Miracle-dz/UniFAR-FTUs huggingface dataset:
The Effect of Job Burnout on Employees’ Satisfaction: A Comparison Study between Public Universities and Private Universities in Jordan

This study seeks to shed light on the phenomenon of job burnout, and its prevalence amongst the staff and seeks to address the issue of the level of job satisfaction in Jordanian universities, together with the examination of the effect of job burnout on job satisfaction. The study adopted a descriptive analytical approach through a comparative study between public universities and private universities, and used the questionnaire as basic tool for data collection, which was distributed to a sample of (200) members of the administrative staff in Jordanian public and private universities. The study found that the degree of job burnout experienced by the administrative staff in the university sector was more than average, Showed that low personal performance dimension has ranked the first as the most persistent job burnout dimension then physical and emotional exhaustion then negative attitude towards relationships. It observed that the degree of job burnout in public universities was greater than in the private universities. The level of staff job satisfaction in the public universities was less than that observed in private universities. The study showed that no dimension of job morally affects on employees satisfaction in public universities. while only one dimension (low personal achievement) affects employees satisfaction in private universities.
Yenidoğan yoğun bakım birimindeki hastalarda temassız infrared alın termometresi ile standart termometrelerin karşılaştırılması Özgün Araştırma

Ozet Amac: Bu calismada yenidogan doneminde temassiz infrared alin termometresi ile civali termometre ve dijital termometre olcumlerinin karsilastirilmasi amaclandi Gerec ve Yontem: Calismaya rastgele secilmis 179 yenidogan alindi Isi olcumleri infrared derece ile alindan diger iki termometre ile de koltuk altindan olmak uzere es zamanli olarak uc farkli teknik ile yapildi Olcumlerde Thermoflash LX 26 France China marka temassiz infrared alin termometresi MC 203 E Omron Health Care Europe dijital termometre ve civali cam geleneksel termometre kullanildi Her olcum cihazi ile 2091 defa olcum olmak uzere toplam 6273 olcum yapildi Bulgular: Elde edilen ortalama degerler ve standart sapmalar sirasiyla temassiz infrared alin termometresi icin 37 2 plusmn;0 5 deg;C civali termometre icin 36 7 plusmn;0 4 deg;C ve dijital termometre icin 36 6 plusmn;0 4 deg;C olarak saptandi Bland Altman egrisine gore temassiz infrared alin termometresi ile yapilan olcumlerin 95 guven araliginda kabul edilen sinirlarda civali termometre sonuclarina gore 0 37 deg;C ve 1 54 deg;C araligi arasinda dijital termometre sonuclarina gore 0 40 deg;C ve 1 54 deg;C araliginda oldugu saptandi Temassiz infrared alin termometresinin duyarliligi yuksek 81 ozgunlugu dusuk 50 olarak belirlendi [ 95 guven araligi 41 6 58 4 ] Cikarimlar: Temassiz infrared alin termometresinin yenidogan yogun bakim birimlerinde yatan bebeklerde vucut isisinin degerlendirilmesi amaciyla kullanilamayacagi sonucuna varildi Turk Ped Ars 2010; 45: 257 63 Anahtar sozcukler: Civali termometre dijital termometre temassiz infrared alin termometresi vucut isisi yenidogan
Sex-specific prevalence of adenomas and colorectal cancer.

OBJECTIVE: To determine whether Medicare managed care penetration impacted the diffusion of endoscopy services (sigmoidoscopy, colonoscopy) among the fee-for-service (FFS) Medicare population during 2001-2006. METHODS: We model utilization rates for colonoscopy or sigmoidoscopy as impacted by both market supply and demand factors. We use spatial regression to perform ecological analysis of county-area utilization rates over two time intervals (2001-2003, 2004-2006) following Medicare benefits expansion in 2001 to cover colonoscopy for persons of average risk. We examine each technology in separate cross-sectional regressions estimated over early and later periods to assess differential effects on diffusion over time. We discuss selection factors in managed care markets and how failure to control perfectly for market selection might impact our managed care spillover estimates. RESULTS: Areas with worse socioeconomic conditions have lower utilization rates, especially for colonoscopy. Holding constant statistically the socioeconomic factors, we find that managed care spillover effects onto FFS Medicare utilization rates are negative for colonoscopy and positive for sigmoidoscopy. The spatial lag estimates are conservative and interpreted as a lower bound on true effects. Our findings suggest that managed care presence fostered persistence of the older technology during a time when it was rapidly being replaced by the newer technology. © Health Research and Educational Trust. PMCID: PMC3227000 [Available on 2012/12/1] PMID: 22092022 [PubMed indexed for MEDLINE] Related citations
A Study on Bacteriological Profile and Drug Sensitivity & Resistance Pattern of Isolates of the Patients Admitted in Intensive Care Units of a Tertiary Care Hospital in Ahmadabad -

Background: Throughout the world multi-drug resistant nosocomial infections are one of the leading causes of deaths and morbidity amongst hospitalized patients. Objective: The aim of study was to identify prevalence of predominant bacterial microorganisms and their drug sensitivity and resistance in different ICUs of a tertiary care public hospital. Methods: The study was conducted in the different Intensive Care Units of a tertiary care public hospital in Ahmadabad during January, 2012 to April, 2012. Patients admitted in any of the four ICUs of the hospital who were clinically suspected of having acquired any infection after 48 hours of admission to the ICUs were included. Depending on the clinical suspicion laboratory samples were collected from the patients. Samples were subjected to the testing and antibiotic sensitivity. Results: The commonest organism isolated from all samples was E.coli 32 (25). In NICU, CONS 16(66.67), in PICU E.coli 6(27.27), in MICU, E.coli, Acinetobacter spp. and Pseudomonas spp. 10(21.28), and in SICU, E.coli 16(45.71) were predominantly isolated. E.coli is most commonly sensitive to Amikacin 28(87.5), CONS to Cefotaxime 20(95), Klebsiella sp. to Cefoperazone+Salbactum 14(78), Psudomonas to Piperacillin+Tazobactum 11(65), and Acinebacter sp. to Cefoperazone+Sulbactum 11(55). The most common multidrug resistant organisms were Citrobacter spp. (66.7) followed by Proteus spp. (33.3) and Enterococcus (33.3). Conclusion: Nosocomial infections and antimicrobial resistance in the ICUs is a major deterrent to patient’s outcome, increasing duration of patient stay as well as expense. Reduction of the same is both challenge and goal of all intensive care units around world.
Prognostic role of restenosis in 10 004 patients undergoing routine control angiography after coronary stenting.

AIM Routine control angiography is a valuable tool with high-sensitivity in detecting restenosis after coronary stenting. However, the prognostic role of restenosis is still controversial. We investigated the impact of restenosis on 4-year mortality in patients undergoing routine control angiography after coronary stenting. METHODS AND RESULTS All the patients undergoing successful implantation of coronary stents for de novo lesions from 1998 to 2009 and routine control angiography after 6-8 months at two centres in Munich, Germany were studied. Restenosis was defined as diameter stenosis ≥50% in the in-segment area at follow-up angiography. The primary outcome was 4-year mortality. The study included 10 004 patients with 15 004 treated lesions. Restenosis was detected in 2643 (26.4%) patients. Overall, there were 702 deaths during the follow-up. Of these, 218 deaths occurred among patients with restenosis and 484 deaths occurred among patients without restenosis [unadjusted hazard ratio: HR: 1.19; (95% confidence interval CI: 1.02-1.40); P = 0.03]. The Cox proportional hazards model adjusting for other variables identified restenosis as an independent correlate of 4-year mortality [HR: 1.23; (95% CI: 1.03-1.46); P = 0.02]. Other independent correlates of 4-year mortality were age [for each 10-year increase, HR: 2.34; (95% CI: 2.12-2.60); P < 0.001], diabetes mellitus [HR: 1.68; (95% CI: 1.41-1.99); P < 0.001], current smoking habit [HR: 1.39; (95% CI: 1.09-1.76); P = 0.01], and left ventricular ejection fraction [for each 5% decrease, HR: 1.39; (95% CI: 1.31-1.48); P < 0.001]. CONCLUSIONS In this large cohort of patients, the presence of restenosis at follow-up angiography after coronary stenting was predictive of 4-year mortality. Whether routine control angiography after coronary stenting is beneficial and influences outcomes should be evaluated by properly designed randomized trials.
In their own words: The 9/11 disaster child care providers.

In the days following the 9/11 tragedy in New York City, Disaster Child Care (DCC) and Childcare Aviation Incident Response (CAIR) volunteers provided care for the young children of families whose loved ones died in the World Trade Center collapse. This retrospective pilot study of 66 DCC/ CAIR volunteers examined qualitative data on the following topics: (1) Observations of the children’s caregivers/parents and differences from other childcare or disaster settings, (2) Personal reactions to the experience, differences from other childcare or disaster settings, poignant anecdotes, utility of debriefings, stress after returning from New York, and (3) Observations of coworkers’ behavior and differences from previous disaster responses. Response rate was 71% (66 of 93 potential subjects). Parental behaviors noted were the following: distress (74%), difficulty separating (48%), and checking in to see whether child was safe (44%). DCC/CAIR volunteers reported high emotionality (28%), a need to share their experience (20%). and sleep disturbance (13%) upon return from New York City. Implications for future research and practice are discussed.
Preserving the lifesaving power of antimicrobial agents.

AMONG THE MOST IMPORTANT MEDICINES EVER DIScovered, antimicrobial agents have saved millions of lives and improved the outcomes for countless patients since these drugs were introduced in the early 1930s. However, the effectiveness of these lifesaving resources is at risk. Many medical advances that physicians and patients take for granted—including cancer treatment, surgery, transplantation, and neonatal care—are endangered by increasing antibiotic resistance and a distressing decline in the antibiotic research and development pipeline. Antibiotic-resistant infections have been estimated to cost the US health care system more than $20 billion annually and result in more than 8 million additional days in the hospital. Drug resistance is both a public health and national security threat. Virtually all of the antibioticresistant pathogens that exist naturally today can be bioengineered through forced mutation or cloning, and existing pathogens could be genetically manipulated to make them resistant to currently available antibiotics. As underscored by recent reports of infections caused by strains of gramnegative bacteria producing the New Delhi metallo-betalactamase (NDM-1) enzyme, which confers multidrug resistance, antibiotic resistance is also a growing global public health threat. Addressing this complex problem is a high priority. Overcoming the impending public health crisis will require comprehensive, multipronged strategies to reduce the emergence of antimicrobial-resistant organisms and spur the development of new antibiotics.
Flavonols and fertilization in Petunia hybrida: localization and mode of action during pollen tube growth

Flavonols form an important class of flavonoids which serve an essential function during plant reproduction. Flavonoid biosynthesis is initiated by the enzyme chalcone synthase (CHS). A high abundance of flavonols and chs mRNA was demonstrated in male and female reproductive organs of Petunia hybrida. Detailed analyses revealed precise spatial and temporal regulation of the chs promoter and flavonol synthesis in the stigma, style and ovules. Transgenic plants were generated with a complete block of flavonol biosynthesis as the result of anti-sense inhibition of chs gene activity. The absence of flavonols by this dominant mutation rendered these plants self-sterile. Pollination experiments with wild-type and mutant plants revealed that the production of flavonols in either the anthers or the pistils was required for pollen tube growth and seed set. Mutant pollen without flavonols in their exine germinated normally. However, after a short period of in vitro pollen tube growth the tips of these tubes disrupted and the protoplasm was disloaded leading to the death of the pollen grain. Addition of flavonol aglycones but not other flavonoids complemented this phenotype. Confocal laser scanning microscopy revealed the localization of high levels of flavonols throughout the wild-type pollen tube. These compounds were not detected in the exine or cell wall of growing tubes. In addition, it was observed that the flavone apigenin could completely inhibit pollen tube growth. Taken together, it is shown that flavonols play an important role in the growth of the pollen tube and their mode of action is discussed.
A study of implanted cardiac rhythm recorders in advanced cardiac AL amyloidosis.

AIMS AL amyloidosis may respond to chemotherapy but two-thirds of patients with severe cardiac involvement die within a year of diagnosis, purportedly from tachyarrhythmias or electromechanical dissociation. We sought to characterize the nature of cardiac arrhythmias in severe cardiac AL amyloidosis using implanted cardiac rhythm recorders. METHODS AND RESULTS Implantable loop recorders (ILRs) were inserted within 24 h of baseline evaluation at the UK National Amyloidosis Centre, into 20 consecutive patients with newly diagnosed severe cardiac AL amyloidosis and symptoms of syncope or pre-syncope. Weekly ILR recordings and additional recordings at the time of symptoms were obtained. Median (range) follow-up from baseline was 308 (10-399) days. Thirteen patients died, and median survival in the whole cohort was 61 days from device insertion. In each of eight evaluable cases, death was heralded by bradycardia, usually associated with complete atrioventricular block (CAVB), followed shortly thereafter by pulseless electrical activity. Four patients received pacemakers, a median (range) of 7 (3-38) h after development of symptomatic CAVB, but these did not prevent rapid cardiac decompensation and death in three cases. Despite 272 loop recordings, there was only one episode of non-sustained ventricular tachycardia, which was preceded by severe bradycardia. Patients who died had significantly worse global left ventricular strain on echocardiography (P = 0.029) and reduced 6 min walk distance (P = 0.048) at baseline compared with survivors. CONCLUSIONS The discovery that bradyarrhythmias heralded terminal cardiac decompensation in most patients with severe cardiac AL amyloidosis supports a study of prophylactic pacemaker insertion in this patient population.
ISAR-SAFE: a randomized, double-blind, placebo-controlled trial of 6 vs. 12 months of clopidogrel therapy after drug-eluting stenting.

BACKGROUND In patients receiving aspirin, the optimal duration of clopidogrel therapy after drug-eluting stent (DES) implantation remains unclear. METHODS This multicentre, randomized, double-blind, placebo-controlled trial tested the hypothesis that in patients undergoing DES implantation, 6 months of clopidogrel is non-inferior to 12 months in terms of clinical outcomes. At 6 months after DES implantation, patients on clopidogrel were randomly assigned to either a 6-month period of placebo or an additional 6-month period of clopidogrel. The primary endpoint was the composite of death, myocardial infarction, stent thrombosis, stroke, and thrombolysis in myocardial infarction major bleeding at 9 months after randomization. RESULTS Owing to slow recruitment and low event rates, the trial was stopped prematurely after enrolment of 4005 of 6000 planned patients. Of 4000 patients included in the final analysis, 1997 received 6 months of clopidogrel and 2003 received 12 months. The primary endpoint occurred in 29 patients (1.5%) assigned to 6 months of clopidogrel and 32 patients (1.6%) assigned to 12 months, observed difference -0.1%, upper limit of one-sided 95% confidence interval (CI) 0.5%, limit of non-inferiority 2%, Pfor noninferiority <0.001. Stent thrombosis was observed in five patients (0.3%) assigned to 6 months of clopidogrel and three patients (0.2%) assigned to 12 months; hazard ratio (HR) 1.66, 95% CI: 0.40-6.96, P = 0.49. Thrombolysis in myocardial infarction major bleeding was observed in 4 patients (0.2%) assigned to 6 months clopidogrel and 5 patients (0.3%) assigned to 12 months; HR 0.80, 95% CI: 0.21-2.98, P = 0.74. CONCLUSIONS In the present trial, characterized by low event rates, we did not observe a significant difference in net clinical outcome between 6 and 12 months of clopidogrel therapy after DES implantation. However, the results of the trial must be considered in view of its premature termination and lower than expected event rates. The trial is registered with ClinicalTrials.gov, Identifier: NCT00661206.
Impact of clinical presentation on ischaemic and bleeding outcomes in patients receiving 6- or 24-month duration of dual-antiplatelet therapy after stent implantation: a pre-specified analysis from the PRODIGY (Prolonging Dual-Antiplatelet Treatment After Grading Stent-Induced Intimal Hyperplasia) t

AIMS We investigated if acute coronary syndrome (ACS) rather than stable coronary artery disease (SCAD) presentation is an outcome modifier with respect to the duration of dual-antiplatelet therapy (DAPT) in patients undergoing coronary stenting. METHODS AND RESULTS In the Prolonging Dual-Antiplatelet Treatment After Grading Stent-Induced Intimal Hyperplasia (PRODIGY) trial, a total of 1465 (74.3%) patients presented ACS whereas 505 (25.7%) had SCAD and were randomized to 6- or 24-month DAPT. At 24 months, the composite of death, myocardial infarction (MI), or cerebrovascular accident (CVA) did not differ between the long- and short-term DAPT arms in both ACS (11.1 vs. 11.7%; P = 0.67) and SCAD (7.5 vs. 4.8%; P = 0.21) patients, respectively. Long-term DAPT was associated with a 75% increase of Bleeding Academic Research Consortium (BARC)-class 2, 3, or 5 bleeding in ACS [7.1 vs. 4.1%; hazard ratio (HR) 1.75, 95% confidence interval (CI) 1.11-2.74, P = 0.015; number needed to treat for harm (NNTH): 33.3] and a five-fold increase in SCAD (8.2 vs. 1.6%; HR 5.37, 95% CI 1.84-15.74, P = 0.002; NNTH: 15.1) patients, with a borderline quantitative interaction (PINT = 0.056). As a result, net adverse cardiovascular events (death, MI, CVA, BARC class 2, 3, or 5 bleeding) were more than doubled in SCAD patients receiving 24-month DAPT, whereas they did not differ in ACS patients (PINT = 0.024). CONCLUSIONS This analysis suggests that clinical presentation may be a treatment modifier with respect to DAPT duration after stenting consistent with the hypothesis that SCAD-but not ACS-patients are exposed to a significant increase in bleeding and net adverse clinical events when treated with 24-month compared with 6-month therapy. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00611286. http://clinicaltrials.gov/ct2/show/NCT00611286? term=prodigy&rank=2.
A collaborative review of the current concepts and challenges of anastomotic leaks in colorectal surgery

The reduction of the incidence, detection and treatment of anastomotic leakage (AL) continues to challenge the colorectal surgical community. AL is not consistently defined and reported in clinical studies, its occurrence is variably reported and its impact on longterm morbidity and health‐care resources has received relatively little attention. Controversy continues regarding the best strategies to reduce the risk. Diagnostic tests lack sensitivity and specificity, resulting in delayed diagnosis and increased morbidity. Intra‐operative fluorescence angiography has recently been introduced as a means of real‐time assessment of anastomotic perfusion and preliminary evidence suggests that it may reduce the rate of AL. In addition, concepts are emerging about the role of the rectal mucosal microbiome in AL and the possible role of new prophylactic therapies. In January 2016 a meeting of expert colorectal surgeons and pathologists was held in London, UK, to identify the ongoing controversies surrounding AL in colorectal surgery. The outcome of the meeting is presented in the form of research challenges that need to be addressed.
Efficacy and safety of a 4-drug fixed-dose combination regimen compared with separate drugs for treatment of pulmonary tuberculosis: the Study C randomized controlled trial.

CONTEXT Fixed-dose combinations (FDCs) of drugs for treatment of tuberculosis have been advocated to prevent the emergence of drug resistance. OBJECTIVE To assess the efficacy and safety of a 4-drug FDC for the treatment of tuberculosis. DESIGN, SETTING, AND PATIENTS The Study C trial, a parallel-group, open-label, noninferiority, randomized controlled trial conducted in 11 sites in Africa, Asia, and Latin America between 2003 and 2008. Patients were 1585 adults with newly diagnosed smear-positive pulmonary tuberculosis. INTERVENTIONS Patients were randomized to receive daily treatment with 4 drugs (rifampicin, isoniazid, pyrazinamide, ethambutol) given as an FDC (n = 798 patients) or separately (n = 787) in the 8-week intensive phase of treatment. MAIN OUTCOME MEASURE Favorable treatment outcome, defined as negative culture result at 18 months post randomization and not having already been classified as unfavorable. Noninferiority was dependent on consistent results from a per-protocol and modified intention-to-treat analysis, using 2 different models for the latter, classifying all changes of treatment or refusal to continue treatment (eg, bacteriological failure/relapse, adverse event, default, drug resistance) as unfavorable (model 1) and classifying changes of treatment for reasons other than therapeutic outcomes according to their 18-month bacteriological outcome if available (post hoc model 2). The prespecified noninferiority margin was 4%. RESULTS In the per-protocol analysis, 555 of 591 patients (93.9%) had a favorable outcome in the FDC group vs 548 of 579 (94.6%) in the separate-drugs group (risk difference, -0.7% [90% confidence interval {CI}, -3.0% to 1.5%]). In the model 1 analysis, 570 of 684 patients (83.3%) had a favorable outcome in the FDC group vs 563 of 664 (84.8%) in the separate-drugs group (risk difference, -1.5% [90% CI, -4.7% to 1.8%]). In the post hoc model 2 analysis, 591 of 658 patients (89.8%) in the FDC group and 589 of 647 (91.0%) in the separate-drugs group had a favorable outcome (risk difference, -1.2% [90% CI, -3.9% to 1.5%]). Adverse events related to trial drugs were similarly distributed among treatment groups. CONCLUSIONS Compared with a regimen of separately administered drugs, a 4-drug FDC regimen for treatment of tuberculosis satisfied prespecified noninferiority criteria in 2 of 3 analyses. Although the results do not demonstrate full noninferiority of the FDCs compared with single drugs given separately using the strict definition applied in this trial, use of FDCs is preferred because of potential advantages associated with the administration of FDCs compared with separate-drug formulations. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00216333.