Miracle-dz/UniFAR-FTUs huggingface dataset:
What every intensivist should know about using high-flow nasal oxygen for critically ill patients

The most conventional forms of oxygen delivery rely on facemasks, a nasal cannula or nasal prongs. However, the use of these methods is limited by certain drawbacks, including the need for a flow of oxygen higher than 15L/min in case of severe hypoxemia or the dilution of administered oxygen by entrained room air in cases of high inspiratory flow. An alternative to conventional oxygen therapy has received growing attention: heated, humidified, high flow nasal oxygen (HFNO), a technique that can deliver heated and humidified oxygen, with a controlled fraction of inspired oxygen (FiO2), at a maximum flow rate of 60L/min via a nasal cannula. For a decade, the use of HFNO has been considered for patients with hypoxemic de novo acute respiratory failure (ARF). Recent reports suggest that HFNO can also be used to secure intubation and to prevent post-extubation ARF. The purpose of the present review is to provide clinicians with the most recent information on HFNO and to discuss its benefits and risks in its most common indications.
Efficacy of Aedes aegypti control by indoor Ultra Low Volume (ULV) insecticide spraying in Iquitos, Peru

Background Aedes aegypti is a primary vector of dengue, chikungunya, Zika, and urban yellow fever viruses. Indoor, ultra low volume (ULV) space spraying with pyrethroid insecticides is the main approach used for Ae. aegypti emergency control in many countries. Given the widespread use of this method, the lack of large-scale experiments or detailed evaluations of municipal spray programs is problematic. Methodology/Principal Findings Two experimental evaluations of non-residual, indoor ULV pyrethroid spraying were conducted in Iquitos, Peru. In each, a central sprayed sector was surrounded by an unsprayed buffer sector. In 2013, spray and buffer sectors included 398 and 765 houses, respectively. Spraying reduced the mean number of adults captured per house by ~83 percent relative to the pre-spray baseline survey. In the 2014 experiment, sprayed and buffer sectors included 1,117 and 1,049 houses, respectively. Here, the sprayed sector’s number of adults per house was reduced ~64 percent relative to baseline. Parity surveys in the sprayed sector during the 2014 spray period indicated an increase in the proportion of very young females. We also evaluated impacts of a 2014 citywide spray program by the local Ministry of Health, which reduced adult populations by ~60 percent. In all cases, adult densities returned to near-baseline levels within one month. Conclusions/Significance Our results demonstrate that densities of adult Ae. aegypti can be reduced by experimental and municipal spraying programs. The finding that adult densities return to approximately pre-spray densities in less than a month is similar to results from previous, smaller scale experiments. Our results demonstrate that ULV spraying is best viewed as having a short-term entomological effect. The epidemiological impact of ULV spraying will need evaluation in future trials that measure capacity of insecticide spraying to reduce disease transmission.
Kraepelin’s views on obsessive neurosis: a comparison with DSM-5 criteria for obsessive-compulsive disorder

Emil Kraepelin (1856-1926) is considered one of the founders of modern psychiatric nosology. However, his conceptualization of obsessive-compulsive phenomena is relatively understudied. In this article, we compare and contrast excerpts from the eighth edition (1909-1915) of Kraepelin’s Textbook of Clinical Psychiatry focusing on what Kraepelin called “obsessive neurosis” and related “original pathological conditions” with the current DSM-5 criteria for obsessive-compulsive disorder (OCD). Consistently with DSM-5 OCD, Kraepelin described obsessive neurosis as characterized by obsessive ideas, compulsive acts, or both together. His detailed descriptions of these symptoms are broadly coherent with their characterization in DSM-5, which is also true for the differential diagnoses he provided. He also mentioned cases illustrating decreased insight into symptoms and association with tic disorders. In conclusion, Kraepelin’s experience, which reflects decades of consistent clinical work, may help validate current ideas and explain how the current conceptualization has emerged and developed. Even though one can hardly say that the classification laid out in DSM-5 goes back to Kraepelin’s views directly, it still is true that Kraepelin played an outstanding role in systematizing psychiatric diagnostic criteria in general, and provided a major contribution to the conceptual history of OCD.
Impact behavior of sandwich structures made of flax/epoxy face sheets and agglomerated cork

ABSTRACT The unremitting quest of natural and renewable materials able to replace their synthetic counterparts in high-performance applications has involved also sandwich structures. In this regard, the aim of this work is to characterize the impact response, in both high- and low-velocity conditions, of green sandwich structures made of agglomerated cork as core and flax/epoxy laminates as face sheets. Both bare cork, flax skins, and complete sandwich structures were subjected to impacts at three different energy levels representing the 25%, 50%, and 75% of the respective perforation thresholds. A gas gun was instead used to assess the high-velocity impact behavior of these green sandwich structures and evaluate their ballistic limit. This study shows that the buckling of cell walls of agglomerated cork enables to tailor the damage extension through-the-thickness in low-velocity impacts compared to traditional synthetic foams coupled with a considerable amount of energy absorption.
Numerical evaluation of a deeply buried pipe testing facility

A new facility for testing pipes under deep burial has been developed. However, before the facility was commissioned, the influence of the loading scheme and boundary conditions on the pipe behaviour was investigated so that the most appropriate experimental setup could be developed. Two- and three-dimensional finite element analyses were used to assess the impact of the top and side boundary conditions on both flexible and rigid pipes with varying diameters. The vertical overburden pressures expected in the field are simulated using actuators applying vertical forces to two steel grillages. The numerical results show that the use of two independent grillages on the surface produced a more uniformly distributed ‘overburden’ pressure, a novel approach that performs significantly better than previous loading systems. Proximity of the test facility’s walls to the pipes was also investigated and found to have less than a 0.2% impact on pipe response when compared to simulations of field geometries. Results examining five different approaches to reducing the effect of sidewall friction were compared to the case of zero friction (i.e. the field case), and it was found that while lubricating the wall to create a friction angle of 5° over the full height produced the most accurate results, lubrication of only the top 2.5 m of the wall also produces thrust forces and bending moments within 10% of values from the zero-friction case. Finally, the effect of the position of the pipe within the test cell was investigated, where pipe testing with 0.3 m of bedding is expected to produce results like those for pipes close to rock foundations in the field. These results are already being used to inform testing procedures using this unique facility.
Clinical Relevance of Type II Fatty Acid Synthesis Bypass in Staphylococcus aureus

ABSTRACT The need for new antimicrobials to treat bacterial infections has led to the use of type II fatty acid synthesis (FASII) enzymes as front-line targets. However, recent studies suggest that FASII inhibitors may not work against the opportunist pathogen Staphylococcus aureus, as environmental fatty acids favor emergence of multi-anti-FASII resistance. As fatty acids are abundant in the host and one FASII inhibitor, triclosan, is widespread, we investigated whether fatty acid pools impact resistance in clinical and veterinary S. aureus isolates. Simple addition of fatty acids to the screening medium led to a 50% increase in triclosan resistance, as tested in 700 isolates. Moreover, nonculturable triclosan-resistant fatty acid auxotrophs, which escape detection under routine conditions, were uncovered in primary patient samples. FASII bypass in selected isolates correlated with polymorphisms in the acc and fabD loci. We conclude that fatty-acid-dependent strategies to escape FASII inhibition are common among S. aureus isolates and correlate with anti-FASII resistance and emergence of nonculturable variants.
Simulation of a three-dimensional craniofacial structure under the application of orthodontic loads

The aim of this study was to develop a three-dimensional model of a patient’s craniofacial structure to be analysed using the finite element method in order to estimate the forces required to carry out a dental positioning’s correction. The three-dimensional model was composed by several anatomical structures, namely the teeth, the periodontal ligaments, and the trabecular and cortical bones, which were modelled with the aid of computed tomography cone beam images. The tomographic images were analysed and reconstructed using the 3D Slicer software, while the assembly of the anatomical structures modelled, as well as the contact surfaces between contiguous parts, was defined in computer-aided design software. Bone remodelling and the occurrence of tissue’s injuries were considered during the numerical simulations carried out. By imposing displacements to each tooth, it was possible to calculate the orthodontic loads needed to carry out dental correction (reaction forces), as well as the distributions of stresses and deformations inherent to the clinical treatment, allowing to obtain a craniofacial structure capable of simulating the dental movements of upper and lower arches with anatomical realism. In addition, this methodology constitutes a personalised dental medicine that could lead to the development of highly customised orthodontic appliances where different mechanical loads could be applied individually to each tooth to achieve the foreseen dental correction.
Construction of a vascularized hydrogel for cardiac tissue formation in a porcine model

Replacing cardiac tissues lost to myocardial infarction remains a therapeutic goal for regenerative therapy in recovering cardiac function. We assessed the feasibility of constructing a macrosized human cardiac tissue construct using pluripotent stem cell‐derived cardiomyocytes or control fibroblasts infused fibrin/collagen hydrogel and performed ectopic implantation in peripheral vascular system of a porcine model for 3 weeks. Finally, an optimized vascularized cardiac construct was explanted and grafted onto porcine myocardium for 2 weeks. Myocardial‐grafted human cardiac constructs showed a nascent tissue‐like organization with aligned cardiomyocytes within the remodelled collagen matrix. Nevertheless, no significant changes in intraconstruct density of cardiomyocytes were observed in the myocardial‐grafted constructs (human embryonic stem cell [hESC]‐derived cardiomyocyte [n = 4]: 70.5 ± 22.8 troponin I+ cardiomyocytes/high power field [HPF]) as compared to peripherally implanted constructs (hESC‐derived cardiomyocyte [n = 4]: 59.0 ± 19.6 troponin I+ cardiomyocytes/HPF; human induced pluripotent stem cell‐derived cardiomyocyte [n = 3]: 50.9 ± 8.5 troponin I+ cardiomyocytes/HPF, p = ns). However, the myocardial‐grafted constructs showed an increased in neovascularization (194.4 ± 24.7 microvessels/mm2 tissue, p < .05), microvascular maturation (82.8 ± 24.7 mature microvessels/mm2, p < .05), and tissue‐like formation whereas the peripherally implanted constructs of hESC‐derived cardiomyocyte (168.3 ± 98.2 microvessels/mm2 tissue and 68.1 ± 33.4 mature microvessels/mm2) and human induced pluripotent stem cell‐derived cardiomyocyte (86.8 ± 57.4 microvessels/mm2 tissue and 22.0 ± 32.7 mature microvessels/mm2) were not significantly different in vascularized response when compared to the control human fibroblasts (n = 3) constructs (65.6 ± 34.1 microvessels/mm2 tissue and 30.7 ± 20.7 mature microvessels/mm2). We presented results on technical feasibility and challenges of grafting vascularized centimetre‐sized human cardiac construct that may spur novel approaches in cardiac tissue replacement strategy.
Improving the detection of chronic migraine: Development and validation of Identify Chronic Migraine (ID-CM)

Background Migraine, particularly chronic migraine (CM), is underdiagnosed and undertreated worldwide. Our objective was to develop and validate a self-administered tool (ID-CM) to identify migraine and CM. Methods ID-CM was developed in four stages. (1) Expert clinicians suggested candidate items from existing instruments and experience (Delphi Panel method). (2) Candidate items were reviewed by people with CM during cognitive debriefing interviews. (3) Items were administered to a Web panel of people with severe headache to assess psychometric properties and refine ID-CM. (4) Classification accuracy was assessed using an ICHD-3β gold-standard clinician diagnosis. Results Stages 1 and 2 identified 20 items selected for psychometric validation in stage 3 (n = 1562). The 12 psychometrically robust items from stage 3 underwent validity testing in stage 4. A scoring algorithm applied to four symptom items (moderate/severe pain intensity, photophobia, phonophobia, nausea) accurately classified most migraine cases among 111 people (sensitivity = 83.5%, specificity = 88.5%). Augmenting this algorithm with eight items assessing headache frequency, disability, medication use, and planning disruption correctly classified most CM cases (sensitivity = 80.6%, specificity = 88.6%). Discussion ID-CM is a simple yet accurate tool that correctly classifies most individuals with migraine and CM. Further testing in other settings will also be valuable.
Prediction of Overuse Injuries in Professional U18-U21 Footballers Using Metrics of Training Distance and Intensity

Abstract Bacon, CS and Mauger, AR. Prediction of overuse injuries in professional U18-U21 footballers using metrics of training distance and intensity. J Strength Cond Res 31(11): 3067–3076, 2017—The most common injury in professional football is an overuse injury to the lower limb. A significant external risk factor of this injury is the mismanagement of training and match loads. The aim of the current study was to examine the predictability of overuse injuries in professional youth soccer players using volume and intensity variables derived from Global Positioning Systems. A total of 41 players (age: 17.8 ± 1.1 years) training and match loads were assessed. These external loads were measured over 2 competitive seasons for every training session and match for each individual. A linear regression was used to test the predictability of the injury based on load, which were grouped using loading groups calculated from squad weekly averages. The load groupings assigned were: low load = 1 SD below the squad mean score; normal load = ±1 SD from the squad mean; high load = 1 SD above squad mean. The analysis demonstrated that total distance significantly predicted overuse injury incidence rates (F 1,39 = 6.482, p = 0.015), whereas high-speed running meters could not (F 1,39 = 1.003, p = 0.323). This study demonstrated that distance covered in training and matches can impact on the incidence of overuse injury in youth soccer players. Coaches should seek to monitor player training loads and incorporate this metric into their decision making for protecting players from overuse injury.
The rph-1-Encoded Truncated RNase PH Protein Inhibits RNase P Maturation of Pre-tRNAs with Short Leader Sequences in the Absence of RppH

ABSTRACT RNase PH, encoded by the rph gene, is a 3′→5′ exoribonuclease that in E. coli participates primarily in the 3′ maturation of pre-tRNAs and the degradation of rRNA in stationary-phase cells. Interestingly, the routinely used laboratory strains of MG1655 and W3110 have naturally acquired the rph-1 allele, encoding a truncated catalytically inactive RNase PH protein which is widely assumed to be benign. Contrary to this assumption, we show that the rph-1-encoded Rph-1 protein inhibits RNase P-mediated 5′-end maturation of primary pre-tRNAs with leaders of <5 nucleotides in the absence of RppH, an RNA pyrophosphohydrolase. In contrast, RppH is not required for 5′-end maturation of endonucleolytically generated pre-tRNAs in the rph-1 strain and for any tRNAs in Δrph mutant or rph + strains. We propose that the Rph-1 protein bound to the 3′ end of the substrate creates a steric hindrance that in the presence of a triphosphate at the 5′ end reduces the ability of RNase P to bind to the pre-tRNA. IMPORTANCE In this paper, we demonstrate that the rph-1 mutation found in commonly used E. coli strains leads to the synthesis of a truncated functionally inactive RNase PH protein that interferes with the 5′-end maturation of specific tRNAs with short 5′ leaders by RNase P in the absence of RppH, an RNA pyrophosphohydrolase that converts primary 5′ triphosphates into 5′ monophosphates. The data presented indicate that the presence of the triphosphate interferes with RNase P binding to the pre-tRNA.
Clinical Response of Tedizolid versus Linezolid in Acute Bacterial Skin and Skin Structure Infections by Severity Measure Using a Pooled Analysis from Two Phase 3 Double-Blind Trials

ABSTRACT Tedizolid phosphate is approved for the treatment of acute bacterial skin and skin structure infections (ABSSSI). In a pooled analysis of 1,333 ABSSSI patients from the ESTABLISH clinical trials, treatment with tedizolid or linezolid demonstrated similar early and posttherapy clinical responses in nonsevere and severe disease, irrespective of the parameters used to measure ABSSSI severity. Shorter 6-day treatment of ABSSSI, including those that were severe, with tedizolid phosphate demonstrated efficacy comparable to that of 10-day treatment with linezolid. (The ESTABLISH studies discussed in this paper have been registered at ClinicalTrials.gov under identifiers NCT01170221 and NCT01421511.)
Contemporary microbiology and identification of Corynebacteria spp. causing infections in human

The Corynebacterium is a genus of bacteria of growing clinical importance. Progress in medicine results in growing population of immunocompromised patients and growing number of infections caused by opportunistic pathogens. A new infections caused by new Corynebacterium species and species previously regarded as commensal micro‐organisms have been described. Parallel with changes in Corynebacteria infections, the microbiological laboratory diagnostic possibilities are changing. But identification of this group of bacteria to the species level remains difficult. In the paper, we present various manual, semi‐automated and automated assays used in clinical laboratories for Corynebacterium identification, such as API Coryne, RapID CB Plus, BBL Crystal Gram Positive ID System, MICRONAUT‐RPO, VITEK 2, BD Phoenix System, Sherlock Microbial ID System, MicroSeq Microbial Identification System, Biolog Microbial Identification Systems, MALDI‐TOF MS systems, polymerase chain reaction (PCR)‐based and sequencing‐based assays. The presented assays are based on various properties, like biochemical tests, specific DNA sequences, composition of cellular fatty acids, protein profiles and have specific limitations.
Percutaneous thoracic duct intervention to treat plastic bronchitis related to Fontan palliation

Plastic bronchitis is a life‐threatening condition of airway obstructive cast formation. This pediatric case series from a high altitude center details the course of three patients after percutaneous thoracic duct interventions for refractory plastic bronchitis, with a follow‐up interval of 3.5 years. In two patients, where cisterna chyli maceration (patients 2) or thoracic duct embolization (patient 3) was performed, a sustained clinical improvement is shown, with no subsequent cast recurrence. In patient 1, cisterna chyli maceration resulted in partial improvement. Herein, a favorable outcome is shown in pediatric patients with percutaneous thoracic duct interventions for plastic bronchitis at altitude.
Critical Thinking and Disposition Toward Critical Thinking Among Physical Therapy Students.

PURPOSE Students who enter a physical therapist (PT) entry-level program with weak critical thinking skills may not be prepared to benefit from the educational training program or successfully engage in the future as a competent healthcare provider. Therefore, assessing PT students' entry-level critical thinking skills and/or disposition toward critical thinking may be beneficial to identifying students with poor, fair, or good critical thinking ability as one of the criteria used in the admissions process into a professional program. PARTICIPANTS/METHODS First-year students (n=71) from the Doctor of Physical Therapy (DPT) program at Texas Tech University Health Sciences Center completed the California Critical Thinking Skills Test (CCTST), the California Critical Thinking Dispositions Inventory (CCTDI), and demographic survey during orientation to the DPT program. Three students were lost from the CCTST (n=68), and none lost from the CCTDI (n=71). OUTCOMES Analysis indicated that the majority of students had a positive disposition toward critical thinking, yet the overall CCTST suggested that these students were somewhat below the national average. Also, individuals taking math and science prerequisites at the community-college level tended to have lower overall CCTST scores. CONCLUSION The entering DPT class demonstrated moderate or middle range scores in critical thinking and disposition toward critical thinking. This result does not indicate, but might suggest, the potential for learning challenges. Assessing critical thinking skills as part of the admissions process may prove advantageous.
Understanding and predicting the diffusivity of organic compounds in polydimethylsiloxane material for passive sampler applications using a simple quantitative structure–property relationship model

The diffusivity of 145 compounds in polydimethylsiloxane (PDMS) material was determined in the laboratory using a film stacking technique. The results were pooled with available literature data, providing a final data set of 198 compounds with diffusivity (DPDMS) spanning over approximately 5 log units. The principal variables controlling the diffusivity of penetrants were investigated by comparing DPDMS within and between different homologous series. The dipole moment, molecular size, and flexibility of penetrants appear to be the most prevalent factors controlling a compound's diffusivity. A nonlinear quantitative structure–property relationship is proposed using as predicting variables the molecular volume, the number of rotatable bonds, the topological polar surface area, and the number of O and N atoms. The final relationship has a correlation coefficient of R2 = 0.81 and a mean absolute error of 0.26 m2 s−1 (log unit), approaching the average error for the experimentally determined values (0.12 m2 s−1). The model, based on a heuristic approach, is ready for use by analytical chemists with no specific background in theoretical chemistry (notably for passive sampler development). Environ Toxicol Chem 2018;37:1291–1300. © 2018 SETAC