Miracle-dz/UniFAR-FTUs huggingface dataset:
Information tools for care coordination in patient handover: Is an electronic medical record enough to support nurses?

Background Effectiveness of end-of-shift patient handover between nurses may be impacted by poor communication. This can be improved with the use of information tools, either electronic or paper-based. Few studies have investigated the activities that support patient handover, and fewer have explored how several of these tools used together affects the handover process. Purpose The aim of this study was to understand coordination challenges in end-of-shift patient handover between nurses and the influence of multiple information tools used in that context. Methodology A qualitative methodology to investigate phenomena in an acute care hospital in the United States was used in this study. Semistructured interviews were used to elicit insights from 16 nurses. Data were analyzed by coding three types of task dependencies (prerequisite, simultaneous, and shared) and three information tools (electronic medical records [EMRs], Kardex, and printouts of EMR data). Results In preparation for a handover, nurses were burdened by ensuring that information in the EMR was correct and complete. A one-sheet Kardex was the tool nurses in the study preferred, because the essential information was at hand and it provided structure to the communication. Printouts of EMR data were often physically cumbersome and not useful in their current form, although they may be useful for communicating anomalous data. Conclusion This study provides insights regarding the challenges of care coordination in end-of-shift patient handover between nurses and the usages of a variety of information tools in preparation for handover, as well as the actual handover process. Practice Implications Multiple interrelated information tools may be used to support patient handover. Health leaders should focus efforts on further advancing protocols for end-of-shift nurse handovers. Health system designers should design information tools to align them with their defined purpose in the handover process. Future work should consider both the information needs of nurses and the goal of improving nurse workflows.
Increasing the accumulation of aptamer AS1411 and verapamil conjugated silver nanoparticles in tumor cells to enhance the radiosensitivity of glioma

Radioresistance significantly decreases the efficacy of radiotherapy, which can ultimately lead to tumor recurrence and metastasis. As a novel type of nano-radiosensitizer, silver nanoparticles (AgNPs) have shown promising radiosensitizing properties in the radiotherapy of glioma, but their ability to efficiently enter and accumulate in tumor cells needs to be improved. In the current study, AS1411 and verapamil (VRP) conjugated bovine serum albumin (BSA) coated AgNPs (AgNPs@BSA-AS-VRP) were synthesized and characterized. Dark-field imaging and inductively coupled plasma mass spectrometry were applied to investigate the accumulation of AgNPs@BSA-AS and AgNPs@BSA-AS-VRP mixed in different ratios in U251 glioma cells. To assess the influences of 19:1 mixed AgNPs@BSA-AS and AgNPs@BSA-AS-VRP on the P-glycoprotein (P-gp) efflux activity, rhodamine 123 accumulation assay was carried out. Colony formation assay and tumor-bearing nude mice model were employed to examine the radiosensitizing potential of 19:1 mixed AgNPs@BSA-AS and AgNPs@BSA-AS-VRP. Thioredoxin Reductase (TrxR) Assay Kit was used to detect the TrxR activity in cells treated with different functionally modified AgNPs. Characterization results revealed that AgNPs@BSA-AS-VRP were successfully constructed. When AgNPs@BSA-AS and AgNPs@BSA-AS-VRP were mixed in a ratio of 19:1, the amount of intracellular nanoparticles increased greatly through AS1411-mediated active targeting and inhibition of P-gp activity. In vitro and in vivo experiments clearly showed that the radiosensitization efficacy of 19:1 mixed AgNPs@BSA-AS and AgNPs@BSA-AS-VRP was much stronger than that of AgNPs@BSA and AgNPs@BSA-AS. It was also found that 19:1 mixed AgNPs@BSA-AS and AgNPs@BSA-AS-VRP significantly inhibited intracellular TrxR activity. These results indicate that 19:1 mixed AgNPs@BSA-AS and AgNPs@BSA-AS-VRP can effectively accumulate in tumor cells and have great potential as high-efficiency nano-radiosensitizers in the radiotherapy of glioma.
A topography of 21 phobic fears: network analysis in an epidemiological sample of adult twins

Abstract Background Few factor analyses and no network analyses have examined the structure of DSM phobic fears or tested the specificity of the relationship between panic disorder and agoraphobic fears. Methods Histories of 21 lifetime phobic fears, coded as four-level ordinal variables (no fear to fear with major interference) were assessed at personal interview in 7514 adults from the Virginia Twin Registry. We estimated Gaussian Graphical Models on individual phobic fears; compared network structures of women and men using the Network Comparison Test; used community detection to determine the number and nature of groups in which phobic fears hang together; and validated the anticipated specific relationship between panic disorder and agoraphobia. Results All networks were densely and positively inter-connected; networks of women and men were structurally similar. Our most frequent and stable solution identified four phobic clusters: (i) blood-injection, (ii) social-agoraphobia, (iii) situational, and (iv) animal-disease. Fear of public restrooms and of diseases clustered with animal and not, respectively, social and blood-injury phobias. When added to the network, the three strongest connections with lifetime panic disorder were all agoraphobic fears: being in crowds, going out of the house alone, and being in open spaces Conclusions Using network analyses applied to a large epidemiologic twin sample, we broadly validated the DSM-IV typography but did not entirely support the distinction of agoraphobic and social phobic fears or the DSM placements for fears of public restrooms and diseases. We found strong support for the specificity of the relationship between panic disorder and agoraphobic fears.
Nondestructive Classification of Soybean Seed Varieties by Hyperspectral Imaging and Ensemble Machine Learning Algorithms

During the processing and planting of soybeans, it is greatly significant that a reliable, rapid, and accurate technique is used to detect soybean varieties. Traditional chemical analysis methods of soybean variety sampling (e.g., mass spectrometry and high-performance liquid chromatography) are destructive and time-consuming. In this paper, a robust and accurate method for nondestructive soybean classification is developed through hyperspectral imaging and ensemble machine learning algorithms. Image acquisition, preprocessing, and feature selection are used to obtain different types of soybean hyperspectral features. Based on these features, one of ensemble classifiers-random subspace linear discriminant (RSLD) algorithm is used to classify soybean seeds. Compared with the linear discrimination (LD) and linear support vector machine (LSVM) methods, the results show that the RSLD algorithm in this paper is more stable and reliable. In classifying soybeans in 10, 15, 20, and 25 categories, the RSLD method achieves the highest classification accuracy. When 155 features are used to classify 15 types of soybeans, the classification accuracy of the RSLD method reaches 99.2%, while the classification accuracies of the LD and LSVM methods are only 98.6% and 69.7%, respectively. Therefore, the ensemble classification algorithm RSLD can maintain high classification accuracy when different types and different classification features are used.
A novel digital clock drawing test as a screening tool for perioperative neurocognitive disorders: A feasibility study

We developed a digital clock drawing test (dCDT), an adaptation of the original pen and paper clock test, that may be advantageous over previous dCDTs in the perioperative environment. We trialed our dCDT on a tablet device in the preoperative period to determine the feasibility of administration in this setting. To assess the clinical utility of this test, we examined the relationship between the performance on the test and compared derived digital clock measures with the 4 A's Test (4AT), a delirium and cognition screening tool.
The AP2/ERF Gene Family in Triticum durum: Genome-Wide Identification and Expression Analysis under Drought and Salinity Stresses

Members of the AP2/ERF transcription factor family play critical roles in plant development, biosynthesis of key metabolites, and stress response. A detailed study was performed to identify TtAP2s/ERFs in the durum wheat (Triticum turgidum ssp. durum) genome, which resulted in the identification of 271 genes distributed on chromosomes 1A-7B. By carrying 27 genes, chromosome 6A had the highest number of TtAP2s/ERFs. Furthermore, a duplication assay of TtAP2s/ERFs demonstrated that 70 duplicated gene pairs had undergone purifying selection. According to RNA-seq analysis, the highest expression levels in all tissues and in response to stimuli were associated with DRF and ERF subfamily genes. In addition, the results revealed that TtAP2/ERF genes have tissue-specific expression patterns, and most TtAP2/ERF genes were significantly induced in the root tissue. Additionally, 13 TtAP2/ERF genes (six ERFs, three DREBs, two DRFs, one AP2, and one RAV) were selected for further analysis via qRT-PCR of their potential in coping with drought and salinity stresses. The TtAP2/ERF genes belonging to the DREB subfamily were markedly induced under both drought-stress and salinity-stress conditions. Furthermore, docking simulations revealed several residues in the pocket sites of the proteins associated with the stress response, which may be useful in future site-directed mutagenesis studies to increase the stress tolerance of durum wheat. This study could provide valuable insights for further evolutionary and functional assays of this important gene family in durum wheat.
Antioxidant Supplementation Modulates Neutrophil Inflammatory Response to Exercise-Induced Stress

The aim of the present report was to evaluate the inflammatory response to a 2000-m running test considering neutrophil myeloperoxidase as an inflammatory marker, and to verify if supplements rich in antioxidants could modulate Post-test antioxidant and anti-inflammatory responses. To this end, a 21-day homogenization period was carried out with three groups: a control group, a supplemented group taking an almond beverage enriched with vitamins C and E and a third group consuming the same beverage but enriched with Lippia citriodora extract. At the end of this period, participants performed a 2000-m run, and blood samples were obtained the day before and immediately after the running test. Plasma and neutrophils were isolated. As a result, plasma creatine kinase and myoglobin increased, indicating Post-test muscle damage. Plasma oxidative markers were increased in all groups, except in the group supplemented with the almond beverage. Neutrophil antioxidant enzymes were significantly increased only in the control group, suggesting an antioxidant effect of the supplements provided in the other groups. Myeloperoxidase activity was significantly increased after the test in the control group, while increased enzyme levels were detected in plasma of the supplement groups. Therefore, antioxidant consumption seems to favour myeloperoxidase release. The connection of this observation with post-exercise recovery will require further investigation.
Dietary Interventions to Promote Healthy Eating among Office Workers: A Literature Review

Our aim is to review published studies on dietary interventions to promote healthy eating habits among office workers. The databases PubMed, EBSCO (MEDLINE, Academic Search Elite, CINAHL Plus, PsycARTICLES, PsycINFO), Cochrane Library, SCOPUS, and Google Scholar were searched between February and April 2019. Initially, 6647 articles were identified, and the final number of articles that met the inclusion criteria was 25. We identified four different types of interventions that included educational and/or environmental components, where environmental components provided healthy food in a work-related context. The interventions at the offices included web-based material, availability of food, provision of information in various ways, and a combination of environmental, educational and theory-based psychological approaches (i.e., multicomponent). The most commonly used designs were web-based and information interventions, respectively, which are the least expensive ways to intervene. The interventions assessed a range of outcomes, but this literature review focused on three, i.e., dietary intake, dietary behavior and health-related outcomes. Although the studies were heterogenous in terms of outcomes, design, number of participants, gender distribution and duration, all studies reported at least one positive effect. Thus, workplace dietary interventions are an unutilized area to positively influence dietary intake and health outcomes among office workers. However, the intervention needs to be tailored to the workplace.
The effects of substrate roughness on ultrathin water films

Real surfaces are rough and chemically heterogeneous on many length scales and wetting phenomena on these surfaces are affected by this inhomogeneous nature. We have used x‐ray reflectivity to examine the structure of static precursing films which precede the macroscopic meniscus of water on glass. We have examined the thickness of the film, the roughness of the interfaces bounding the film, and the conformality or correlations between the roughness features of these bounding interfaces. The wetting film consists of three basic components: the bulk meniscus, a thin (≤100 A) precursing wetting film which has a sudden termination, and beyond that, a much thinner film characteristic of the glass surface in contact with water vapor only. The roughness and chemical heterogeneity of the solid manifest themselves in the roughness of the water/vapor interface of the film, in the irregularity of the terminating boundary of the precursor wetting film, and in the hysteretic pinning of that boundary. The roughness of.
Response of monsoon variability in Himalayas to global warming

Reconstructed annual net accumulation from the Dasuopu ice core recovered in Himalayas, with a good correlation to Indian monsoon, reflects a major precipitation trend in central Himalayas. The Dasuopu accumulation (DSP An) also shows a strong correlation to the Northern Hemispheric temperature. Generally, as the Northern Hemispheric temperature increases by 0.1 K, the accumulation decreases by about 90 mm and vise versa. Under the condition of global warming, especially since 1920, the Northern Hemispheric mean temperature has increased by about 0.5 K, whereas accumulation in Dasuopu ice core has decreased by about 450 mm. According to the relationship between accumulation and temperature, a scenario prediction of monsoon rainfall in central Himalayas is made.
An Optical Fiber Sensor Coated with Electrospinning Polyvinyl Alcohol/Carbon Nanotubes Composite Film

A fiber-optics tapered sensor that is covered by an electrospinning polyvinyl alcohol (PVA) nanofiber film, is demonstrated to measure humidity and temperature simultaneously. A section multi-mode fiber (MMF) was sandwiched between two leading-in and out single mode fibers (SMFs), which was further tapered down to 29 μm to promote the humidity sensitivity of the sensor. A thin layer of electrospinning PVA nanofiber film was uniformly coated on the MMF taper region by electrospinning technology. In order to promote the humidity sensitivity and mechanical strength of electrospinning nanofibers, the carbon nanotubes (CNTs) were mixed into PVA to formed PVA/CNTs composite nanofiber film. A Fiber Bragg Grating (FBG) was cascaded with the humidity sensing fiber to monitor the ambient temperature simultaneously. The addition of CNTs effectively eliminated the cracks on the electrospinning nanofiber and made it more uniform and smoother. As experimental results show, the humidity sensitivity of the sensor with PVA/CNTs film was 0.0484 dB/%RH, an improvement of 31.16% compared to that of the sensor with PVA film, for which sensitivity is 0.0369 dB/%RH. The nanofiber humidity-sensitive film constructed using electrospinning had a satisfactory humidity response, special 3D structure and extensive application prospect.
Melflufen and Dexamethasone in Heavily Pretreated Relapsed and Refractory Multiple Myeloma

PURPOSE Melphalan flufenamide (melflufen) is a first-in-class peptide-drug conjugate that targets aminopeptidases and rapidly and selectively releases alkylating agents into tumor cells. The phase II HORIZON trial evaluated the efficacy of melflufen plus dexamethasone in relapsed and refractory multiple myeloma (RRMM), a population with an important unmet medical need. PATIENTS AND METHODS Patients with RRMM refractory to pomalidomide and/or an anti-CD38 monoclonal antibody received melflufen 40 mg intravenously on day 1 of each 28-day cycle plus once weekly oral dexamethasone at a dose of 40 mg (20 mg in patients older than 75 years). The primary end point was overall response rate (partial response or better) assessed by the investigator and confirmed by independent review. Secondary end points included duration of response, progression-free survival, overall survival, and safety. The primary analysis is complete with long-term follow-up ongoing. RESULTS Of 157 patients (median age 65 years; median five prior lines of therapy) enrolled and treated, 119 patients (76%) had triple-class–refractory disease, 55 (35%) had extramedullary disease, and 92 (59%) were refractory to previous alkylator therapy. The overall response rate was 29% in the all-treated population, with 26% in the triple-class–refractory population. In the all-treated population, median duration of response was 5.5 months, median progression-free survival was 4.2 months, and median overall survival was 11.6 months at a median follow-up of 14 months. Grade ≥ 3 treatment-emergent adverse events occurred in 96% of patients, most commonly neutropenia (79%), thrombocytopenia (76%), and anemia (43%). Pneumonia (10%) was the most common grade 3/4 nonhematologic event. Thrombocytopenia and bleeding (both grade 3/4 but fully reversible) occurred concomitantly in four patients. GI events, reported in 97 patients (62%), were predominantly grade 1/2 (93%); none were grade 4. CONCLUSION Melflufen plus dexamethasone showed clinically meaningful efficacy and a manageable safety profile in patients with heavily pretreated RRMM, including those with triple-class–refractory and extramedullary disease.
Preferred Strategies for Delivering Health Information to Patients With Musculoskeletal Disorders

Supplemental digital content is available in the text. Background Patients' information needs may differ from what their care providers may perceive to be the patients' needs. This discordance needs to be recognized and addressed. Objective We conducted a qualitative study to explore the perceptions of patients with selected musculoskeletal disorders and those of rheumatologists, on their preferred strategies for delivery of disease management information. Methods Fifty-two patients diagnosed with either rheumatoid arthritis, knee osteoarthritis, or osteoporosis took part in 6 focus groups and 18 individual semistructured interviews. In addition, 11 rheumatologists participated in 2 focus groups and 4 semistructured individual interviews. Data were explored by thematic content analysis. Perceived preferences were identified and compared between patients and rheumatologists regarding (a) media, (b) setting, (c) messengers, and (d) key message content. Results Patients' preferred media for disease management information were electronic (television and videos delivered as digital optical discs or the Internet), group instruction, and printed material. Patients preferred the information to be delivered in the setting of their homes, doctor's offices, or clinic waiting areas by the rheumatologists and patients with disease experience, addressing healthy lifestyle changes, medication adherence, and consequences of noncompliance. For rheumatologists, the perceived preference for information delivery was through printed material (brochures, booklets, and pamphlets) delivered in waiting areas by nurses and physicians, addressing nature of the disease, complications, and treatment adverse effects. Conclusions Provider perspectives on strategies for education may differ from those of patients. Our findings highlight the need for considering different stakeholder perspectives in designing educational tools and decision support materials for patients with chronic diseases. Take-Home Message Rheumatologists' preferences on strategies for education (mode of delivery, delivery setting, messengers, and topics) differ from those of patients. For example, patients want to learn about lifestyle changes and consequences of compliance versus noncompliance, whereas rheumatologists considered more important for patients to understand their disease, treatment adverse effects, and consequences of noncompliance.
In vitro studies and preclinical evaluation of benznidazole microparticles in the acute Trypanosoma cruzi murine model

Abstract Chagas disease is a serious parasitic infection caused by Trypanosoma cruzi. Unfortunately, the current chemotherapeutic tools are not enough to combat the infection. The aim of this study was to evaluate the trypanocidal activity of benznidazole-loaded microparticles during the acute phase of Chagas infection in an experimental murine model. Microparticles were prepared by spray-drying using copolymers derived from esters of acrylic and methacrylic acids as carriers. Dissolution efficiency of the formulations was up to 3.80-fold greater than that of raw benznidazole. Stability assay showed no significant difference (P > 0.05) in the loading capacity of microparticles for 3 years. Cell cultures showed no visible morphological changes or destabilization of the cell membrane nor haemolysis was observed in defibrinated human blood after microparticles treatment. Mice with acute lethal infection survived 100% after 30 days of treatment with benznidazole microparticles (50 mg kg−1 day−1). Furthermore, no detectable parasite load measured by quantitative polymerase chain reaction and lower levels of T. cruzi-specific antibodies by enzyme-linked immunosorbent assay were found in those mice. A significant decrease in the inflammation of heart tissue after treatment with these microparticles was observed, in comparison with the inflammatory damage observed in both infected mice treated with raw benznidazole and untreated infected mice. Therefore, these polymeric formulations are an attractive approach to treat Chagas disease.