Miracle-dz/UniFAR-FTUs huggingface dataset:
Antibiotic de-escalation in the ICU: how is it best done?

Purpose of review An antimicrobial policy consisting of the initial use of wide-spectrum antimicrobials followed by a reassessment of treatment when culture results are available is termed de-escalation therapy. Our aim is to examine the safety and feasibility of antibiotic de-escalation in critically ill patients providing practical tips about how to accomplish this strategy in the critical care setting. Recent findings Numerous studies have assessed the rates of de-escalation therapy (range from 10 to 60%) in patients with severe sepsis or ventilator-associated pneumonia as well as the factors associated with de-escalation. De-escalation generally refers to a reduction in the spectrum of administered antibiotics through the discontinuation of antibiotics or switching to an agent with a narrower spectrum. Diverse studies have identified the adequacy of initial therapy as a factor independently associated with de-escalation. Negative impact on different outcome measures has not been reported in the observational studies. Two randomized clinical trials have evaluated this strategy in patients with ventilator-associated pneumonia or severe sepsis. These trials alert us about the possibility that this strategy may be linked to a higher rate of reinfections but without an impact on mortality. Summary Antibiotic de-escalation is a well tolerated management strategy in critically ill patients but unfortunately is not widely adopted.
Ca2+-controlled competitive diacylglycerol binding of protein kinase C isoenzymes in living cells

The cellular decoding of receptor-induced signaling is based in part on the spatiotemporal activation pattern of PKC isoforms. Because classical and novel PKC isoforms contain diacylglycerol (DAG)-binding C1 domains, they may compete for DAG binding. We reasoned that a Ca2+-induced membrane association of classical PKCs may accelerate the DAG binding and thereby prevent translocation of novel PKCs. Simultaneous imaging of fluorescent PKC fusion proteins revealed that during receptor stimulation, PKCα accumulated in the plasma membrane with a diffusion-limited kinetic, whereas translocation of PKCɛ was delayed and attenuated. In BAPTA-loaded cells, however, a selective translocation of PKCɛ, but not of coexpressed PKCα, was evident. A membrane-permeable DAG analogue displayed a higher binding affinity for PKCɛ than for PKCα. Subsequent photolysis of caged Ca2+ immediately recruited PKCα to the membrane, and DAG-bound PKCɛ was displaced. At low expression levels of PKCɛ, PKCα concentration dependently prevented the PKCɛ translocation with half-maximal effects at equimolar coexpression. Furthermore, translocation of endogenous PKCs in vascular smooth muscle cells corroborated the model that a competition between PKC isoforms for DAG binding occurs at native expression levels. We conclude that Ca2+-controlled competitive DAG binding contributes to the selective recruitment of PKC isoforms after receptor activation.
Early and Persistent Abnormal Decoding by Glial Cells at the Neuromuscular Junction in an ALS Model

Amyotrophic lateral sclerosis (ALS) is a late-onset neuromuscular disease characterized by progressive loss of motor neurons (MNs) preceded by neuromuscular junction (NMJ) denervation. Despite the importance of NMJ denervation in ALS, the mechanisms involved remain unexplored and ill defined. The contribution of glial cells in the disease has been highlighted, including axonal Schwann cell activation that precedes the decline of motor function and the onset of hindlimb paralysis. Because NMJ denervation occurs early in the process and that perisynaptic Schwann cells (PSCs), glial cells at the NMJ, regulate morphological stability, integrity, and repair of the NMJ, one could predict that PSC functions would be altered even before denervation, contributing to NMJ malfunctions. We tested this possibility using a slowly progressive model of ALS (SOD1G37R mice). We observed a normal NMJ organization at a presymptomatic stage of ALS (120 d), but PSC detection of endogenous synaptic activity revealed by intracellular Ca2+ changes was enhanced compared with their wild-type littermates. This inappropriate PSC decoding ability was associated with an increased level of neurotransmitter release and dependent on intrinsic glial properties related to enhanced muscarinic receptor activation. The alteration of PSC muscarinic receptor functions also persists during the preonset stage of the disease and became dependent on MN vulnerability with age. Together, these results suggest that PSC properties are altered in the disease process in a manner that would be detrimental for NMJ repair. The impairments of PSC functions may contribute to NMJ dysfunction and ALS pathogenesis.
JC virus remains latent in peripheral blood B lymphocytes but replicates actively in urine from AIDS patients.

JC virus (JCV) is thought to reach the central nervous system by a vascular route. To determine whether JCV is conveyed in peripheral blood as latent or reactivated virus, blood leukocytes, plasma, and urine from 50 AIDS patients and plasma and B lymphocytes from 60 AIDS patients were investigated. Peripheral blood from 88 human immunodeficiency virus-negative blood donors was studied. Nested polymerase chain reaction assays allowed the identification of JCV T DNA and VP1 mRNAs. The latter indicate viral replication. Blood harbored JCV DNA in 31.8% of AIDS patients (only 2.3% of blood donors; P > .001) and urine in 56%. VP1 mRNAs were detected in blood of 1 AIDS patient. Notably, 38% of DNA-positive urine samples and 10 cerebrospinal fluid samples (CSF) from AIDS patients with progressive multifocal leukoencephalopathy contained JCV mRNAs. Thus, JCV was significantly more frequent in blood from AIDS patients than from controls, but, in most instances, it was latent, whereas active replication was detected in urine and CSF.
Small world network strategies for studying protein structures and binding

Small world network concepts provide many new opportunities to investigate the complex three dimensional structures of protein molecules. This mini-review explores the published literature on using small-world network approaches to study protein structure, with emphasis on the different combinations of descriptors that have been tested, on studies involving ligand binding in protein-ligand complexes, and on protein-protein complexes. The benefits and success of small world network approaches, which change the focus from specific interactions to the local environment, even to non-local phenomenon, are described. The purpose is to show the different ways that small world network concepts have been used for building new computational models for studying protein structure and function, and for extending and improving existing modelling approaches.
Urban African-American Single Mothers Using Resiliency And Racial Socialization To Influence Academic Success In Their Young Sons

Urban African-American Single Mothers Using Resiliency and Racial Socialization to Influence Academic Success in Their Young Sons. (December 2011) Lisa Doris Henderson-Hubbard, B.S. Texas A& M University-Corpus Christi; M.A., Prairie View A & M University, Co-Chairs of Advisory Committee: Dr. Chance W. Lewis Dr. Norvella P. Carter This research study was conducted as a qualitative case study of five resilient single African-American mothers of successful young sons who attended an elementary school in a large urban school district. The study was designed to hear the voices of these mothers and their lived experiences using racial socialization to influence school readiness and academic achievement in their young sons. The intent of this case study was to broaden the limited qualitative research base on this population and inform administrators, educators, and other single parents about factors that may contribute to more positive academic outcomes for African-American males. This qualitative study used the actual words of the participants to tell their stories, as it provided rich descriptions of their lives. Data was collected through in-depth, semistructured interviews, and the mothers’ responses shaped the phenomena under study. Analysis occurred immediately after each interview, and analytic conclusions were
Exploring Patients’ Views Toward Giving Web-Based Feedback and Ratings to General Practitioners in England: A Qualitative Descriptive Study

Background Patient feedback websites or doctor rating websites are increasingly being used by patients to give feedback about their health care experiences. There is little known about why patients in England may give Web-based feedback and what may motivate or dissuade them from giving Web-based feedback. Objective The aim of this study was to explore patients’ views toward giving Web-based feedback and ratings to general practitioners (GPs), within the context of other feedback methods available in primary care in England, and in particular, paper-based feedback cards. Methods A descriptive exploratory qualitative approach using face-to-face semistructured interviews was used in this study. Purposive sampling was used to recruit 18 participants from different age groups in London and Coventry. Interviews were transcribed verbatim and analyzed using applied thematic analysis. Results Half of the participants in this study were not aware of the opportunity to leave feedback for GPs, and there was limited awareness about the methods available to leave feedback for a GP. The majority of participants were not convinced that formal patient feedback was needed by GPs or would be used by GPs for improvement, regardless of whether they gave it via a website or on paper. Some participants said or suggested that they may leave feedback on a website rather than on a paper-based feedback card for several reasons: because of the ability and ease of giving it remotely; because it would be shared with the public; and because it would be taken more seriously by GPs. Others, however, suggested that they would not use a website to leave feedback for the opposite reasons: because of accessibility issues; privacy and security concerns; and because they felt feedback left on a website may be ignored. Conclusions Patient feedback and rating websites as they currently are will not replace other mechanisms for patients in England to leave feedback for a GP. Rather, they may motivate a small number of patients who have more altruistic motives or wish to place collective pressure on a GP to give Web-based feedback. If the National Health Service or GP practices want more patients to leave Web-based feedback, we suggest they first make patients aware that they can leave anonymous feedback securely on a website for a GP. They can then convince them that their feedback is needed and wanted by GPs for improvement, and that the reviews they leave on the website will be of benefit to other patients to decide which GP to see or which GP practice to join.
Childhood Obesity Associates Haemodynamic and Vascular Changes That Result in Increased Central Aortic Pressure with Augmented Incident and Reflected Wave Components, without Changes in Peripheral Amplification

The aims were to determine if childhood obesity is associated with increased central aortic blood pressure (BP) and to characterize haemodynamic and vascular changes associated with BP changes in obese children and adolescents by means of analyzing changes in cardiac output (stroke volume, SV), arterial stiffness (aortic pulse wave velocity, PWV), peripheral vascular resistances (PVR), and net and relative contributions of reflected waves to the aortic pulse wave amplitude. We included 117 subjects (mean/range age: 10 (5–15) years, 49 females), who were obese (OB) or had normal weight (NW). Peripheral and central aortic BP, PWV, and pulse wave-derived parameters (augmentation index, amplitude of forward and backward components) were measured with tonometry (SphygmoCor) and oscillometry (Mobil-O-Graph). With independence of the presence of dyslipidemia, hypertension, or sedentarism, the aortic systolic and pulse BP were higher in OB than in NW subjects. The increase in central BP could not be explained by the elevation in the relative contribution of reflections to the aortic pressure wave and higher PVR or by an augmented peripheral reflection coefficient. Instead, the rise in central BP could be explained by an increase in the amplitude of both incident and reflect wave components associated to augmented SV and/or PWV.
Creating an Efficient Financial System : Challenges in a Global Economy

The invention consists of an outer jacket surrounding and spaced from an inner tank to create an insulated space therebetween. The inner tank closely conforms to the outer jacket such that the insulation chamber is substantially uniform and the capacity of the inner tank is increased. An insulated support assembly that extends into the inner tank allows communication between the exterior of the vessel and the inner tank for pipes, pressure gauges and the like. The support assembly allows for a long insulated path without reducing the capacity of the tank to the same extent as the prior art devices.
Neuroendocrine control of metabolism

Metabolism is controlled through homeostatic system consisting of central centers, gut hormones, hormones from adipose tissue and the other hormonal axes. This cooperation is based on cross-talk between central and peripheral signals. Among them the hypothalamus plays a crucial role, with interconnected nuclei forming neuronal circuits. Other regions in the brain, such as the brain stem, the endocannabinoid system, the vagal afferents, are also involved in energy balance. The second component is peripheral source of signals − the gastrointestinal tract hormones. Additionally, adipokines from adipose tissue, thyrotropic, gonadotropic and somatotropic axes play a role in energy homeostasis. Knowledge about all components of this neuroendocrine circuit will be helpful in developing novel therapeutic approaches against the metabolic syndrome and its components.
Induction of differentiation and c‐jun expression in human leukemic cells by okadaic acid, an inhibitor of protein phosphatases

Okadaic acid, a protein phosphatase inhibitor, is a strong tumor promoter which activates protein phosphorylation. Because another activator of protein phosphorylation, phorbol esters, stimulates hematopoietic differentiation, we sought to determine whether okadaic acid could also induce the differentiation of the human leukemic cell line U937. Differentiation was assessed by measuring changes in the following: mRNA levels, cell growth, morphology, cell surface markers, and the ability to induce superoxide. We found that okadaic acid treatment of U937 cells induces immediate increases in total cellular levels of both c‐junand c‐fos mRNAs. Nuclear run‐on experiments demonstrate that initial increases are secondary to increases in transcription, whereas latter changes may be secondary to mRNA stabilization. Like phorbol esters, okadaic acid treatment also activates AP‐1 enhancer activity and induces the phosphorylation of c‐Jun protein. Approximately 6–12 hours after treatment with okadaic acid, mRNA levels of c‐myc, p34cdc2, and p58GTA, two cell cycle regulated protein kinases, decrease. Okadaic acid inhibits the growth of U937 cells, induces changes in nuclear morphology, stimulates increases in Mac‐1 and Leu 11 surface antigens, and induces these cells to produce superoxide. These changes, taken together, suggest that U937 cells have been induced by okadaic acid to differentiate towards a more mature cell type. © 1992 Wiley‐Liss, Inc.
Factors affecting in-hospital heat-related mortality: a multi-city case-crossover analysis

Background: Several studies have identified strong effects of high temperatures on mortality at population level; however, individual vulnerability factors associated with heat-related in-hospital mortality are largely unknown. The objective of the study was to evaluate heat-related in-hospital mortality using a multi-city case-crossover analysis. Methods: We studied residents of four Italian cities, aged 65+ years, who died during 1997–2004. For 94 944 individuals who died in hospital and were hospitalised two or more days before death, demographics, chronic conditions, primary diagnoses of last event and hospital wards were considered. A city-specific case-crossover analysis was performed to evaluate the association between apparent temperature and mortality. Pooled odds ratios (OR) of dying on a day with a temperature of 30°C compared to a day with a temperature of 20°C were estimated with a random-effects meta-analysis. Results: We estimated an overall OR of 1.32 (95% confidence interval: 1.25, 1.39). Age, marital status and hospital ward were important risk indicators. Patients in general medicine were at higher risk than those in high and intensive care units. A history of psychiatric disorders and cerebrovascular diseases gave a higher vulnerability. Mortality was greater among patients hospitalised for heart failure, stroke and chronic pulmonary diseases. Conclusions: In-hospital mortality is strongly associated with high temperatures. A comfortable temperature in hospitals and increased attention to vulnerable patients during heatwaves, especially in general medicine, are necessary preventive measures.
Research on Combinatorial-Code Grating Eddy-Current Absolute-Position Sensor

For the shortage of the low coarse localization accuracy of phase-difference grating eddy-current sensor (PDGECS), a combinatorial-code GECS (CCGECS) is presented in this paper. CCGECS adopts a single-track code localization method to realize the coarse localization of the sensor coils of GECS, which has replaced the multitrack phase-difference localization method of PDGECS. In this paper, the measurement principle, the coding and code recognition method, the coarse localization accuracy, and the design of CCGECS are introduced; at last, the calculation method of the absolute position of the sensor coils is concluded. Experimental results show that adoption of a single-track code localization method to realize the coarse localization greatly improved the coarse localization accuracy of GECS, avoided the possibility of the appearance of gross error of measurement results, resolved the contradiction between the coarse localization accuracy and the measurement range caused by adoption of the multitrack phase-difference localization method, realized the absolute-position measurement to larger range, and, at the same time, reduced the technology requirements.
Need for the clarification of data in a recent meta‐analysis about cytokine gene polymorphisms and acute liver graft rejection

We read with great interest the article entitled ‘‘Cytokine Gene Polymorphisms and Acute Liver Graft Rejection: A Meta-Analysis,’’ which was published in Liver Transplantation in 2005. The results suggest that the interleukin-10 (IL-10) polymorphism at position 1082 has been identified as a genetic risk factor for acute liver graft rejection: liver transplant recipients carrying the IL-10-1082 A allele displayed a lower rejection rate [common odds ratio (OR) 1⁄4 0.6, 95% confidence interval (CI) 1⁄4 0.4-0.9]. Nevertheless, some methodological issues need to be addressed with respect to the data provided in this meta-analysis by Warlé et al. First, the data reported by Warlé et al. for the study by Bathgate et al. do not seem to be in line with the data actually provided by Bathgate et al. Warlé et al. report that the incidence of acute rejection for individuals with the IL-10-1082 GG genotype was 42% (16/38), whereas the incidence was 58% (22/38) in Bathgate et al.’s study. Also, the data reported by Warlé et al. for the study by Jonsson et al. are not consistent with the data provided by Jonsson et al. Warlé et al. report that the rates of acute rejection for IL-10-1082 AA, IL-10-1082 AG, and IL-10-1082 GG genotype carriers were 25% (7/ 28), 27% (16/60), and 42% (14/33), respectively; however, the reported rates of acute rejection for individuals with the AA, AG, and GG genotypes were for the IL-10 polymorphism at position 1097 (ie, not at position 1082). Therefore, the study performed by Jonsson et al. should be excluded when studies of the IL-10-1082 G/A polymorphism and the risk of acute rejection are being pooled. When we excluded Jonsson et al.’s study and corrected the data for Bathgate et al.’s study, the pooled OR for the A allele versus the G allele was 0.76 (95% CI 1⁄4 0.56-1.03) in a fixed effect model and 0.79 (95% CI 1⁄4 0.49-1.28) in a random effect model. The results suggest that the IL-101082 G/A polymorphism is not associated with the risk of acute rejection in liver transplant recipients. We updated this analysis with a literature search (the last update was performed on March 1, 2011). Three additional studies were found for the IL-101082 G/A polymorphism and acute rejection in liver transplant recipients. When we included the 3 studies, the pooled OR for the A allele versus the G allele was 0.79 (95% CI 1⁄4 0.60-1.05) in a fixed effect model and 0.82 (95% CI 1⁄4 0.58-1.17) in a random effect model. The results still suggest that the IL-10-1082 G/A polymorphism is not associated with the risk of acute rejection in liver transplant recipients. Thus, these findings may imply that a role of the IL-10-1082 polymorphism in human liver graft rejection is not entirely credible. It would be helpful if the authors, taking this into account, were to provide a new, more accurate estimation of the pooled OR.
OBLIQUE MULTI-CAMERA SYSTEMS - ORIENTATION AND DENSE MATCHING ISSUES

The use of oblique imagery has become a standard for many civil and mapping applications, thanks to the development of airborne digital multi-camera systems, as proposed by many companies (Blomoblique, IGI, Leica, Midas, Pictometry, Vexcel/Microsoft, VisionMap, etc.). The indisputable virtue of oblique photography lies in its simplicity of interpretation and understanding for inexperienced users allowing their use of oblique images in very different applications, such as building detection and reconstruction, building structural damage classification, road land updating and administration services, etc. The paper reports an overview of the actual oblique commercial systems and presents a workflow for the automated orientation and dense matching of large image blocks. Perspectives, potentialities, pitfalls and suggestions for achieving satisfactory results are given. Tests performed on two datasets acquired with two multi-camera systems over urban areas are also reported.
Visual indoor positioning with a single camera using PnP

This paper introduces an accurate and inexpensive method for localizing a calibrated monocular camera in 3D indoor environments. The objective of this work is to localize in 6 degrees-of-freedom (6 DOF) in the presence of a 3D map that contains 3D point clouds co-registered with intensity information. This is done by solving the Perspective-n-Point (PnP) problem to accurately compute the camera location in 6 DOF. An efficient data structure is used to store a large set of point clouds co-registered with intensity information, image features, and transformations between the images. This data structure, referred to as the feature database, is implemented such that it retrieves a match for a query image efficiently. Thus the overall process of localization in 6 DOF becomes a real-time process with high efficiency and accuracy. Our technique was tested with two ground truth data sets of indoor environments, an office and a laboratory. The experimental results show the accuracy and the efficiency of our technique, with an average localization error of less than 10 mm from the ground truth in both environments. In addition, localization results on query images obtained using two different cameras in four different environments are presented. This demonstrates that any type of monocular camera may be used during localization, as long as a sufficient number of environmental features can be extracted from the query images.