Miracle-dz/UniFAR-FTUs huggingface dataset:
The Impact of Operating Room Distractions on Stress, Workload, and Teamwork.

OBJECTIVE To investigate whether distractions in the operating room (OR) are associated with higher mental workload and stress, and poorer teamwork among OR personnel. BACKGROUND Engaging in multiple tasks can affect performance. There is little research on the effect of distractions on surgical team members' behavior and cognitive processes. METHODS Ninety general surgery cases were observed in real time. Cases were assessed by a surgeon and a behavioral scientist using 4 validated tools: OR Distractions Assessment Form, the Observational Teamwork Assessment for Surgery tool, NASA-Task Load Index, and short form of the State Trait Anxiety Inventory. Analysis of variance was performed to evaluate significant differences between teamwork, workload, and stress level among team members. Correlations (Pearson r) were computed to evaluate associations between variables. RESULTS The most prevalent distractions were those initiated by external staff, followed by case-irrelevant conversations. Case-irrelevant conversations were associated with poorer team performance. Irrelevant conversations initiated by surgeons were associated with lower teamwork in surgeons (across team skills: r = -0.44 to -0.58, P < 0.05 to 0.01) and anesthesiologists (r = -0.38 and r = -0.40, for coordination and leadership; P < 0.05). Equipment-related distractions correlated with higher stress (r = 0.48, P < 0.05) and lower teamwork (across team skills: r = -0.42 to -0.50, P < 0.05) in nurses. Acoustic distractions correlated with higher stress in surgeons (r = 0.32, P < 0.05) and higher workload in anesthesiologists (r = 0.30, P < 0.05). CONCLUSIONS Although some distractions may be inevitable in the OR, they can also be detrimental to the team. A deeper understanding of the effect of distractions on teams and their outcomes can lead to targeted quality improvement.
Facilitation and suppression of wrist and digit muscles from single rubromotoneuronal cells in the awake monkey.

1. The output effects of 214 cells in the magnocellular red nuclei of two rhesus monkeys (Macaca mulatta) were tested with spike-triggered averaging of electromyogram (EMG) activity from six forearm extensor and six flexor muscles. The monkeys performed an alternating wrist movement task (auxotonic paradigm) or generated wrist torque trajectories alternating between flexion and extension (isometric paradigm). 2. Sixty-five cells (30%) were identified as rubromotoneuronal (RM) cells on the basis of their postpike effects on forearm flexor and extensor muscles. Three major types of RM cell output organization were identified: 1) pure facilitation (28 cells), 2) reciprocal (18 cells), and 3) cofacilitation (16 cells). 3. RM cell output showed a strong preference for facilitation of extensor forearm muscles. This preference was reflected in the fact that 69% (43 of 62) of RM cells facilitated extensors exclusively or most strongly; 27% facilitated flexors exclusively or most strongly; and 5% facilitated flexors and extensors equally. Postspike facilitation (PSpF) was observed in 45% of the extensor muscles and 20% of the flexors tested. In contrast, postpike suppression (PSpS) was observed in 3% of the extensors and 7% of the flexors. 4. The mean number of extensors facilitated per RM cell was 3.1 (53% of tested) compared with 2.8 (51% of tested) flexors facilitated per cell. The extensor and flexor PSpS muscle field sizes were both 2.0 (35% of extensors and 36% of flexors tested). The mean number of muscles facilitated by cofacilitation cells was 5.8 (48%) per cell. No clear preference was found for facilitation of particular combinations of synergist muscles. 5. PSpF magnitude was assessed by measuring both the percent change of facilitation or suppression from baseline and the signal-to-noise ratio of effects. The overall average magnitudes of RM PSpF and PSpS were 4.1 +/- 2.0 and 4.0 +/- 2.3% change from baseline, respectively. The average magnitude of PSpF in flexors was not significantly different from that of extensors; neither was there a difference in the average magnitude of PSpS in flexors and extensors. 6. The mean onset latency of RM cell PSpS was greater than PSpF (9.2 +/- 3.0 vs. 5.7 +/- 1.8 ms; P less than or equal to 0.05). This can be attributed to an underlying minimal disynaptic linkage to motoneurons for suppression effects, whereas most PSpFs are probably mediated by underlying monosynaptic connections. The mean onset latency of flexor PSpFs was greater than that of extensors (6.4 +/- 2.3 vs. 5.4 +/- 1.5 ms; P less than or equal to 0.05). (ABSTRACT TRUNCATED AT 400 WORDS)
Balance of pro‐ versus anti‐angiogenic splice isoforms of vascular endothelial growth factor as a regulator of neuroblastoma growth

Neuroblastoma (NB) is the second most common extracranial tumour of childhood. Angiogenesis plays a crucial role in the growth and development of NB and vascular endothelial growth factor (VEGF), one of the most potent stimuli of angiogenesis, has been studied extensively in vitro. VEGF165 has been shown to be the predominant angiogenic isoform expressed in NB cell lines and tumours. In this study, we investigated the anti‐angiogenic isoform of VEGF‐A, generated from distal splice site selection in the terminal exon of VEGF (VEGF165b) and shown to be down‐regulated in epithelial malignancies. The expression of both the pro‐ (VEGFxxx) and the anti‐angiogenic (VEGFxxxb) isoforms was compared in a range of NB and ganglioneuroma (GN) tumours. Whereas VEGFxxxb and VEGFxxx were both expressed in GN, specific up‐regulation of the VEGFxxx isoforms was seen in NB at RNA and protein levels. Highly tumourigenic NB cell lines also showed up‐regulation of the angiogenic isoforms relative to VEGFxxxb compared to less tumourigenic cell lines, and the isoforms were differentially secreted. These results indicate that VEGF165 is up‐regulated in NB and that there is a difference in the balance of isoform expression from anti‐angiogenic VEGF165b to angiogenic VEGF165. Treatment with recombinant human VEGF165b significantly reduced the growth rate of established xenografts of SK‐N‐BE(2)‐C cells (4.24 ± 1.01 fold increase in volume) compared with those treated with saline (9.76 ± 3.58, p < 0.01). Microvascular density (MVD) was significantly decreased in rhVEGF165b‐treated tumours (19.4 ± 1.9 vessels/mm3) in contrast to the saline‐treated tumours (45.5 ± 8.6 vessels/mm3). VEGF165b had no significant effect on the proliferative or apoptotic activity, viability or cytotoxicity of SK‐N‐BE(2)‐C cells after 48 h. In conclusion, VEGF165b is an effective inhibitor of NB growth. These findings provide the rationale for further investigation of VEGF165b in NB and other paediatric malignancies. Copyright © 2010 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.
Physical activity and lung cancer risk in the European Prospective Investigation into Cancer and Nutrition Cohort

Research conducted predominantly in male populations on physical activity and lung cancer has yielded inconsistent results. We examined this relationship among 416,277 men and women from the European Prospective Investigation into Cancer and Nutrition (EPIC). Detailed information on recent recreational, household and occupational physical activity, smoking habits and diet was assessed at baseline between 1992 and 2000. Relative risks (RR) were estimated using Cox regression. During 6.3 years of follow‐up we identified 607 men and 476 women with incident lung cancer. We did not observe an inverse association between recent occupational, recreational or household physical activity and lung cancer risk in either males or females. However, we found some reduction in lung cancer risk associated with sports in males (adjusted RR = 0.71; 95% confidence interval 0.50–0.98; highest tertile vs. inactive group), cycling (RR = 0.73; 0.54–0.99) in females and non‐occupational vigorous physical activity. For occupational physical activity, lung cancer risk was increased for unemployed men (adjusted RR = 1.57; 1.20–2.05) and men with standing occupations (RR = 1.35; 1.02–1.79) compared with sitting professions. There was no evidence of heterogeneity of physical activity associations across countries, or across any of the considered cofactors. For some histologic subtypes suggestive sex‐specific reductions, limited by subgroup sizes, were observed, especially with vigorous physical activity. In total, our study shows no consistent protective associations of physical activity with lung cancer risk. It can be assumed that the elevated risks found for occupational physical activity are not produced mechanistically by physical activity itself but rather reflect exposure to occupation‐related lung cancer risk factors. © 2006 Wiley‐Liss, Inc.
N‐terminal pro‐brain natriuretic peptide used for the prediction of coronary artery stenosis

Background The level of the inactive N‐terminal fragment of pro‐brain (B‐type) natriuretic peptide (NT‐proBNP) is a prognostic marker in patients with acute and chronic coronary artery disease (CAD). It might also be valuable for non‐invasive diagnosis of coronary artery disease.
Selenium supplementation improves the nutritional status of hemodialysis patients: a randomized, double-blind, placebo-controlled trial.

BACKGROUND Malnutrition is highly prevalent in hemodialysis (HD) patients. These patients have high levels of oxidative stress and inflammation which can subsequently induce malnutrition. Selenium levels have been found to be decreased in HD patients. As selenium deficiency leads to oxidative stress and inflammatory response, the aim of this study was to evaluate the effects of selenium supplementation on oxidative and inflammatory markers and the nutritional status of HD patients. METHODS In this randomized double-blind placebo-controlled trial, 80 patients on stable HD for at least 3 months without any acute illness or active infections were randomly allocated to two equal groups to receive one selenium (200 µg) or placebo capsule daily for 12 weeks. Serum levels of lipoproteins, malondialdehyde (MDA), interleukin-6 (IL-6), high-sensitivity C-reactive protein (HSCRP), homocysteine, ferritin and transferrin as well as the subjective global assessment (SGA) score, malnutrition-inflammation score (MIS) and hemoglobin (Hb) levels were measured at the baseline and at the end of the treatment phase. The primary outcome was a change in the nutritional status measured by the SGA score from the baseline towards the end of the treatment phase of the study. RESULTS The SGA score and MIS decreased significantly in the selenium group compared to the placebo group (P < 0.001 for both). Moreover, serum levels of MDA decreased significantly in the selenium group compared with increasing levels in the placebo group (P < 0.001). Selenium supplementation also hindered an increase in IL-6 levels compared with the placebo group (P = 0.016). There were no significant differences between the selenium and placebo groups in terms of changes in serum levels of lipoproteins, HSCRP, homocysteine, ferritin and transferrin or Hb levels. CONCLUSIONS This study shows that selenium may be an effective complementary supplement for reducing the severity of malnutrition in HD patients through alleviating oxidative stress and inflammation.
Detomidine-propofol anesthesia for abdominal surgery in horses.

OBJECTIVE To evaluate propofol for induction and maintenance of anesthesia, after detomidine premedication, in horses undergoing abdominal surgery for creation of an experimental intestinal adhesion model. STUDY DESIGN Prospective study. ANIMALS Twelve horses (424 +/- 81 kg) from 1 to 20 years of age (5 females, 7 males). METHODS Horses were premedicated with detomidine (0.015 mg/kg i.v.) 20 to 25 minutes before induction, and a propofol bolus (2 mg/kg i.v.) was administered for induction. Propofol infusion (0.2 mg/kg/min i.v.) was used to maintain anesthesia. The infusion rate was adjusted to maintain an acceptable anesthetic plane as determined by muscle relaxation, occular signs, response to surgery, and cardiopulmonary responses. Oxygen (15 L/min) was insufflated through an endotracheal tube as necessary to maintain the SpO2 greater than 90%. Systolic (SAP), mean (MAP), and diastolic (DAP) arterial pressures, heart rate (HR), electrocardiogram (ECG), respiratory rate (RR), SpO2 (via pulse oximetry), and nasal temperature were recorded at 15 minute intervals, before premedication and after induction of anesthesia. Arterial blood gas samples were collected at the same times. Objective data are reported as mean (+/-SD); subjective data are reported as medians (range). RESULTS Propofol (2.0 mg/kg i.v.) induced anesthesia (mean bolus time, 85 sec) within 24 sec (+/-22 sec) after the bolus was completed. Induction was good in 10 horses; 2 horses showed signs of excitement and these two inductions were not smooth. Propofol infusion (0.18 mg/kg/min +/- 0.04) was used to maintain anesthesia for 61 +/- 19 minutes with the horses in dorsal recumbency. Mean SAP, DAP, and MAP increased significantly over time from 131 to 148, 89 to 101, and 105 to 121 mm Hg, respectively. Mean HR varied over time from 43 to 45 beats/min, whereas mean RR increased significantly over anesthesia time from 4 to 6 breaths/min. Mean arterial pH decreased from a baseline of 7.41 +/- 0.07 to 7.30 +/- 0.05 at 15 minutes of anesthesia, then increased towards baseline values. Mean PaCO2 values increased during anesthesia, ranging from 47 to 61 mm Hg whereas PaO2 values decreased from baseline (97 +/- 20 mm Hg), ranging from 42 to 57 mm Hg. Muscle relaxation was good and no horses moved during surgery: Recovery was good in 9 horses and acceptable in 3; mean recovery time was 67 +/- 29 minutes with 2.4 +/- 2.4 attempts necessary for the horses to stand. CONCLUSIONS Detomidine-propofol anesthesia in horses in dorsal recumbency was associated with little cardiovascular depression, but hypoxemia and respiratory depression occurred and some excitement was seen on induction. CLINICAL RELEVANCE Detomidine-propofol anesthesia is not recommended for surgical procedures in horses if dorsal recumbency is necessary and supplemental oxygen is not available (eg, field anesthesia).
Soluble NSF Attachment Protein Receptors (SNAREs) in RBL-2H3 Mast Cells: Functional Role of Syntaxin 4 in Exocytosis and Identification of a Vesicle-Associated Membrane Protein 8-Containing Secretory Compartment1

Mast cells upon stimulation through high affinity IgE receptors massively release inflammatory mediators by the fusion of specialized secretory granules (related to lysosomes) with the plasma membrane. Using the RBL-2H3 rat mast cell line, we investigated whether granule secretion involves components of the soluble N-ethylmaleimide-sensitive factor attachment protein receptor (SNARE) machinery. Several isoforms of each family of SNARE proteins were expressed. Among those, synaptosome-associated protein of 23 kDa (SNAP23) was central in SNARE complex formation. Within the syntaxin family, syntaxin 4 interacted with SNAP23 and all vesicle-associated membrane proteins (VAMPs) examined, except tetanus neurotoxin insensitive VAMP (TI-VAMP). Overexpression of syntaxin 4, but not of syntaxin 2 nor syntaxin 3, caused inhibition of FcεRI-dependent exocytosis. Four VAMP proteins, i.e., VAMP2, cellubrevin, TI-VAMP, and VAMP8, were present on intracellular membrane structures, with VAMP8 residing mainly on mediator-containing secretory granules. We suggest that syntaxin 4, SNAP23, and VAMP8 may be involved in regulation of mast cell exocytosis. Furthermore, these results are the first demonstration that the nonneuronal VAMP8 isoform, originally localized on early endosomes, is present in a regulated secretory compartment.
ALIS are Stress-Induced Protein Storage Compartments for Substrates of the Proteasome and Autophagy

Misfolded proteins can be directed into cytoplasmic aggregates such as aggresomes and dendritic cellaggresome-like induced structures (DALIS). DALIS were originally identified in lipopolysaccharidestimulateddendritic cells and act as storage compartments for polyubiquitinated Defective RibosomalProducts (DRiPs) prior to their clearance by the proteasome. Here we demonstrate that ubiquitinatedprotein aggregates that are similar to DALIS, and not related to aggresomes, can be observed in severalcell types in response to stress, including oxidative stress, transfection, and starvation. Significantly, bothimmune and non-immune cells could form these aggresome-like induced structures (ALIS). Proteinsynthesis was essential for ALIS formation in response to oxidative stress, indicating that DRiP formationwas required. Furthermore, puromycin, which increases DRiP formation, was sufficient to induce ALISformation. Inhibition of either proteasomes or of autophagy interfered with ALIS clearance in puromycintreated cells. Autophagy inhibition enhanced ALIS formation under a variety of stress conditions. Duringstarvation, ALIS formation in autophagy-deficient cells was only partially inhibited by protein synthesisinhibitors, indicating that both long-lived proteins and DRiPs can be targeted to ALIS. Together, thesefindings demonstrate that ALIS act as generalized stress-induced protein storage compartments forsubstrates of the proteasome and autophagy.
Secrecy analysis for forward link multi-user massive MIMO system with MRT precoding

The secrecy performance of forward link multi-user massive multiple-input multiple-output (MIMO) system is investigated in this paper. The base station (BS) equipped with a large number of transmit antennas sends mutually independent datas to multiple single-antenna legitimate users simultaneously. A passive multi-antenna eavesdropper is placed in the scenario to intercept the signals. We consider the case that the number of legitimate users and eavesdropper antennas increases proportionally with the number of BS antennas. Maximum ratio transmission (MRT) is used as linear precoder at the BS. Lower bounds on the ergodic achievable rate of legitimate users and upper bounds of the eavesdropper are derived. By minimizing the upper bounds on the achievable rates of the eavesdropper while satisfying the rate constraints of legitimate users, we present the corresponding optimal radiated power scaling (RPS) factor. In the limit of an infinite number of BS antennas, we prove that the optimal RPS factor converge to a different constant limit with that of the case in which the number of legitimate users and eavesdropper antennas is finite. We show that when the number of BS antennas grows large, the secrecy performance is mainly determined by the ratios between the number of BS antennas, legitimate users and eavesdropper antennas. A number of simulation results are presented to visualize the analysis.
Brain deposition of beta-amyloid is a common pathologic feature in HIV positive patients

Background:We planned to analyze the prevalence and distribution of β-amyloid deposition in the HIV+ brain in the HAART era. Our working hypothesis is that long term survival, aging and the secondary effects of HAART may contribute to increased beta-amyloid accumulation in this patient population. Methods:Paraffin embedded archival brain autopsy tissues were assessed by immunocytochemistry for β-amyloid. Detailed in-vivo neuro-behavioral assessments and ApoE genotyping were available for a subset of the studied population. Results:Immunoreactivity with the antibodies 4G8 and 6E10 was found predominantly in neuronal soma and dystrophic axonal processes. Extracellular, often perivascular plaques were also identified in many cases. Conclusions:We propose that prolonged HAART and aging may contribute to an overall increase in amyloid deposition, potentially mediated by inhibition of insulin degradation enzyme (IDE) or disruption of the axonal transport of the amyloid precursor protein.
Preferential Retention of Circadian Clock Genes during Diploidization following Whole Genome Triplication in Brassica rapa[W]

Whole genome duplication is typically followed by considerable gene loss, during which the gene dosage hypothesis predicts the preferential retention of highly networked or dose-sensitive genes. Here, circadian clock genes are found to conform to the gene dosage hypothesis in Brassica rapa, consistent with the current model of the circadian clock as a key regulator of multiple cellular pathways. Much has been learned about the architecture and function of the circadian clock of Arabidopsis thaliana, a model for plant circadian rhythms. Circadian rhythms contribute to evolutionary fitness, suggesting that circadian rhythmicity may also contribute to agricultural productivity. Therefore, we extend our study of the plant circadian clock to Brassica rapa, an agricultural crop. Since its separation from Arabidopsis, B. rapa has undergone whole genome triplication and subsequent diploidization that has involved considerable gene loss. We find that circadian clock genes are preferentially retained relative to comparison groups of their neighboring genes, a set of randomly chosen genes, and a set of housekeeping genes broadly conserved in eukaryotes. The preferential retention of clock genes is consistent with the gene dosage hypothesis, which predicts preferential retention of highly networked or dose-sensitive genes. Two gene families encoding transcription factors that play important roles in the plant core oscillator—the PSEUDO-RESPONSE REGULATORS, including TIMING OF CAB EXPRESSION1, and the REVEILLE family, including CIRCADIAN CLOCK ASSOCIATED1 and LATE ELONGATED HYPOCOTYL—exhibit preferential retention consistent with the gene dosage hypothesis, but a third gene family, including ZEITLUPE, that encodes F-Box proteins that regulate posttranslational protein stability offers an exception.
Bolton anterior tooth size discrepancies among different malocclusion groups.

Orthodontic treatment comprises different phases with unique characteristics and challenges. The orthodontic "finishing" phase is recognized for the multitude of details necessary to achieve an excellent result. In some cases, the finishing phase is very difficult, requiring the production of complicated biomechanical forces to reach a satisfactory orthodontic solution. A high percentage of these finishing-phase difficulties arise because of tooth size imbalances that could have been detected and considered during initial diagnosis and treatment planning. The present study aimed to investigate the correlation between anterior tooth size discrepancies and Angle's Class I, II, and III malocclusions, as well as their prevalence in the Brazilian population from Belo Horizonte. We assessed the mesiodistal width of six anterior teeth in 300 patients, who were selected randomly. These patients were allocated to three groups according to their malocclusion. A chi-square test was performed to statistically compare the prevalence of anterior tooth size discrepancies among the three malocclusion groups and two genders. Analysis of variance was used to compare the mean Bolton anterior tooth size ratios as a function of Angle classification and gender. Statistical differences were determined at the 95% confidence level (P < .05). The important conclusions of our study are as follows: (1) Individuals with Angle Class I and Class III malocclusions show significantly greater prevalence of tooth size discrepancies than do individuals with Class II malocclusions; and (2) Mean anterior tooth size discrepancy for Angle Class III subjects was significantly greater than for Class I and Class II subjects.