Miracle-dz/UniFAR-FTUs huggingface dataset:
Caregiver Fatigue: Implications for Patient and Staff Safety, Part 1

OBJECTIVE: This article describes the profound impact of fatigue and the process by which 1 academic medical center assessed fatigue levels, and associated factors, among nursing personnel in their effort to develop a comprehensive fatigue management program. BACKGROUND: To adequately perform amid high patient acuity and in today’s fast paced healthcare environment, nurses must be attentive and react quickly and appropriately with clear judgment and reasoning—abilities that can be greatly impaired by fatigue. Nursing leaders are instrumental in systematically addressing work-related fatigue and implementing processes designed to prevent fatigue and overwork; however, baseline measures are necessary if the efficacy of these initiatives is to be assessed. METHODS: The 15-item Occupational Fatigue Exhaustion/Recovery scale was used to assess current fatigue levels among nursing staff at a university medical center. Demographic and schedule-related questions were used to examine the characteristics of the population and identify any associated factors. RESULTS: Work-related fatigue is prevalent among all nursing staff, but differences were noted based on the respondent’s position, age, and typical work shift. CONCLUSIONS: Nursing administrators and shared governance councils can address the factors contributing to work-related fatigue and negatively impacting nursing personnel’s ability to rest and recuperate. Nurse leader involvement is needed to develop comprehensive fatigue reduction strategies.
Intraoperative Descending Aorta Dissection During Cardiac Surgery

Intraoperative acute aortic dissection is a rare and potentially fatal complication of open cardiac surgery,the reported incidence of which is approximately 0.16% to 0.35% [1]. Its early diagnosis and treatment are essential to achieve a favorable outcome. Transesophageal Echocardiography (TEE) is routinely used intraoperatively during open cardiac surgery and is the only useful monitor for detection and diagnosis of intraoperative aortic dissection. We report an unusual case of intraoperative descending aortic dissection, and its detection by TEE during extracorporeal circulation.
Prevalence of depression, anxiety and their associated factors among medical students in Karachi, Pakistan.

OBJECTIVE To estimate the prevalence of anxiety, depression and their associated risk factors among students of a public medical college in Karachi, Pakistan. METHODS A cross sectional study was done on the students of a public sector, who had spent more than six months in the medical college and had no physical or mental illness other than anxiety and depression. A self administered questionnaire was given out to students who were randomly selected from the list of names obtained from the college administration. Primary outcome was anxiety and depression which was defined as a cut of score 19 or above on AKUADS. Multivariable models were built and logistic regression analysis was performed to determine the factors independently associated with the primary. RESULTS The mean (SD) age of the students was 21.3 (1.88) years. Majority of the students were females. A very high prevalence of anxiety and depression (70%) was found among students. Students using substance abuse, having family history of depression and anxiety and those who had lost a relative in last 1 year were 2.66, 2.35, 3.4 times more likely to be depressed and suffered from anxiety, respectively. CONCLUSION This study suggests that there are certain risk factors other than academic stressors which predispose a medical student to psychological morbidity such as anxiety and depression.
Evaluation of a crystalline sirolimus-eluting coronary stent with a bioabsorbable polymer designed for rapid dissolution: two-year outcomes from the DESSOLVE I and II trials.

AIMS Our aim was to evaluate the two-year clinical results of a new sirolimus-eluting stent (MiStent SES) with a bioabsorbable coating designed for rapid polymer dissolution but sustained drug delivery. METHODS AND RESULTS Major adverse cardiac events (MACE), target lesion failure (TLF), target vessel failure (TVF), and stent thrombosis (ST) at two-year follow-up are reported for the DESSOLVE I and II trials. In DESSOLVE I, the MiStent SES (n=29) demonstrated a 3.4% two-year MACE rate without TLF or TVF. In DESSOLVE II, the MiStent group had a 6.7% (8/120) two-year MACE rate compared to 13.3% (8/60) for Endeavor (p=0.167). TLF was 5.0% in the MiStent and Endeavor groups (p=1.00). TVF was 5.0% for MiStent versus 11.7% for Endeavor (p=0.129). No probable or definite ST was reported with the MiStent up to two years. The median duration of dual antiplatelet therapy (DAPT) in DESSOLVE I and II was 364 and 366 days, respectively. CONCLUSIONS The MiStent SES demonstrated good long-term safety and effectiveness with low two-year MACE, TLF, and TVF rates.
Characterization of a heat-modifiable outer membrane protein of Haemophilus somnus

In immunoblot analysis, a murine monoclonal antibody (MAb), 27-1, which was produced to an outer membrane protein (OMP) of Haemophilus somnus, showed that a major OMP is heat modifiable, having a molecular mass of 28 kDa when the N-lauroylsarcosine-insoluble OMP preparation was solubilized at 60 degrees C and a mass of 37 kDa when the OMP preparation was solubilized at 100 degrees C. The heat-modifiable OMP reacted intensely with convalescent sera obtained from calves with experimental H. somnus pneumonia in immunoblot analysis. Immunoelectron microscopic and antibody absorption studies revealed that the MAb 27-1 epitope was not surface exposed on the intact bacterium. However, a decrease in antibody reactivity to the heat-modifiable OMP in immunoblot analysis after absorption of convalescent serum with intact bacterial cells of H. somnus suggests that a surface-exposed portion of the heat-modifiable OMP is expressed on the intact bacterium. MAb 27-1 reacted with 45 of 45 strains of H. somnus tested in immunoblot analysis. The apparent molecular mass of the antigen varied among strains, and five reactivity patterns demonstrated by MAb 27-1 were observed. MAb 27-1 also reacted with six species in the family Pasteurellaceae, Escherichia coli, and Salmonella dublin, but not with the other eight species of gram-negative bacteria. The heat-modifiable OMP of H. somnus showed immunological cross-reactivity with the OmpA protein of E. coli K-12 and significant N-terminal amino acid sequence homology with the OmpA proteins of gram-negative bacteria. We conclude that a major, 37-kDa heat-modifiable OMP of H. somnus, which elicits an antibody response in H. somnus-infected animals, is a common antigen among H. somnus strains tested and is structurally related to the OmpA protein of E. coli.
Biologic functions of the IFN‐γ receptors

Interferon-gamma (IFN-gamma) is a cytokine that plays an important role in inducing and modulating an array of immune responses. Cellular responses to IFN-gamma are mediated by its heterodimeric cell-surface receptor (IFN-gammaR), which activates downstream signal transduction cascades, ultimately leading to the regulation of gene expression. In order to study the role of IFN-gamma in a number of immune responses and pathways, researchers have generated mice with altered patterns of IFN-gammaR gene expression. These studies, together with analyses of naturally occurring mutations of the IFN-gammaR in man, have been instrumental in elucidating the diverse functions of IFN-gamma, and are the subject of this review.
Enabling Next Generation Multimedia Social Services

For more than twenty years we have been living in a society of online social relationships, where people tend to connect and share with others. Despite we have not yet seen its truly utility, we are facing an era of social functionality where social context can be used to personalize multimedia content and services. Contributing towards this vision, this paper presents an architectural approach that will enable multimedia social services, by securely exposing user social profiles, relationships and interests. Furthermore, it extends these data by providing interfaces to infer distance, similarity and influence. In addition, by connecting with an external framework, it enhances the supported functionalities, allowing the calculation of relevant social network metrics. Finally, it introduces the results from our prototype implementation.
Update on astigmatism management

Purpose of review Astigmatism is a common refractive error that affects a significant portion of the population. This is a review of the most salient topics on assessing astigmatism as well as a discussion of the latest developments in surgical options and newest technologies to improve outcomes. Recent findings Laser corneal ablation continues to be highly effective for correcting low-to-moderate levels of astigmatism and may be the best option for the younger patient population. For eyes with astigmatism and cataracts, both peripheral corneal-relaxing incisions and cataract extraction with toric intraocular lenses have proven to be effective. Improved assessment of astigmatism, methods to select more accurate lens power, and new technologies to confirm proper axis alignment have all contributed to minimizing postoperative residual astigmatism. Summary Cataract surgery has evolved into a refractive procedure, in which not only the sphere but also cylinder errors can now be confidently corrected. Careful assessment and surgical planning of astigmatism should not be an option, but essential components of cataract surgery.
The effects of alpha-methyl derivatives of noradrenaline, phenylethylamine and tryptamine on the central nervous system of the chicken.

The mammalian central nervous system contains noradrenaline (Vogt, 1954) and 5-hydroxytryptamine (Amin, Crawford & Gaddum, 1954), but study of the possible central functions of these amines poses particular problems. One of these is that parenterally injected amines may elicit a central effect by a peripheral action. For example, behavioural and electrocortical arousal is produced not only by amphetamine, which readily penetrates to the brain, but also by catechol amines, which do not readily cross the blood-brain barrier. Although the central nervous system is clearly involved in both instances, the similarity in effect does not indicate whether the primary action of the amine is central, peripheral or both. Indeed, if the blood-brain barrier is circumvented and an apparently potent excitant, such as adrenaline, is given intracisternally (Leimdorfer, 1950) or intraventricularly (Feldberg & Sherwood, 1954) sleep or sedation ensue.
Towards Successful Cloud Ordering Service

Abstract Background: The rise of cloud services has led to a drastic growth of e-commerce and a greater investment in development of new cloud services systems by related industries. For SaaS developers, it is important to understand customer needs and make use of available resources at as early as the system design and development stage. Objectives: This study integrates E-commerce Systems (ECS) Success model and Importance-Performance Analysis (IPA) into empirical research of the critical factors for cloud ordering system success. Methods/Approach: A survey research is conducted to collect data on customer perceptions of the importance and performance of each attribute of the particular cloud ordering service. The sample is further divided according to the degree of use of online shopping into high-usage users and low-usage users in order to explore their views regarding the system and generate adequate coping strategies. Results: Developers of online ordering systems can refer to the important factors obtained in this study when planning strategies of product/service improvement. Conclusions: The approach proposed in this study can also be applied to evaluation of other kinds of cloud services systems.
Effect of Moderate and High Resistance Training Intensity on Indices of Inflammatory and Oxidative Stress

This study was designed to examine the effect of moderate (MR) and high resistance (HR) training on systemic inflammation and circulating enzymatic antioxidant activity. Thirty males were assigned to HR (n = 10), MR (n = 10), or control (C; n = 10) groups. Resistance training was performed for eight weeks. Activities of superoxide dismutase (SOD), glutathione peroxidase (GPX), creatine kinase (CK), and concentrations of malondialdehyde (MDA), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α) were measured before and after training in plasma. The results show increased SOD activity in MR (p = 0.026) and HR (p = 0.044) groups. GPX activity in HR (p = 0.012) and MR (p = 0.037) increased significantly more than in C. Whilst a significant reduction in MDA in MR (p = 0.013) and HR (p = 0.023) was observed compared with C, no significant difference in IL-6, TNF-α and CK occurred between groups. We conclude that changes in enzymatic antioxidant defense and inflammatory markers following resistance training are independent of training intensity.
Effect of antioxidants on the dentin interface bond stability of adhesives exposed to hydrolytic degradation.

PURPOSE This study assessed the effect of antioxidants vitamin C (Vit. C), vitamin E (Vit. E) and quercetin (Querc) on the dentin bonding performance, degree of conversion, and rate of polymerization of three commercial adhesive systems (Adper Single Bond 2 [SB], Clearfil SE Bond [CSE], Adper Easy Bond [EB]). MATERIALS AND METHODS Human premolars were restored using antioxidant-doped adhesives. The samples were stored for 24 h in distilled water or 6 months under simulated pulpal pressure. Teeth were cut into sticks and the microtensile bond strength (μTBS) to dentin was tested in a universal testing machine. Qualitative nanoleakage analysis was performed from a central stick of each restored tooth. Degree of conversion and rate of polymerization of adhesive systems were evaluated in triplicate using real-time FT-IR. RESULTS Although the inclusion of the antioxidants negatively affected the μTBS over 24 h, the antioxidant-doped adhesives maintained (SB-Vit. C, SB-Vit. E, CSE-Vit. C, EB-Querc) or increased (SB-Querc, CSE-Vit. E, CSE-Querc, EB-Vit. E, and EB-Vit. C) their μTBS during 6 months of storage. Only the μTBS of Adper Single Bond 2 dropped significantly after 6 months among the control groups. Slight changes in the nanoleakage pattern after aging were observed in all groups, except for the EB-control group, which showed a noteworthy increase in nanoleakage after 6 months, and for EB-Vit. C, which presented a remarkable decrease. A lower degree of conversion was obtained with all antioxidants in SB and EB, except for the EB-Vit. E group. Similar degrees of conversion were attained in control and experimental groups for CSE. The rate of polymerization was reduced in antioxidant-doped adhesives. CONCLUSION The performance of antioxidants changed according to the adhesive system to which they were added, and antioxidant-doped adhesives appear to have a positive effect on the adhesive interface durability, since their bond strength obtained after 24 h was maintained or increased over time.
COMPARISON OF NEAR INFRARED AND MID INFRARED DIFFUSE REFLECTANCE SPECTROSCOPY FOR FIELD-SCALE MEASUREMENT OF SOIL FERTILITY PARAMETERS

Data-intensive technologies such as precision agriculture require new approaches for acquisition of soil data on landscapes. We compared the ability of near infrared (NIR; 400-2500 nm) and mid infrared (MIR; 2,500-25,000 nm) spectroscopy for field-scale acquisition of soil fertility parameters. Samples were obtained in a grid pattern (25 m spacing) from the surface (0-10 cm) and sub-surface (10-30 cm) samples collected at 272 locations. Samples were analyzed for organic C and total N, texture (clay, silt, and sand), soil pH, and Mehlich I extractable Ca, K, Mg, and P. We found that chemometric analyses NIR and MIR provided good calibrations for organic carbon, total N, and soil texture. To varying degrees of precision, these regions also calibrated for pH and exchangeable Ca, Mg, and K. Exchangeable P did not form useful calibrations in either spectral region. In all cases, MIR calibrations were better than those formed in the NIR region. Test of calibrations based on one-third of the samples was used to predict the remaining samples. This demonstrated the strategy of developing field-scale calibrations for the spectral regions by chemical analysis of a small sub-set of samples for the prediction of large numbers of samples. This approach can be used to accurately map the spatial distribution of soil properties within agricultural landscapes. These studies demonstrate the utility of infrared spectral approaches for generating the spatial soil properties data needed to implement precision agriculture technology.
Thymidylate synthase but not excision repair cross-complementation group 1 tumor expression predicts outcome in patients with malignant pleural mesothelioma treated with pemetrexed-based chemotherapy.

PURPOSE The relationship between thymidylate synthase (TS) expression and outcome in patients with malignant pleural mesothelioma (MPM) treated with pemetrexed (P) was retrospectively evaluated. PATIENTS AND METHODS Sixty histologically confirmed patients with MPM previously treated with P and platinum (45 of 60) or as single agent (15 of 60) were retrospectively considered. Eighty-one control patients with MPM not P-treated were also evaluated. TS and excision repair cross-complementation group 1 (ERCC1) gene expression levels were evaluated by real-time polymerase chain reaction and by immunohistochemistry using the H-score. RESULTS Median TS H-score value was 90 (range, 5 to 240). A significant correlation between low TS protein expression and longer time to progression (TTP; 17.9 v 7.9 months; hazard ratio [HR], 2.05, 95% CI, 1.19 to 3.77; P = .02) or overall survival (OS; 30 v 16.7 months; HR, 2.38; 95% CI, 1.15 to 4.91; P = .019) was found when patients were divided according to median H-score. Conversely, TS mRNA levels were not significantly correlated with outcome. In platinum-treated patients (n = 45), no correlation was found with survival according to ERCC1 median H-score, but patients in the lower tertile had a significantly shorter survival (HR, 3.06; 95% CI, 1.08 to 8.69; P = .035). In control MPMs, TS had no prognostic role. At multivariate analysis, TS protein levels were the only independent prognostic factor for both TTP (HR, 2.71; 95% CI, 1.13 to 6.49; P = .02) and OS (HR, 6.91; 95% CI, 1.90 to 25.07; P = .003). CONCLUSION In patients with MPM treated with P-based chemotherapy, low TS protein levels are predictive of improved TTP and OS. The role of TS assessment is worth of prospective validation in future studies on MPM.
Improving Deep Learning by Inverse Square Root Linear Units (ISRLUs)

We introduce the “inverse square root linear unit” (ISRLU) to speed up learning in deep neural networks. ISRLU has better performance than ELU but has many of the same benefits. ISRLU and ELU have similar curves and characteristics. Both have negative values, allowing them to push mean unit activation closer to zero, and bring the normal gradient closer to the unit natural gradient, ensuring a noise- robust deactivation state, lessening the over fitting risk. The significant performance advantage of ISRLU on traditional CPUs also carry over to more efficient HW implementations on HW/SW codesign for CNNs/RNNs. In experiments with TensorFlow, ISRLU leads to faster learning and better generalization than ReLU on CNNs. This work also suggests a computationally efficient variant called the “inverse square root unit” (ISRU) which can be used for RNNs. Many RNNs use either long short-term memory (LSTM) and gated recurrent units (GRU) which are implemented with tanh and sigmoid activation functions. ISRU has less computational complexity but still has a similar curve to tanh and sigmoid.
Structural analysis of the O-antigen of Francisella tularensis subspecies tularensis strain OSU 10.

Francisella tularensis, the causative agent of the disease tularaemia, is one of the most infectious bacteria known. F. tularensis subspecies tularensis (type A) and holarctica (type B) are the major subspecies, with the former being highly virulent for humans (Conlan et al., 2002). A live vaccine strain (LVS) of F. tularensis empirically derived from a virulent strain of type B F. tularensis provides considerable protection against highly virulent type A strains in humans (Conlan et al., 2002; Fulop et al., 2001). Although the F. tularensis LVS is attenuated for humans, it is fully virulent for mice (Conlan et al., 2002), and infection with F. tularensis LVS in mice has been used as an experimental model of tularaemia in a number of studies.
Geometric and Textural Blending for 3D Model Stylization

Stylizing a 3D model with characteristic shapes or appearances is common in product design, particularly in the design of 3D model merchandise, such as souvenirs, toys, furniture, and stylized items. A model stylization approach is proposed in this study. The approach combines base and style models while preserving user-specified shape features of the base model and the attractive features of the style model with limited assistance from a user. The two models are first combined at the topological level. A tree-growing technique is utilized to search for all possible combinations of the two models. Second, the models are combined at textural and geometric levels by employing a morphing technique. Results show that the proposed approach generates various appealing models and allows users to control the diversity of the output models and adjust the blending degree between the base and style models. The results of this work are also experimentally compared with those of a recent work through a user study. The comparison indicates that our results are more appealing, feature-preserving, and reasonable than those of the compared previous study. The proposed system allows product designers to easily explore design possibilities and assists novice users in creating their own stylized models.
Degloving of the inferior turbinates: pilot study to assess the effectiveness of a new technique in turbinate reduction

A pilot study to assess the safety and efficacy of ’degloving’ of the inferior turbinate is described. This prospective study reports on the effectiveness of the technique in 37 patients with nasal obstruction due to inferior turbinate hypertrophy. Both objective and subjective measurements of nasal patency were made pre-operatively, and repeated at six weeks, six months and two years post-operatively using nasal inspiratory peak flow rates, saccharin clearance time and an end referenced visual analogue scale to record nasal symptoms. There was a significant improvement in the peak inspiratory flow at six weeks (96.4 to 151.2 l/min) and at six months (148.4 l/min), which was sustained at two years (117.1 l/min, p<0.001). There was an overall improvement in patient satisfaction with nasal symptoms (23.4 to 76.7, 76.8 and 66.8 at six weeks, six months and two years, p<0.001) and a decrease in the sensation of nasal obstruction (71.9 to 21.5, 32.9 and 29.8, p<0.001), which was also sustained. Rhinorrhoea was reduced, and sense of smell increased across the group, but the improvements did not reach statistical significance. The results for postnasal drip and saccharin clearance did not show a significant change over the period of the study. There were no haemorrhagic complications in the group studied. This pilot study demonstrates a new surgical technique for reduction of the inferior turbinates, that yields significant improvement in nasal obstruction, an acceptably low complication rate and is well tolerated by patients. A randomized controlled trial is being planned.