Miracle-dz/UniFAR-FTUs huggingface dataset:
The Surgical Safety Checklist: Results of Implementation in Otorhinolaryngology.

OBJECTIVES To assess the impact of implementing the surgical safety checklist (SSCL) on the outcome of patient safety in otorhinolaryngology (ENT) surgical procedures in two hospitals in Saudi Arabia: Aseer Central and Abha Private Hospitals. METHODS This retrospective study conducted over seven years (1 July 2008 to 30 June 2015) followed a staff educational and training program for the implementation of the World Health Organization Surgical Safety Checklist (WHO SSCL). The program included the use of audiovisual aids and practical demonstrations. Incidents of non-compliance were treated as sentinel events and were audited by the process of root cause analysis. RESULTS There were 5 144 elective ENT surgical cases in both hospitals in which the SSCL was utilized over the seven-year study period. The average compliance rate was 96.5%. Reasons for non-compliance included staff shortage, fast staff turnover, excessive workload, communication problems, and presence of existing processes. CONCLUSIONS The implementation of the SSCL was a substantial leap in efforts towards ensuring surgical patients' safety. It is compulsory in the healthcare system in many countries. Such progress in healthcare improvement can be accomplished with the commitment of the operating suite staff by spending few moments checking facts and establishing an environment of teamwork for the benefit of the surgical patient.
Is Bactra bactrana (Kennel, 1901) a novel pest of sweet peppers?

Abstract This is the first report of Bactra bactrana (Kennel, 1901) (Lepidoptera: Tortricidae) attacking a major solanaceous crop, sweet pepper Capsicum annuum L. The infestation was detected in two greenhouses at the area of Tympaki (Southern Crete, Greece). The moth larvae caused typical symptoms of a fruit borer with numerous small holes on the surface of the peppers and extensive damage on the inside of the fruit as a result of the feeding activity. Unknown factors facilitated this major shift in host range since B. bactrana is typically a stem borer of sedges. In addition, the pest status of B. bactrana is currently under question, as in both cases the infestations by the moth were associated with significant yield losses. B. bactrana was moderately controlled with chemicals registered for Lepidoptera management in sweet pepper due to the boring nature of the infestation. Some comparative taxonomic notes are provided to facilitate accurate pest discrimination of related Bactra species. Finally, biological attributes of the species are summarized and are discussed from pest control and ecological perspectives. Because Bactra species have been used in augmentative releases for the control of sage, the implications of our findings on the release of biocontrol agents are placed in perspective.
Wait time reduction for patients awaiting chemotherapy infusion using a formal process improvement approach and sequential.

92 Background: At a community hospital satellite of an academic cancer center, baseline data indicated that 49% of patients waited longer than 30 minutes from arrival in the treatment chair until treatment was started, resulting in dissatisfaction and decreased chair turnover. METHODS A team was assembled, including physicians, nurses, pharmacists, and administrative staff. The team constructed a detailed process flow map and performed a cause-and-effect analysis. Wait time data were collected using the electronic scheduling system and time sheets. Additionally, nurses used a structured data collection sheet to categorize the reasons for prolonged wait times. A p-type statistical process control chart was constructed to track the proportion of infusion visits per day with wait times longer than 30 minutes. The team brainstormed process improvements and selected ones to implement by employing a priority/pay-off matrix. RESULTS Baseline data were assessed for 403 visits over a 3 week period. Of 232 visits with wait times longer than 30 minutes, 98 (42%) involved excessive waiting for the physician to see the patient or write orders. One of 4 physicians was responsible for 56 (57%) of these. This physician's patients were seen exclusively in the infusion room, while the other physicians saw patients in the exam room before sending them to the infusion area. Three PDSA cycles were conducted: (1) All physicians started seeing patients in the exam room before sending them to infusion chairs, (2) Specific treatments were selected that could be routinely administered without the physician seeing the patient, and (3) A reminder system prompted physicians to enter treatment orders within 24 hours of each patient's visit. After 6 months, 29% of patients waited longer than 30 minutes, down from 49% at baseline. CONCLUSIONS These interventions implemented using PDSA cycles successfully reduced wait times. Measurement and presentation of data were critical in persuading physicians to practice in a more homogeneous fashion.
Experience of wrong site surgery and surgical marking practices among clinicians in the UK

Background: Little is known about the incidence of “wrong site surgery”, but the consequences of this type of medical error can be severe. Guidance from both the USA and more recently the UK has highlighted the importance of preventing error by marking patients before surgery. Objective: To investigate the experiences of wrong site surgery and current marking practices among clinicians in the UK before the release of a national Correct Site Surgery Alert. Methods: 38 telephone or face-to-face interviews were conducted with consultant surgeons in ophthalmology, orthopaedics and urology in 14 National Health Service hospitals in the UK. The interviews were coded and analysed thematically using the software package QSR Nud*ist 6. Results: Most surgeons had experience of wrong site surgery, but there was no clear pattern of underlying causes. Marking practices varied considerably. Surgeons were divided on the value of marking and varied in their practices. Orthopaedic surgeons reported that they marked before surgery; however, some urologists and ophthalmologists reported that they did not. There seemed to be no formal hospital policies in place specifically relating to wrong site surgery, and there were problems associated with implementing a system of marking in some cases. The methods used to mark patients also varied. Some surgeons believed that marking was a limited method of preventing wrong site surgery and may even increase the risk of wrong site surgery. Conclusion: Marking practices are variable and marking is not always used. Introducing standard guidance on marking may reduce the overall risk of wrong site surgery, especially as clinicians work at different hospital sites. However, the more specific needs of people and specialties must also be considered.
Frequency Separation Locking and Synchronization for FDM Optical Sources Using Widely Frequency Tunable Laser Diodes

A laser diode (LD) frequency separation locking method (called the reference pulse method) is proposed. This method has advantageous features for frequency division multiplexing (FDM) networks from the viewpoint of frequency separation stability with a strict frequency separation standard, modulation format independence, controllability over a large number of LDs, and frequency synchronization capability. Frequency locking experiments, using four and ten controlled LDs, confirmed that the control system using the method can stabilize frequency spacing for more than 100 LDs. The frequency fluctuation is suppressed to less than 10 MHz. Frequency synchronization, utilizing the reference pulse method, is proposed and demonstrated experimentally for two controlled LD groups, each consisting of three LDs. Frequency discrepancy between two LD groups was only 2.7% of the frequency separation. Required frequency-swept light power and controlled LD power at the detector input for frequency synchronization indicate that more than 50000 LD groups within a 10 km area, each having 100 LDs, can be synchronized simultaneously. >
The standardization of law and its effect on developing economies

A widely used tool in law and development programmes is the supply of well-designed laws from the outside. This method of law development has now been embraced by international organizations as a way to improve the legal framework for global markets. The International Monetary Fund (IMF) has endorsed attempts by various organizations to develop legal standards with special emphasis on corporate and financial institution laws. The common idea behind these attempts is that the supplied laws once incorporated into domestic legal systems will improve the existing legal framework, and thus further economic development. This paper takes issue with this concept of law development. It argues that for developing effective legal systems, the contents of the supplied laws is of only secondary importance to the process of law development and the compatibility of the new laws with pre-existing conditions, including existing legislation and legal institutions. Three factors account for this: (i) only a few rules are freestanding, i.e. can be fully understood and enforced without reference to other legal terms and concepts; (ii) law is a cognitive institution, and the application and enforcement of rules is determined by the perception of new rules by users and enforcers in the receiving country; and (iii) effective law enforcement is a function of the extent of voluntary compliance and available resources in a given country. A closer analysis of the rules whose standardization is currently proposed for building an international financial architecture shows that the implementation of these standards and their effectuation will require more efforts by the law receiving countries than underwriting them, if the goals of standardizing the law are to be achieved. The paper discusses the implications for countries wishing to attract foreign investments by adopting the new standards, and makes some proposals for creating more effective legal systems in the area of financial law.
Big data solution for Sri Lankan development: A case study from travel and tourism

In this paper, the key aim is to provide conceptual, technical solution design to implement a supportive dashboard which integrates with Big Data indicators and online transaction processing (OLTP) systems. The proposed solution is mainly focusing on a case study of Travel and Tourism industry in Sri Lanka. We carried out in-depth analysis to identify the necessity of a dashboard and examine significant challenges need to consider when designing the solution. Moreover, we evaluate suitable big data technologies for implementation and Hadoop, Hbase, MapReduce has been proposed. Centralized repository for user Meta data, Contextual Search, Early Warning Alerts, Index Indicators, Analytic tool and Reports, Marketing campaign optimization, Link with social media features, Sales and marketing forecasting are main dashboard features that has been designed based on the requirements. Our results attest importance of Index indicators, one of the major functionality which is built-in to dashboard. In this work, we present a detailed analysis of a total efficiency index using four indexing strategies of varying complexity including Visit Index, Wealth Index, Health Index, and Lifestyle Index. We conclude by designing an open architecture, that can track and leverage data on the behavior of tourist via a dashboard which consider trends, to make better decisions, reduce risks and drive personal tourist experiences.
Oral health behaviours according to demographic characteristics in Korean adolescents: a national representative sample.

OBJECTIVES To provide information on how to teach correct oral health behaviour to youths and to develop programmes to that end, this study examined the oral health behaviour and demographic characteristics of adolescents. METHODS The raw data of 'The Third 2007 Youth Health Behavior Online Survey' carried out by the Korea Center for Disease Control and Prevention were analysed. Independent t-test, one-way ANOVA, and chi-squared analyses were used to assess the relationships between oral health behaviours and demographic characteristics. RESULTS The oral health behaviour of the adolescents who were investigated differed significantly depending on their demographic characteristics (P<0.001). Tooth brushing frequency differed significantly depending on gender and student grade (P<0.001) and the frequency of visits to a dental clinic differed depending on the gender, student grade, type of residential area (urban/rural), and type of school (middle or high) (P<0.001). School grade, type of residential area, and type of school also affected the likelihood of receiving preventive dental treatment (P<0.001). CONCLUSIONS Adolescents who were in lower grades, female, and lived in large urban communities visited dental clinics more frequently and received more preventive dental treatment than adolescents who were in higher grades, male and resided in small urban and rural areas. These results highlight the need for the further development and dissemination of oral health programmes.
Disruption of the plasminogen activator inhibitor‐1 gene reduces the adiposity and improves the metabolic profile of genetically obese and diabetic ob/ob mice

Elevated levels of plasma and adipose tissue plasminogen activator inhibitor‐1 (PAI‐1) are observed frequently in obese humans and rodents. In this report, genetically obese (ob/ob) mice lacking the PAI‐1 gene (PAI‐1−/−) were generated and then used to test the hypothesis that the presence of PAI‐1 promotes the hyperglycemia, hyperinsulinemia, and insulin resistance associated with obesity. Both wild‐type (WT) ob/ob and PAI‐1−/− ob/ob mice developed substantial adiposity compared with their lean counterparts. However, the PAI‐1−/− ob/ob mice weighed significantly less than the WT ob/ob mice, and their hyperglycemia and hyperinsulinemia improved significantly. Although intraperitoneal glucose administration resulted in a dramatic increase in serum insulin levels in WT ob/ob mice, the increase in PAI‐1−/−ob/ob mice was relatively small. Reverse transcription polymerase chain reaction assays and in situ hybridization studies demonstrated that tumor necrosis factor α (TNF‐α) mRNA expression increased significantly in the adipose tissue of WT ob/ob mice at most ages tested. However, it was not increased, or only mildly increased, in the adipose tissue of the PAI‐1−/− ob/ob mice. The concentration and rate of secretion of TNF‐α protein in adipose tissue from PAI‐1−/− ob/ob mice also were significantly lower compared with their WT ob/ob counterparts as shown by immunohistochemistry and ELISA. These results suggest that PAI‐1 contributes to the development of the characteristic hyperglycemia and hyperinsulinemia associated with murine obesity, possibly by facilitating increased adipose tissue TNF‐α gene expression.
Data mining techniques for large-scale gene expression analysis

Modern computational biology is awash in large-scale data mining problems. Several high-throughput technologies have been developed that enable us, with relative ease and little expense, to evaluate the coordinated expression levels of tens of thousands of genes, evaluate hundreds of thousands of single-nucleotide polymorphisms, and sequence individual genomes. The data produced by these assays has provided the research and commercial communities with the opportunity to derive improved clinical prognostic indicators, as well as develop an understanding, at the molecular level, of the systemic underpinnings of a variety of diseases. Aside from the statistical methods used to evaluate these assays, another, more subtle challenge is emerging. Despite the explosive growth in the amount of data being generated and submitted to the various publicly available data repositories, very little attention has been paid to managing the phenotypic characterization of their samples (i.e., managing class labels in a controlled fashion). If sense is to be made of the underlying assay data, the samples' descriptive metadata must first be standardized in a machine-readable format. In this thesis, we explore these issues, specifically within the context of curating and analyzing a large DNA microarray database. We address three main challenges. First, we acquire a large subset of a publicly available microarray repository and develop a principled method for extracting phenotype information from free-text sample labels, then use that information to generate an index of the sample's medically-relevant annotation. The indexing method we develop, Concordia, incorporates pre-existing expert knowledge relating to the hierarchical relationships between medical terms, allowing queries of arbitrary specificity to be efficiently answered. Second, we describe a highly flexible approach to answering the question: "Given a previously unseen gene expression sample, how can we compute its similarity to all of the labeled samples in our database, and how can we utilize those similarity scores to predict the phenotype of the new sample? " Third, we describe a method for identifying phenotype-specific transcriptional profiles within the context of this database, and explore a method for measuring the relative strength of those signatures across the rest of the database, allowing us to identify molecular signatures that are shared across various tissues ad diseases. These shared fingerprints may form a quantitative basis for optimal therapy selection and drug repositioning for a variety of diseases. (Copies available exclusively from MIT Libraries, Rm. 14-0551, Cambridge, MA 02139-4307. Ph. 617-253-5668; Fax 617-253-1690.)
The effect of head-induced interaural time and level differences on speech intelligibility in noise.

A study was made of the effect of interaural time delay (ITD) and acoustic headshadow on binaural speech intelligibility in noise. A free-field condition was simulated by presenting recordings, made with a KEMAR manikin in an anechoic room, through earphones. Recordings were made of speech, reproduced in front of the manikin, and of noise, emanating from seven angles in the azimuthal plane, ranging from 0 degree (frontal) to 180 degrees in steps of 30 degrees. From this noise, two signals were derived, one containing only ITD, the other containing only interaural level differences (ILD) due to headshadow. Using this material, speech reception thresholds (SRT) for sentences in noise were determined for a group of normal-hearing subjects. Results show that (1) for noise azimuths between 30 degrees and 150 degrees, the gain due to ITD lies between 3.9 and 5.1 dB, while the gain due to ILD ranges from 3.5 to 7.8 dB, and (2) ILD decreases the effectiveness of binaural unmasking due to ITD (on the average, the threshold shift drops from 4.6 to 2.6 dB). In a second experiment, also conducted with normal-hearing subjects, similar stimuli were used, but now presented monaurally or with an overall 20-dB attenuation in one channel, in order to simulate hearing loss. In addition, SRTs were determined for noise with fixed ITDs, for comparison with the results obtained with head-induced (frequency dependent) ITDs. (ABSTRACT TRUNCATED AT 250 WORDS)
Differential graft‐versus‐leukaemia effect by CD28 and CD40 co‐stimulatory blockade after graft‐versus‐host disease prophylaxis

Co‐stimulatory blockade may be a promising strategy for tolerance induction in transplantation. In allogeneic bone marrow transplantation (BMT) for leukaemia treatment, however, preservation of the graft‐versus‐leukaemia (GVL) effect is another critical requirement for clinical application. In this study, we have compared the effect on GVL of using CD28 and CD40 co‐stimulatory blockades as graft‐versus‐host disease (GVHD) prophylaxis in a murine allogeneic BMT model with simultaneous transfer of BCL1 leukaemia. Despite the relative improvement of GVHD as assessed by survival and body weight in both treatment regimes, treatment with anti‐CD154 moAb clearly diminished the GVL effect, whereas treatment with anti‐CD80 and CD86 MoAbs maintained this effect. Although T cell‐mediated effector function at 14 days post‐BMT assessed by IFNγ expression and cytotoxicity against host alloantigen was comparable between both co‐stimulatory blockades, IL‐12 mRNA expression was preferentially reduced by CD40 blockade. Our results suggest the differential involvement of the CD28 and CD40 co‐stimulatory pathways in the development of GVHD and GVL effects. CD28 blockade may be a favourable strategy for tolerance induction in leukaemia patients undergoing BMT.
Decision Procedures for Equationally Based Reasoning

This work develops new automated reasoning techniques for verifying the correctness of equationally specified programs These techniques are not just theoretical, but have been implemented, and applied to actual program verification projects. Although the work spans several different areas, a major theme of this work is to develop better techniques at the boundary between decidable and undecidable problems. That is, this work seeks out not just positive decidability results, but ways to extend the underlying techniques to be effective on problems outside of decidable subclasses. For program verification to succeed, we feel that two important directions must be pursued: (1) considering more expressive logics to allow designers to more easily specify systems, and (2) develop decision procedures that can reason efficiently about these more sophsticated logics. This work pursues both directions, and the main topics addressed include: new decidability and undecidability results for equational tree automata (Chapter 3), order-sorted unification (Chapter 4), sufficient completeness for specifications with partiality and rewriting modulo axioms (Chapter 5), completeness problems for context-sensitive specifications (Chapter 6), coverset induction in membership equational logic (Chapter 7), and a case study for verifying properties of powerlists with the Maude ITP (Chapter 8). Each of these theoretical topics have lead to the development of new libraries and tools. Two of the tools have already been used in external projects including our tree automata library's integration into the ACTAS protocol verification tool [126], and the order-sorted unification procedures use in the Maude-NRL protocol analyzer [49].
Development of a physical performance assessment checklist for athletes who sustained a lower extremity injury in preparation for return to sport: a delphi study.

PURPOSE/BACKGROUND To develop a consensus on the critical constructs necessary to be included in a physical performance assessment checklist (PPAC) to assess an athlete's ability for return to sport following a lower extremity injury. METHODS The study used a 3-round Delphi method to finalize the PPAI originally developed by a panel of experts. Fourteen Delphi representative sample participants were randomly derived from the authors of peer-reviewed publications of lower extremity injuries. Nine participants completed all 3 rounds. RESULTS Throughout the 3 rounds, the 10 initial constructs were modified and revised to produce the finalized PPAC consisting of 12 constructs necessary to consider for an athlete's return to sport after a lower extremity injury. CONCLUSIONS This instrument can be used as a checklist to advocate for prospective batteries of physical performance tests to incorporate the elements identified by this study. LEVEL OF EVIDENCE 5.