Miracle-dz/UniFAR-FTUs huggingface dataset:
Extubation in intensive care units in the UK: an online survey.

AIM To determine the current practice among critical care nurses in the UK with regard to airway management during cuff deflation and extubation. BACKGROUND There are a number of techniques used by clinicians to prevent aspiration during cuff deflation and extubation of patients. There are no published clinical studies comparing the different manoeuvres available to clinicians at the time of extubation nor any data to suggest which technique is most commonly used. METHODS All members of the British Association of Critical Care Nurses with an email address were invited to participate in an online survey. RESULTS A total of 533 (29%) nurses from 184 (84%) intensive care unit (ICUs) in the UK completed the survey. Just under half of the sample (n = 258, 48.4%) had more than 10 years of critical care experience and the vast majority (n = 427, 80.1%) worked in general ICUs. The majority of respondents (n = 461, 86.5%) suction the trachea during cuff deflation and extubation. A further 304 (57%) respondents ask patients to cough as part of extubation. Respondents increase the positive end expiratory pressure setting on the ventilator infrequently as part of routine procedure for extubation (n = 7, 1.3%). CONCLUSION The majority of UK critical care nurses either suction the trachea during cuff deflation and extubation of patients and/or simply ask the patient to cough. Further clinical trials are required to identify the most appropriate and safe technique for critically ill patients.
Nutritional Knowledge, Attitude, and Practices among Pregnant and Lactating Women Living with HIV in the Manzini Region of Swaziland

ABSTRACT The prevalence of HIV infection in Swaziland (26%) is among the highest in the world. We investigated nutritional knowledge, attitude, and practices (KAP) and the influence of sociodemographic factors on KAP among pregnant and lactating women living with HIV in the Manzini region of Swaziland. Interviews were conducted using a structured questionnaire to collect data from 324 subjects seeking healthcare from selected regional hospitals, health centres, and clinics in Manzini region. The results showed mean percentage scores of nutritional knowledge (67%), attitude (67%), and practices (51%) whereby educational level (p=0.002), employment status (p=0.009), income (p=0.008), religion (p=0.007), type of accommodation (p=0.006), type of transport used when going for shopping (p=0.001), and BMI (p=0.015) were significantly associated with nutritional practices. Significant positive correlations between nutritional KAP were observed: nutritional K and A (r=0.155, p=0.005), nutritional K and P (r=0.456, p=0.001), and nutritional A and P (r=0.230, p=0.001). Multiple linear regression analysis indicated that type of transport used when going for shopping (p=0.002), educational level (p=0.001), income (p=0.001), employment (p=0.038), knowledge of food proportion in a plate (p=0.000), a positive attitude towards high-fibre diet (p=0.004), and eating a variety of foods (p=0.006) were predictors of nutritional practices. Educational level was identified as a common predictor of nutritional knowledge, attitude, and practices, suggesting that both formal and informal education systems are potential factors influencing dietary practices among pregnant and lactating women living with HIV in Swaziland.
Drosophila lifespan control by dietary restriction independent of insulin-like signaling

Reduced insulin/insulin‐like growth factor (IGF) signaling may be a natural way for the reduction of dietary nutrients to extend lifespan. While evidence challenging this hypothesis is accumulating with Caenorhabditis elegans, for Drosophila melanogaster it is still thought that insulin/IGF and the mechanisms of dietary restriction (DR) might as yet function through overlapping mechanisms. Here, we aim to understand this potential overlap. We found that over‐expression of dFOXO in head fat body extends lifespan and reduces steady‐state mRNA abundance of insulin‐like peptide‐2 under conditions of high dietary yeast, but not when yeast is limiting. In contrast, conditions of DR that increase lifespan change only insulin‐like peptide‐5 (ilp5) mRNA abundance. Thus, reduction of ilp5 mRNA is associated with longevity extension by DR, while reduction of insulin‐like peptide‐2 is associated with the diet‐dependent effects of FOXO over‐expression upon lifespan. To assess whether reduction of ilp5 is required for DR to extend lifespan, we blocked its diet‐dependent change with RNAi. Loss of the ilp5 dietary response did not diminish the capacity of DR to extend lifespan. Finally, we assessed the capacity of DR to extend lifespan in the absence of dFOXO, the insulin/IGF‐responsive transcription factor. As with the knockdown of ilp5 diet responsiveness, DR was equally effective among genotypes with and without dFOXO. It is clear from many Drosophila studies that insulin/IGF mediates growth and metabolic responses to nutrition, but we now find no evidence that this endocrine system mediates the interaction between dietary yeast and longevity extension.
Blood glucose concentration and outcome of critical illness: The impact of diabetes*

Objective:To study the impact of diabetes mellitus on the relationship between glycemia and mortality in critically ill patients. Design:Retrospective observational study. Setting:Intensive care units of two university hospitals. Patients:Cohort of 4946 critically ill patients including 728 patients with diabetes mellitus. Intervention:None. Measurements and Main Results:We assessed and compared the relationship between glycemia during intensive care unit stay and mortality in diabetic and nondiabetic patients. There were 125,036 blood glucose measurements (5.7 measurements/day on average). Intensive care unit mortality increased significantly with increasing mean blood glucose concentration in nondiabetes mellitus patients but not in diabetes mellitus patients. Nondiabetes mellitus patients with a time-weighted glucose concentration (GluTw) between 8.0 and 10.0 mmol/L were found to be 1.74 times more likely to die in intensive care unit as diabetes mellitus patients in the same range (odds ratio = 1.74 [1.13–2.68] p = 0.01). They were also more than three times more likely to die in the intensive care unit compared with diabetes mellitus patients when the Glutw was between 10.0 and 11.1 mmol/L (odds ratio = 3.34 [1.35–8.23] p = 0.009). Using multivariate logistic regression analysis, hyperglycemia was strongly and independently associated with outcome in nondiabetic patients (p < 0.001) but showed no significant association with outcome in diabetic patients. Conclusions:Unlike nondiabetic patients, diabetic patients show no clear association between hyperglycemia during intensive care unit stay and mortality and markedly lower odds ratios of death at all levels of hyperglycemia. These findings suggest that, in critically patients with diabetes mellitus, hyperglycemia may have different biological and/or clinical implications. LEARNING OBJECTIVESOn completion of this article, the reader should be able to: Explain the impact of blood glucose monitoring on outcomes. Describe the impact of the diagnosis of diabetes on outcomes in patients with hyperglycemia. Use this information in a clinical setting. Dr. French has disclosed that he was the recipient of grant/research funds from Novartis and is currently receiving grant/research funds from Novartis, Wyeth, Lilly, and Takeda. Dr. French has disclosed that he was a consultant/advisor for Wyeth. The remaining authors have disclosed that they have no financial relationships with or interests in any commercial companies pertaining to this educational activity. All faculty and staff in a position to control the content of this CME activity have disclosed that they have no financial relationship with, or financial interests in, any commercial companies pertaining to this educational activity. Lippincott CME Institute, Inc., has identified and resolved all faculty conflicts of interest regarding this educational activity. Visit the Critical Care Medicine Web Site (www.ccmjournal.org) for information on obtaining continuing medical education credit.
Hepatic arterial infusion of floxuridine in patients with liver metastases from colorectal carcinoma: long-term results of a prospective randomized trial.

PURPOSE A multicentric randomized study that compared patients who received intrahepatic arterial infusion (HAI) to a group of patients who did not receive HAI (control group) was performed for unresectable hepatic metastases from primary colorectal carcinoma. PATIENTS AND METHODS One hundred sixty-six patients were assigned randomly to HAI of floxuridine (5 fluoro-2'deoxyuridine [FUDR]) 0.3 mg/kg/d for 14 days every 4 weeks or to the control group; this latter group, depending on the investigator's choice, was either under observation or received systemic fluorouracil (5-FU). The same regimen of systemic 5-FU also was administered to the HAI group in the event of extrahepatic progression. No crossover from the control group to the HAI group was permitted. The mean duration of follow-up was 54 months (range, 31 to 72), and 163 patients were analyzed. RESULTS A significant improvement was observed in the survival rate for the 81 patients assigned to HAI group (P less than .02) with a 1-year survival rate of 64% versus 44% in the control group (82 patients). The 2-year survival rate was 23% versus 13%. The median survival was 15 months versus 11 months for the HAI group and the control group, respectively. Survival was better for patients with a less than 30% liver involvement, and for those treated in more specialized centers. The hepatotoxic effects of HAI were observed in 47 patients (chemical hepatitis [n = 28], and biliary sclerosis [n = 19]). The 1-year rate of sclerosing cholangitis was equal to 25%. Gastrointestinal toxicity was infrequent and consisted of gastritis or diarrhea. CONCLUSIONS Therapy with HAI of FUDR improves the survival of patients with liver metastases over colorectal carcinoma. However, the methods that are used to diminish the toxicity of HAI and efficient systemic chemotherapy, such as a combination of 5-FU and leucovorin, are required to prevent extrahepatic metastases.
CYP56 (Dit2p) in Candida albicans: Characterization and Investigation of Its Role in Growth and Antifungal Drug Susceptibility

ABSTRACT The complete DNA sequence of Candida albicans DIT2, encoding cytochrome P450 family 56 (CYP56), was obtained, and heterologous expression was achieved in Escherichia coli, where CYP56 was targeted to the membrane fraction. In reconstituted assays with the purified enzyme, CYP56 was shown to catalyze the conversion of N-formyl tyrosine into N,N′-bisformyl dityrosine, a reaction that was dependent on cytochrome P450 reductase, NADPH, and oxygen, yielding a turnover of 21.6 min−1 and a ks of 26 μM. The Hill number was calculated as 1.6, indicating that two molecules of the substrate could bind to the protein. Azole antifungals could bind to the heme of CYP56 as a sixth ligand with high affinity. Both chromosomal alleles of CYP56 were disrupted using the SAT1 flipper technique, and CYP56 was found to be nonessential for cell viability under the culture conditions investigated. Susceptibility to azole drugs that bind to cytochromes P450 was tested, and the mutant showed unaltered susceptibility. However, the mutant showed increased susceptibility to the echinocandin drug caspofungin, suggesting an alteration in 1,3-glucan synthase and/or cell wall structure mediated by the presence of dityrosine. Phenotypically, the wild-type and mutant strains were morphologically similar when cultured in rich yeast extract-peptone-dextrose medium. However in minimal medium, the cyp56Δ mutant strain exhibited hyphal growth, in contrast to the wild-type strain, which grew solely in the yeast form. Furthermore, CYP56 was essential for chlamydospore formation.
Muju Virus, Harbored by Myodes regulus in Korea, Might Represent a Genetic Variant of Puumala Virus, the Prototype Arvicolid Rodent-Borne Hantavirus

The genome of Muju virus (MUJV), identified originally in the royal vole (Myodes regulus) in Korea, was fully sequenced to ascertain its genetic and phylogenetic relationship with Puumala virus (PUUV), harbored by the bank vole (My. glareolus), and a PUUV-like virus, named Hokkaido virus (HOKV), in the grey red-backed vole (My. rufocanus) in Japan. Whole genome sequence analysis of the 6544-nucleotide large (L), 3652-nucleotide medium (M) and 1831-nucleotide small (S) segments of MUJV, as well as the amino acid sequences of their gene products, indicated that MUJV strains from different capture sites might represent genetic variants of PUUV, the prototype arvicolid rodent-borne hantavirus in Europe. Distinct geographic-specific clustering of MUJV was found in different provinces in Korea, and phylogenetic analyses revealed that MUJV and HOKV share a common ancestry with PUUV. A better understanding of the taxonomic classification and pathogenic potential of MUJV must await its isolation in cell culture.
Attenuation of Skeletal Muscle and Renal Injury to the Lower Limb following Ischemia-Reperfusion Using mPTP Inhibitor NIM-811

Introduction Operation on the infrarenal aorta and large arteries of the lower extremities may cause rhabdomyolysis of the skeletal muscle, which in turn may induce remote kidney injury. NIM-811 (N-metyl-4-isoleucine-cyclosporine) is a mitochondria specific drug, which can prevent ischemic-reperfusion (IR) injury, by inhibiting mitochondrial permeability transition pores (mPTP). Objectives Our aim was to reduce damages in the skeletal muscle and the kidney after IR of the lower limb with NIM-811. Materials and methods Wistar rats underwent 180 minutes of bilateral lower limb ischemia and 240 minutes of reperfusion. Four animal groups were formed called Sham (receiving vehicle and sham surgery), NIM-Sham (receiving NIM-811 and sham surgery), IR (receiving vehicle and surgery), and NIM-IR (receiving NIM-811 and surgery). Serum, urine and histological samples were taken at the end of reperfusion. NADH-tetrazolium staining, muscle Wet/Dry (W/D) ratio calculations, laser Doppler-flowmetry (LDF) and mean arterial pressure (MAP) monitoring were performed. Renal peroxynitrite concentration, serum TNF-α and IL-6 levels were measured. Results Less significant histopathological changes were observable in the NIM-IR group as compared with the IR group. Serum K+ and necroenzyme levels were significantly lower in the NIM-IR group than in the IR group (LDH: p<0.001; CK: p<0.001; K+: p = 0.017). Muscle mitochondrial viability proved to be significantly higher (p = 0.001) and renal function parameters were significantly better (creatinine: p = 0.016; FENa: p<0.001) in the NIM-IR group in comparison to the IR group. Serum TNF-α and IL-6 levels were significantly lower (TNF-α: p = 0.003, IL-6: p = 0.040) as well as W/D ratio and peroxynitrite concentration were significantly lower (p = 0.014; p<0.001) in the NIM-IR group than in the IR group. Conclusion NIM-811 could have the potential of reducing rhabdomyolysis and impairment of the kidney after lower limb IR injury.
EnrichNet: network-based gene set enrichment analysis

Motivation: Assessing functional associations between an experimentally derived gene or protein set of interest and a database of known gene/protein sets is a common task in the analysis of large-scale functional genomics data. For this purpose, a frequently used approach is to apply an over-representation-based enrichment analysis. However, this approach has four drawbacks: (i) it can only score functional associations of overlapping gene/proteins sets; (ii) it disregards genes with missing annotations; (iii) it does not take into account the network structure of physical interactions between the gene/protein sets of interest and (iv) tissue-specific gene/protein set associations cannot be recognized. Results: To address these limitations, we introduce an integrative analysis approach and web-application called EnrichNet. It combines a novel graph-based statistic with an interactive sub-network visualization to accomplish two complementary goals: improving the prioritization of putative functional gene/protein set associations by exploiting information from molecular interaction networks and tissue-specific gene expression data and enabling a direct biological interpretation of the results. By using the approach to analyse sets of genes with known involvement in human diseases, new pathway associations are identified, reflecting a dense sub-network of interactions between their corresponding proteins. Availability: EnrichNet is freely available at http://www.enrichnet. org. Contact: Natalio.Krasnogor@nottingham.ac. uk, reinhard.schneider@uni.lu or avalencia@cnio.es Supplementary Information: Supplementary data are available at Bioinformatics Online.
High increments of overweight along with low length-for-age growth during the first 24 months of life.

BACKGROUND It has been reported that children nursed in orphanages loose one month of lineal growth for every three months they spend in the orphanage. OBJECTIVE The purpose of this study was to evaluate the daily variation of weight- for- length and length-for-age among infants under 24 months of age, living in a temporary public orphanage in Mexico. METHODS Ninety children from 0 to 24 months of age, who were institutionalized at an orphanage, were assessed during a three month period. Upon arrival their height and weight were measured daily, Monday through Friday. Daily growth velocity for weight and length was calculated. Length-for age (LAZ) and weight-for-length (WHZ) age z- scores were calculated based on WHO criteria. Risk of overweight (ROW) and overweight (OW) were classified using the WHO criteria. RESULTS The increments of daily weight were lower than the normal range (9 g daily), but the ROW and OW increased from 10% and 3% at the beginning of the study to 14% and 11% at the end. At the end of the follow-up, WHZ was inversely associated to length (cm/day) velocity (r = -302, p < 0.01). Although a significant increase in ROW and OW was observed, at the end of the study, 31% of the children showed signs of stunting (-2 SD in length-age) and 5% remained emaciated (-2 SD in weight-length). CONCLUSIONS Children living in an orphanage showed reduced increments of weight and length-for-age, as well as a reduced length velocity and an increased ROW and OW.
Biological Control Strategies for Mosquito Vectors of Arboviruses

Historically, biological control utilizes predatory species and pathogenic microorganisms to reduce the population of mosquitoes as disease vectors. This is particularly important for the control of mosquito-borne arboviruses, which normally do not have specific antiviral therapies available. Although development of resistance is likely, the advantages of biological control are that the resources used are typically biodegradable and ecologically friendly. Over the past decade, the advancement of molecular biology has enabled optimization by the manipulation of genetic materials associated with biological control agents. Two significant advancements are the discovery of cytoplasmic incompatibility induced by Wolbachia bacteria, which has enhanced replacement programs, and the introduction of dominant lethal genes into local mosquito populations through the release of genetically modified mosquitoes. As various arboviruses continue to be significant public health threats, biological control strategies have evolved to be more diverse and become critical tools to reduce the disease burden of arboviruses.
Seismic Resistance of Square Concrete Columns Retrofitted with Glass Fiber-Reinforced Polymer

The capacity of key structural members, particularly columns, to absorb and dissipate energy without severe strength degradation dictates the survival of structures during a major earthquake. Reinforced concrete columns with inadequate confinement do not possess the necessary ductility to dissipate sufficient seismic energy. This research evaluates the effectiveness of glass fiber-reinforced polymer (GFRP) wraps in strengthening deficient and repairing damaged square concrete columns. Each of the eight specimens tested, representing columns of buildings and bridges constructed before 1971, consisted of a 305 x 305 x 1473 mm column connected to a 508 x 762 x 813 mm stub. Specimens were tested under constant axial compression and cyclic lateral displacement excursions simulating earthquake loads. Test results reveal that retrofitting with GFRP wraps significantly enhanced ductility, energy dissipation ability, and shear and moment capacities of deficient columns. Cyclic behavior progressively improved as the number of GFRP layers increased, causing both stiffness degradation and strength reduction rates to decrease. Improvements observed following GFRP repair of damaged columns depended mainly on the extent of damage stained. GFRP-confined columns exceeded the performance of similar columns that contained transverse steel reinforcement in accordance with the seismic provisions of the current North American codes.
Third Order Loops of Contacts in a Granular Force Network

The existence of small order loops of contacts is presented as an intrinsic characteristic of force granular networks. Based on molecular dynamics simulations, it is proposed that the presence of these small order loops — and in particular third order loops of contacts — is important to understand the transition from fluid-like to solid-like behavior of granular packings. In addition, we show a close relationship between the development of third order loops and the small forces of the granular packing in the sense that almost all third order loops allocate a force component smaller than the average.
Linear Recursive Filters and Nonlinear Dynamics

In this paper we investigate the eeects of ltering a chaotic time series with a linear IIR lter. Using the Kaplan and Yorke conjecture it has been argued that such ltering can result in an increase in information dimension. Here we show that the lter dynamics induce an extended dynamical system and that this system possesses a globally attracting invariant graph over the base system. Using this framework we obtain suucient conditions on the lter dynamics that guarantee that the dimension remains unchanged.
Pumping tests in networks of multilevel sampling wells: Motivation and methodology

The identification of spatial variations in hydraulic conductivity (K) on a scale of relevance for transport investigations has proven to be a considerable challenge. Recently, a new field method for the estimation of interwell variations in K has been proposed. This method, hydraulic tomography, essentially consists of a series of short‐term pumping tests performed in a tomographic‐like arrangement. In order to fully realize the potential of this approach, information about lateral and vertical variations in pumping‐induced head changes (drawdown) is required with detail that has previously been unobtainable in the field. Pumping tests performed in networks of multilevel sampling (MLS) wells can provide data of the needed density if drawdown can accurately and rapidly be measured in the small‐diameter tubing used in such wells. Field and laboratory experiments show that accurate transient drawdown data can be obtained in the small‐diameter MLS tubing either directly with miniature fiber‐optic pressure sensors or indirectly using air‐pressure transducers. As with data from many types of hydraulic tests, the quality of drawdown measurements from MLS tubing is quite dependent on the effectiveness of well development activities. Since MLS ports of the standard design are prone to clogging and are difficult to develop, alternate designs are necessary to ensure accurate drawdown measurements. Initial field experiments indicate that drawdown measurements obtained from pumping tests performed in MLS networks have considerable potential for providing valuable information about spatial variations in hydraulic conductivity.