Miracle-dz/UniFAR-FTUs huggingface dataset:
Decade of Patient Experience Improvement at a Tertiary Care Urban Hospital

Background and Objective: The purpose of this quality management study was to demonstrate how one hospital made a journey from average patient experience to become a regional leader in the experience of patient care for nationally recognized quality and safety metrics. Methods: Saint Francis Hospital & Medical Center (SFHMC) located in Hartford, Connecticut, serves a diverse sociodemographic community as part of Trinity Health. “Recommend the Hospital” (RTH) has been the main marker of patient experience at SFHMC and Trinity Health across the United States as part of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). From 2010 to 2019, SFHMC implemented unit-based rounding hospital-wide, adopting charge nurse and executive leadership rounding as standard work. The intense support from senior leadership spurred the implementation of these changes across middle management and all frontline workers. The t test was used to determine differences between the mean RTH scores between SFHMC, Connecticut, and the United States. Results: Patient experience at SFHMC was regularly assessed by Press Ganey surveys and HCAHPS, which demonstrated higher scores than averages for the state of Connecticut and the United States between 2010 and 2019 (both Ps < .001). SFHMC was the top performer with an RTH score of 83%, with the state average being 71% and the national average being 72%. In the years following the implementation of a multipronged low-cost strategy, hospital RTH scores rose linearly from the state and national average. SFHMC observed gains in patient safety and quality scores as measured by national benchmarks, including Leapfrog patient safety scores of 7 A's and 1 B over a 4-year period. SFHMC was the only hospital in Connecticut to receive an A grade 4 years in a row. Conclusion: A combination of nurse-led, unit-based rounding and executive team rounding with a consistent focus on patient experience resulted in significant improvement in RTH scores for a busy teaching urban hospital, with only a modest investment of resources. There was also improvement in quality and safety outcomes, which together with patient experience of care drove fiscal stability in an increasingly value-based health care environment.
Cell physiology and molecular mechanism of anion transport by erythrocyte band 3/AE1

The major transmembrane protein of the red blood cell, known as band 3, AE1, and SLC4A1, has two main functions: 1) catalysis of Cl−/HCO3− exchange, one of the steps in CO2 excretion, and 2) anchoring the membrane skeleton. This review summarizes the 150-year history of research on red cell anion transport and band 3 as an experimental system for studying membrane protein structure and ion transport mechanisms. Important early findings were that red cell Cl− transport is a tightly coupled 1:1 exchange and band 3 is labeled by stilbenesulfonate derivatives that inhibit anion transport. Biochemical studies showed that the protein is dimeric or tetrameric (paired dimers) and that there is one stilbenedisulfonate binding site per subunit of the dimer. Transport kinetics and inhibitor characteristics supported the idea that the transporter acts by an alternating access mechanism with intrinsic asymmetry. The sequence of band 3 cDNA provided a framework for detailed study of protein topology and amino acid residues important for transport. The identification of genetic variants produced insights into the roles of band 3 in red cell abnormalities and distal renal tubular acidosis. The publication of the membrane domain crystal structure made it possible to propose concrete molecular models of transport. Future research directions include improving our understanding of the transport mechanism at the molecular level and of the integrative relationships among band 3, hemoglobin, carbonic anhydrase, and gradients (both transmembrane and subcellular) of HCO3−, Cl−, O2, CO2, pH, and nitric oxide (NO) metabolites during pulmonary and systemic capillary gas exchange.
Overview on immobilization of enzymes on synthetic polymeric nanofibers fabricated by electrospinning

The arrangement and type of support has a significant impact on the efficiency of immobilized enzymes. 1‐dimensional fibrous materials can be one of the most desirable supports for enzyme immobilization. This is due to their high surface area to volume ratio, internal porosity, ease of handling, and high mechanical stability, all of which allow a higher enzyme loading, release and finally lead to better catalytic efficiency. Fortunately, the enzymes can reside inside individual nanofibers to remain encapsulated and retain their three‐dimensional structure. These properties can protect the enzyme's tolerance against harsh conditions such as pH variations and high temperature, and this can probably enhance the enzyme's stability. This review article will discuss the immobilization of enzymes on synthetic polymers, which are fabricated into nanofibers by electrospinning. This technique is rapidly gaining popularity as one of the most practical ways to fibricate polymer, metal oxide, and composite micro or nanofibers. As a result, there is interest in using nanofibers to immobilize enzymes. Furthermore, present research on electrospun nanofibers for enzyme immobilization is primarily limited to the lab scale and industrial scale is still challanging. The primary future research objectives of this paper is to investigate the use of electrospun nanofibers for enzyme immobilization, which includes increasing yield to transfer biological products into commercial applications.
Proteomic Signatures of Human Visceral and Subcutaneous Adipocytes

Abstract Context Adipose tissue distribution is a key factor influencing metabolic health and risk in obesity-associated comorbidities. Objective Here we aim to compare the proteomic profiles of mature adipocytes from different depots. Methods Abdominal subcutaneous (SA) and omental visceral adipocytes (VA) were isolated from paired adipose tissue biopsies obtained during bariatric surgery on 19 severely obese women (body mass index > 30 kg/m2) and analyzed using state-of-the-art mass spectrometry. Differential expression analysis and weighted gene co-expression network analysis (WGCNA) were performed to investigate proteome signature properties and to examine a possible association of the protein expression with the clinical data. Results We identified 3686 protein groups and found 1140 differentially expressed proteins (adj. P value < 0.05), of which 576 proteins were upregulated in SA and 564 in VA samples. We provide a global protein profile of abdominal SA and omental VA, present the most differentially expressed pathways and processes distinguishing SA from VA, and correlate them with clinical and body composition data. We show that SA are significantly more active in processes linked to vesicular transport and secretion, and to increased lipid metabolism activity. Conversely, the expression of proteins involved in the mitochondrial energy metabolism and translational or biosynthetic activity is higher in VA. Conclusion Our analysis represents a valuable resource of protein expression profiles in abdominal SA and omental VA, highlighting key differences in their role in obesity.
A developmental lens on food insecurity: the role of children in the household and age groups on food insecurity impacting mental health

Abstract Objectives: The current study investigates the differential coping strategies and mental health consequences of food insecurity in relation to period of the lifespan (middle vs. late adulthood) and household composition (living with vs. without children). Method: Using a cross-sectional design, food-related coping strategies, anxiety (GAD-7), and depression (WHO-5) were compared among the following groups: middle adults with vs. without children, and middle adults without children vs. late adults without children. Predictive models using hierarchical linear regression examined the main effects of age and household composition with food insecurity predicting mental health; additionally, the interaction of food insecurity with age and household composition was tested in a separate model. Results: Middle-adults with and without children share similar frequencies in levels of food insecurity and coping strategies, which were significantly higher than late adults. Conclusion: The link between food insecurity and depression was stronger for middle-adults without children than late adults. Food insecurity was a stronger predictor of anxiety for middle-adults with children than those without.
Robust estimates of heritable coronary disease risk in individuals with type 2 diabetes

Type 2 diabetes (T2D) is an important heritable risk factor for coronary artery disease (CAD), the risk of both diseases being increased by metabolic syndrome (MS). With the availability of large‐scale genome‐wide association data, we aimed to elucidate the genetic burden of CAD risk in T2D predisposed individuals within the context of MS and their shared genetic architecture. Mendelian randomization (MR) analyses supported a causal relationship between T2D and CAD [odds ratio (OR) = 1.13 per log‐odds unit 95% confidence interval (CI): 1.10–1.16; p = 1.59 × 10−17]. Simultaneously adjusting MR analyses for the effects of the T2D instrument including blood pressure, dyslipidaemia, and obesity attenuated the association between T2D and CAD (OR = 1.07, 95% CI: 1.04–1.11). Bayesian locus‐overlap analysis identified 44 regions with the same causal variant underlying T2D and CAD genetic signals (FDR < 1%) at a posterior probability >0.7; five (MHC, LPL, ABO, RAI1 and MC4R) of these regions contain genome‐wide significant (p < 5 × 10−8) associations for both traits. Given the small effect sizes observed in genome‐wide association studies for complex diseases, even with 44 potential target regions, this has implications for the likely magnitude of CAD risk reduction that might be achievable by pure T2D therapies.
Antioxidant potential and α-glucosidase inhibitory activity of onion (Allium cepa L.) peel and bulb extracts.

Allium cepa L. is a commonly consumed vegetable that belongs to the Amaryllidaceae family and contains nutrients and antioxidants in ample amounts. In spite of the valuable food applications of onion bulb, its peel and outer fleshy layers are generally regarded as waste and exploration of their nutritional and therapeutic potential is still in progress with a very slow progression rate. The present study was designed with the purpose of doing a comparative analysis of the antioxidant potential of two parts of Allium cepa, i.g. , bulb (edible part) and outer fleshy layers and dry peels (inedible part). Moreover, the inhibitory effect of the onion bulb and peel extracts on rat intestinal α-glucosidase and pancreatic α-amylase of porcine was also evaluated. The antioxidant potential of onion peel and bulb extracts were evaluated using 2,2-diphenyl- 1-picryl hydrazyl (DPPH), ferric-reducing antioxidant power assay (FRAP), 2,2'-azino-bis- 3-ethylbenzothiazoline-6-sulfonic acid (ABTS) radical scavenging assay, H2O2 radical scavenging activity and Fe2+ chelating activity. Total flavonoids and phenolic content of ethanolic extract of onion peel were significantly greater as compared to that of onion bulb. Ethanolic extract of onion peel also presented better antioxidant and free-radical scavenging activity as compared to the ethanolic extract of bulb, while the aqueous extract of bulb presented weakest antioxidative potential. Onion peel extract's α-glucosidase inhibition potential was also correlated with their phenolic and flavonoid contents. The current findings presented onion peel as a possible source of antioxidative agents and phenolic compounds that might be beneficial against development of various common chronic diseases that might have an association with oxidative stress. Besides, outer dry layers and fleshy peels of onion exhibited higher phenolic content and antioxidant activities, compared to the inner bulb. The information obtained by the present study can be useful in promoting the use of vegetable parts other than the edible mesocarp for several future food applications, rather than these being wasted.
The effect of whole blood viscosity on contrast-induced nephropathy development in patients undergoing percutaneous coronary intervention

ABSTRACT Objective In our study, we aimed to investigate how whole blood viscosity (WBV) affects the development of contrast-induced nephropathy (CIN) in patients undergoing percutaneous coronary intervention (PCI). Methods In our study, 500 patients who applied to the cardiology clinic and underwent PCI for elective procedure, ST segment elevation myocardial infarction (STEMI), and non-STEMI were prospectively included. Before the procedure, we calculated WBV using the formula [(0.12× hematocrit) + (0.17×(total protein – 2.07)]. We defined CIN as the absolute (≥0.5 mg/dl) or relative increase (≥25%) in serum creatinine 48–72 h after exposure to a contrast agent compared with baseline serum creatinine values. Results CIN was developed in 69 (13.6%) of the 500 patients in the study. PCI was performed in 206 patients (41.2%) electively, 175 (35%) due to non-STEMI, and 119 (23%) due to STEMI. CIN was observed in 20.2% of the STEMI group, 13.7% of the non-STEMI group, and 10.2% of the elective PCI group. Multivariate logistic regression analysis results show that the independent predictors of CIN are low ejection fraction [OR:0.95 (95% CI:0.92–0.97); p < 0.001], low glomerular filtration rate [OR:0.96 (95% CI:0.95–0.98); p < 0.001], and increased amount of contrast agent [OR:1.008 (95% CI:1.004–1.01); p < 0.001]. When all patients were examined, no significant relationship was found between WBV and CIN. However, in the subgroup evaluation, it was concluded that low WBV was an independent predictor in elective PCI patients [OR:0.60 (95% CI:0.36–0.99); p = 0.04] for CIN. Conclusion We found that low WBV was an independent predictor of CIN in patients undergoing elective PCI(NCT04703049).
Hepatocellular Carcinoma in a Patient with Tetralogy of Fallot: A Case Report and Literature Review

We herein report a 34-year-old woman born with tetralogy of Fallot who had undergone 5 cardiac repair procedures. She developed liver nodules with congestive cirrhosis secondary to severe mitral regurgitation and an atrial septal defect. A percutaneous liver biopsy showed hepatocellular carcinoma with liver fibrosis, which was treated using transarterial chemoembolization.
Brain Motor Region Diffusion Tensor Imaging in Patients with Catatonic Schizophrenia: A Case-Control Study.

BACKGROUND Only a small proportion of schizophrenia patients present with catatonic symptoms. Imaging studies suggest that brain motor circuits are involved in the underlying pathology of catatonia. However, data about diffusivity dysregulation of these circuits in catatonic schizophrenia are scarce. OBJECTIVES To assess the involvement of brain motor circuits in schizophrenia patients with catatonia. METHODS Diffusion tensor imaging (DTI) was used to measure white matter signals in selected brain regions linked to motor circuits. Relevant DTI data of seven catatonic schizophrenia patients were compared to those of seven non-catatonic schizophrenia patients, matched for sex, age, and education level. RESULTS Significantly elevated fractional anisotropy values were found in the splenium of the corpus callosum, the right peduncle of the cerebellum, and the right internal capsule of the schizophrenia patients with catatonia compared to those without catatonia. This finding showed altered diffusivity in selected motor-related brain areas. CONCLUSIONS Catatonic schizophrenia is associated with dysregulation of the connectivity in specific motoric brain regions and corresponding circuits. Future DTI studies are needed to address the neural correlates of motor abnormalities in schizophrenia-related catatonia during the acute and remitted state of the illness to identify the specific pathophysiology of this disorder.
Spectroscopic Studies of Surface Chemistry on Cerium Oxide

Fundamental studies of three C1 molecules (CO, CO2, and CH3OH/CD3OD) adsorption on surfaces of ceria single crystals and/or nanocrystals have been carried out by using ultra-high vacuum Fourier transform infrared spectroscopy (UHV-FTIRS) or near-edge X-ray absorption fine structure (NEXAFS) spectroscopy. The oxidation states of cerium cations were determined by the core-level and valence band X-ray photoelectron spectroscopy (XPS).
Adolescents’ experiences with group antenatal care: Insights from a mixed‐methods study in Senegal

Group antenatal care (G‐ANC) is an innovative model in which antenatal care is delivered to a group of 8–12 women of similar gestational age. Evidence from high‐income countries suggests G‐ANC is particularly effective for women from marginalised populations, including adolescents. The objective of this study was to examine the experiences of Senegalese adolescents engaged in group antenatal care.
Outcomes and recommendations for revision of thumb carpometacarpal resection arthroplasty

This study investigated revision surgery for the thumb after failed trapeziectomy with ligament reconstruction and tendon interposition and defined a revision concept. Twenty-four patients with 25 affected thumbs were examined at a mean of 5.5 years after their last revision operation. Pain during daily activities was 2.7 on a 0–10 numeric rating scale, pain at rest was 1.6 and the brief Michigan Hand Outcomes Questionnaire score was 63. Although 68% of patients indicated that their thumb was better than before primary surgery, the outcome after revision surgery was less favourable than that reported for primary trapeziectomy with ligament reconstruction and tendon interposition. We defined a revision algorithm to use as a guide for patients with residual symptoms after resection arthroplasty. The main reason for revision, symptomatic impingement of the thumb metacarpal, should be treated with resection of the metacarpal base and scaphotrapezoidal joint. An existing interposition should be revised, or a new interposition should be used, preferably with an autologous tendon or alternately with an allograft. Level of evidence: IV
A parent-implemented embedded AAC intervention for teaching navigational requests and other communicative functions to children with Autism spectrum disorder

Abstract This study evaluated the effectiveness of an embedded naturalistic intervention for teaching augmentative and alternative communication (AAC) application responses to three preschool-aged males with autism spectrum disorder (ASD). Parents were taught to embed opportunities for their child to communicate with a grid-based AAC application during every-day routines such as play or mealtime. Communication targets included requesting objects using two-step taxonomic navigational responses, and requesting assistance, rejecting items, or making social comments/responses using a two-step message-strip response. During intervention, parents used strategies such as time delay, prompting, reinforcement, and device proximity (faded over time) to encourage target responses. Display formats and intervention targets were selected in consideration of prior dynamic assessment results. Effects of intervention were evaluated using a multiple probe across participants design. For functional navigational AAC item requesting, all three participants showed an immediate increase in responding that maintained at high levels. Functional AAC responding for other communicative purposes also increased, but at a more gradual pace. All three participants showed generalized responding when new items were added to displays, and when display pages with a larger array of folders and vocabulary items were introduced. Generalization to labeling tasks was mixed.
The Impact of High-Flow Nasal Cannula Device, Nebulizer Type, and Placement on Trans-Nasal Aerosol Drug Delivery

BACKGROUND: Aerosol delivery via high-flow nasal cannula (HFNC) has been increasingly used in recent years. However, the effects of different HFNC devices, nebulizer types, and placement on aerosol deposition remain largely unknown. METHODS: An adult manikin with anatomically correct upper airway was used with a collection filter placed between the manikin’s trachea and a breathing simulator, composed of a dual-chamber model lung driven by a critical care ventilator. Three HFNC device configurations were compared, with vibrating mesh nebulizer and small-volume nebulizer placed at the humidifier (inlet for Optiflow and outlet for Airvo 2) and proximal to the nasal cannula at gas flows of 10, 20, 40 and 60 L/min, in quiet and distressed breathing patterns. Albuterol (2.5 mg) was nebulized for each condition (no. = 3). The drug was eluted from the collection filter and assayed with ultraviolet spectrophotometry (276 nm). RESULTS: At all settings, except when a nebulizer was placed proximal to the nasal cannula with the Optiflow and when the HFNC flow was set at 60 L/min, the vibrating mesh nebulizer generated a higher inhaled dose than did the small-volume nebulizer (all P < .05). With the exception of distressed breathing at an HFNC flow of 10 L/min, the inhaled dose with the vibrating mesh nebulizer placed at the humidifier was greater than with the vibrating mesh nebulizer placed proximal to the nasal cannula (all P < .05), Optiflow provided a higher inhaled dose than did Airvo 2 with either AirSpiral or 900PT501 circuits with the vibrating mesh nebulizer placed at the humidifier (all P < .05). CONCLUSIONS: During transnasal aerosol delivery, the vibrating mesh nebulizer generated a higher inhaled dose than did the small-volume nebulizer when the nebulizer was placed at the humidifier. With the vibrating mesh nebulizer placed at the humidifier and an HFNC flow > 10 L/min, the inhaled dose was higher than with the vibrating mesh nebulizer placed proximal to the nasal cannula, and the inhaled dose was higher with Optiflow than with Airvo 2.
Skeletal Muscle Nitrate as a Regulator of Systemic Nitric Oxide Homeostasis PERSPECTIVE FOR PROGRESS

JONES. Skeletal muscle nitrate as a regulator of systemic nitric oxide homeostasis. Exerc. Sport Sci. Rev., Vol. 50, No. 1, pp. 2 – 13, 2022. Nonenzymatic nitric oxide (NO) generation via the reduction of nitrate and nitrite ions, along with remarkably high levels of nitrate ions in skeletal muscle, have been described recently. Skeletal muscle nitrate storage may be critical for maintenance of NO homeostasis in healthy aging, and nitrate supplementation may be useful for the treatment of specific pathophysiologies and for enhancing normal functions. ing intense or prolonged exercise. stored within cells into nitrite, which could be further reduced into NO by the same molybdenum proteins or Fe II -deoxy-heme (five-coordinated Fe II heme) proteins (deoxyhemoglobin, deoxymyoglobin, and cytochromes). NO also is synthetized from arginine by a family of NOS enzymes and either used in situ, exhaled via the lungs, or oxidized to nitrite by ceruloplasmin or oxygen (in bloodstream) or to nitrate by oxyFe II proteins (oxyhemoglobin in blood, oxymyoglobin in muscle). The concentration of nitrate in organ reservoirs is in the micromolarrange(withthehighestamountsfoundinsomeskeletalmuscles);theconcentrationofthedirectNOprecursor,nitrite,ismaintainedinthenanomolarrange;andNOisthoughttooccurinhighfemto-tolownanomolarconcentrationsnecessaryforitsmanyphysiologicalroles.
Tobacco control in young people and adults: did Brazil do their homework?

Over the past 30 years, more than 200 million deaths have been caused by tobacco use and the annual economic costs arising from this use exceed US$1 trillion. (1-4) Updated data on smoking prevalence and the burden of disease attributable to Global Burden of Disease (GBD) 2019 are an urgent call to action for countries to program and implement stronger tobacco control policies than currently in place. (1,3,4)