Miracle-dz/UniFAR-FTUs huggingface dataset:
A Systematic Review of Nurses' Experiences With Unintended Consequences When Using the Electronic Health Record

In response to unprecedented financial government incentives, electronic health record (EHR) adoption has tripled since 2009. While EHR benefits are emphasized, research demonstrates that adoption may result in unintended consequences that nurse administrators can anticipate and mitigate. Unintended consequences are defined as unplanned effects, whether positive or negative. Little is known about nursing perceptions and experience of unintended consequences arising from EHR implementation, and nursing studies are minimal in comparison with research on experience among their interprofessional colleagues. The purpose of this article is to present the state of the science on nurses' experiences with unintended consequences of EHRs derived from a systematic review that includes 4 original studies. Findings demonstrate that nurses experience changes to workflow, must continually adapt to meet patient's needs in the context of imperfect EHR systems, and have difficulty accessing the information they need to make patient care decisions. Even so, most state they would not revert to paper records if given the choice. Implications for nurse administrators include the need for continual engagement with nurses along the continuum of EHR design, as well as the need to encourage nurses to speak up and acknowledge workflow changes that threaten patient safety or do not support work efficiency.
Prognostic significance of Ubiquilin1 expression in invasive breast cancer.

AIM To explore the correlation between Ubiquilin1 (UBQLN1) expression and clinicopathological characteristics and determine its prognostic significance in patients with breast cancer. METHODS UBQLN1 expression was evaluated by immunohistochemistry in 125 invasive breast cancer samples. The association between UBQLN1 and clinicopathological parameters and prognosis of breast cancer were detected. RESULTS The UBQLN1 protein was overexpressed in breast cancer samples (68/125) and associated with tumor size (P = 0.034), lymph node metastasis (P = 0.035), TNM stage (P = 0.049) and vascular invasion (P = 0.003). The DFS and OS rates at 5 years were 27.7% and 48.7% for UBQLN1 positive patients compared with 49.6% and 77.4% for UBQLN1 negative patients, respectively (both P = 0.001). Multivariate analyses revealed that UBQLN1 was an independent prognostic factor for overall survival (hazard ratio, 2.416; 95% CI, 1.134-5.149, P= 0.022) and disease-free survival (hazard ratio, 2.113; 95% CI, 1.203-3.709, P= 0.009). Furthermore, UBQLN1 overexpression was associated with poor prognosis in patients without lymph node metastasis (DFS 35 months vs 62 months, P = 0.005; OS 68 months vs 72 months, P = 0.017). CONCLUSION The expression level of UBQLN1 and prognosis in breast cancer is clarified for the first time and UBQLN1 seems to be a novel molecular marker to predict poor prognosis in breast cancer.
Oxidation of melatonin and its catabolites, N1‐acetyl‐N 2‐formyl‐5‐methoxykynuramine and N1‐acetyl‐5‐methoxykynuramine, by activated leukocytes

Abstract: N 1‐acetyl‐N2‐formyl‐5‐methoxykynuramine (AFMK) and N1‐acetyl‐5‐methoxykynuramine (AMK), two melatonin catabolites, have been described as potent antioxidants. We aimed to follow the kinetics of AFMK and AMK formation when melatonin is oxidized by phorbol myristate acetate (PMA) and lipopolysaccharide (LPS)‐activated leukocytes. An HPLC‐based method was used for AFMK and AMK determination in neutrophil and peripheral blood mononuclear cell cultures supernatants. Samples were separated isocratically on a C18 reverse‐phase column using acetonitrile/H2O (25:75) as the mobile phase. AFMK was detected by fluorescence (excitation 340 nm and emission 460 nm) and AMK by UV‐VIS absorbance (254 nm). Activation of neutrophils and mononuclear cells with PMA produces larger amounts of AFMK than activation with LPS, probably due to the lower levels of reactive oxygen species formation and myeloperoxidase (MPO) degranulation that occurs when cells are stimulated with LPS. The concentration of AMK found in the supernatant was about 5–10% (from 18‐hr cultures) compared with AFMK. This result may reflect its reactivity. Indeed AMK, but not AFMK, is easily oxidized by activated neutrophils in a MPO and hydrogen peroxide‐dependent reaction. In conclusion, we defined a simple procedure for the determination of AFMK and AMK in biological samples and demonstrated the capacity of leukocytes to oxidize melatonin and AMK.
MOLECULAR PHYLOGENETIC ANALYSIS OF IXODID TICKS BASED ON THE RIBOSOMAL DNA SPACER, INTERNAL TRANSCRIBED SPACER 2, SEQUENCES

An internal transcribed spacer (ITS2) sequence between the 5.8S and 28S rRNA genes was used to estimate the phyletic relationships among Ixodes spp. tick vectors of Lyme disease-causing Borrelia spirochetes. Analysis indicates that Borrelia burgdorferi sensu lato species associated with Lyme disease are found mainly in ticks of the Ixodes ricinus species complex. Other closely related tick species are not known to transmit the Borrelia-that cause Lyme disease in humans, but they appear to have a specific association with other closely related Borrelia species. There is a high degree of concordance in the phylogenetics of Borrelia taxa and the phylogenetic relationships among Ixodes ticks.
Postoperative hypertension: A multicenter, prospective, randomized comparison between intravenous nicardipine and sodium nitroprusside

ObjectiveTo compare the efficacy and safety of iv nicardipine with sodium nitroprusside in the treatment of postoperative hypertension after both cardiac and noncardiac surgery. DesignMulticenter, prospective, randomized, open-label study. SettingSix tertiary referral medical centers (recovery rooms and surgical ICUs). PatientsA total of 139 patients with postoperative hypertension: iv nicardipine (n = 71), sodium nitroprusside (n = 68). InterventionAdministration of iv nicardipine or sodium nitroprusside. MeasurementsVital signs (BP, heart rate), hemodynamic variables, medication dosage, total number of dose changes, and time to achieve BP control were recorded. Main ResultsBoth medications were equally effective in reducing BP in both the cardiac and noncardiac surgical groups. Under the conditions of the study, iv nicardipine controlled hypertension more rapidly than sodium nitroprusside (iv nicardipine 14.0 ± 1.0 mins and sodium nitroprusside 30.4 ± 3.5 mins, p = .0029). The total number of dose changes required to achieve therapeutic BP response was significantly less in the iv nicardipine-treated patients (iv nicardipine 1.5 ± 0.2 vs. sodium nitroprusside 5.1 ± 1.4, p < .05). Adverse effects were observed with both drugs (iv nicardipine 7% [5/71] and sodium nitroprusside 18% [12/68] [NS]). ConclusionsIntravenous nicardipine is as effective as sodium nitroprusside in the therapy of postoperative hypertension. Specific advantages have been identified. The use of iv nicardipine should be considered in the therapy of postoperative hypertension. (Crit Care Med 1992; 20:1637–1643)
Gut‐specific genes from the black fly Simulium vittatum encoding trypsin‐like and carboxypeptidase‐like proteins

In haematophagous insects digestion of the blood meal provides nutrients for survival and essential components for egg production. We have isolated and partially characterized two gut‐specific genes from the black fly Simulium vittatum. Sequence analysis revealed that both are highly similar to digestive proteases, one to trypsins and the other to carboxypeptidases. RNA blot analysis indicates that the expression of these two genes is regulated in a sexspecific manner; when fed the same sucrose‐based diet, expression in males is substantially lower than in females. In females, expression of both genes is strongly induced by a blood meal. At 6 h after the blood meal the trypsin‐like gene product was immunolocalized to the midgut epithelium and to the outer layers of the peritrophic matrix.
A community study of sleep-disordered breathing in middle-aged Chinese men in Hong Kong.

BACKGROUND Sleep-disordered breathing (SDB) in Asian populations is being increasingly recognized. This study investigated the prevalence of SDB in Chinese middle-aged office-based male workers in Hong Kong. METHODS Sleep questionnaires were distributed to 1,542 men (age range, 30 to 60 years), and 784 questionnaires were returned. Subsequently, full polysomnographic (PSG) examinations were conducted in 153 questionnaire respondents. Subjects with an apnea-hypopnea index (AHI) > or =5 were recalled for clinical assessment. RESULTS Questionnaire respondents were similar in age and body mass index (BMI) to the general community in the target age range and gender. Habitual snoring was reported by 23% of this cohort and was associated with excessive daytime sleepiness (EDS), hypertension, witnessed abnormal breathing pattern, BMI, and leg movements during sleep. Allowing for subject bias in undergoing PSG, the estimated prevalence of SDB and obstructive sleep apnea syndrome (OSAS) (defined as SDB in the presence of EDS) at various AHI cutoff threshold values was 8.8% and 4.1% (AHI > or =5), 6.3% and 3.2% (AHI > or =10), and 5.3% and 3.1% (AHI > or =15). Multiple stepwise logistic regression analysis identified BMI, habitual snoring, time taken to fall asleep, and age as predictors of SDB at AHI > or =5. Analysis of anthropometric parameters indicated that the relative risk of OSAS attributable to obesity was less than in white subjects. CONCLUSION This community-based study of sleep apnea among middle-aged men in Hong Kong using full PSG demonstrated an estimated prevalence of OSAS (AHI > or =5 and EDS) at 4.1%. Increasing BMI and age were associated with SDB, although factors other than adiposity may also have an important pathogenic role in OSA in Chinese subjects.
Human Leukocyte Antigen Antibodies and Human Complement Activation: Role of IgG Subclass, Specificity, and Cytotoxic Potential

Background. Human leukocyte antigen (HLA) antibodies are defined as complement (C) fixing and clinically relevant based upon the complement-dependent cytotoxicity (CDC) test. However, the sub-lytic activation of individual C components is of critical biologic significance. The requirements of HLA antibodies to activate human C are not known. Methods. IgG, IgM, IgG subclasses, and human C3b deposition upon T cells were evaluated by flow cytometry with sera from HLA-sensitized patients and human monoclonal HLA antibodies. Results. Comparative studies showed that there was poor correlation between the amount of IgG on target cells and their ability to produce CDC. Human C3b deposition was influenced more by the particular serum/cell combination under study than by the amount of IgG, with some combinations showing high IgG and low C3b and others showing low IgG and high C3b. IgG1 was the predominant IgG subclass in all patients. The other subclasses were low or undetectable and did not correlate with C3b deposition. Human monoclonal HLA antibodies, mostly IgG1, did not activate human C efficiently despite high IgG binding. However, combinations of two monoclonal antibodies to different epitopes of the same antigen did produce significant C3b deposition. Conclusions. Contrary to common assumptions, CDC, IgG binding, and IgG subclass are poor predictors of human C activation by HLA antibodies. The mix of specificities in a given serum and the antigens of a particular target cell appear to determine the efficiency of C activation. Measuring both antibody and C3b deposition (or other C component) may improve the assessment of donor-recipient compatibility.
Multiple Domains of the Jaagsiekte Sheep Retrovirus Envelope Protein Are Required for Transformation of Rodent Fibroblasts

ABSTRACT Jaagsiekte sheep retrovirus (JSRV) is an exogenous retrovirus of sheep that induces a contagious lung cancer, ovine pulmonary adenocarcinoma. We previously showed that the gene encoding JSRV envelope protein (Env) appears to function as an oncogene, since it can transform mouse NIH 3T3 cells. The cytoplasmic tail of the Env transmembrane protein (TM) is necessary for the transformation. However, previous experiments did not exclude the involvement of the Env surface protein (SU) in transformation. In this study, we created a series of nested deletion mutants through the SU domain and assessed their ability to transform rodent fibroblasts. All SU deletion mutants downstream of the predicted signal peptide were unable to transform murine NIH 3T3 or rat 208F cells. Transport to the plasma membrane of selected deleted Env proteins was confirmed by confocal immunofluorescence microscopy of hemagglutinin-tagged versions. Additional sequential SU deletion mutants lacking 50-amino-acid (aa) blocks throughout SU also were unable to transform. Furthermore, minimal insertion mutants of two amino acids (Leu/Gln) at various positions in SU also abolished transformation. These data indicate that domains in SU facilitate efficient JSRV transformation. This could reflect a necessity of SU for appropriate configuration of the Env protein or independent activation by SU of a signaling pathway necessary for transformation. Complementation between SU and TM mutants for transformation supported the latter hypothesis. Cotransfection with ΔGP Y590F (mutant in the TM cytoplasmic tail) with ΔGP SUΔ103-352 (lacking most of SU) resulted in efficient transformation. The resulting transformants showed evidence for the presence and expression of both mutant plasmids.
GABAA‐receptor heterogeneity in the adult rat brain: Differential regional and cellular distribution of seven major subunits

GABAA‐receptors display an extensive structural heterogeneity based on the differential assembly of a family of at least 15 subunits (α1–6, β1–3, γ1–3, θ, ρl–2) into distinct heteromeric receptor complexes. The subunit composition of receptor subtypes is expected to determine their physiological properties andipharmacological profiles, thereby contributing to flexibility in signal transduction and allosteric modulation. In heterologous expression systems, functional receptors require a combination of α‐, β‐, and γ‐subunit variants, the γ2‐subunit being essential to convey a classical benzodiazepine site to the receptor. The subunit composition and stoichiometry of native GABAA‐receptor subtypes remain unknown. The aim of this study was to identify immunohistochemically the main subunit combinations expressed in the adult rat brain and to allocate them to identified neurons. The regional and cellular distribution of seven major subunits (α1, α2, α3, α5, β2,3, γ2, δ) was visualized by immunoperoxidase staining with subunit‐specific antibodies (the β2‐ and β3‐subunits were covisualized with the monoclonal antibody bd‐17). Putative receptor subtypes were identified on the basis of colocalization of subunits within individual neurons, as analyzed by confocal laser microscopy in double‐ and triple‐immunofluoreseence staining expeximents. The results reveal an extraordinary heterogeneity in the distribution of GABAA‐receptor subunits, as evidenced by abrupt changes in immunoreactivity along well‐defined cytoarchitectonic boundaries and by pronounced differences in the cellular distribution of subunits among various types of neurons. Thus, functionally and morphologically diverse neurons were characterized by a distinct GABAA‐receptor subunit repertoire. The pultiple staining experiments identified 12 subunit combinations in defined neurons. The most prevalent combination was the triplet α1/β2,3/γ2, detected in numerous cell types throughout the brain. An additional subunit (α2, α3, or δ) sometimes was associated with this triplet, pointing to the existence of receptors containing four subunits. The triplets α2/β2,3/γ2, α3/β2,3/γ2, and α5/β2,3/γ2 were also identified in discrete cell populations. The prevalence of these seven combinations suggest that they represent major GABAA‐receptor subtypes. Five combinations also apparently lacked the β2,3‐subunits, including one devoid of γ2‐subunit (α1/α2/γ2, α2/γ2, α3/γ2, α2/α3/γ2, α2/α5/δ). These combinations were selectively associated with small neuron populations, thereby representing minor GABAA receptor subtypes. These results provide the basis for a functional analysis of GABAA‐receptor subtypes of known subunit composition and may open the way for unproved therapeutic approaches based on the development of subtype‐selective drugs. © 1995 Wiley‐Liss, Inc.
Improving cardiopulmonary resuscitation with a CPR feedback device and refresher simulations (CPR CARES Study): a randomized clinical trial.

IMPORTANCE The quality of cardiopulmonary resuscitation (CPR) affects hemodynamics, survival, and neurological outcomes following pediatric cardiopulmonary arrest (CPA). Most health care professionals fail to perform CPR within established American Heart Association guidelines. OBJECTIVE To determine whether "just-in-time" (JIT) CPR training with visual feedback (VisF) before CPA or real-time VisF during CPA improves the quality of chest compressions (CCs) during simulated CPA. DESIGN, SETTING, AND PARTICIPANTS Prospective, randomized, 2 × 2 factorial-design trial with explicit methods (July 1, 2012, to April 15, 2014) at 10 International Network for Simulation-Based Pediatric Innovation, Research, & Education (INSPIRE) institutions running a standardized simulated CPA scenario, including 324 CPR-certified health care professionals assigned to 3-person resuscitation teams (108 teams). INTERVENTIONS Each team was randomized to 1 of 4 permutations, including JIT training vs no JIT training before CPA and real-time VisF vs no real-time VisF during simulated CPA. MAIN OUTCOMES AND MEASURES The proportion of CCs with depth exceeding 50 mm, the proportion of CPR time with a CC rate of 100 to 120 per minute, and CC fraction (percentage CPR time) during simulated CPA. RESULTS The quality of CPR was poor in the control group, with 12.7% (95% CI, 5.2%-20.1%) mean depth compliance and 27.1% (95% CI, 14.2%-40.1%) mean rate compliance. JIT training compared with no JIT training improved depth compliance by 19.9% (95% CI, 11.1%-28.7%; P < .001) and rate compliance by 12.0% (95% CI, 0.8%-23.2%; P = .037). Visual feedback compared with no VisF improved depth compliance by 15.4% (95% CI, 6.6%-24.2%; P = .001) and rate compliance by 40.1% (95% CI, 28.8%-51.3%; P < .001). Neither intervention had a statistically significant effect on CC fraction, which was excellent (>89.0%) in all groups. Combining both interventions showed the highest compliance with American Heart Association guidelines but was not significantly better than either intervention in isolation. CONCLUSIONS AND RELEVANCE The quality of CPR provided by health care professionals is poor. Using novel and practical technology, JIT training before CPA or real-time VisF during CPA, alone or in combination, improves compliance with American Heart Association guidelines for CPR that are associated with better outcomes. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT02075450.
Lack of Association Between Chlamydophila Pneumoniae Seropositivity and Abdominal Aortic Aneurysm

Chronic Chlamydophila pneumoniae infection has been suggested as a possible contributing factor for the development and expansion of abdominal aortic aneurysm (AAA). The relevance of C pneumoniae involved in the processes underlying aneurysmal rupture is unknown. The aim of this study was to examine the relationship between C pneumoniae seropositivity and AAA rupture. In a case-control study, 119 patients with AAA and 36 matched controls were prospectively investigated with C pneumoniae serology. Patients with ruptured AAA have similar levels of IgG antibodies against C pneumoniae as patients with an electively operated AAA, a small AAA, and controls. In conclusion, this study fails to demonstrate a connection between C pneumoniae seropositivity and AAA rupture.
Curcumin and resveratrol in combination modulates benzo(a)pyrene-induced genotoxicity during lung carcinogenesis

The present study attempted to explore the efficacy of curcumin and resveratrol in modulating mitotic catastrophe and apoptosis during lung carcinogenesis. The mice were segregated into five groups, which included normal control, benzo(a)pyrene (BP)-treated, BP + curcumin (C)-treated, BP + resveratrol (R)-treated and BP + C + R-treated groups. The BP treatment resulted in a significant increase in the formation of micronuclei as well as in the protein expression of bcl-2 in the lungs of mice. On the other hand, a significant decrease was observed in the number of apoptotic cells and protein expression of bax in the lungs of BP-treated mice. Supplementation of curcumin and resveratrol individually to BP-treated animals resulted in a decrease in the micronuclei formation; however, it was not statistically significant. Interestingly, combination of curcumin and resveratrol resulted in a statistically significant decrease in micronuclei formation. Moreover, phytochemicals in combination significantly reduced the protein expression of bcl-2 in BP-treated mice. Furthermore, supplementation of phytochemicals in combination brought a noticeable improvement in the number of apoptotic cells as well as in the protein expression of bax. The present study, therefore, concludes that the combined treatment with curcumin and resveratrol modulates mitotic catastrophe by stimulating apoptosis in BP-treated mice.
Perpetual Licensing vs. Subscription of Software: A Theoretical Evaluation

Software vendors have been using the subscription (leasing) model to replace or supplement the traditional perpetual licensing (selling) model. Durable goods theories generally support such a model. This paper looks at a software vendor who can sell (at a posted price) or lease his product and guarantee that subscribers will always have the latest version of the software. We discuss the optimal way of licensing software: perpetual licensing, subscription, or a hybrid approach that involves both. By addressing such specific issues in the packaged software market as network effects, upgrade compatibility, and the vendor's ability to commit to future prices in a dynamic environment, we demonstrate how a software vendor can manage the trade-offs of perpetual licensing and subscription to achieve a higher profit, as well as the corresponding welfare effect on consumers.
Mechanisms of Cholesterol-Lowering Effects of Lactobacilli and Bifidobacteria Strains as Potential Probiotics with Their bsh Gene Analysis

The bile salt hydrolase (BSH) enzyme activities of human-derived lactic acid bacteria and bifidobacteria were evaluated. The highest enzyme activity was identified as 1.76 ± 0.23 U/mg protein for Bifidobacterium breve A26 and 1.42 ± 0.11 U/mg protein for Lactobacillus plantarum LA3. The bile salt deconjugation ability of the 6 isolates representing the highest BSH enzyme activity was calculated as the release of cholic acid and was between the range of 2.03 ± 0.22 and 1.05 ± 0.25 mM. The strains with high BSH enzyme activity also showed high deconjugation ability (p < 0.01). The effect of increasing bile concentrations on the growth of bacteria and their cholesterol removal abilities based on cholesterol precipitation were determined. Cholesterol removal in control medium was between 22.6 ± 0.4 and 26.5 ± 0.4%. The highest value was recorded at a 0.2% bile concentration. As the biliary concentration increased, a decrease in cholesterol removal and viability of the bacteria was noted in all strains. The percent of similarity of the bsh gene region between different genes was specified. The results may throw some light on proving the ability of these probiotics either as a novel alternative or as adjuvants to chemical drugs in treating hypercholesterolemia.