Miracle-dz/UniFAR-FTUs huggingface dataset:
Double-lumen tube tracheal intubation using a rigid video-stylet: a randomized controlled comparison with the Macintosh laryngoscope.

BACKGROUND Despite an increasing need, there is limited experience of double-lumen endobronchial tube (DLT) placement using video laryngoscope. We evaluated DLT intubation using an OptiScope, a rigid video-stylet with a malleable tip derived from the Clarus Video System, in comparison with a Macintosh laryngoscope. METHODS After airway evaluation and anaesthetic induction, Cormack and Lehane (C and L) grade was initially assessed in all patients using a Macintosh laryngoscope before tracheal intubation. The trachea was then intubated using either a Macintosh laryngoscope (n=200) or an OptiScope® (n=200). Success rate, intubation time, number of attempts at intubation, vocal cord view during intubation, need for external manipulation, and the incidences of oral mucosal or dental injury were compared between the two devices. RESULTS Data were analysed for 397 patients. Intubation time with the OptiScope® was faster [median (inter-quartile range): 15 (12-19) s] than with the Macintosh [18(12-28) s] {mean difference [95% confidence interval (CI)}: 5.5 (3.8-13.2) s, P=0.010]. The success rate of the first intubation was higher with the OptiScope® than with the Macintosh [80.4% vs 89.9%, odds ratio (95% CI): 2.2 (1.22-3.87), P=0.036]. Initial view of the vocal cords was also better, although the final success rate was not different between devices. The need for external laryngeal manipulation, oral mucosal, or dental injury was lower with the OptiScope® compared with the Macintosh laryngoscope (all P<0.01). CONCLUSIONS The OptiScope® provides faster tracheal intubation and a higher success rate for the first intubation with less trauma and a better vocal cord view than the Macintosh laryngoscope.
Supersaturation in the Boolean lattice

We prove a "supersaturation-type'' extension of both Sperner's Theorem (1928) and its generalization by Erdos (1945) to k-chains. Our result implies that a largest family whose size is x more than the size of a largest k-chain free family and that contains the minimum number of k-chains is the family formed by taking the middle (k-1) rows of the Boolean lattice and x elements from the k-th middle row. We prove our result using the symmetric chain decomposition method of de Bruijn, van Ebbenhorst Tengbergen, and Kruyswijk (1951).
Effects of Rainfall on E. coli Concentrations at Door County, Wisconsin Beaches

Rainfall and its associated storm water runoff have been associated with transport of many pollutants into beach water. Fecal material, from a variety of animals (humans, pets, livestock, and wildlife), can wash into beach water following rainfall and result in microbial contamination of the beach. Many locales around the world issue pre-emptive beach closures associated with rainfall. This study looked at eight beaches located in Door County, Wisconsin, on Lake Michigan to determine the impact of rainfall on E. coli concentrations in beach water. Water samples were collected from beach water and storm water discharge pipes during rainfall events of 5 mm in the previous 24 hours. Six of the eight beaches showed a significant association between rainfall and elevated beach water E. coli concentrations. The duration of the impact of rainfall on beach water E. coli concentrations was variable (immediate to 12 hours). Amount of rainfall in the days previous to the sampling did not have significant impact on the E. coli concentrations measured in beach water. Presence of storm water conveyance pipes adjacent to the beach did not have a uniform impact on beach water E. coli concentrations. This study suggests that each beach needs to be examined on its own with regard to rain impacts on E coli concentrations in beach water.
Increased Killing of Liver NK Cells by Fas/Fas Ligand and NKG2D/NKG2D Ligand Contributes to Hepatocyte Necrosis in Virus-Induced Liver Failure

The role of liver NK cells in virus-induced severe viral hepatitis and, subsequently, hepatic failure is not well defined. In this study, we investigated the role of liver NK cells in the development of hepatocyte necrosis in fulminant hepatic failure (FHF)and acute-on-chronic liver failure (ACLF) because of viral infection. A mouse model of FHF induced by murine hepatitis virus strain 3 (MHV-3) was used to study the role of liver NK cells. Samples from patients with hepatitis B virus-related ACLF (HBV-ACLF) were examined. After MHV-3 infection, the number of NK cells in livers of BALB/cJ mice increased markedly, peaked at 48 h postinfection, and remained at a high level until sacrifice. In peripheral blood, spleen, and bone marrow, this number decreased significantly. Expression of CD69, cytotoxic activity, and intracellular IFN-γ and TNF-α production by liver NK cells at 48 h postinfection were all significantly upregulated. Depletion of NK cells 24 h post-MHV-3 infection increased the mice survival from 0 of 18 (0%) to 4 of 18 (22.2%). Highly activated liver NK cells were cytotoxic to MHV-3-infected hepatocytes and this effect was markedly inhibited by anti-Fas ligand (FasL) plus anti-NKG2D mAbs. Furthermore, the accumulation of hepatic NK cells and increased expression of FasL and natural cytotoxicity receptors (NKp30 and NKp46) on the peripheral NK cells from patients with HBV-ACLF were correlated with disease progression. These results indicate NK cells play a pivotal role in the pathogenesis of FHF and HBV-ACLF, in which process Fas/FasL and NKG2D/NKG2D ligand pathway contribute to the liver NK cell-mediated hepatocyte injury.
Electrostatic forces and micromanipulator design: on the importance of surface topography parameters

Micro manipulations of objects between 10 mum and 1 mm by contact are often disturbed by the surface forces appearing between the handled object and the gripper. They may overcome gravity and prevent the release of the object. Capillary, electrostatic and van der Waals forces are the main surface forces responsible for this adhesive phenomenon. Several factors may influence these forces such as the materials in contact, the fabrication process, the surface treatments or the surface contaminations. All of these contribute to shape the topography of the surface. In this paper is investigated in which way surface roughness could be used to overcome the problem of adhesive electrostatic forces. Simulations are performed for smooth surfaces and for rough surfaces in order to study the influence of surface topography. The simulation tool is validated using analytical models for the smooth case and shows a good correlation. Roughness is modeled using a fractal representation (Weierstrass-Mandelbrot function). The simulations using fractal representation show a significant influence of the surface topography at small separation distances and correlate experimental benchmarks from literature. Topography of the surface should not be neglected in micromanipulator design.
Effects of Sperm Membrane Disruption and Electrical Activation of Oocytes on In vitro Development and Transgenesis of Porcine Embryos Produced by Intracytoplasmic Sperm Injection

The intracytoplasmic sperm injection (ICSI) procedure has recently been utilized to produce transgenic animals and may serve as an alternative to the conventional pronuclear microinjection in species such as pigs whose ooplasm is opaque and pronuclei are often invisible. In this study, the effects of sperm membrane disruption and electrical activation of oocytes on in vitro development and expression of transgene green fluorescent protein (GFP) in ICSI embryos were tested to refine this recently developed procedure. Prior to ICSI, sperm heads were treated with Triton X-100+NaCl or Triton X-100+NaCl+NaOH, to disrupt membrane to be permeable to exogenous DNA, and incubated with linearized pEGFP-Nl vector. To induce activation of oocytes, a single DC pulse of 1.3 kV/cm was applied to oocytes for 30 μsec. After ICSI was performed with the aid of a micromanipulator, in vitro development of embryos and GFP expression were monitored. The chemical treatment to disrupt sperm membrane did not affect the developmental competence of embryos. 40 to 60% of oocytes were cleaved after injection of sperm heads with disrupted membrane, whereas 48.6% (34/70) were cleaved without chemical treatment. Regardless of electrical stimulation to induce activation, oocytes were cleaved after ICSI, reflecting that, despite sperm membrane disruption, the perinuclear soluble sperm factor known to mediate oocyte activation remained intact. After development to the 4-cell stage, 11.8 (2/17, Triton X-100+NaCl+NaOH) to 58.8% (10/17, Triton X-100+NaCl) of embryos expressed GFP. The expression of GFP beyond the stage of embryonic genome activation (4-cell stage in the pig) indicates that the exogenous DNA might have been integrated into the porcine genome. When sperm heads were co-incubated with exogenous DNA following the treatment of Triton X-100+NaCl, GFP expression was observed in high percentage (58.8%) of embryos, suggesting that transgenic pigs may efficiently be produced using ICSI.
Predictors of the quality of health worker treatment practices for uncomplicated malaria at government health facilities in Kenya.

BACKGROUND When replacing failing drugs for malaria with more effective drugs, an important step towards reducing the malaria burden is that health workers (HW) prescribe drugs according to evidence-based guidelines. Past studies have shown that HW commonly do not follow guidelines, yet few studies have explored with appropriate methods why such practices occur. METHODS We analysed data from a survey of government health facilities in four Kenyan districts in which HW consultations were observed, caretakers and HW were interviewed, and health facility assessments were performed. The analysis was limited to children 2-59 months old with uncomplicated malaria. Treatment was defined as recommended (antimalarial recommended by national guidelines), a minor error (effective, but non-recommended antimalarial), or inappropriate (no effective antimalarial). RESULTS We evaluated 1006 consultations performed by 135 HW at 81 facilities: 567 children received recommended treatment, 314 had minor errors, and 125 received inappropriate treatment (weighted percentages: 56.9%, 30.4%, and 12.7%). Multivariate logistic regression analysis revealed that programmatic interventions such as in-service malaria training, provision of guidelines and wall charts, and more frequent supervision were significantly associated with better treatment quality. However, neither in-service training nor possession of the guideline document showed an effect by itself. More qualified HW made more errors: both major and minor errors (but generally more minor errors) when second-line drugs were in stock, and more major errors when second-line drugs were not in stock. Child factors such as age and a main complaint of fever were also associated with treatment quality. CONCLUSIONS Our results support the use of several programmatic strategies that can redress HW deficiencies in malaria treatment. Targeted cost-effectiveness trials would help refine these strategies and provide more precise guidance on affordable and effective ways to strengthen and maintain HW practices.
Decreased risk of suicides and attempts during long-term lithium treatment: a meta-analytic review.

OBJECTIVES To update and extend comparisons of rates of suicides and suicide attempts among patients with major affective disorders with versus without long-term lithium treatment. METHODS Broad searching yielded 45 studies providing rates of suicidal acts during lithium treatment, including 34 also providing rates without lithium treatment. We scored study quality, tested between-study variance, and examined suicidal rates on versus off lithium by meta-analytic methods to determine risk ratios (RRs) and 95% confidence intervals (CI). RESULTS In 31 studies suitable for meta-analysis, involving a total of 85,229 person-years of risk-exposure, the overall risk of suicides and attempts was five times less among lithium-treated subjects than among those not treated with lithium (RR = 4.91, 95% CI 3.82-6.31, p < 0.0001). Similar effects were found with other meta-analytic methods, as well as for completed versus attempted suicide, and for bipolar versus major mood disorder patients. Studies with higher quality ratings, including randomized, controlled trials, involved shorter exposures with somewhat lesser lithium superiority. Omitting one very large study or those involving lithium-discontinuation had little effect on the results. The incidence-ratio of attempts-to-suicides increased 2.5 times with lithium-treatment, indicating reduced lethality of suicidal acts. There was no indication of bias toward reporting positive findings, nor were outcomes significantly influenced by publication-year or study size. CONCLUSIONS Risks of completed and attempted suicide were consistently lower, by approximately 80%, during treatment of bipolar and other major affective disorder patients with lithium for an average of 18 months. These benefits were sustained in randomized as well as open clinical trials.
Antigenic nature of the chloride-stimulated cellobiosidase and other cellulases of Fibrobacter succinogenes subsp. succinogenes S85 and related fresh isolates

Polyclonal and monoclonal antibodies to the Cl-stimulated cellobiosidase of Fibrobacter succinogenes subsp. succinogenes S85 reacted with numerous proteins of both higher and lower molecular weights from F. succinogenes subsp. succinogenes S85, but not with Escherichia coli proteins, and only one protein each from Butyrivibrio fibrisolvens and Ruminococcus albus. Different profiles were observed for Western blots (immunoblots) of peptide digests of both the purified enzyme from F. succinogenes and immunoreactive proteins of higher and lower molecular weights, demonstrating that they were different proteins. Therefore, F. succinogenes appeared to produce numerous proteins with one or more common antigenic determinants. However, with the exception of Cl-stimulated cellobiosidase, none were cellulases that have been characterized. An affinity-purified polyclonal antibody to Cl-stimulated cellobiosidase reacted with numerous proteins in cells of each of three fresh isolates of F. succinogenes subsp. succinogenes and one of F. succinogenes subsp. elongata when analyzed by Western blotting. Antibodies to periplasmic cellodextrinase, endoglucanase 2 (EG2), and EG3, when reacted in Western blots with the various cellulases, including Cl-stimulated cellobiosidase, revealed limited antigenic similarity among the different proteins and none with either B. fibrisolvens or R. albus proteins. The periplasmic cellodextrinase antibody reacted with an antigen with a size corresponding to cellodextrinase in each of the three F. succinogenes subsp. succinogenes isolates but not with any antigens from the F. succinogenes subsp. elongata isolate. The anti-EG2 antibody reacted with single antigens in each of the four isolates, while the anti-EG3 antibody reacted with only one of the four isolates. (ABSTRACT TRUNCATED AT 250 WORDS)
Lateral transfer and GC content of bacterial resistance genes

Lateral genetic transfer (LGT) is one of the ways in which microorganisms such as bacteria could move and rearrange genetic materials from and into their genomes (Ragan and Beiko, 2009). The dissemination of antibiotic resistance genes between two microorganisms or between a microorganism and the environment could occur, for example, by conjugation, transduction, and transformation (Fondi and Fani, 2010; Stokes and Gillings, 2011). Therefore, having a resistance gene or genes on a mobile element like plasmids and genomic islands, transposons, integrons, or integrative conjugative elements will facilitate their overall distribution, which will affect among other organisms, humans and more specifically their health and survival (Stokes and Gillings, 2011). This fact, made the selection for antibiotic resistance a crucial step in microorganism's selective evolution (Waksman and Woodruff, 1940). However, even though this selection is enhanced and accelerated by the use of antibiotics (Hegreness et al., 2008), the acquisition of a new genetic material is balanced by mechanisms that restrict DNA uptake (Navarre et al., 2006; Palmer and Gilmore, 2010). One of these mechanisms is the clustered regularly interspaced short palindromic repeat (CRISPR) (van der Oost et al., 2009), which was found to be negatively related to the number of acquired resistant genes in a Enterococcus faecalis (Palmer and Gilmore, 2010).
Randomised controlled trial of homoeopathy versus placebo in perennial allergic rhinitis with overview of four trial series.

Abstract Objective: To test the hypothesis that homoeopathy is a placebo by examining its effect in patients with allergic rhinitis and so contest the evidence from three previous trials in this series. Design: Randomised, double blind, placebo controlled, parallel group, multicentre study. Setting: Four general practices and a hospital ear, nose, and throat outpatient department. Participants: 51 patients with perennial allergic rhinitis. Intervention: Random assignment to an oral 30c homoeopathic preparation of principal inhalant allergen or to placebo. Main outcome measures: Changes from baseline in nasal inspiratory peak flow and symptom visual analogue scale score over third and fourth weeks after randomisation. Results: Fifty patients completed the study. The homoeopathy group had a significant objective improvement in nasal airflow compared with the placebo group (mean difference 19.8 l/min, 95% confidence interval 10.4 to 29.1, P=0.0001). Both groups reported improvement in symptoms, with patients taking homoeopathy reporting more improvement in all but one of the centres, which had more patients with aggravations. On average no significant difference between the groups was seen on visual analogue scale scores. Initial aggravations of rhinitis symptoms were more common with homoeopathy than placebo (7 (30%) v 2 (7%), P=0.04). Addition of these results to those of three previous trials (n=253) showed a mean symptom reduction on visual analogue scores of 28% (10.9 mm) for homoeopathy compared with 3% (1.1 mm) for placebo (95% confidence interval 4.2 to 15.4, P=0.0007). Conclusion: The objective results reinforce earlier evidence that homoeopathic dilutions differ from placebo.
The congenitally missing maxillary lateral incisor. Part 2: assessing dentists' preferences for treatment.

AIM To (1) determine if there are different preferences among general dentists, a combined group of dental specialists, and orthodontists concerning whether a patient with congenitally missing lateral incisors should have the teeth restored or if the canines should be orthodontically moved into the position of the missing teeth; (2) determine the role that esthetics and function of the final result has on the respondents' treatment preferences; and (3) compare the respondents' opinions about treatment preferences to their rankings of esthetics reported in part 1. METHODS The questionnaire accompanied the photographic evaluation in part 1. Percentages were computed and chi-squares were used to compare response patterns. RESULTS Compared to orthodontists, a significantly greater percentage of general dentists and combined dental specialists would restore the lateral incisors and would do so primarily for esthetic reasons. Interestingly, for those dental professionals who responded that the missing teeth should be restored, many did not rank any photograph of a restorative option as the best option. CONCLUSIONS Dental professionals should attempt to eliminate their personal opinions when recommending treatment options for a congenitally missing maxillary lateral incisor because discrepancies exist between the treatment result judged as most esthetic and the one most likely to be recommended.
Musculoskeletal Disorders and Perceived Work Demands among Female Nurses at a Tertiary Care Hospital in India

Introduction. Musculoskeletal disorders (MSD) are common among nurses and can affect patient outcomes. There is a dearth of literature on MSD among Indian nurses. The study objective was to measure prevalence of MSD and their association with perceived work demands and sociodemographic variables among female nurses at a tertiary care hospital in rural India. Methods. A cross-sectional study was undertaken in 2013 through interviewer administered questionnaires which comprised three parts: sociodemographic data, modified Nordic questionnaire, and perceived physical and psychological work demands. Results. 296 nurses with a mean age of 30.4 years participated. Prevalence of any MSD in the last seven days was 60.5% with low back pain being the most common and elbow pain the least common. Occurrence of any MSD was associated with age, number of children, working hours at home, BMI, and total work experience. High perceived physical demands score was associated with lower back (OR: 3.06) and knee pain (OR: 7.73). Conclusion. Prevalence of MSD was high and occurrence of lower back and knee MSD was associated with perceived physical demands. This information should be used as a benchmark and guiding tool for designing work place interventions to improve working conditions and health of nurses.
Diffuse Axonal Injury at Ultra-High Field MRI

Objective Diffuse axonal injury (DAI) is a specific type of traumatic brain injury caused by shearing forces leading to widespread tearing of axons and small vessels. Traumatic microbleeds (TMBs) are regarded as a radiological marker for DAI. This study aims to compare DAI-associated TMBs at 3 Tesla (T) and 7 T susceptibility weighted imaging (SWI) to evaluate possible diagnostic benefits of ultra-high field (UHF) MRI. Material and Methods 10 study participants (4 male, 6 female, age range 20-74 years) with known DAI were included. All MR exams were performed with a 3 T MR system (Magnetom Skyra) and a 7 T MR research system (Magnetom 7 T, Siemens AG, Healthcare Sector, Erlangen, Germany) each in combination with a 32-channel-receive coil. The average time interval between trauma and imaging was 22 months. Location and count of TMBs were independently evaluated by two neuroradiologists on 3 T and 7 T SWI images with similar and additionally increased spatial resolution at 7 T. Inter- and intraobserver reliability was assessed using the interclass correlation coefficient (ICC). Count and diameter of TMB were evaluated with Wilcoxon signed rank test. Results Susceptibility weighted imaging revealed a total of 485 TMBs (range 1-190, median 25) at 3 T, 584 TMBs (plus 20%, range 1-262, median 30.5) at 7 T with similar spatial resolution, and 684 TMBs (plus 41%, range 1-288, median 39.5) at 7 T with 10-times higher spatial resolution. Hemorrhagic DAI appeared significantly larger at 7 T compared to 3 T (p = 0.005). Inter- and intraobserver correlation regarding the counted TMB was high and almost equal 3 T and 7 T. Conclusion 7 T SWI improves the depiction of small hemorrhagic DAI compared to 3 T and may be supplementary to lower field strengths for diagnostic in inconclusive or medicolegal cases.