Miracle-dz/UniFAR-FTUs huggingface dataset:
Leadership across boundaries: a qualitative study of the nurse consultant role in English primary care.

AIM To explore the emerging role of nurse consultant in an English primary care setting. BACKGROUND Nurse consultants have been introduced in England since 1999 as senior, non-managerial nurse leaders. They have generally found it that it takes time to negotiate manageable work-loads. DESIGN Four qualitative case studies METHODS Semi-structured interviews with stakeholders within the organization. Data were analysed thematically. FINDINGS All four nurse consultants might potentially work with a very large number of disciplines, departments and other organizations. As a result, it took time to identify priorities and to make relationships. Thus, although nurse consultants are well-placed to work across boundaries, two had made relatively little progress in doing so. CONCLUSION Nurse consultants working in primary and community health care settings are well-placed to be boundary-spanners, delivering change across organizations. Negotiating priorities and relationships are time-consuming tasks, and nurse consultants may have to work with a restricted number of partners initially.
The effect of lavender oil on serum testosterone levels and epididymal sperm characteristics of formaldehyde treated male rats

Abstract. – Background and Objectivies: In this study, the harmful effects of formaldehyde (FA) on serum testosterone levels and epididymal sperm characteristics were investigated. In addition, possible protective effect of lavender oil was evaluated. Materials and Methods: For this purpose, 21 adult male Wistar-Albino rats were used. The rats of group I was used as control group. The rats of group II were exposed FA (10 ppm/1 hour) for 35 days. The rats of group III inhaleted lavender oil (1 ml/1 hour) with FA. Results: While the testosterone levels, the epididymal sperm concentration and the progressive sperm motility were significantly decreased, the abnormal sperm rate was significantly increased in FA treated group when compared to control group. However, in group III, the epididymal sperm concentration and the progressive sperm motility were significantly increased, the abnormal sperm rate was significantly decreased in comparison with the FA treated group. Conclusion: It can be expressed that serious damages occured via formaldehyde exposure in reproductive system and that the lavender oil had protective effects against these damages.
SEPN1: Associated with congenital fiber‐type disproportion and insulin resistance

Our first objective was to determine whether SEPN1 gene mutations are a cause of congenital fiber‐type disproportion (CFTD), a rare form of congenital myopathy in which relative hypotrophy of type 1 (slow twitch) muscle fibers is the principal abnormality on histology. Second, we investigated an association between SEPN1‐related myopathy and insulin resistance.
Impact of long-term political conflict on population health in Nepal

Nepal is a small Himalayan kingdom sandwiched between India and China. With a population of 25 million, of whom 90% live in rural areas, it ranks as one of the poorest countries in the world. [1][1] In 2001 Nepal's gross domestic product (GDP) was US$236 per capita, and nearly two-fifths of the
Vector-borne diseases in cats in Germany

Summary Vector-borne diseases (VBDs) are caused by a wide range of pathogens, which are transmitted by a variety of vectors, such as ticks and fleas. As a result of climate changes, more vector-borne diseases are becoming endemic in Germany, not only in dogs, but also in cats. For some of the pathogens prevalence data still need to be investigated in Germany. However, natural infections with Bartonella, Anaplasma, haemotropic Mycoplasma and Borrelia species have already been described in German cats. Clinical relevance of these pathogens is not fully understood, and it is still unknown, why most infected cats stay asymptomatic and which predisposing factors contribute to the development of clinical signs in cats. Moreover, there is a risk of zoonotic transmission for some of the pathogens, e. g. , for some Bartonella spp. infections that are associated with cat scratch disease in humans. Due to the increasing number of VBDs in cats in Germany, preventive measures, such as the use of acaricides and insecticides, should be performed on a regular base in order to reduce the risk of these infections.
Effects of Immediate Versus Delayed Pushing During Second‐Stage Labor on Fetal Well‐Being: A Randomized Clinical Trial

BackgroundAlthough there are two methods of caring for women with epidural anesthesia during second-stage labor (coached closed-glottis pushing immediately at 10-cm cervical dilation or delayed pushing until the woman feels the urge to push, passive fetal descent, and encouragement of open-glottis pushing when the woman has the urge to push), there are limited data concerning which method is most optimal for fetal well-being. ObjectiveTo evaluate effects on fetal well-being, as measured by fetal oxygen saturation, of two different methods of second-stage labor nursing care for women with epidural anesthesia. MethodsForty-five nulliparous women who had progressed to the second stage were randomized to 1 of 2 groups (immediate or delayed pushing). Fetal oxygen saturation was continuously monitored and values at 10 cm, initiation of pushing and immediately prior to birth, as well as the amount of time that fetal oxygen saturation values were abnormal (≤30%) were compared between groups. Also evaluated were additional measures of fetal well-being such as fetal heart rate patterns, Apgar scores, and umbilical cord blood gases and maternal outcomes including length of labor, method of birth, and perineal status. ResultsThere was a significant difference between groups in fetal oxygen desaturation during the second stage (immediate: M = 12.5; delayed: M = 4.6) F(1, 43) = 12.24, p = . 001, and in the number of ≥2-min epochs of fetal oxygen saturation <30% (immediate: M = 7.9; delayed: M = 2.7), F(1, 43) = 6.23, p = . 02. There were more variable decelerations of the fetal heart rate in the immediate pushing group (immediate: M = 22.4; delayed: M = 15.6) F(1, 43) = 5.92, p = . 02. There were no differences in length of labor, method of birth, Apgar scores, or umbilical cord blood gases. Women who pushed immediately had more perineal lacerations (immediate: n = 13; delayed: n = 5) χ2(1, N = 45) = 6.54, p = . 01. DiscussionDelayed pushing results in less fetal oxygen desaturation and less ≥2-min epochs of fetal oxygen saturation <30% during second-stage labor than the immediate pushing method; thus, delayed pushing is more favorable for fetal well-being as measured by fetal oxygen saturation.
UK Food Standards Agency Optimal Nutrition Status Workshop: environmental factors that affect bone health throughout life

The UK Food Standards Agency (FSA) convened a group of expert scientists to discuss and review UK FSA- and Department of Health-funded research on diet and bone health. This research focused on the lifestyle factors that are amenable to change and may significantly affect bone health and the risk of osteoporotic fracture. The potential benefits of fruits and vegetables, meat, Ca, vitamins D and K and phyto-oestrogens were presented and discussed. Other lifestyle factors were also discussed, particularly the effect of physical activity and possible gene–nutrient interactions affecting bone health.
Detection of Giardia Trophozoites in Archival Pathology Specimens of Human Small Intestine

The examination of archival pathology specimens of human small intestine by light microscopy, field emission scanning electron microscopy (FESEM), and confocal scanning laser microscopy using fluorescent in situ hybridization (FISH) techniques was undertaken to better understand the epidemiology of Giardia. Giardia trophozoites were tentatively identified in the light microscope after hematoxylin and eosin (H&E) staining. The organisms were adherent to the intestinal epithelium where they were also associated with strands of mucus within the lumen. Fluorochrome-conjugated antisense oligonucleotide probes, developed for the 16S rRNA of Giardia lamblia and Giardia muris, were used in FISH experiments with confocal scanning laser microscopy. Positive identification of trophozoites could be obtained with the G. lamblia probe, but not with the G. muris probe. FESEM examination of serial sections adjacent to FISH-stained sections revealed trophozoites characterized by their morphological features. The 16S rDNA probes specifically distinguished different species of Giardia, but whether multiple infections can occur within an individual host could not be determined.
Micro-scale photofluorometric determination of "free erythrocyte pophyrin" (protoporphyrin IX).

It has been known for years that free erythrocyte protoporphyrin (FEP)1 concentrations increase in lead poisoning, iron-deficiency states, and protoporphyria, an uncommon inborn error of porphyrin metabolism. The complex nature of the older procedures for extracting protoporphyrin IX (PROTO) in multiple steps from blood (1, 2), the lack of readily available standards from commercial sources, and other factors have largely limited PEP measurements in the past to experimental work and clinical investigation. The purpose of this report is to describe a simple and reproducible micro-scale fluorometric procedure, which can be performed on 20 tl of blood with use of either a filter fluorometer or a spectrophotofluorometer and with standard disposable glassware and commercially available high-purity calibrationmaterials and reagents. It is based on the classicalethyl acetate/aceticacid extraction technique of Schwartz et al. (1), as are other recently published micromethods (3-5). One of the final stages in the biosynthesis of hemoglobin involves the incorporation of iron into protoporphyrin IX to form heme. Unutilized protoporphyrin IX accumulates in circulating erythrocytes if iron
Partner Experiences of “Near-Miss” Events in Pregnancy and Childbirth in the UK: A Qualitative Study

Objective Severe life-threatening complications in pregnancy that require urgent medical intervention are commonly known as “near-miss” events. Although these complications are rare (1 in 100 births), there are potentially 8,000 women and their families in the UK each year who live through a life-threatening emergency and its aftermath. Near-miss obstetric emergencies can be traumatic and frightening for women, and their impact can last for years. There is little research that has explored how these events impact on partners. The objective of this interview study was to explore the impact of a near-miss obstetric emergency, focusing particularly on partners. Design Qualitative study based on narrative interviews, video and audio recorded and transcribed for analysis. A qualitative interpretative approach was taken, combining thematic analysis with constant comparison. The analysis presented here focuses on the experiences of partners. Participants Maximum variation sample included 35 women, 10 male partners, and one lesbian partner who had experienced a life-threatening obstetric emergency. Setting Interviews were conducted in participants’ own homes. Results In the hospital, partner experiences were characterized by powerlessness and exclusion. Partners often found witnessing the emergency shocking and distressing. Support (from family or staff) was very important, and clear, honest communication from medical staff highly valued. The long-term emotional effects for some were profound; some experienced depression, flashbacks and post-traumatic stress disorder months and years after the emergency. These, in turn, affected the whole family. Little support was felt to be available, nor acknowledgement of their ongoing distress. Conclusion Partners, as well as women giving birth, can be shocked to experience a life-threatening illness in childbirth. While medical staff may view a near-miss as a positive outcome for a woman and her baby, there can be long-term mental health consequences that can have profound impacts on the individual, but also their families.
Comparison of the effects of primary somatostatin analogue therapy and pituitary adenomectomy on survival in patients with acromegaly: a retrospective cohort study.

OBJECTIVE Acromegalic patients have an increased risk of mortality. The objective of this study was to compare the effect of different therapies for acromegaly on mortality. DESIGN AND METHODS The mortality rate of 438 consecutive acromegalic patients was compared with that of the general population using the standardized mortality ratio (SMR); the effect of different therapies on survival was evaluated using Cox regression analysis. RESULTS Twenty patients (4.5%) died between 1999 and 2009. Age- and sex-adjusted SMR was 0.70 (95% CI 0.43-1.08). The Cox regression analysis revealed that, in the whole population, both general risk factors (age and physical status) and specific factors for acromegaly (macroadenoma, hypopituitarism and uncontrolled disease) were associated with death. The most compromised patients at diagnosis had a higher mortality rate (P=0.001), which also occurred in patients with controlled acromegaly. Death occurred in 2.4% (adenomectomy), 2.6% (adenomectomy followed by somatostatin analogue (SSA) therapy) and 11.4% (SSA therapy as the primary therapy) of the patients. The risk of death was higher in patients receiving SSA therapy as the primary therapy (hazard ratio (HR) 5.52, 95% CI 1.06-28.77, P=0.043) than in all patients submitted to adenomectomy; however, a higher risk of death occurred only in diabetic patients treated with SSAs alone (HR 21.94, 95% CI 1.56-309.04, P=0.022). Radiotherapy was associated with an increased risk of mortality, which occurred in patients with the more locally advanced disease. CONCLUSIONS Therapies for acromegaly and comorbidities have lowered the risk of mortality to the level of the general population; the effect of SSA therapy alone or that following pituitary adenomectomy was comparable to that of curative neurosurgery on survival in non-diabetic patients; on the contrary, SSA therapy as the primary therapy may be less effective than adenomectomy in reducing mortality rate in diabetic patients.
Single Event Upsets in a 130 nm Hardened Latch Design Due to Charge Sharing

Critical charge to represent a logic HIGH is steadily decreasing with decreasing technology feature size. Many methods have been developed to increase critical charge requirement for storage elements, thereby reducing the soft error rates. Design-based approaches have been proposed that use four storage nodes instead of two nodes to retain data. Such designs are considered single event upset (SEU) immune at low energy ion hits for all practical purposes because a single ion hit at a storage node does not cause an upset. However, such designs are vulnerable to ion hits that result in multiple nodes collecting charges. For deep sub-micron technologies, the proximity of circuit nodes results in charge collection at multiple nodes when a single ion strikes a node. Researchers first observed the effect of such charge sharing in SRAM designs. In this paper, circuit and 3D technology computer aided design (TCAD) mixed-mode simulations are used to characterize charge sharing between sensitive pairs of devices and the resulting upsets in a hardened storage cell. The simulation results were verified with experimental data showing upsets due to charge sharing in a hardened cell when exposed to low energy ions
Matriptase-2- and Proprotein Convertase-cleaved Forms of Hemojuvelin Have Different Roles in the Down-regulation of Hepcidin Expression*

Hemojuvelin (HJV) is an important regulator of iron metabolism. Membrane-anchored HJV up-regulates expression of the iron regulatory hormone, hepcidin, through the bone morphogenic protein (BMP) signaling pathway by acting as a BMP co-receptor. HJV can be cleaved by the furin family of proprotein convertases, which releases a soluble form of HJV that suppresses BMP signaling and hepcidin expression by acting as a decoy that competes with membrane HJV for BMP ligands. Recent studies indicate that matriptase-2 binds and degrades HJV, leading to a decrease in cell surface HJV. In the present work, we show that matriptase-2 cleaves HJV at Arg288, which produces one major soluble form of HJV. This shed form of HJV has decreased ability to bind BMP6 and does not suppress BMP6-induced hepcidin expression. These results suggest that the matriptase-2 and proprotein convertase-cleavage products have different roles in the regulation of hepcidin expression.
A role of apolipoprotein D in triglyceride metabolism[S]

Apolipoproteins (apo) are constituents of lipoproteins crucial for lipid homeostasis. Aberrant expression of apolipoproteins is associated with metabolic abnormalities. Here we characterized apolipoprotein D (apoD) in triglyceride metabolism. Unlike canonical apolipoproteins that are mainly produced in the liver, apoD is an atypical apolipoprotein with broad tissue distribution. We show that circulating apoD is present mainly in HDL and, to a lesser extent, in LDL and VLDL and that its plasma levels were reduced in db/db mice with visceral obesity and altered lipid metabolism. Elevated apoD production, derived from adenovirus-mediated gene transfer, resulted in significant reduction in plasma triglyceride levels in mice. This effect was attributable to enhanced LPL activity and improved catabolism of triglyceride-rich particles. In contrast, VLDL triglyceride production remained unchanged in response to elevated apoD production. These findings were recapitulated in high-fat–induced obese mice. Obese mice with elevated apoD production exhibited significantly improved triglyceride profiles, correlating with increased plasma LPL activity and enhanced postprandial fat tolerance. ApoD was shown to promote LPL-mediated hydrolysis of VLDL in vitro, correlating with its TG-lowering action in vivo. Apolipoprotein D plays a significant role in lipid metabolism. These data provide important clues to clinical observations that genetic variants of apoD are associated with abnormal lipid metabolism and increased risk of metabolic syndrome.
Exercise training preserves vagal preganglionic neurones and restores parasympathetic tonus in heart failure

Heart Failure (HF) is accompanied by reduced ventricular function, activation of compensatory neurohormonal mechanisms and marked autonomic dysfunction characterized by exaggerated sympathoexcitation and reduced parasympathetic activity. With 6 weeks of exercise training, HF‐related loss of choline acetyltransferase (ChAT)‐positive vagal preganglionic neurones is avoided, restoring the parasympathetic tonus to the heart, and the immunoreactivity of dopamine β‐hydroxylase‐positive premotor neurones that drive sympathetic outflow to the heart is reduced. Training‐induced correction of autonomic dysfunction occurs even with the persistence of abnormal ventricular function. Strong positive correlation between improved parasympathetic tonus to the heart and increased ChAT immunoreactivity in vagal preganglionic neurones after training indicates this is a crucial mechanism to restore autonomic function in heart failure.
Knowledge of Chemical Hazards and Prevalence of Darkroom Diseases among Darkroom Technicians and Assistants in Southeast, Nigeria

Darkroom technicians and assistants are exposed daily to x-ray processing chemicals. These chemicals contain known irritants which can cause some disease symptoms to its handlers. The aim of this study was to assess the knowledge of chemical hazards and prevalence of darkroom diseases among darkroom technicians and assistants in Southeast, Nigeria. The study adopted cross-sectional survey. A total of 105 darkroom technicians and assistants who met the inclusion criteria in the 10 tertiary hospitals in Southeast, Nigeria were enlisted in the study. Data were collected using researcher-developed questionnaire and on-the-spot assessment of adequacy of ventilation in the darkroom. The questionnaire sought data on demographic variables, knowledge of the constituents of the processing chemicals, adherences to operating guidelines, knowledge of possible side effects, any observed sudden episodes of ill health and presence of workshops for new employees and older staff. The reliability of the instrument was conducted using test re-test in two tertiary hospitals in Southwest Nigeria. The internal consistency was calculated using Cronbach alpha which yielded a co-efficient of 0.82. A total of 105 questionnaires were administered and 100 copies properly completed and returned giving a return rate of 95.2%. 72% of the respondents had knowledge (mean = 3.20±0.71) of chemical hazard associated with x-ray processing chemicals while 34% had knowledge (mean = 3.12±1.3) of the constituents of the processing chemicals. Forty-four respondents (44%) always read the enclosed Materials Safety Data Sheet (MSDS) (mean = 2.57±1.1) before mixing the chemicals. The prevalence of darkroom disease among darkroom technicians and assistant in Southeast, Nigeria from our study was 68%. There were no significant differences (p>0.05) on the knowledge of darkroom disease, constituents of the processing chemicals and attention to Material Safety Data Sheet (MSDS) among darkroom technicians and assistants of different educational levels. There was high knowledge of chemical hazards among darkroom technicians and assistants from our study. However poor knowledge of the constituents of the processing chemicals and poor attention to the MSDS were noted to contribute to increase in the prevalence of the diseases.
Review of β-carboline Alkaloids from the Genus Aspidosperma

Plants belonging to the genus Aspidosperma, a member of the family Apocynaceae, provide a rich source of β-carboline alkaloids, which makes them potentially poisonous. However, some of these alkaloids possess antitumor and antimicrobial activity. The present review is a survey of the β-carboline alkaloids and shows that they comprise of a diverse array of structural modifications.
The Role of Thoracic Epidural Analgesia in Receptor-Dependent and Receptor-Independent Pulmonary Vasoconstriction in Experimental Pancreatitis

BACKGROUND:Acute pancreatitis commonly results in lung injury and deterioration of pulmonary endothelial function and vasoregulation. Despite a variety of potential risks with the use of thoracic epidural analgesia (TEA) in the critically ill, this technique is an important component of pain management in pancreatitis in selected cases. Although there is evidence that epidural analgesia improves lung function through effective pain relief, the influence of continuously applied epidural local anesthetics on pulmonary endothelial dysfunction is still unknown. METHODS:In an in vivo model of TEA in awake rats with acute pancreatitis, we evaluated blood gas analysis, arterial blood pressure, and exhaled nitric oxide. This was followed by in vitro studies of receptor-dependent and receptor-independent pulmonary vasoconstriction using an isolated perfused lung model. Pulmonary myeloperoxidase activity, indicating leukocyte sequestration into the lungs and wet/dry ratio evaluating pulmonary edema, were also measured. RESULTS:Deteriorated oxygenation, metabolic and lactate acidosis, as well as exhaled nitric oxide levels occurring during acute pancreatitis, were reduced by TEA to levels observed in sham-operated animals. TEA also partially ameliorated the hypotension occurring in pancreatitis. In isolated perfused lungs, receptor-dependent vasoconstriction due to angiotensin II was reduced during acute pancreatitis, indicating pulmonary vascular smooth muscle cell dysfunction. Hypoxic pulmonary vasoconstriction was likewise abolished. Treatment with TEA partly restored the vasoreactivity to angiotensin II and hypoxia. Bradykinin-induced vasoconstriction, indicating pulmonary endothelial dysfunction, myeloperoxidase activity and the degree of pulmonary edema, was not influenced by TEA. CONCLUSIONS:Our study demonstrated that TEA improves pancreatitis-associated impairment of pulmonary vasoreactivity and gas exchange.