Miracle-dz/UniFAR-FTUs huggingface dataset:
Creating an environment for patient safety and teamwork training in the operating theatre: A quasi-experimental study

Abstract Introduction: Positive safety and a teamwork climate in the training environment may be a precursor for successful teamwork training. This pilot project aimed to implement and test whether a new interdisciplinary and team-based approach would result in a positive training climate in the operating theatre. Method: A 3-day educational module for training the complete surgical team of specialist nursing students and residents in safe teamwork skills in an authentic operative theatre, named Co-Op, was implemented in a university hospital. Participants’ (n = 22) perceptions of the ‘safety climate’ and the ‘teamwork climate’, together with their ‘readiness for inter-professional learning’, were measured to examine if the Co-Op module produced a positive training environment compared with the perceptions of a control group (n = 11) attending the conventional curriculum. Results: The participants’ perceptions of ‘safety climate’ and ‘teamwork climate’ and their ‘readiness for inter-professional learning’ scores were significantly higher following the Co-Op module compared with their perceptions following the conventional curriculum, and compared with the control group’s perceptions following the conventional curriculum. Conclusion: The Co-Op module improved ‘safety climate’ and ‘teamwork climate’ in the operating theatre, which suggests that a deliberate and designed educational intervention can shape a learning environment as a model for the establishment of a safety culture.
Development of a Theory-Based (PEN-3 and Health Belief Model), Culturally Relevant Intervention on Cervical Cancer Prevention Among Latina Immigrants Using Intervention Mapping

The development of efficacious theory-based, culturally relevant interventions to promote cervical cancer prevention among underserved populations is crucial to the elimination of cancer disparities. The purpose of this article is to describe the development of a theory-based, culturally relevant intervention focusing on primary (sexual risk reduction) and secondary (Pap smear) prevention of cervical cancer among Latina immigrants using intervention mapping (IM). The PEN-3 and Health Belief Model provided theoretical guidance for the intervention development and implementation. IM provides a logical five-step framework in intervention development: delineating proximal program objectives, selecting theory-based intervention methods and strategies, developing a program plan, planning for adoption in implementation, and creating evaluation plans and instruments. We first conducted an extensive literature review and qualitatively examined the sociocultural factors associated with primary and secondary prevention of cervical cancer. We then proceeded to quantitatively validate the qualitative findings, which led to development matrices linking the theoretical constructs with intervention objectives and strategies as well as evaluation. IM was a helpful tool in the development of a theory-based, culturally relevant intervention addressing primary and secondary prevention among Latina immigrants.
Analysis of a disk-type piezoelectric ultrasonic motor using impedance matrices

The dynamic behavior and the performance characteristics of the disk-type traveling wave piezoelectric ultrasonic motors (USM) are analyzed using impedance matrices. The stator is divided into three coupled subsystems: an inner metal disk, a piezoelectric annular actuator with segmented electrodes, and an outer metal disk with teeth. The effects of both shear deformation and rotary inertia are taken into account in deriving an impedance matrix for the piezoelectric actuator. The impedance matrices for each subsystem then are combined into a global impedance matrix using continuity conditions at the interfaces. A comparison is made between the impedance matrix model and the three-dimensional finite element model of the piezoelectric stator, obtaining the resonance and antiresonance frequencies and the effective electromechanical coupling factors versus circumferential mode numbers. Using the calculated resonance frequency and the vibration modes for the stator and a brush model with the Coulomb friction for the stator and rotor contact, stall torque, and no-load speed versus excitation frequencies are calculated at different preloads. Performance characteristics such as speed-torque curve and the output efficiency of the USM also are estimated using the current impedance matrix and the contact model. The present impedance model can be shown to be very effective in the design of the USM.
Enhancement of a culture‐based bacterial detection system (eBDS) for platelet products based on measurement of oxygen consumption

BACKGROUND: An enhanced bacterial detection system (Pall eBDS) was developed that distinguishes itself from its predecessor (Pall BDS) by removal of the platelet (PLT)‐retaining filter allowing for optimal bacterial transfer, modification of the culture tablet to reduce the confounding effects of respiring PLTs while enhancing bacterial growth, and facilitation of nutrients and gas exchange by agitating the sample pouch during incubation at 35°C. The objective was to evaluate the performance of the new eBDS.
Rat model for the study of penile erection: pharmacologic and electrical-stimulation parameters.

We report the use of a modified rat model for the study of the mechanisms of penile erection. In 92 Sprague-Dawley rats, the cavernous nerve was stimulated with different pulse intensities and frequencies, and the intracavernous pressure, time to maximal pressure and total duration of tumescence were measured. A maximal response was elicited at 20 pulses per second (pps) and 1.5 mA. Using this as 100%, we determined the relative pressure responses obtained with other frequencies: 5 pps, 57.3% (p = 0.007), 10 pps, 84.9% (p = 0.043); 30 pps, 99.5% (p = 0.832); 40 pps, 97.8% (p = 0.168); 50 pps, 90.9% (p = 0.021); 100 pps, 76.1% (p < 0.001). The time to maximal pressure varied with different frequencies, but was in all cases significantly different from the 20-pps response. Erection time during continuous cavernous nerve stimulation was significantly longer with frequencies below 20 pps (10 and 5 pps). In 30 rats, the physiologic response to intracavernous injection (0.03 ml) of acetylcholine, atropine, guanethidine, norepinephrine, phenylephrine, papaverine, terbutaline (intravenous also) and phentolamine was measured. Papaverine caused a dose-dependent rise in pressure; acetylcholine, atropine (a parasympathetic blocking agent) and guanethidine all had minimal effects. Phentolamine and norepinephrine increased systemic blood pressure, whereas phenylephrine decreased the intracavernous pressure in response to electrostimulation significantly. (ABSTRACT TRUNCATED AT 250 WORDS)
Modulation of murine gastric vagal afferent mechanosensitivity by neuropeptide W

Neuropeptide W (NPW) is an endogenous ligand for the receptors GPR7 and GPR8 and is involved in central regulation of energy homeostasis. NPW in the periphery is found in gastric gastrin (G) cells. In the stomach, energy intake is influenced by vagal afferent signals, so we aimed to determine the effect of NPW on mechanosensitive gastric vagal afferents under different feeding conditions.
Left ventricular systolic and diastolic function in children with overweight and obesity.

OBJECTIVES Several studies have found an association between obesity and heart failure. The purpose of our study was to identify the influence of the severity of obesity in children on structural and functional changes of the left ventricle and parameters of the systolic and diastolic function. METHODS This was a prospective controlled study carried out between February 1 and October 31, 2010, involving 21 children with overweight and obesity and 23 healthy controls. Following parameters were evaluated: nutritional status, intermittent and continuous ambulatory blood pressure monitoring, echocardiographic examination including aortal root diameter, left atrial diameter, interventricular septum thickness, left ventricular end-diastolic diameter, left ventricular end-systolic diameter, left ventricular posterior wall thickness, left ventricle mass, relative wall thickness, left ventricular mass/height index and ejection fraction. RESULTS In overweight and obese children, systolic blood pressure, diastolic blood pressure, average day-time SBP were higher than in controls. Also, left ventricular size was increased and diastolic dysfunction with preserved systolic function was present in overweight children. CONCLUSIONS In our study we have found that in obese and overweight children signs of early myocardial damage, both structural and functional, are detectable mainly as the alteration of the left ventricular diastolic function, despite preserved global systolic function. These changes seem to be intensified by the severity of obesity (Tab. 3, Ref. 39).
Kinetics of gene expression profiling in Swiss 3T3 cells exposed to aqueous extracts of cigarette smoke.

Previous studies from different laboratories have demonstrated that cigarette smoke (CS) harbours a strong oxidative stress potential, which broadly impacts exposed cells. Many of these studies have been devoted to identifying differentially expressed genes in exposed cells. Emerging DNA microarray techniques provide a sophisticated tool to characterize gene expression on a more comprehensive basis. Here, we report on kinetic studies performed to characterize gene expression profiles in Swiss 3T3 cells exposed to aqueous extracts of CS ('smoke-bubbled phosphate-buffered saline') up to 24 h through glass chips containing 513 different cDNA probes. The results obtained display a distinct expression pattern of up regulated and repressed genes, which was most evident after 4-8 h of exposure. The CS-related stress response involves mainly antioxidant response genes coding for, e.g. haem oxygenase-1 (HO-1), metallothionein 1/2 (MT1/2) and heat shock proteins (HSPs); genes coding for transcription factors, e.g. JunB and CAAT/enhancer binding protein (C/EBP); cell cycle-related genes, e.g. gadd34 and gadd45; and notably, genes described as mediators of an inflammatory/immune-regulatory response, e.g. st2, kc and id3. From a kinetic perspective, the stress response is characterized by the synchronized up regulation of antioxidant pathways, e.g. as reflected by the co-ordinated expression of ho-1 and ferritin. This expression pattern is obviously orchestrated by stress-responsive transcription factors, as exemplified by the early and strong expression of junB and c/ebp. Interestingly, among the 10 most up regulated genes are five which are known to counteract stress brought about by peroxynitrite. Altogether, these results demonstrate that CS induces a distinct signature of differential gene expression in exposed cells.
Purification, Characterization and Antibacterial Activity of l‐amino Acid Oxidase from Cerastes cerastes

Antibiotic resistance presents a real problem in which new antibacterial molecules from natural secretions could be beneficial in the development of new drugs. In this study, Cerastes cerastes venom was investigated for its antibacterial activity against Gram‐positive and Gram‐negative bacteria. The antibacterial activity was evaluated by measuring the halo inhibition and minimum inhibitory concentration (MIC). An l‐amino acid oxidase (CcLAAO) was purified from this venom using three chromatographic steps; its homogeneity (60 kDa) was confirmed by SDS‐PAGE. LC–MS/MS analysis of CcLAAO showed similarities with other LAAO enzymes from Echis ocellatus and Viridovipera stejnegeri venoms. CcLAAO presents an antibacterial activity against three bacterial strains (Staphylococcus aureus, Methicillin‐resistant S. aureus, and Pseudomonas aeruginosa) with MIC values of 10, 10, and 20 μg/mL, respectively. However, no effect was observed against Escherichia coli and yeast strains. Kinetic parameters of CcLAAO evaluated on l‐leucine at pH 8.0 and 20°C were Km = 0.06 mmol and Vmax = 164 mmol/min.
Prognostic evaluation in multiple myeloma: an analysis of the impact of new prognostic factors

We have analysed the prognostic information for survival of presenting features in an unselected series of 394 myeloma patients. 15 variables with significant prognostic information were identified, among these were some not previously or only recently reported: serum levels of hepatocyte growth factor (HGF), interleukin‐6 (IL‐6), C‐terminal cross‐linked telopeptide of collagen I (ICTP) and soluble interleukin‐6 receptor (sIL‐6R). In a multivariate Cox analysis six variables were significantly and independently associated with poor survival: high age, low W.H. O. ‐performance status (PS), high serum levels of calcium, β‐2‐microglobulin (β‐2M), IL‐6 and sIL‐6R. A risk score formed to predict survival for each percentile of the patient population allowed an efficient separation of prognostic groups. The discriminating power of the model compared favourably with three other previously published staging systems applied to the study population. Exclusion of IL‐6 and sIL‐6R from the model only marginally decreased the efficacy of the separation. The predictive value of some variables (sIL‐6R, β‐2M and W.H.O.‐PS) decreased significantly over time. We conclude that formation of a risk score based on independent variables is an efficient way to separate prognostic groups, that the contribution of new and not easily available parameters should be thoroughly evaluated before inclusion in prognostic models for clinical use and that the predictive value of parameters may decrease over time.
Identification of patients at high risk for death and cardiac ischemic events after hospital discharge.

BACKGROUND Patients with unstable angina (UA) and non-ST-elevation myocardial infarction (NSTEMI) remain at risk for death and cardiac ischemic events after being discharged from the hospital. METHODS We examined whether the Thrombolysis In Myocardial Infarction (TIMI) risk score for UA/NSTEMI, ascertained at presentation in patients enrolled in the TIMI 11B and Efficacy and Safety of Subcutaneous Enoxaparin in Unstable Angina and Non-Q-Wave MI (ESSENCE) trials, could be used to identify patients at high risk for major cardiac events after hospital discharge. RESULTS There were a total of 1218 major cardiac events, defined as death, nonfatal myocardial infarction, or urgent revascularization, by day 43. Of these events, 336 (28%) occurred in patients after they were discharged from the hospital. Use of the TIMI risk score for UA/NSTEMI revealed a progressive, statistically significant increase in the rate of events after leaving the hospital as the patients' baseline level of risk increased (P <.001 for chi(2) test for trend). For patients with a risk score of 5 to 7, treatment with enoxaparin during the acute phase was associated with an odds ratio of 0.51 (95% CI 0.29-0.91) for the occurrence of death and cardiac ischemic events after hospital discharge. CONCLUSIONS More than one fourth of the major cardiac events that will occur in the first 6 weeks occur after discharge from the hospital. Stratification at presentation on the basis of the TIMI risk score for UA/NSTEMI can be used to identify patients at high risk for these events. Among patients at high-risk, acute-phase treatment with enoxaparin significantly reduces the risk of major cardiac events after leaving the hospital.
In vitro expression of the human cytomegalovirus DNA polymerase gene: effects of sequence alterations on enzyme activity

Genomic DNA of the Towne strain human cytomegalovirus polymerase (pol) gene (4.4-kb RsrII-NcoI segment of the EcoRI J fragment) was cloned into plasmids containing either the T3 or the T7 promoter for in vitro transcription-translation studies. The translation efficiency of unmodified pol cRNA was poor in this system and could not be improved by capping. However, the efficiency could be enhanced by replacing the leader sequence with a 40-bp AT-rich sequence derived from an alfalfa mosaic virus, R4. pol cRNA directed the synthesis of a 140-kDa polypeptide in a rabbit reticulocyte translation system. The in vitro-translated wild-type enzyme possessed significant polymerization activity which could be stimulated by salt as could that of the authentic enzyme purified from virus-infected cells. To study the critical domains of this enzyme, nine mutations were introduced into the pol gene around the conserved domains of eukaryotic polymerase by oligonucleotide-directed mutagenesis. Two constructs with mutations at amino acid residues 323 to 325 (M32QS) and 725 to 726 (M72II) remained active, with partial loss of enzyme activity, while the enzyme activities of other mutants with alterations at four domains located around amino acid residues 729 to 730 (M73HN), 804 to 807 (M80 and DE80), 910 to 913 (M91 and DE91), and 962 to 964 (M96 and DE96) were abolished. DNA template and triphosphate binding assays indicated that the mutation at 804 to 807 (conserved region III) lost the ability to bind DNA template, and four mutants, M73HN (within conserved region II), M80 (in region III), M91 (in region I), and M96 (around region V [962 to 964; amino acid sequence KKR]), failed to bind deoxyribonucleoside triphosphate. These data suggest that conserved region III is essential for DNA template binding, while residues between conserved region II and V (725 to 964) are involved in triphosphate binding.
Fabrication of a novel micron scale Y‐structure‐based chiral metamaterial: Simulation and experimental analysis of its chiral and negative index properties in the terahertz and microwave regimes

In this report, we describe the fabrication of a chiral metamaterial based on a periodic array of Y‐shaped Al structures on a dielectric Mylar substrate. The unit cell dimensions of the Y‐structure are ∼100 μm on a side with 8 μm linewidths. The fabricated Y‐structure elements are characterized using scanning electron microscopy (SEM) and atomic force microscopy (AFM). Quantitative elemental analyses were carried out on both the Y‐structure, comprised of Al and its oxide, as well as adjacent regions of the underlying mylar substrate using the energy dispersive X‐ray spectroscopy (EDS) capability of the SEM. Finite‐Difference Time‐Domain (FDTD) calculations of the negative index of refraction for a 3D wedge of multiple layers of the 2D metamaterials showed that these metamaterials possess double negative (−μ,−ϵ) electromagnetic bulk properties at THz frequencies. The same negative index of refraction was determined for a wedge comprised of appropriately scaled larger Y‐structures simulated in the microwave region. This double negative property was confirmed experimentally by microwave measurements on a 3D wedge comprised of stacked and registered Y‐structure sheets. Microsc. Res. Tech., 2007. © 2007 Wiley‐Liss, Inc.
Dietary control of exertional rhabdomyolysis in horses.

OBJECTIVE To determine whether feeding a low-carbohydrate, high-fat diet would decrease severity of exercise-induced muscle injury in horses with exertional rhabdomyolysis. ANIMALS 19 horses with a history of exertional rhabdomyolysis. DESIGN Case series. PROCEDURE Specimens of the semitendinosus or semimembranosus muscle were obtained for histologic examination, and serum creatine kinase (CK) and aspartate transaminase (AST) activities 4 hours after exercise were determined. Horses were then fed a low-carbohydrate, high-fat diet, and serum CK and AST activities 4 hours after exercise were reevaluated at approximately monthly intervals for 3 to 6 months. RESULTS Serum CK and AST activities 4 hours after exercise were high before any change in diet. All 19 horses had evidence of chronic myopathic change and abnormal glycogen accumulation in muscle biopsy specimens; 11 horses also had evidence of complex polysaccharide accumulation. Adaptation to diet change required approximately 3 to 6 months. Sixteen horses did not have any episodes of exertional rhabdomyolysis after 3 to 6 months of diet change, and 3 horses had mild episodes of exertional rhabdomyolysis following either a reduction in dietary fat intake or restriction in exercise. Postexercise serum CK and AST activities 3 to 6 months after the change in diet were significantly less than initial values. CLINICAL IMPLICATIONS Results indicated that exertional rhabdomyolysis may be a result of abnormal carbohydrate metabolism in some horses. Feeding a diet with low carbohydrate and high fat content may reduce severity of exercise-induced injury in some horses with exertional rhabdomyolysis.
Analysis of Propofol/Remifentanil Infusion Protocol for Tumor Surgery With Intraoperative Brain Mapping

Background There is no general consensus about the best anesthesiologic approach to use during craniotomies with intraoperative brain mapping, and large prospective studies evaluating the complications associated with different approaches are lacking. Objective of this study was to prospectively collect and evaluate data about a large series of consecutive asleep-awake and asleep-asleep craniotomies. Methods We analyzed 238 consecutive procedures from January 2005 to December 2008. During asleep-awake procedures, patients were initially ventilated through a laryngeal mask which was removed to allow language testing. During asleep-asleep procedures, patients remained sedated and intubated to permit motor testing. Results In asleep-awake craniotomies [n=135, age 42 y (range: 16 to 72 y), American Society of Anesthologists classification (ASA) 1 (1 to 3), and body mass index 24.2±3.7 kg/m2], 43% of the procedures were free of complications. Most common complications were hypertension (27%) and brief clinical seizures (16%), but also hypotension (10%), vomiting (7%), brief periods of apnea (4%), and agitation (6%) were observed. In 7% of the procedures, seizures required pharmacologic treatment. Fifty-nine percent of the asleep-asleep procedures [n=103, age 51 y (range: 21 to 76 y), ASA 1 (1 to 3), body mass index 25.4±3.9 kg/m2, P<0.05 vs. asleep-awake] were free of complications. Clinical seizures were observed in 31% of the cases. The administration of boluses of hypnotics was rarely necessary (6%) and safer because of secured airways. Conclusions With this study, we demonstrated the feasibility and safety of our protocols on large prospective case series. Asleep-awake protocol can be safely used when intraoperative language mapping is planned, whereas an asleep-asleep protocol with secured airway might be preferred when motor testing only is required.