Miracle-dz/UniFAR-FTUs huggingface dataset:
Development and testing of the ‘Culture of Care Barometer’ (CoCB) in healthcare organisations: a mixed methods study

Objective Concerns about care quality have prompted calls to create workplace cultures conducive to high-quality, safe and compassionate care and to provide a supportive environment in which staff can operate effectively. How healthcare organisations assess their culture of care is an important first step in creating such cultures. This article reports on the development and validation of a tool, the Culture of Care Barometer, designed to assess perceptions of a caring culture among healthcare workers preliminary to culture change. Design/setting/participants An exploratory mixed methods study designed to develop and test the validity of a tool to measure ‘culture of care’ through focus groups and questionnaires. Questionnaire development was facilitated through: a literature review, experts generating items of interest and focus group discussions with healthcare staff across specialities, roles and seniority within three types of public healthcare organisations in the UK. The tool was designed to be multiprofessional and pilot tested with a sample of 467 nurses and healthcare support workers in acute care and then validated with a sample of 1698 staff working across acute, mental health and community services in England. Exploratory factor analysis was used to identify dimensions underlying the Barometer. Results Psychometric testing resulted in the development of a 30-item questionnaire linked to four domains with retained items loading to four factors: organisational values (α=0.93, valid n=1568, M=3.7), team support (α=0.93, valid n=1557, M=3.2), relationships with colleagues (α=0.84, valid n=1617, M=4.0) and job constraints (α=0.70, valid n=1616, M=3.3). Conclusions The study developed a valid and reliable instrument with which to gauge the different attributes of care culture perceived by healthcare staff with potential for organisational benchmarking.
Range and determinants of white blood cell count in a large survey of Israelis without inflammation.

BACKGROUND The white blood cell count and its differential are established inflammation-sensitive biomarkers with a proven prognostic value in the field of atherothrombosis. However, the WBCC count range and determinants havenot been explored in the absence of a significant inflammatory response. OBJECTIVE To analyze the WBCC range and determinants in a large Israeli sample of individuals, excluding patients with a significant inflammatory response. METHODS WBCC and differential count reference ranges were determined in a large sample of apparently heal participants with high sensitivity C-reactive protein concentrations below 10 mg/L. Linear regression models were used to identify the determinants of the WBCC. The central 95% areas under the distribution curves were established for each gender. RESULTS The study population comprised 8247 individuals (5391 males and 2856 females). The main laboratory and clinical variables found to affect the WBCC were gender, hemoglobin level, smoking status, triglycerides, and body mass index (all P < 0.001). Similar results were obtained for the differential count. The reference ranges for men and women were 3.6-9.9 and 3.4-10.0 x10(3) microl, respectively.The reference ranges for currently smoking men and women were 3.6-11.5 and 3.6-11.2 x10(3) microl, respectively, and were significantly higher compared with those of the never smokers and past smokers. CONCLUSIONS We have demonstrated new limits of normal values for the WBCC in apparently healthy individuals who lack a significant "background" acute-phase response in a large Israeli sample. Our data might be useful for the risk stratification of apparently healthy individuals in the field of atherothrombosis.
Prevalence of lumbar facet joint pain in chronic low back pain.

This prospective study was designed to determine the prevalence of lumbar facet joint pain in a consecutive series of patients with chronic low back pain treated at an interventional, multidisciplinary private pain management practice utilizing double diagnostic blocks, to determine the prevalence of false positive rate of uncontrolled facet joint blocks, and to determine the relationship of clinical features of responders and non-responders to double diagnostic blocks. One hundred and twenty patients with low back pain with or without lower extremity pain were selected. The procedure consisted of diagnostic blocks using lidocaine and bupivacaine on separate occasions, usually two weeks apart. Each facet joint nerve was infiltrated with either 0.4 to 0.6 ml of 1% lidocaine (Xylocaine(R)) or 1% lidocaine (Xylocaine(R)) and 0.25% bupivacaine (Marcaine(R)). A definite response was defined as substantial with at least 75% relief of pain in the symptomatic area following local anesthetic block. Confirmatory blocks using bupivacaine 0.25% were performed at the same levels as the first injection if definite relief was obtained. The response to bupivacaine blocks which lasted longer than the lidocaine blocks was accepted as a positive response. All blocks were performed under fluoroscopic guidance. Eighty-one patients (67.5%) reported a definite response to lidocaine blocks. Confirmatory blocks with bupivacaine were performed in all 81 patients with 54 patients, i.e. 45% of total sample or 66.6% of lidocaine positive group reporting definite response with a false positive rate of 41%. Prevalence and relationship of pain referral pattern in patients with and without facet joint pain confirmed by double blocks showed no significant correlation. We found no relationship between the history, physical findings, age, gender, trauma, duration of pain, and diagnostic blocks. However, history of previous surgery showed a negative correlation as only 29% of the patients after previous surgery were positive in contrast to 51% of the nonsurgical population. The results of this study echo previous concerns of reliability of uncontrolled single blocks, history, and clinical features. This study demonstrated that the facet joint is a source of pain in 45% of the patients suffering with chronic low back pain in an interventional pain management setting in a private practice.
A Comparison of Structural and Mechanical Properties of Tubularized and Native Semitendinosus Graft

Background: The semitendinosus tendon has a broad and thin length of aponeurosis. Tubularizing this portion of the graft converts it into a cylindrical structure, which may have implications for graft fixation. Hypothesis: A tubularized semitendinosus tendon will demonstrate a higher tensile load to failure and increased stiffness compared with its native form. Study Design: Controlled laboratory study. Methods: Twenty cadaveric paired semitendinosus specimens were used. Ten served as the control group; the other 10 underwent tubularization along the length of the aponeurosis. All testing was performed on the MTS 858 Mini Bionix II. Outcome measures included cross-sectional area, stress, stiffness, and peak load to failure. Results: The nontubularized tendons had a higher peak tensile load to failure (mean 1112.6 ± 345.0 N) than the tubularized tendons (mean 711.4 ± 228.7 N, P = .007). The nontubularized specimens also had a higher stiffness (213.0 ± 37.2 N) than the tabularized group (144.9 ± 44.8 N, P = .002). Conclusion: Tubularization of the semitendinosus graft weakens its structural and mechanical properties. Clinical Relevance: On the basis of the results of this study, we do not tubularize the semitendinosus graft in ACL reconstruction because of weakened structural and mechanical properties.
Neurobehavioral Responses and Drug Concentrations in Newborns after Maternal Epidural Anesthesia with Bupivacaine

The neurobehavioral status of 20 newborn infants was evaluated after two to four hours of life following maternal epidural anesthesia with hupivacaine for labor and vaginal delivery. All infants were normal products of uncomplicated full-term gestations. The 20 infants, whose mothers had received continuous lumbar epidural anesthesia with bupivacaine. demonstrated no measurable difference from control infants and did not have the decrease in muscle tone and strength observed in infants whose mothers had received continous lumbar epidural anesthesia with lidocaine or mepivacaine in a previous study.
Co-Overexpression of GRK5/ACTC1 Correlates With the Clinical Parameters and Poor Prognosis of Epithelial Ovarian Cancer

Background: The prognosis of epithelial ovarian cancer (EOC) is poor, and the present prognostic predictors of EOC are neither sensitive nor specific. Objective: The aim of this study was to search the prognostic biomarkers of EOC and to investigate the expression of G protein-coupled receptor kinase 5 (GRK5) and actin alpha cardiac muscle 1 (ACTC1) in EOC tissues (both paraffin-embedded and fresh-frozen tissues) and to explore their association with clinicopathological parameters and prognostic value in patients with EOC. Methods: A total of 172 paraffin-embedded cancer tissues of EOC patients diagnosed and operated at the memorial hospital of Sun Yat-sen University between December 2009 and March 2017 and 41 paratumor tissues were collected and the expression of GRK5 and ACTC1 was examined using immunohistochemistry. Furthermore, 16 fresh-frozen EOC tissues and their matched paratumor tissues were collected from the Integrated Hospital of Traditional Chinese Medicine, Southern Medical University, between August 2013 and November 2019 and subjected to reverse-transcription quantitative PCR analysis to detect the mRNA expression of GRK5 and ACTC1. Results: The expression of GRK5 and ACTC1 was both higher in cancer tissues than in paratumor tissues. GRK5 expression was positively correlated with ACTC1 expression. In addition, GRK5, ACTC1, and GRK5/ACTC1 expression was associated with the recurrence-free survival and overall survival of EOC patients. Furthermore, multivariate logistic regression analysis indicated that GRK5+/ACTC1+ co-expression, intestinal metastasis, postoperative chemotherapy, platinum resistance, and hyperthermic intraperitoneal chemotherapy were independent prognostic factors of EOC. Conclusion: GRK5 and ACTC1 are both upregulated in EOC compared with those in paratumor tissues. The co-expression of GRK5+/ACTC1+ rather than GRK5 or ACTC1 is an independent prognostic biomarker of EOC.
Age‐Related Changes in Postprandial Plasma Glucose, Insulin, and Free Fatty Acid Concentrations in Nondiabetic Individuals

Plasma glucose, insulin, and free fatty acid (FFA) concentrations were measured from 0800 to 1600 hours in 40 nondiabetic individuals, separated into younger (38 ± 1.4 years) and older (64 ± 1.5 years) age groups. Meals were served at 0800 (20% total daily calories) and 1200 h (40% of total daily calories), and blood drawn just before the 0800 hours meal and at hourly intervals thereafter until 1600 hours. Statistical evaluation of the results of these measurements indicated that day‐long plasma glucose and insulin levels were higher in the older individuals. In contrast, the day‐long FFA response was reduced in this age group. These data suggest that the ability of insulin to maintain normal plasma glucose levels deteriorates with age, whereas regulation of FFA levels does not.
The relationship between bispectral index and endtidal concentration of sevoflurane during anesthesia and recovery in spontaneously ventilating children

Background: Global inverse correlation between BIS (bispectral index) and depth of anesthesia using sevoflurane has been documented in children in several studies under experimental conditions and in steady‐state conditions during mechanically controlled ventilation. Because sevoflurane mask anesthesia combined with a peripheral nerve block is widely used in children, we studied the relationship between BIS and endtidal concentration of sevoflurane (PEsevo) under these conditions during surgery and emergence.
Environmental enrichment: effects on stereotyped behavior and dendritic morphology.

We evaluated whether environmental enrichment-related effects on the development of stereotyped behavior in deer mice were associated with alterations in dendritic morphology. Deer mice were reared under enriched or standard housing conditions and then tested in automated photocell detectors and classified as stereotypic or nonstereotypic. Dendritic morphology was assessed in layer V pyramidal neurons of the motor cortex, medium spiny neurons of the dorsolateral striatum, and granule cells of the dentate gyrus using Golgi-Cox histochemistry. Enriched nonstereotypic mice exhibited significantly higher dendritic spine densities in the motor cortex and the striatum than enriched stereotypic or standard-cage mice. Significant increases in dendritic arborization following environmental enrichment also were observed. These results suggest that the enrichment-related prevention of stereotyped behavior is associated with increased dendritic spine density.
The characterisation of gait patterns of people with multiple sclerosis

Background. There are relatively few reports describing gait patterns in multiple sclerosis (MS) and most are confined to the analysis of temporal distance parameters with some assessment of joint range of motion. The aim of this study was to perform a biomechanical characterisation of gait patterns among people with MS across a wide range of severity of ambulatory impairment. Methods. Sixteen patients with MS were recruited for this study. Initially, the spasticity of lower limb muscle groups was measured and ambulatory ability was graded. Patients were then placed in two groups based on the level of severity of ambulatory ability. Kinematic, kinetic and EMG gait data from both MS groups were then compared to a control group of 10 healthy subjects. Results. Patients with MS in both groups were found to walk with reduced gait speed, reduced maximum hip and knee extension, ankle plantarflexion angle and propulsive force compared to the control group. In general, the same gait impairments were found in both MS groups compared to the control group, and were greater for the more severely affected MS patient group. Interpretation. This study highlights typical gait patterns of people with MS and provides an indication of common pathways in the degeneration of ambulatory ability as a consequence of disease progression. This information should enable improved clinical treatment of ambulation, as well as the prescription, or even design, of appropriate assistive devices.
Resistance training and diastolic myocardial tissue velocities in obese children.

PURPOSE The primary purpose of this study was to determine the effects of resistance exercise training on early diastolic myocardial velocities (E') in an obese pediatric population. METHODS Twenty-three obese adolescents were selected to participate in either a resistance-based training program (RT; n = 13, 12.2 +/- 0.4 yr, body mass index [BMI] = 32.5 +/- 1.9 kg m(-2)) or a nonexercise control intervention (n = 10, 13.6 +/- 0.7 yr, BMI = 30.2 +/- 2.6 kg m(-2)) for 8 wk. All subjects had repeated echocardiographic assessments to determine left ventricular (LV) geometry, early transmitral flow velocity (E), and E'. RESULTS LV mass and wall thicknesses did not significantly change with training or in controls. RT improved E' (11.9 +/- 0.5 to 13.3 +/- 0.5 cm s(-1), P< 0.01) in the presence of a decrease in E/E' (8.17 +/- 0.39 to 7.06 +/- 0.30 cm s(-1), P < 0.01), a marker of left atrial pressure. No changes were evident in the inactive control subjects. CONCLUSIONS A supervised 8-wk RT exercise program improved early diastolic tissue velocity in obese children, independent of changes in LV morphology.
Distributed MPPT PV system with current source inverter

The operation of a distributed maximum power point tracking (DMPPT) photovoltaic (PV) system with a current source inverter (CSI) is confirmed. We proposed a current-linked distributed PV system instead of a voltage-linked one. All the previous studies of DMPPT PV systems use a voltage source inverter (VSI). Moreover, all commercial power optimizers that are provided by Solar Edge, Solar Magic, Tigo Energy, and so on are assumed to be connected to a VSI. The drawback of the power conditioning system (PCS) with a VSI is that it has to carry an electrolytic capacitor, which determines the life span of the PCS. By using a CSI, the reliability of the PCS is greatly improved; moreover, the module integrated converter (MIC) can consist of a buck-only converter. In this paper, we implemented two cascaded MICs with a CSI and confirmed the operation of the entire current-linked distributed PV system. The experimental results agree strongly with the theory and it proves the validity of the proposed system.
Alpha-decay damage and recrystallization in zircon: evidence for an intermediate state from infrared spectroscopy

α-decay damage and recrystallization in natural zircon (with dose ranging from 0.06 to 23.3 × 10 18 α-events g −1 ) were studied using polarized reflection infrared spectroscopy. The experimental results show that α-decay damage leads to a gradual decrease in reflectivity and a loss of anisotropy of IR spectra. Recrystallization of damaged zircon is found as a multi-stage process with a strong dependence on the initial degree of damage. In weakly and moderately damaged samples the major recrystallization takes place near 1000 K. Annealed samples recrystallize epitaxially along their original crystallographic orientations. A highly damaged zircon with radiation dose of 15.9 × 10 18 α-events g −1 decomposes into SiO2 and ZrO2 near 1100 K. In this sample the growth of ZrSiO4 from the binary oxides occurs between 1400 and 1500 K. An additional IR signal peaked near 790 cm−1 is detected in moderately damaged samples annealed at temperatures higher than 800 K. This peak is sharp and isotropic. The peak tends to disappear at temperatures above 1400 K. This signal may be related to an unknown intermediate phase caused by heating of radiation-damaged zircon. Alternatively, the signal may be due to the structural distortions near the boundaries between the amorphized and crystalline regions.
Chromosome 14q may harbor multiple tumor suppressor genes in primary glioblastoma multiforme.

OBJECTIVE To evaluate whether deletion of chromosome 14q is involved in the carcinogenesis of primary glioblastoma multiforme and to identify possibly common deletion regions. METHJODS: Fourteen fluorescent dye-labeled polymorphic markers were used and polymerase chain reaction-based microsatellite analysis was employed to investigate loss of heterozygosity (LOH) on chromosome 14q in 20 primary glioblastoma multiforme (GBM). RESULTS Ten of twenty (50%) GBM displayed LOH at one or more of the markers on chromosome 14q. Five tumors showed either LOH or non-informative on all markers tested. The most frequent LOH was observed at locus D14S65 (57.1%) on 14q32.1, and in the chromosomal region spanning from D14S63 (47.1%) to D14S74 (46.7%) on 14q23-31. None of the informative loci exhibited microsatellite instability. CONCLUSIONS Allelic deletion on chromosome 14q plays an important role in the pathogenesis of GBM. Chromosomal regions at locus D14S65 on 14q32.1 and spanning from D14S63 to D14S74 on 14q23-31 may harbor multiple tumor suppressor genes associated with GBM.
Field data do not support a textbook example of convergent character displacement

Experimental evidence supporting convergent character displacement is rare; only one example exists and it is in the form of orientation and territory competition experiments performed in the laboratory. However, outcomes of laboratory experiments involving behaviour or competition can be artefacts of unnatural conditions and, therefore, the results of the previous experiments supporting convergent character displacement are equivocal. In this study, we re–examine the evolution of melanic nuptial coloration in male three–spined stickleback (Gasterosteus aculeatus) inhabiting the Chehalis River drainage in Washington State. This novel nuptial coloration has been thought to have evolved in response to competition for nesting territories with the co–distributed Olympic mudminnow (Novumbra hubbsi), which is also melanic and breeds at the same time. I found that melanic stickleback males did not have an advantage over their red counterparts from typical populations when competing for nesting territories with Olympic mudminnows. Additionally, competitive interactions between sticklebacks and mudminnows were rare in both cage experiments and naturally breeding sticklebacks. Finally, melanic coloration in the Chehalis populations did not develop until males were parental, well after the hypothesized territory establishment period. These results refute the only experimental support for convergent character displacement and emphasize the importance of conducting behavioural experiments and observations under natural conditions.
Determinants of 800-m and 1500-m running performance using allometric models.

PURPOSE To identify the optimal aerobic determinants of elite, middle-distance running (MDR) performance, using proportional allometric models. METHODS Sixty-two national and international male and female 800-m and 1500-m runners undertook an incremental exercise test to volitional exhaustion. Mean submaximal running economy (ECON), speed at lactate threshold (speedLT), maximum oxygen uptake (.VO(2max)), and speed associated with . VO(2max) (speed.VO(2max)) were paired with best performance times recorded within 30 d. The data were analyzed using a proportional power-function ANCOVA model. RESULTS The analysis identified significant differences in running speeds with main effects for sex and distance, with . VO(2max) and ECON as the covariate predictors (P < 0.0001). The results suggest a proportional curvilinear association between running speed and the ratio (.VO(2max). ECON(-0.71))(0.35) explaining 95.9% of the variance in performance. The model was cross-validated with a further group of highly trained MDR, demonstrating strong agreement (95% limits, 0.05 +/- 0.29 m.s(-1)) between predicted and actual performance speeds (R(2) = 93.6%). The model indicates that for a male 1500-m runner with a . VO(2max) of 3.81 L.min(-1) and ECON of 15 L.km(-1) to improve from 250 to 240 s, it would require a change in . VO(2max) from 3.81 to 4.28 L.min(-1), an increase of Delta0.47 L.min(-1). However, improving by the same margin of 10 s from 225 to 215 s would require a much greater increase in . VO(2max), from 5.14 to 5.85 L.min(-1), an increase of Delta0.71 L.min(-1) (where ECON remains constant). CONCLUSION A proportional curvilinear ratio of . VO(2max) divided by ECON explains 95.9% of the variance in MDR performance.