Miracle-dz/UniFAR-FTUs huggingface dataset:
A concept map development: articulation of the alignment between relational nurse leadership & team building strategies in order to support RN team leader practice

Supervisory Committee Dr. Gwen Hartrick Doane, Nursing Department Supervisor Dr. Noreen Frisch, Nursing Department Co-Supervisor or Departmental Member ABSTRACT Canadian RNs have recently been faced with the new challenge of being removedCanadian RNs have recently been faced with the new challenge of being removed from the bedside in order to fulfill the position of team leader. However, as the majority of frontline RNs may not be equipped with the skills, traits, or abilities necessary to execute such a role (Eddy et al., 2009; Heller et al., 2004; Pate, 2013), this MN project was undertaken as a way to help me grasp how the skills, traits, and abilities promoted within some relational nurse leadership works and within some team building tools and strategies, aligned with one another. In order to uncover alignment between these two areas, I employed Novak and Gowin’s (1984) systematic concept mapping methodology as a way to develop two concept maps that explicitly articulated the skills, traits, and abilities endorsed within the resources reviewed on relational nurse leadership and team building. Then, the theory of the relational work of nurses (Terrizzi DeFrino, 2009) was enlisted as a way to help me analyze how the skills depicted on my two maps aligned and reflected the three main theoretical assertions described by Terrizzi DeFrino (2009). In doing this, I was able to locate nine main aligning skill sets that were then illustrated within a visual spider map (All, Huycke & Fisher, 2003). I believe that this spider map could one day be used or tailored by hospital nurse leaders, clinicians, or educators as a way to help inform or guide RN team leaders for their new practice roles. 4 Table of
Doença péptica: estudo comparativo entre crianças e adolescentes

Objetivo: Analisar comparativamente os dados clinicos e endoscopicos concernentes a doenca peptica em grupo de criancas (CR) e adolescentes (AD). Material e Metodos: Foram estudadas 30 criancas e 76 adolescentes, no periodo de agosto de 1992 a novembro de 1994, portadores de doenca peptica. O diagnostico foi firmado mediante exame endoscopico e histologico em todos os casos. Pesquisou-se a colonizacao pelo H. pylori (biopsia gastrica corada pelo Giensa). Foram tomados e comparados dados clinicos quanto a dor abdominal (localizacao, intensidade, cronicidade e sintomas acompanhantes) em ambos os grupos. A analise estatistica foi efetuada pelo teste exato de Fisher (valor de significância p
MDR TB : CURRENT STATUS

Drug resistant tuberculosis has been reported since the early days of the introduction of chemotherapy but recently multi-drug resistant tuberculosis (MDR-TB) has been an area of growing concern and is posing a threat to control of tuberculosis. A review of 63 surveys conducted between 1985 and 1994 suggested that primary and acquired MDR-TB was between 0-10.8% and 0-48% respectively. However the qualities of these studies were variable due to the lack of proper representativeness and size of population sampled as well as lack of standardized laboratory methods in some of them. In 1994 WHO-IUATLD carried out a surveillance which concluded that the problem is global; the median prevalence of primary and acquired multi drug resistance was 1.4% (0-14.4%) and 13% (0-54.4%) respectively. A second WHO-IUATLD global project on drug surveillance carried out in 1996-1999 in 58 countries found that the median prevalence of primary and acquired multi-drug resistance was 1% (0-14%) and 9% (0 - 48%) respectively. Current estimates report the prevalence of primary and acquired multidrug resistance in India as 3.4% and 25% respectively. It must be emphasized that optimal treatment of MDR-TB alone will not curb the epidemic. Efforts must be focused on the effective use of first line drugs in every new patient so as to prevent the ultimate emergence of multidrug resistance. The use of reserve drugs to cure multi-drug resistant tuberculosis and to reduce further transmission should be considered but only as part of well structured programmes of tuberculosis control. (authors)
Characterization of a Fibrin Glue-Gdnf Slow-Release Preparation

• Abstract — One novel method to deliver trophic fac­ tor locally in the CNS is to mix it into fibrin glue. In the present studies, [ 1 2 S I]labeled GDNF-containing fibrin glue balls were used to determine binding and spread of the trophic factor. First, the binding of different concen­ trations of [ 1 2 5 I] labeled GDNF in fibrin glue was deter­ mined in vitro. Within the six concentrations used (from 200 nM to 0.004 nM, 0 M as control), there was a strong linear correlation between the [ 1 2 S I ] -GDNF concentra­ tion and the recovered radioactivity (r = 0.992). The mean bound radioactivity in 16 samples with 4 nM [ 1 2 5 I ] -GDNF was 71262 ± 2710 CPM, and accounted for 89.8% of the mean initial count of free [ 1 2 5 I ] -GDNF (79369 ± 3499 CPM). Second, [ 1 2 5 I ] -GDNF-conta in ing glue balls were implanted into the anterior chamber of adult rats. The implanted fibrin glue balls decreased in size with time, but could still be identified on the irises 2 wk after implantation. Radioactivity was concentrated at the implantation sites in the early stages with a distribu­ tion in the surrounding iris tissue, which became sepa­ rated into focal radioactive spots at the third week. Counts of radioactivity were significantly higher in the [ 1 2 S I ] -GDNF glue ball-implanted irises than controls until 14 days after implantation. A study of the [ 1 2 S I ] decay over time using least-squares linear regression demonstrated first-order kinetics (r = —0.98, p <0.02) with k = 0.0091 and T 1/2 = 76 h. Finally, [ 1 2 5 I ] G D N F containing glue balls were implanted in the spinal cord of adult rats. Radioactivity was concentrated at the implan­ tation sites in the early stages and was later distributed more widely in the surrounding thoracic cord. The [ 1 2 5 I ] -GDNF-conta in ing glue degraded over time and became a porous meshwork with decreasing radioactivity at the later time points. Radioactivity in the spinal cords subjected to implantation of [ 1 2 5 I ] -GDNF-conta in ing glue balls was higher than in controls for 14 days. Study of the [ 1 2 S I ] decay by time with least-squares linear regression demonstrated first-order kinetics (r = —0.97, p = 0.001) with T 1/2 = 75.6 h. We conclude that the trophic factor GDNF becomes bound in the fibrin glue matrix from which it is gradually released. Our results suggest that fibrin glue is an effective substrate for keeping a trophic factor localized in situ for a finite period, protected from the circulation, surrounding aqueous humor or CSF. © 1998 Elsevier Science Inc.
Article original / Original article L'humeur vitrée en toxicologie médico-légale : revue de la littérature et applications Vitreous humor as an alternative matrix in forensic toxicology: literature review and applications

Introduction: In toxicology, vitreous humor is used mainly for ethanol determinations, and more recently in studies focusing on drug determinations and correlation of concentrations with other matrices. Objectives: Our goal was to establish different cases where vitreous humor may be useful in forensic toxicology. Previous studies were referencedtoknowwhichdrugs(licitorillicit)canorcannotbedetected.Here,wediscusstheresultsobtainedindifferent studies and describe cases analyzed in our laboratory where vitreous humor results were useful for case interpretation. Methods: Vitreous humor was screened for alcohol, amphetamine, cocaine, opiates, cannabinoids and psychoactive drugs. Results: Amphetamines are easily detected in vitreous humor with no post-mortem changes. Opiates poorly distributeintovitreoushumor,butthehalf-lifeof6-monoacetylmorphinewasreportedtobelongerinvitreoushumorthan inblood.Cocaineand benzoylecgoninecanbefoundinvitreoushumor. Onthecontrary,cannabinoids arenotdetectable invitreoushumor.Conclusion:Vitreoushumorhasadvantagesoverothermatricesintermsofstabilityanditisrelatively exemptfrompost-mortemredistribution.However,interestislimitedbythelackofdataformostdrugs.Literatureisscarce ondiffusionofprescriptionmedicinesinvitreoushumorandinterpretationofconcentrationsintheabsenceofreferences is difficult. Toxicologists should be encouraged to analyze vitreous humor and publish their results.
RECENT STUDIES OF THE RISKS AND BENEFITS OF INHALED THERAPY FOR COPD

Anticholinergic drugs, a mainstay of treatment for chronic obstructive pulmonary disease, are generally considered to be very safe. There have been some new signals, however, of possible cardiovascular mortality with long-term use. Studies of these risks have yielded conflicting findings and warrant further assessment. Abrupt discontinuation of therapy could have serious clinical consequences. Much of the existing literature does not show an adverse impact on mortality and survival with anticholinergic treatment, and some studies support survival benefits. Some studies have demonstrated increased rates of pneumonia with combination therapy that includes inhaled corticosteroids, but these need to be weighed against the benefits of improved lung function and fewer exacerbations. Increasingly, clinicians are prescribing combination therapy, and the medical literature supports this approach. This article summarizes key findings from selected studies. (Adv Stud Med. 2008;8(13):451-456) B
Nvel srico da vitamina A em crianas portadoras de leishmaniose visceral

Vitamin A is considered an anti-infectious disease vitamin, and its deficiency is associated with severe infections such as in measles. In developing countries the low concentrations of vitamin A are a public health problem. The aim of this study is to describe serum vitamin A concentrations among children with visceral leishmaniasis (VL). Blood sample was collected from 22 children with VL, and stored in a freezer, 9 siblings, with no clinical signs of the VL patients had their blood collected for a control group. Samples were assayed by high performance liquid chromatography. The median vitamin A concentration in the LV group was 21. 38µg/100ml and in the control group it was 31. 39µg/100. The mean in the LV was statistically lower than in the control group, using Student's t test, p<0.01.
Model Predictive Control of Vibration in a Two Flexible Link Manipulator — Part 2

A finite element based model predictive controller (FEMPC) is developed and practically implemented for attenuating in-plane vibration of a two flexible link planar manipulator. This FEMPC structure is based on that used in dynamic matrix control (DMC), with the exception that a finite element (FE) model replaces how the predictions are formulated. A linear FE model is developed for each individual link, which is used with the current measured strain and control actions, to predict the response of each link. These predictions are carried out at each time step to address the geometric non-linearities associated with the orientation of the second link and those associated with friction, backlash and compliance of the geared motors. Furthermore, the use of FE modelling enables the control structure to be formulated based on known properties of the system, eliminating the need for open loop testing. The resulting FEMPC scheme is shown to outperform DMC and is capable of providing substantial attenuation of vibration, reducing the mean amplitude of dominant vibration by 92.5% and 15.6%, for the first and second links, respectively.
The diet quality index evaluates the adequacy of energy provided by dietary macronutrients

Objective To investigate the relationship between macronutrient intake adequacy and the national diet quality index score. Methods The study analyzed a representative sample of 1,662 individuals from the municipality of Sao Paulo who participated in a cross-sectional study called Health Survey-Capital (2008/2009). Two 24-hour recalls were collected. Habitual intake was determined by the Multiple Source Method. The Brazilian index was calculated as suggested, and macronutrient adequacy was given by the World Health Organization and Food and Agriculture Organization recommendations. A generalized linear model verified the relationship between the Brazilian index and macronutrient adequacy. All analyses with a descriptive level below 0.05 were considered significant. The analyses were performed by the software Stata 12.0, survey mode. Results The vast majority (91%) of the population had inappropriate macronutrient intakes, and the total median Brazilian index score was 61.3 points (interquartile range=10.1). The total Brazilian index score of individuals with high lipid intake was worse than that of individuals with proper lipid intake (β=0,96; p=0,004), while those with high protein intake had a better score (β=1,10; p=0,003) than those with proper protein intake. Conclusion The revised Brazilian Healthy Eating Index assesses diet quality properly regarding high lipid intake, but it has some limitations regarding high protein intake according to the World Health Organization and Food and Agriculture Organization recommendations. New studies should investigate the possibility of adapting this index to the World Health Organization and Food and Agriculture Organization recommendations.
THREE CASE REPORTS OF 5-FLUOROURACIL INDUCED SERPENTINE SUPRAVENOUS HYPERPIGMENTATION

The toxicity of the 5-fluorouracil is strongly influence by the dosage used, the rate and duration of drug administration. However, common side effects of 5-fluorouracil include nausea, vomiting and diarrhoea, leucopenia and thrombocytopenia. We report two cases with inoperable carcinoma of stomach who developed serpentine supravenous hyperpigmentation at the 4 th cycle of chemotherapy.
A Comparative Study of Efficacy and Tolerability of Telmisartan and Ramipril

There is a constant debate over comparative efficacy of Angiotensin Converting Enzyme Inhibitors (ACEI) and Angiotensin Recptor Blockers (ARB). This study was undertaken to compare the efficacy and tolerability of ACEI and ARB. Patients of mild to moderate hypertension were randomized into 2 groups and received either Telmisartan 40 mg or Ramipril 10 mg once a day orally for 12 weeks. At each visit, the systolic blood pressure (BP) and diastolic BP of each patient were recorded. The mean reduction in systolic BP in the Telmisartan/Ramipril group was 42.267 ± 6.923/41.467 ± 7.352 mmHg, while the mean reduction in diastolic BP in the Telmisartan/Ramipril group was 16.267 ± 1.362/12.4 ± 4.738 mmHg, respectively, at 12 weeks. When the reduction in systolic BP in the two groups was compared, there was no significant difference between the groups (P > 0.05). However, the mean reduction in diastolic BP achieved with Telmisartan was significantly higher (P < 0.001) than that achieved with Ramipril at the end of 12 weeks. In the Ramipril group, the incidence of dry cough was higher as compared to that in the Telmisartan group (13.33% vs. 0%, respectively; P < 0.05). Telmisartan produces a greater reduction in diastolic BP than Ramipril and is free from the adverse-effect of dry cough which is common with Ramipril.
Dietary proclivities of Paranthropus robustus from Swartkrans, South Africa

Pleistocene Paranthropus robustus fossils from Swartkrans have yielded stable isotope values suggesting some foraging on C4 plants possibly including underground storage organs. Dental microwear texture analysis on P. robustus (SK 6, SK 34 and SK 47) from Swartkrans Member 1 is performed to examine whether tooth surface damage from mastication agrees with prior dietary inferences from carbon isotopes. There is considerable variation in textural characteristics among the P. robustus specimens. Specifically, adult SK 34 stands apart from the two subadult specimens, SK 6 and SK 47, suggesting life history could be reflected in patterns of dental microwear texture characteristics, although seasonality and availability of fallback foods may also explain the variation observed in P. robustus. The fossils all exhibit elevated surface texture complexity, resembling the values for Lophocebus albigena and Cebus apella, and to a lesser extent, Pan troglodytes. Paranthropus robustus is dissimilar to primary folivores, such as Trachypithecus cristatus or folivore-frugivores such as Alouatta palliata suggesting leaves comprised very little of its diet. The textural fill volume of P. robustus differs from that observed in extant primates from tropical forests indicating extreme durophagy, perhaps a function of differences in habitat. Ingestion of extraneous grit on the underground parts of plants and from terrestrial resources, perhaps as fallback foods or as dietary staples, may account for these enamel textural properties and may help explain the mixed C3/C4 isotopic signal in P. robustus.
Contact dermatitis

Contact dermatitis is a disorder in which an eczematous reaction occurs in response to exposure to an external agent. This stimulus may act as an irritant, by having a direct noxious effect on the skin, or an allergen, where a type-4 T-cell-mediated hypersensitivity reaction occurs. Both reactions produce an inflammatory response in the skin, resulting in erythema and sometimes vesiculation followed by dryness, lichenification and fissuring. The irritant and allergic types of contact dermatitis can co-exist, so a good history with exploration of occupation and recreational factors is necessary. This article discusses the presentation of contact dermatitis and possible causative factors, and then outlines suitable investigations and management strategies.
Tick bites and Erythema migrans in Transylvania

Erythema migrans (EM), the hallmark and the most frequent manifestation of Lyme Borreliosis (LB), has not been studied in Romanian patients until the present study. Forty patients with solitary or multiple EM that presented to the Teaching Hospital of Infectious Diseases, Cluj-Napoca, between June 2011 and August 2012, were prospectively studied. Clinical and serological outcome of the patients was investigated comparing two groups of patients: patients with a short observation period of 3 months and patients with a longer observation of 9 months-1 year. Only one patient was diagnosed at the follow-up with late LB with musculoskeletal manifestations, but a number of unspecific symptoms with no objective signs were described in other 16 patients. Our data prove that the serological profile is not correlated with the clinical course, and sustain the recommendation of clinical follow-up of EM patients with no repeated serological testing for assessing therapy efficacy. Epidemiological and clinical data are presented in comparison with the results of similar studies performed in Europe and USA.
Clinical analysis of concurrent chemo-radiotherapy combined with adjuvant chemotherapy after surgical resection in patients with high-grade glioma

Objective: To investigate the efficacy and safety of concurrent chemo-radiotherapy [magnetic resonance imaging (MRI) simulation localization] combined with adjuvant chemotherapy after surgical resection in patients with high-grade glioma. Methods: Seventy-nine consecutive postoperative patients with grades Ⅲ-Ⅳ glioma received concurrent chemo-radiotherapy in Department of Radiation Oncology, Shanghai Minhang District Cancer Hospital between December 2004 and November 2009. The conformal radiation therapy was performed with a 6 MV X-ray fractionated-dose of 1.8-2.0 Gy and up to a total dose of 60 Gy in 30-33 fractions. The concurrent chemotherapy was administered with temozolomide at a dose of 75 mg/m2 per day until the end of radiation therapy. One month after radiotherapy, temozolomide was administered 150 mg/m2 per day for 5 days in the first cycle of adjuvant chemotherapy and 200 mg/m2 per day for 5 days in the following cycles and repeated every 21 days. The follow-up was conducted in 79 patients. The one-, two-, and three-year survival rates were calculated by Kaplan-Meier method. Results: The rate of follow-up was 100% with a median follow-up of 44 months (range: 12-60). The one-, two-, and three-year survival rates were 87.3%, 58.5% and 37.6%, respectively. The median survival time was 42 months. The result of COX proportional-hazards regression revealed that the age (≥ 48 years vs < 48 years, P = 0.027), pathological classification (grade Ⅲ vs grade Ⅳ, P = 0.023), cycles of chemotherapy with temozolomide after radiation (1-2 vs 3-6, P = 0.053), radiation dose (< 60 Gy vs 60 Gy, P = 0.008) and residual tumor after operation (yes vs no, P = 0.020) were independent prognostic factors. No severe adverse effects related to radiation therapy and chemotherapy were observed. Conclusion: The conformal radiation therapy using MRI simulation localization combined with concurrent chemotherapy and adjuvant chemotherapy after surgical resection in patients with high-grade glioma seems to have a favorable efficacy and tolerability. DOI:10.3781/j.issn. 1000-7431.2014. 04.010
Epithelioid angiosarcoma of bone and soft tissue: A report of seven cases with emphasis on morphologic diversity, immunohistochemical features and clinical outcome

Aims and background Epithelioid angiosarcoma is a rare histopathologic variant of angiosarcoma characterized by an epithelioid morphology. This subset can histologically mimic non-vascular neoplasms and impose serious challenges in reaching a correct diagnosis, especially in the context of limited tissue sampling (e.g., needle core biopsy). To improve recognition of epithelioid angiosarcoma – and the spectrum of morphologic diversity associated with this rare variant – and to avoid a misdiagnosis, we describe the clinical, histopathologic, and immunohistochemical findings of cases of epithelioid angiosarcoma diagnosed at our institution. Methods and study design Seven cases of epithelioid angiosarcoma with appropriate pathologic material were identified from our archives. Immunohistochemistry was used to detect the expression of CD31, CD34, Factor VIII, cytokeratin, epithelial membrane antigen, vimentin, HMB45, CD1a, CD68, lysozyme, CD45, desmin, and smooth muscle actin in all cases. Follow-up information was obtained by reviewing medical records or by direct communication with family members. Results The lesions involved the bone (n = 4) and soft tissues (n = 3). Microscopically, all tumors had a predominantly diffuse growth pattern, with a focal nested architecture in 6 cases, which closely mimicked metastatic carcinoma. The initial biopsy was performed in 2 of 6 patients and revealed the presence of a malignant neoplasm suggestive of metastatic carcinoma. Immunohistochemically, the epithelioid endothelial cells usually showed strong reactivity for CD31 (7/7), variable or focal positive staining for CD34 (5/7), Factor VIII (4/7), cytokeratin (6/7), epithelial membrane antigen (2/7), vimentin (7/7), and CD68 (3/7). In contrast, they were negative for CD1a, HMB45, lysozyme, CD45, desmin, and smooth muscle actin. Three patients died of disease within one year of the diagnosis, 2 patients developed local recurrence or metastases, and another 2 were disease-free at this writing. Conclusions With any unusual epithelioid neoplasm displaying some or all of the morphologic features described above, epithelioid angiosarcoma should be included in the differential diagnosis. In such an instance, endothelial markers should be incorporated in the immunohistochemical analysis to avoid misdiagnosis, particularly with limited sampling.