Miracle-dz/UniFAR-FTUs huggingface dataset:
An evaluation of operating room throughput in a stand-alone soft-tissue trauma operating theatre.

BACKGROUND Operating room time is a limited, expensive commodity in acute hospitals. Strategies aimed at reduction of non-operative time improve operating room throughput and capacity. We conducted a prospective study to evaluate and augment operating room throughput and capacity using context-specific work practice changes. METHODS Following institutional and ethical approval, an interdisciplinary group designed and introduced a series of work practice changes specific to a stand-alone soft tissue trauma theatre, comprising modifications to patient processing, staff behaviours and additional anaesthesiologist hours. Time intervals relating to each patient were measured during a 16 week period before and after implementing work practice changes. The primary outcome measure was non-operative time, with daily caseload and cancellations amongst secondary outcome measures. RESULTS 251 procedures were included over 58 working days (8 to 17 Monday to Friday). Non-operative time [55.6 (31.1) vs 52.3 (9.8) minutes, p = 0.48], daily caseload [4 [1-9] vs 4 [2-7], p = 0.56], and the number of daily cancellations [3 [0-11] vs 5 [0-8], p = 0.38], did not differ between baseline and study phases. Regional anaesthesia for upper limb surgery increased during the study phase [26/59 (44.0%) vs 10/63 (15.9%), p = 0.014] with resultant decrease in mean duration of recovery room stay [20.7 (17.7) vs 30 (20.5) minutes, p = 0.0001] and increased recovery room bypass [26/116 (22.4%) vs 6/135 (4.4%), p = 0.0002]. Avoidable delays accounted for 124.8 (72.2) minutes of theatre time lost each day. CONCLUSION In conclusion, additional attending anaesthesiologist hours combined with work practice changes did not impact on measures of theatre throughput and capacity. The study identified important variables that contribute to avoidable delays, and points the way for future research.
The cold face test (diving reflex) in clinical autonomic assessment: methodological considerations and repeatability of responses.

1. Cold stimulus applied to the face causes bradycardia and peripheral vasoconstriction (i.e. the diving reflex), and has been suggested as a test of the autonomic pathways involved. The purpose of this study was to define standard procedures for conducting the test and analysing the responses to the cold face test, to evaluate variability in responses between subjects and within subjects when the same test is repeated, and to examine its usefulness in clinical autonomic assessment. 2. Sixteen (nine female, seven male) healthy adult (21-35 years old) subjects were used. Cold stimulus was applied with gel-filled compresses. Forehead temperature under the compress as an indication of stimulus magnitude, heart rate, blood flow in the finger, toe and calf by venous occlusion plethysmography, and systolic and diastolic blood pressure were monitored. Three protocols were carried out in which the temperature (0, 5, 10, 15 degrees C), placement (whole face, unilateral, forehead) and duration (20, 40, 60, 120 s) of the cold compress application were varied. 3. The data indicate that 0 degrees C compresses applied bilaterally for 40 s produced the maximum bradycardia and peripheral vasoconstriction. No subject found this test to be obnoxious, but a 120 s application was objectionable to some subjects. This cold face test resulted in 22%, 72%, 59% and 44% reductions in heart rate and blood flow to the finger, toe and calf, respectively. There was significant between-subject variability, but good consistency in responses to tests repeated in the same subject on different days, at different times of day and in different seasons. (ABSTRACT TRUNCATED AT 250 WORDS)
Improved metabolic control after supplemented fasting in overweight type II diabetic patients.

Twenty obese type II diabetes patients were treated in a metabolic ward during 4 weeks with a very low calorie regimen (200 kcal/day). They were given dietary advice and reexamined 3 months after discharge. Mean body weight decreased by 10 kg during fasting, blood glucose was normalized, urinary glucose disappeared and the K-value at i.v. glucose tolerance test increased. Fasting serum insulin concentrations decreased by 54%. Serum triglycerides (TG) decreased by 65%, serum cholesterol (Chol) by 28% and high density lipoprotein (HDL) Chol by 14%. Three months later, only serum TG remained significantly decreased (-47%) while HDL Chol was significantly higher than on admission (+11%). Fasting blood glucose remained significantly lower (-25%) with a low urinary glucose excretion. Supplemented fasting appears to be a safe and useful tool in the treatment of obese type II diabetics. It causes, at least during a limited follow-up period, a significant improvement in glucose control and lipoprotein metabolism in spite of a concomitant reduction of the antidiabetic medication.
Particle electrophoresis as a tool to understand the aggregation behavior of red blood cells

Red blood cell (RBC) electrophoresis measurements in polymer solutions have recently been introduced as a promising approach for investigating polymer‐cell interactions near the RBC surface. A polymer‐poor depletion layer near the RBC has been demonstrated: for depletion layers thicker than the double layer, viscosity within the depletion layer, rather than suspending medium viscosity, affects cell mobility. Using a well‐documented model of sepsis in rats, we have induced RBC membrane damage, and then measured the electrophoretic mobility of rat RBC from control and septic animals. Mobility measurements were carried out for cells suspended in polymer‐free buffer and in 0.5–2% solutions of dextran 500 (500 kDa molecular mass); RBC aggregation in autologous plasma and in dextran 500 was also studied. Our results indicate: (i) as anticipated from prior studies, the aggregation of RBC from septic animals is markedly enhanced (p<0.001) in plasma and in 0.5–1% dextran; (ii) the mobility of septic RBC in polymer‐free buffer was identical to control, whereas cells from septic animals had lower mobilities in 0.5% dextran; (iii) Over the range studied (0.5–2%), the mobility of RBC from septic animals was less sensitive to increases of dextran concentration and hence medium viscosity. These mobility‐aggregation findings can be partially interpreted in terms of a depletion model for RBC aggregation; alterations of RBC surface charge and the hydrodynamic friction within the cell's glycocalyx may also be involved. In overview, we believe that these results suggest the merits of microelectrophoresis for exploring protein or polymer behavior near biological particles and the potential value of future studies for understanding cell‐cell interactions.
Hypoglycemia in hospitalized adult patients without diabetes.

OBJECTIVE To study hypoglycemia in hospitalized patients without diabetes and to assess the role of underlying illness in th development of hypoglycemia and its association with outcome. METHODS We undertook a retrospective review of medical records at a university-affiliated tertiary care teaching hospital to identify adult patients without diabetes, admitted between 1994 and 2002, who presented with a blood glucose level of < or =50 mg/dL (< or =2.8 mmol/L). RESULTS We identified 88 patients (51 men and 37 women) who fulfilled the inclusion criteria. The mean age of the study group was 64 years. Specific contributing comorbid illnesses that could cause hypoglycemia were found in 63 patients (72%), 24 (38%) of whom had more than one comorbid condition. Chronic renal failure was found in 22 patients (25%); alcohol intoxication was present in 13 patients (15%); and liver failure, sepsis, cancer, and endocrine disorders each accounted for 11 cases of hypoglycemia (12%). Of the 88 patients, 14 (16%) died. These patients were significantly older than those who survived: mean age, 75.4 versus 61.8 years, respectively (P = 0.034). Only 2 of 51 patients with a single episode of hypoglycemia died, in comparison with 12 of 37 patients with more than one hypoglycemic episode (P = 0.001). CONCLUSION Hypoglycemia in patients without diabetes is associated with a high mortality rate. This study of hospitalized adult patients without diabetes who had low blood glucose levels extends the observation that hypoglycemia is associated with major comorbid conditions. Thus, hypoglycemia is a marker for poor outcome and a signal to the clinician to search for underlying illnesses.
Content of Phenolic Compounds and Antioxidant Capacity in Fruits of Apricot Genotypes

Research on natural compounds is increasingly focused on their effects on human health. In this study, we were interested in the evaluation of nutritional value expressed as content of total phenolic compounds and antioxidant capacity of new apricot (Prunus armeniaca L.) genotypes resistant against Plum pox virus (PPV) cultivated on Department of Fruit Growing of Mendel University in Brno. Fruits of twenty one apricot genotypes were collected at the onset of consumption ripeness. Antioxidant capacities of the genotypes were determined spectrometrically using DPPH• (1,1-diphenyl-2-picryl-hydrazyl free radicals) scavenging test, TEAC (Trolox Equivalent Antioxidant Capacity), and FRAP (Ferric Reducing Antioxidant Power)methods. The highest antioxidant capacities were determined in the genotypes LE-3228 and LE-2527, the lowest ones in the LE-985 and LE-994 genotypes. Moreover, close correlation (r = 0.964) was determined between the TEAC and DPPH assays. Based on the antioxidant capacity and total polyphenols content, a clump analysis dendrogram of the monitored apricot genotypes was constructed. In addition, we optimized high performance liquid chromatography coupled with tandem electrochemical and spectrometric detection and determined phenolic profile consisting of the following fifteen phenolic compounds: gallic acid, 4-aminobenzoic acid, chlorogenic acid, ferulic acid, caffeic acid, procatechin, salicylic acid, p-coumaric acid, the flavonols quercetin and quercitrin, the flavonol glycoside rutin, resveratrol, vanillin, and the isomers epicatechin, (–)- and (+)- catechin.
Identification of cancer‐associated proteins by proteomics and downregulation of β‐tropomyosin expression in colorectal adenoma and cancer

Elucidating the molecular mechanism underlying the development of adenoma, the major precursor lesion of colorectal cancer (CRC), would provide a basis for early detection, prevention as well as treatment of CRC. Using the highly sensitive 2‐D DIGE method coupled with MS, we identified 24 differentially expressed proteins in adenoma tissues compared with matched normal colonic mucosa and CRC tissues. Fifteen proteins were downregulated and three proteins were upregulated in adenoma tissues when compared with individual‐matched normal colonic mucosa. Five proteins were downregulated, while one protein was upregulated in adenoma tissues when compared with matched CRC tissues. A protein, β‐tropomyosin (TM‐β), recently suggested to be a biomarker of esophageal squamous carcinoma, was downregulated in both adenoma and CRC tissues. Additionally, the reduction in the level of TM‐β in adenoma and CRC tissues was further validated by Western blotting (p<0.05) and RT‐PCR (p<0.001). Our findings suggest that downregulation of TM‐β is involved in the early development of CRC and that differentially expressed proteins might serve as potential biomarkers for detection of CRC.
Improving the practice of the World Health Organisation’s surgical pause checklist at a tertiary paediatric surgical unit

Background and aims The World Health Organisation (WHO) surgical checklist acts as a safety check before surgery. The three components are: sign in, surgical pause and sign out. This study aims to assess and improve the surgical pause at a tertiary paediatric surgical unit. Methods and results Theatre nurses used as a standardised tool to record how the pause was carried out. All other theatre staff were blinded. Presentation of these data at departmental meetings allowed creation of a checklist poster which was placed in every theatre. Data collection was repeated five months later. Data on 114 operations were initially collected. Fifty-one per cent of operations completed all four steps to guideline. Introduction step met guideline in 61% of operations, identity and procedure in 90%, checklist in 98% and concerns in 71%. Following intervention, data were collected from 39 operations; 77% of operations completed all four steps to guideline. Introduction step met guideline in 87% of operations, identity and procedure in 100%, checklist in 100% and concerns in 90%. Conclusions This study shows that by engaging with theatre staff to create an acceptable checklist poster, better standard of patient safety in the operating theatre can be achieved.
Increased susceptibility to lethal Candida infections in burned mice preinfected with Pseudomonas aeruginosa or pretreated with proteolytic enzymes

Lethal Candida infections in burn patients are frequently preceded by or occur concomitantly with bacterial infections, which are often due to Pseudomonas aeruginosa. In this study, we developed a burned, mixed-challenge mouse model, which was designed to determine whether and how a recent bacterial infection could influence the development of subsequent candidosis. In this model, burned mice that were preinfected with a sublethal challenge of elastase-producing P. aeruginosa strain WR-5 and then sublethally challenged with Candida albicans exhibited a mortality rate of 60%, while unburned mice challenged in the same way and burned mice that received only one challenge organism exhibited mortality rates of less than 10%. Quantitative microbial counts performed with the kidneys, livers, and eschars of burned mice challenged with both organisms indicated that the deaths were due to Candida infection. Substitution of an elastase-negative P. aeruginosa strain for strain WR-5 in the model resulted in significantly lower mortality rates and lower microbial numbers in the organs. When the Pseudomonas enzyme elastase was substituted for the elastase-positive bacteria in the model, both the mortality rates and the organ counts were comparable to the values found after preinfection with strain WR-5. Another protease, thermolysin, was substituted for the elastase and produced similar mortality results. When the protease inhibitor alpha 2-macroglobulin was given to burned mice infected with the two organisms, it prevented the deaths due to Candida infection. We concluded that this model is one way to study bacterial-fungal infections in burned mice, that recent Pseudomonas infections could predispose burned mice to fatal candidosis, and that the proteolytic activity generated by the bacteria was primarily responsible for the establishment of lethal fungal infections.
Macrophage‐Derived Growth Factor for Fibroblasts and Interleukin‐1 Are Distinct Entities

P388D1, a mouse macrophagelike cell line, was adapted to grow continuously in an unsupplemented, serum‐free culture medium and continued to elaborate substances that were mitogenic for quiescent mouse fibroblasts (BALB/c 3T3 cells) and for thymocytes suboptimally stimulated with lectins. We have previously described [37] the fibroblast mitogenic activity as a macrophage‐derived competence factor (MDCF). Serum‐free, macrophage‐conditioned culture medium was concentrated 1,000‐fold by a combination of ultrafiltration (hollow fiber) and lyophilization. Concentrates of medium were subjected to gel filtration (Sephadex G‐75 or G‐150), and the fractions were assayed for mitogenic activity (MDCF) on density‐arrested BALB/c 3T3 cells and for Interleukin‐1 (IL‐1) activity in suboptimally stimulated (Con A) mouse thymocytes. The apparent molecular weight (MW) of MDCF activity was estimated at 56,000 daltons, whereas the peak of IL‐1 chromatographed at an apparent MW of 14–16K daltons. There was no detectable IL‐1 activity in the MDCF fractions and no detectable MDCF in the IL‐1 fractions. These data indicate that P388D1 cells produce both MDCF and IL‐1 activities under continuous serum‐free conditions and that the two activities are not identical. Stimulation of responsive mononuclear phagocytes with lipopolysaccharide and/or lymphokine‐rich supernates resulted in a differential modulation of MDCF and IL‐1 activities. Finally, antibody‐purified IL‐1 had no significant ability to stimulate DNA synthesis in quiescent fibroblasts at concentrations that were mitogenic for thymocytes. However, IL‐1 did augment the mitogenic activity of suboptimal amounts of platelet‐derived growth factor (PDGF), another competence factor. Further studies revealed that neither the generation nor the activity of MDCF was modulated by the presence of various inhibitors of proteolytic enzymes.
A single-gene explanation for the probability of having idiopathic talipes equinovarus.

It has been hypothesized that the pathogenesis of idiopathic talipes equinovarus (ITEV, or clubfoot) is explained by genetic regulation of development and growth. The objective of the present study was to determine whether a single Mendelian gene explains the probability of having ITEV in a sample of 143 Caucasian pedigrees from Iowa. These pedigrees were ascertained through probands with ITEV. Complex segregation analyses were undertaken using a regressive logistic model. The results of these analyses strongly rejected the hypotheses that the probability of having ITEV in these pedigrees was explained by a non-Mendelian pattern of transmission with residual sibling correlation, a nontransmitted (environmental) factor with residual sibling correlation, or residual sibling correlation alone. These results were consistent with the hypothesis that the probability of having ITEV was explained by the Mendelian segregation of a single gene with two alleles plus the effects of some unmeasured factor(s) shared among siblings. The segregation of alleles at this single Mendelian gene indicated that the disease allele A was incompletely dominant to the nondisease allele B. The disease allele A, associated with ITEV affection, was estimated to occur in the population of inference with a frequency of . 007. After adjusting for sex-specific population incidences of ITEV, the conditional probability (penetrance) of ITEV affection given the AA, AB, and BB genotypes was computed to be 1.0, . 039, and . 0006, respectively. Individual pedigrees in this sample that most strongly supported the single Mendelian gene hypothesis were identified. These pedigrees are candidates for genetic linkage analyses or DNA association studies.
Cognitive therapy for people with a schizophrenia spectrum diagnosis not taking antipsychotic medication: an exploratory trial

Background Although antipsychotic medication is the first line of treatment for schizophrenia, many service users choose to refuse or discontinue their pharmacological treatment. Cognitive therapy (CT) has been shown to be effective when delivered in combination with antipsychotic medication, but has yet to be formally evaluated in its absence. This study evaluates CT for people with psychotic disorders who have not been taking antipsychotic medication for at least 6 months. Method Twenty participants with schizophrenia spectrum disorders received CT in an open trial. Our primary outcome was psychiatric symptoms measured using the Positive and Negative Syndromes Scale (PANSS), which was administered at baseline, 9 months (end of treatment) and 15 months (follow-up). Secondary outcomes were dimensions of hallucinations and delusions, self-rated recovery and social functioning. Results T tests and Wilcoxon's signed ranks tests revealed significant beneficial effects on all primary and secondary outcomes at end of treatment and follow-up, with the exception of self-rated recovery at end of treatment. Cohen's d effect sizes were moderate to large [for PANSS total, d=0.85, 95% confidence interval (CI) 0.32–1.35 at end of treatment; d=1.26, 95% CI 0.66–1.84 at follow-up]. A response rate analysis found that 35% and 50% of participants achieved at least a 50% reduction in PANSS total scores by end of therapy and follow-up respectively. No patients deteriorated significantly. Conclusions This study provides preliminary evidence that CT is an acceptable and effective treatment for people with psychosis who choose not to take antipsychotic medication. An adequately powered randomized controlled trial is warranted.
Safeguarding Female Reproductive Health Against Endocrine Disrupting Chemicals—The FREIA Project

Currently available test methods are not well-suited for the identification of chemicals that disturb hormonal processes involved in female reproductive development and function. This renders women’s reproductive health at increasing risk globally, which, coupled with increasing incidence rates of reproductive disorders, is of great concern. A woman’s reproductive health is largely established during embryonic and fetal development and subsequently matures during puberty. The endocrine system influences development, maturation, and function of the female reproductive system, thereby making appropriate hormone levels imperative for correct functioning of reproductive processes. It is concerning that the effects of human-made chemicals on the endocrine system and female reproductive health are poorly addressed in regulatory chemical safety assessment, partly because adequate test methods are lacking. Our EU-funded project FREIA aims to address this need by increasing understanding of how endocrine disrupting chemicals (EDCs) can impact female reproductive health. We will use this information to provide better test methods that enable fit-for-purpose chemical regulation and then share our knowledge, promote a sustainable society, and improve the reproductive health of women globally.
The Outcome of Surgery for Lumbar Disc Herniation: I. A 4-17 Years' Follow-up with Emphasis on Somatic Aspects

Records of 575 patients operated on for the first time for lumbar disc herniation have been reviewed. Four to 17 years after the operation 371 (65%) patients answered a questionnaire on number of reoperations, working capacity, lumbar or sciatic pain as well as necessity of treatment. Of these, 255 (70%) still complained of back pain, and 83 (23%) of this group complained of constant heavy pain; 172 patients (45%) have a residual sciatica; 131 (35%) are still under some kind of treatment; 47 (14%) patients are receiving a disability pension. Repeat operations were performed in 17%. Based on the criteria given by Spine Update 1984 as related to justified or unjustified indication there was no statistical difference in long-term results concerning the above-mentioned criteria of success. The so-called justified indication for disc herniation neurosurgery does not necessarily imply a good long-term result. In the preoperative investigation, not only symptoms and neurological signs, but also the socially and personally defined career of the illness are of importance. The patients with complaints, mainly those receiving a pension, are psychologically conspicuous and show more psychopathological features as monitored by MMPI than the patients without complaints after surgery. Psychological assessment should increasingly be used in the preoperative evaluation, especially in patients who do not present an absolute indication for neurosurgical intervention.