mechanism remains largely unknown. In this study, we demonstrated for the first time in vivo that hantavirus infection increases pulmonary vascular permeability and results in the development of pulmonary edema in SCID mice. This novel mouse model for human hantavirus infection will be a valuable tool and will contribute to elucidation of the pathogenetic mechanisms. Although the involvement of neutrophils in the pathogenesis of hantavirus infection has largely been ignored, the results of this study using the mouse model suggest that neutrophils are involved in the vascular hyperpermeability and development of pulmonary edema in hantavirus infection. Further study of the mechanisms could lead to the development of specific treatment for hantavirus infection.
Consequences of Teen Dating Violence

Increasing attention has been given to the problem of teen dating violence with more research needed on mediating and moderating factors in the relationship between victimization and negative consequences. This article explores mental health and educational consequences of physical and sexual abuse by peers in a convenience sample of adolescents. Dating violence was associated with higher levels of depression, suicidal thoughts, and poorer educational outcomes. The use of alcohol and depression complicated the relationship between victimization and outcomes. Sex differences in patterns of perceived social support as a moderator were also examined with more significant effects for girls.
Detection of the floR Gene in a Diversity of Florfenicol Resistant Gram‐Negative Bacilli from Freshwater Salmon Farms in Chile

Florfenicol is an important antibiotic in veterinary medicine that is used extensively in aquaculture, including salmon farming in Chile. We analysed a set of 119 florfenicol‐resistant Gram‐negative bacilli from seven freshwater Chilean salmon farms for the molecular determinants involved in the florfenicol resistance. Ninety‐seven of these strains were glucose non‐fermenting bacilli, mainly belonging to the Pseudomonas genus, whereas 22 strains were glucose‐fermenters. The floR gene was detected in 26 strains (21.8%) that had been isolated from three of the seven salmon farms. Most of the floR‐carrying strains were glucose fermenters (21 strains), and most of the floR‐carrying strains were also resistant to streptomycin, chloramphenicol and oxytetracycline. The minimum inhibitory concentrations against florfenicol were assessed in the presence and absence of the efflux pump inhibitor Phe‐Arg‐β‐naphthylamide (MC‐207,110). There was evidence that in the majority of non‐fermenting bacteria (82 strains), florfenicol resistance was at least partially mediated by non‐specific efflux pump systems. Given the diversity of antibiotic resistance patterns observed in this study in the floR‐positive isolates, a single antibiotic has the potential to co‐select for a diversity of resistances. For this reason, human health as well as animal health can potentially be impacted by the use of antibiotics in aquaculture. To assess this potential risk, future studies should focus on the ability of different antibiotics used in aquatic environments to co‐select for multiple resistances, the molecular basis of this diversity of resistance, and whether the genes conferring resistance can be transferred to other bacteria, including those of human health concern.
Paclitaxel, Cisplatin, and Concurrent Radiation for Esophageal Cancer

Paclitaxel is an active agent for adenocarcinomas and squamous cell carcinomas of the esophagus and is a radiation sensitizer. We sought to investigate the toxicity and complete response rate of paclitaxel, cisplatin, and concurrent radiation for esophageal cancer. Forty-one patients with esophageal cancer were studied, 29 with adenocarcinomas and 12 with squamous cell cancers. Twelve patients had tumor extension into the proximal stomach and/or abdominal adenopathy. Patients received paclitaxel 60 mg/m2 by 3-hour intravenous (IV) infusion, and cisplatin 25 mg/m2 weekly on days 1, 8, 15, and 22. Radiation was administered concurrently to a total dose of 39.60 Gy, in 1.80 Gy fractions, for 22 treatments. Patients with medical or surgical contraindications to esophagectomy received 2 additional weeks of paclitaxel with a radiation boost to 50.4 Gy. Neutropenia was the most common grade 3/4 toxicity occurring in 10 patients (24%). Only 2 patients (5%) had grade 4 esophagitis requiring parenteral nutrition. Twelve patients (29%) obtained a complete response. The 2-year progression-free and overall survival rates were 40% and 42%, respectively. Esophagitis was less severe than expected and prophylactic enteral feeding tubes were not necessary. Additional effective systemic treatments are needed to reduce the development of distant metastases.
Is the adhesive material secreted by sea urchin tube feet species‐specific?

Sea urchin adoral tube feet are highly specialized organs that have evolved to provide efficient attachment to the substratum. They consist of a disk and a stem that together form a functional unit. Tube foot disk tenacity (adhesive force per unit area) and stem mechanical properties (e.g., stiffness) vary between species but are apparently not correlated with sea urchin taxa or habitats. Moreover, ultrastructural studies of sea urchin disk epidermis pointed out differences in the internal organization of the adhesive secretory granules among species. This prompted us to look for interspecific variability in the composition of echinoid adhesive secretions, which could explain the observed variability in adhesive granule ultrastructure and disk tenacity. Antisera raised against the footprint material of Sphaerechinus granularis (S. granularis) were first used to locate the origin of adhesive footprint constituents in tube feet by taking advantage of the polyclonal character of the generated antibodies. Immunohistochemical assays showed that the antibodies specifically labeled the adhesive secretory cells of the disk epidermis in the tube feet of S. granularis. The antibodies were then used on tube foot histological sections from seven other sea urchin species to shed some light on the variability of their adhesive substances by looking for antibody cross‐reactivity. Surprisingly, no labeling was observed in any of the species tested. These results indicate that unlike the adhesive secretions of asteroids, those of echinoids do not share common epitopes on their constituents and thus would be “species‐specific. ” In sea urchins, variations in the composition of adhesive secretions could therefore explain interspecific differences in disk tenacity and in adhesive granule ultrastructure. J. Morphol. , 2011. © 2011 Wiley Periodicals, Inc.
İşyerinde Kişisel İnternet ve Teknoloji Kullanimi: Sanal Kaytarma

Sanal kaytarma faaliyetleri, calisanlar ve isletmeler uzerinde onemli negatif etkilereyol acabilmektedir. Ancak Turk literaturu sanal kaytarma faaliyetlerinin bu onemi konusunda oldukca sinirli kalmistir. Bu kapsamda arastirmada, akademik ve akademik olmayan universite personeli arasindaki sanal kaytarma faaliyetlerinin belirlemesi amaclanmistir. 151 anket araciligiyla yapilan arastirmada, sanal kaytarma faaliyetleri ozellikle demografik degiskenler acisindan incelenmistir. Bulgular, sanal kaytarma faaliyetlerinin calisanlarin demografik degiskenleri acisindan anlamli farkliliklar gosterdigini ifade etmektedir. Ayrica, arastirma sonucunda uygulayicilar ve calýþanlar icin cesitli onerilerde bulunulmustur.
Bβ15-42 (FX06) reduces pulmonary, myocardial, liver, and small intestine damage in a pig model of hemorrhagic shock and reperfusion*

Objective:The fibrin-derived peptide Bβ15-42 (also called FX06) has been shown to reduce myocardial infarct size following ischemia/reperfusion. Hemorrhagic shock (HS) followed by volume resuscitation represents a similar scenario, whereby a whole organism is vulnerable to reperfusion injury. Design:We subjected male farm-bred landrace pigs (∼30 kg) to HS by withdrawing blood to a mean arterial pressure of 40 mm Hg for 60 minutes. Pigs were then resuscitated with shed blood and crystalloids for 60 minutes, and at this time, FX06 (2.4 mg/kg, n = 8) or vehicle control (phosphate buffered saline; 2.4 mg/kg, n = 7) was injected as an intravenous bolus. Setting:University hospital laboratory. Subjects:Anesthetized male farm-bred landrace pigs. Measurements and Main Results:Data are presented as mean ± sd. Five hours after resuscitation, controls presented acute lung injury (Pao2/Fio2-ratio <300 mm Hg; extra-vascular lung water index (marker for lung injury): 9.0 ± 1.8 mL/kg) and myocardial dysfunction/damage (cardiac index: 4.3 ± 0.25 L/min/m2; stroke volume index: 30 ± 6 mL/m2; cardiac TnT levels: 0.58 ± 0.25 ng/mL). In contrast, FX06-treated animals showed significantly improved pulmonary and circulatory function (Pao2/Fio2-ratio >*400 mm Hg; extra-vascular lung water index: *5.2 ± 2.1 mL/kg, cardiac index: *6.3 ± 1.4 L/min/m2; stroke volume index: *51 ± 11 mL/m2; cardiac TnT levels: *0.11 ± 0.09 ng/mL; *p < 0.05). Also, tissue oxygenation (tpO2; mm Hg) was significantly improved during reperfusion in FX06-treated pigs when compared with controls (liver 51 ± 4 vs. *65 ± 4; serosa 44 ± 5 vs. *55 ± 7; mucosa 14 ± 4 vs. *26 ± 4). Finally, FX06 reduced accumulation of myeloperoxidase-positive cells (mainly neutrophils) in myocardium, liver, and small intestine and reduced interleukin-6 plasma levels (*p < 0.05; compared with controls). Conclusion:We conclude that in a pig model of HS and reperfusion, administration of FX06 during reperfusion protects shock- susceptible organs such as heart, lung, liver, and small intestine.