Miracle-dz/UniFAR-FTUs huggingface dataset:
Who is responsible for pediatric triage decisions in Australian emergency departments: A description of the educational and experiential preparation of general and pediatric emergency nurses

Background Pediatric presentations to the emergency department (ED) account for approximately one third of ED presentations. Triage is the process employed by the ED to prioritize presenting patients, including children, on the basis of clinical urgency. This role is undertaken by emergency nurses, and a range of recommendations are available regarding the level of experience and education required by the nurse responsible for pediatric triage decisions. However, little is known about the actual education and experience of nurses undertaking pediatric triage. Objectives To describe the level of experiential and educational preparation of emergency nurses responsible for pediatric triage decisions in pediatric and adult and pediatric population EDs. Methods An anonymous survey of emergency nurses responsible for pediatric triage decisions in a number of specialist and mixed EDs was conducted. Results Education and experience varies widely among nurses responsible for pediatric triage decisions. Many nurses practicing pediatric triage do not meet recognized guidelines for the levels of education and experience required to undertake pediatric triage. Nurses practicing in mixed population EDs were less likely to meet the recommended educational requirements than pediatric emergency nurses and yet reported no difference in their level of confidence in undertaking pediatric triage. Conclusions Educationalists and managers must make a commitment to pediatric triage preparation for nurses in EDs providing pediatric services. In particular, emphasis must be placed on providing pediatric continuing education for nurses practicing in mixed population EDs. However, it is also essential that the impact of education and experience on patient outcomes be investigated before an attempt is made to influence the preparation of nurses for triage.
PRINCIPLES OF EXHIBIT DESIGN

In the last issue (Bitgood & Patterson, 1987), we described some principles that apply to orientation and circulation. In the next to the last issue the empirical factors involved in the design of effective exhibit labels were discussed (Volume I, No. 3). The current article will describe principles of visitor behavior that relate to three other aspects of exhibit design: (1) the characteristics of the exhibit object or animal; (2) the characteristics of exhibit architecture; and (3) the characteristics of the visitors. The list of principles does not claim to be exhaustive; we hope that it stimulates your thinking and challenges you to further test their validity. Most of these principles have at least some empirical basis; however, additional research is needed to confirm these effects, to discover the specific parameters of each variable, and to determine the relative impact of each factor on visitor behavior. We are indebted to the work of others for ideas on many of these principles (e.g., Koran & Koran, 1986; Melton, 1972; Screven, 1986).
Effects on human heart valve immunogenicity in vitro by high concentration cryoprotectant treatment

It has been shown previously that cryopreservation, using an ice‐free cryopreservation method with the cryoprotectant formulation VS83, beneficially modulated immune reactions in vivo and in vitro when compared with conventionally frozen tissues. In this study, we assessed the impact of a VS83 post‐treatment of previously conventionally frozen human tissue on responses of human immune cells in vitro. Tissue punches of treated and non‐treated (control) aortic heart valve tissue (leaflets and associated aortic root) were co‐cultured for 7 days with peripheral blood mononuclear cells or enriched CD14+ monocytes. Effects on cellular activation markers, cytokine secretion and immune cell proliferation were analysed by flow cytometry. Flow cytometry studies showed that VS83 treatment of aortic root tissue promoted activation and differentiation of CD14+ monocytes, inducing both up‐regulation of CD16 and down‐regulation of CD14. Significantly enhanced expression levels for the C‐C chemokine receptor (CCR)7 and the human leukocyte antigen (HLA)‐DR on monocytes co‐cultured with VS83‐treated aortic root tissue were measured, while the interleukin (IL)‐6 and monocyte chemoattractant protein (MCP)‐1 release was suppressed. However, the levels of interferon (IFN)γ and tumour necrosis factor (TNF)α remained undetectable, indicating that complete activation into pro‐inflammatory macrophages did not occur. Similar, but non‐significant, changes occurred with VS83‐treated leaflets. Additionally, in co‐cultures with T cells, proliferation and cytokine secretion responses were minimal. In conclusion, post‐treatment of conventionally cryopreserved human heart valve tissue with the VS83 formulation induces changes in the activation and differentiation characteristics of human monocytes, and thereby may influence long‐term performance following implantation. Copyright © 2017 John Wiley & Sons, Ltd.
Critical care nurses--perceptions of 12-h shifts.

BACKGROUND Twelve-hour shifts have been illustrated in the literature as being a highly contentious shift pattern. However, it has also been highlighted that there is a distinct paucity of literature solely related to such a shift pattern in critical care areas, where there is high activity and a requirement for multiple and highly significant decision-making situations. It was therefore identified that such an area deserved further exploration. AIM This study aimed to elicit critical care nurses' perceptions of working 12-h shifts. METHODS Fifty-four nurses from three critical care areas within a large local NHS teaching hospital currently working 12-h shifts completed a self-administered questionnaire on their perceptions of 12-h shifts. Following on, a focus group interview was conducted to complement this questionnaire in an attempt to further explore these perceptions. RESULTS From the results of the questionnaire, patient care, job satisfaction, off duty and family life achieved the most positive responses, whereas communication, fatigue and education achieved the most negative. The focus group explored these issues with added comments on work-shy staff, suggestions on shift patterns, breaks and staffing levels. CONCLUSIONS Twelve-hour shifts in critical care areas are suitable shift patterns for nurses, patients and management, provided that they are fundamentally well-managed.
Verbal memory impairment correlates with hippocampal pyramidal cell density

Thirty-five patients with medically refractory epilepsy localized to the temporal lobe (18 left, 17 right) completed the verbal Selective Reminding Test before surgery. Verbal memory impairments existed before surgery regardless of the lateralization of the seizure focus, but patients with left temporal seizure foci were significantly more impaired. After surgical removal of the mesial temporal lobe structures, 2 blinded observers established volumetric cell densities for hippocampal subfields CA1, CA2, CA3, the hilar area, and the granule cell layer of the area dentata. Statistically significant correlations existed between presurgical memory impairment and cell counts (in CA3 and the hilar area, only) for patients with left temporal seizure foci. These findings support the hippocampal model of memory and complement prior research documenting the memory impairments present after surgical removal of the mesial temporal structures.
Alcohol Use in Students Seeking Primary Care Treatment at University Health Services

Abstract Objective: Given the high rate of at-risk drinking in college students, the authors examined drinking behaviors and associated factors in students being seen in student health services for primary care visits from October 30, 2004, to February 15, 2007. Methods: Analyses were based on a Health Screening Survey completed by 10,234 college students seeking general medical treatment. Results: Alcohol use was similar to other studies with 57% (n = 5,840) meeting the National Institute on Alcohol Abuse and Alcoholism criteria for at-risk drinking. Twenty-six percent of the students reported smoking at least once in the last 3 months. Risk factors for at-risk drinking included young age, white males, drinking at a fraternity/sorority house, and use of tobacco. Conclusions: These findings support the widespread implementation of alcohol screening and intervention in university health services.
Induction of nuclear decondensation of mammalian spermatozoa in vitro.

The nucleus ofthe mammalian spermatozoon is an exceptionally stable organelle requiring very rigorous chemical treatments to free its chromatin (Boren-freund 1961). In spite of this, the nucleus swells and its chromatin begins to decondense very rapidly as the spermatozoon is incorporated into the egg cytoplasm (Austin, 1961; Yanagimachi & Noda, 1970; Bedford, 1972). As yet, the mechanism underlying this phenomenon has not been directly examined. Various methods have been used to decondense sperm nuclei and to isolate and characterize the sperm chromatin and nuclear proteins (Borenfreund 1961; Henricks Mayer, Sodium dodecyl sulphate (SDS, an anionic surfactant) and dithiothreitol (DTT, a reagent which specifically cleaves disulphide linkages) have been used to study nuclear stabilization during maturation of mammalian spermatozoa (Calvin & Bedford, 1971; Calvin 1973). Nuclear stabilization by disulphide (-S-S-) bonding has been studied from an evolutionary standpoint by Bedford & Calvin (1974), who have found that this -S-S- bonding is prominent in the spermatozoa only of eutherian mammals. In the present study, the types of chemicals that can decondense mammalian sperm nuclei were determined, then the common characteristics of these chemicals were evaluated so that possible inferences could be made about the mechanism of nuclear decondensation during fertilization. Epididymal spermatozoa of the golden hamster, rat, guinea-pig and rabbit were obtained by puncturing the excised cauda epididymidis with a needle and squeezing the spermatozoa into a Petri dish containing 0-9% NaCl at 37°C. Pellets of frozen canine semen were prepared according to the techniques of
Monte Carlo Modeling of Computed Tomography Ceiling Scatter for Shielding Calculations

AbstractRadiation protection for clinical staff and members of the public is of paramount importance, particularly in occupied areas adjacent to computed tomography scanner suites. Increased patient workloads and the adoption of multi-slice scanning systems may make unshielded secondary scatter from ceiling surfaces a significant contributor to dose. The present paper expands upon an existing analytical model for calculating ceiling scatter accounting for variable room geometries and provides calibration data for a range of clinical beam qualities. The practical effect of gantry, false ceiling, and wall attenuation in limiting ceiling scatter is also explored and incorporated into the model. Monte Carlo simulations were used to calibrate the model for scatter from both concrete and lead surfaces. Gantry attenuation experimental data showed an effective blocking of scatter directed toward the ceiling at angles up to 20–30° from the vertical for the scanners examined. The contribution of ceiling scatter from computed tomography operation to the effective dose of individuals in areas surrounding the scanner suite could be significant and therefore should be considered in shielding design according to the proposed analytical model.
Environmental tobacco smoke and adult-onset asthma: a population-based incident case-control study.

OBJECTIVES The authors assessed the effects of environmental tobacco smoke (ETS) on the development of asthma in adults. METHODS In the Pirkanmaa district of South Finland, all 21- to 63-year-old adults with new cases of asthma diagnosed during a 2.5-year period (n = 521 case patients, out of 441 000 inhabitants) and a random sample of control subjects from the source population (932 control subjects) participated in a population-based incident case-control study. RESULTS Risk of asthma was related to workplace ETS exposure (adjusted odds ratio [OR] = 2.16; 95% confidence interval [CI] = 1.26, 3.72) and home exposure (OR = 4.77; 95% CI = 1.29, 17.7) in the past year. Cumulative ETS exposure over a lifetime at work and at home increased the risk. CONCLUSIONS This study indicates for the first time that both cumulative lifetime and recent ETS exposures increase the risk of adult-onset asthma.
Quality control of anti-tuberculosis FDC formulations in the global market: part II-accelerated stability studies.

OBJECTIVE To determine the quality and performance of rifampicin (RMP) containing fixed-dose combination (FDC) formulations of anti-tuberculosis drugs sourced from the international market with respect to physical, chemical and dissolution properties after storage at accelerated stability conditions (40 degrees C/75% relative humidity) and to identify appropriate storage specifications. METHODS Formulations across different companies and combinations were subjected to 6-month accelerated stability testing in packaging conditions recommended by the manufacturer. Various pharmacopeial and nonpharmacopeial tests for tablets were performed for 3- and 6-month samples. RESULTS All the formulations were found to be stable, where extent of dissolution was within +/- 10% of that of the initial value, and all formulations passed the pharmacopeial limits for assay and content uniformity of 90-110% and +/- 15% of average drug content, respectively. CONCLUSIONS Good quality RMP-containing FDCs that remain stable after 6-month accelerated stability testing are available in the marketplace.
Epidemiology of Childhood Type I Diabetes in Sudan, 1987–1990

OBJECTIVE To determine the incidence of type I diabetes in children 0–14 yr of age in Khartoum, Sudan. RESEARCH DESIGN AND METHODS Prospective registration of newly diagnosed patients in a hospital-based registry with independent validation of completeness of case ascertainment. Eligible patients were Sudanese children < 15 yr of age, who developed type I diabetes during the period 1 January 1987 through 31 December 1990, and who were living in Khartoum city at the time of diagnosis. The denominator is the stable childhood population of Khartoum city, as estimated by the National Bureau of Statistics. RESULTS In 4 yr, 239 cases were notified in the primary source and 268 in the secondary source. Some 196 patients were registered in both sources. Using the capture-recapture method to correct for underascertainment, the estimated total number of cases was 327, and the overall degree of ascertainment was 95%. The incidence of type I diabetes in children 0–14 yr of age increased from 5.9/105) in 1987 to 10.1/105) in 1990 (P < 0.001). Girls exhibited slightly higher incidence rates than boys in the 10–14-yr age-group throughout the 4 yr, but the differences were not statistically significant. The age distribution at onset was bimodal with a clear peak at age 12 yr in girls and age 14 yr in boys and another smaller peak at age 7 yr in both sexes. The number of new cases was markedly higher in the cooler months of the year, with a peak in January and a nadir in June (P < 0.01). This trend was consistent over the period of observation. CONCLUSIONS Childhood diabetes is increasing in Sudan. Our incidence figures are higher than those reported from other Arab countries and is similar to reports from France and Italy.
Bold Recommendations that Lead the Market

My paper provides a new way to understand analysts’ bold recommendations by dividing them into two categories: (a) Contra-bold recommendations (bold without followers) and (b) leading-bold recommendations (bold with followers). A comparison of market performance indicates that (1) leading-bold recommendations create higher market returns than contra-bold or non-bold recommendations both in reaction to the immediate announcement and also in terms of longer period price behavior; and (2) bold recommendations create higher market returns than non-bold recommendations. Cross-sectional analyses provide further information about which factor make analysts more likely to be market leaders. These results confirm the findings in the first part which show that analysts’ private information channels or personal expertise will be highly valued by other analysts and the market as well.
Emergency department noninvasive (NICOM) cardiac outputs are associated with trauma activation, patient injury severity and host conditions and mortality

BACKGROUND A noninvasive cardiac output (CO) monitor (NICOM), using Bioreactance technology, has been validated in several nontrauma patient studies. We hypothesized that NICOM CO would have more significant associations with clinical conditions than would systolic blood pressure (sBP). METHODS This is a prospective observational study of consecutive trauma activation patients during the first 10 to 60 minutes after emergency department arrival. RESULTS Analysis includes 270 consecutive trauma activation patients with 1,568 observations. CO was decreased (p ⩽ 0.002) with major blood loss, hypotension, red blood cell transfusion, Injury Severity Score (ISS) higher than 20, low PetCO2, abnormal pupils, elderly, preexisting conditions, low body surface area level, females, hypothermia, and death. CO was increased (p < 0.0001) with base deficit, ethanol positivity, and illicit drug positivity. The sBP was decreased (p ⩽ 0.0005) with major blood loss, red blood cell transfusion, low PetCO2, low body surface area level, and illicit drug positivity. The sBP was increased (p ⩽ 0.01) with ISS higher than 20, elderly, and preexisting conditions. Total significant condition associations were CO 83% (15 of 18 patients) and sBP 47% (8 of 17 patients; p = 0.03). In hypotensive patients, CO was lower with major blood loss (3.3 ± 2.1 L/min) than without (6.0 ± 2.2 L/min; p < 0.0001). Of survivors with ISS 15 or higher, NICOM patients experienced a shorter hospital length of stay (10.5 days) when compared with 2009 and 2010 patients (14.0 days; p = 0.03). CONCLUSION The multiple associations of CO with patient conditions imply that NICOM provides an objective and clinically valid, relevant, and discriminate measure of cardiac function in acutely injured trauma activation patients. NICOM use may be associated with a shorter length of stay in surviving patients with complex injuries. LEVEL OF EVIDENCE Diagnostic study, level II.
Multihoming users' preferences for two-sided exchange networks

Online business-to-business (B2B) exchanges are proliferating, giving firms numerous platforms from which to choose. Many firms are also multihoming, using competing platforms concurrently. In this study, we examine how selling and buying activities on B2B exchanges affect multihoming buyers' preferences for exchanges. We posit that these activities influence buyers' perceived returns and risks of using the exchanges, and impact buyers' preferences. Using a unique dataset of 118 buyers' participation in two B2B exchanges over seven months, we find that buyers prefer exchanges with more selling activities. However, buyers' preferences and buying levels on the exchanges are non-monotonically related. At low buying levels, an increase in buying by others positively affects buyers' preferences. This effect may result from observational learning, where individual buyers learn from other buyers' behaviors. On the other hand, as buying level increases further on the exchange, competition among buyers also increases. Consequently, buyers lower their preferences for the exchange. In addition, we find that the effects of selling and buying activities on buyers' preferences change over time. Our results highlight the need to correctly model buyers' homing behavior; failing to do so could bias the picture of competitive dynamics between platforms and lead to suboptimal strategies by exchanges.
Frequency and expression of mutacin and putative bacteriocin genes in isolated Streptococcus mutans and its antimicrobial activity against gram-positive and gram-negative bacteria

Background: Streptococcus mutans in the oral cavities sable to produce mutacin (bacteriocin-like substances) with antibiotic properties . The aim of this study was to investigate the frequency and expression of genes encoding mutacins typeI, II, III and IV and also two of 8 genes in a cluster encoding the putative bacteriocins, the designated bsm 283, bsm 299, bsm 423, bsm 1889c, bsm 1892c, bsm 1896, bsm 1906c and bsm 1914, were also screened by PCR and specific primers for each type of mutacin biosynthesis gene and then mutacin activity against the indicator strains determined. Methods: In this study, dental clinic samples were collocated; Streptococcus mutans was detected using biochemical tests and molecular methods (PCR). Frequency of mutacin biosynthesis genes types I, II, III and IV, bsm299 and bsm1899 were measured by PCR, using specific primers for each type of mutacin biosynthesis gene. Furthermore, the antimicrobial spectra of Streptococcus mutans isolates against other indicators, including Staphylococcus aureus, Staphylococcus epidermidis, Enterococcus faecalis, Salmonella typhi, Pseudomonas, Escherichia coli were evaluated using well diffusion, disk diffusion and the minimal inhibitory concentrations (MICs) methods. Results: Out of 56 samples collected from patients referred to Milad Hospital dental clinic on October 2011 and three private dental clinics on November 2011, 24 strains of Streptococcus mutans produced mutacins. 67.52% of the strains had a wide antimicrobial spectrum and 37.5% of 67.5% had a high frequency of genes with more inhibitory activity against, Staphylococcus epidermidis, Staphylococcus aureus and Enterococcus faecalis respectively that are more related to putative bacteriocins. The expression frequency o f the bsm gene (putative bacteriocins) was higher than that of the characterized mutacins types (I–IV). The lowest dilution rate mutacin was found against Staphylococcus epidermidis (0.0625 unit/mL). Conclusion: These findings suggested that all putative bacteriocins may represent a large repertoire of inhibitory substances produced by Streptococcus mutans. Therefore, the high diversity of mutacin-producing phenotypes, associated with high frequency of expression of the biosynthesis genes screened and wide antimicrobial activity against Staphylococcus epidermidis could be used as safe antimicrobial agents in treatment of superficial infections such as, removing the pimple caused by Staphylococcus epidermidis.