Miracle-dz/UniFAR-FTUs huggingface dataset:
Compatibility of medications with 3-in-1 parenteral nutrition admixtures.

BACKGROUND The absence of drug compatibility information with 3-in-1 parenteral nutrition admixtures has been problematic. The purpose of this project was to evaluate the physical compatibility of 106 selected drugs during simulated Y-site injection into nine different 3-in-1 parenteral nutrition admixture formulations. METHODS Four-milliliter samples of each of the representative 3-in-1 parenteral nutrition admixture formulations were combined in a 1:1 ratio with 4-mL samples of each of 106 drugs, including supportive care drugs, anti-infectives, and antineoplastic drugs. Six replicate samples of each combination were prepared. Two samples were evaluated initially after mixing, two more after 1 hour, and the last two after 4 hours at 23 degrees C. At each test interval, the samples were subjected to centrifugation, causing the fat to rise to the top. The top fat layer and most of the aqueous phase were removed, and the remaining liquid was diluted with about 7 mL of particle-free, high-performance liquid chromatography-grade water to facilitate observation of any particulates that might have formed. Visual examinations were performed in normal diffuse fluorescent laboratory light and under high-intensity, monodirectional light. RESULTS Most of the drugs tested were physically compatible with the 3-in-1 parenteral nutrition admixtures for 4 hours at 23 degrees C. However, 23 drugs exhibited various incompatibilities with one or more of the parenteral nutrition admixtures. Six drugs resulted in the formation of precipitate with some or all of the admixtures. Seventeen drugs caused disruption of the emulsion, usually with oiling out. CONCLUSIONS Most of the test drugs were physically compatible with the nine representative 3-in-1 parenteral nutrition admixtures. However, the 23 drugs that resulted in incompatibilities should not be administered simultaneously with the incompatible parenteral nutrition admixtures via a Y injection site.
A finite-element-boundary-integral method for scattering and radiation by two- and three-dimensional structures

A hybrid finite-element-boundary-integral formulation for scattering and radiation by 2-D and 3-D composite structures is described. In contrast to other hybrid techniques involving the finite-element method, the method is in principle exact, and can be implemented using low O(N) amounts of storage. This is of particular importance for large-scale applications, and is a characteristic of the boundary chosen to terminate the finite-element mesh, usually as close to the structure as possible. A general description of the method, without reference to any specific geometry or application, is given. A number of 2-D and 3-D applications are then considered, to demonstrate its accuracy, efficiency, and capabilities. Of particular concern in these applications is the choice of the fictitious boundary enclosing the structure. Boundaries of a certain class lead to convolutional boundary integrals, which can be evaluated by the fast Fourier transform without generating a matrix, thus retaining the O(N) storage requirement. <<ETX>>
Role of Integrin-linked Kinase in Regulating Phosphorylation of Akt and Fibroblast Survival in Type I Collagen Matrices through a β1 Integrin Viability Signaling Pathway*

A β1 integrin phosphatidylinositol 3-kinase/Akt pathway regulates fibroblast survival in collagen matrices. When fibroblasts attach to collagen, Akt becomes phosphorylated, providing a survival signal. In contrast, in response to mechanical forces generated during collagen contraction, Akt is dephosphorylated and fibroblasts undergo apoptosis. The kinase(s) responsible for regulating Akt phosphorylation in response to matrix-derived mechanical signals are unclear. Integrin-linked kinase (ILK) is associated with the β1 integrin in the focal adhesion complex and as such is a candidate kinase that may regulate Akt phosphorylation and fibroblast viability. Nevertheless, there is no direct evidence that matrix-derived mechanical forces regulate cell viability by modulating ILK activity. Here, we show that ILK activity decreased in response to collagen matrix contraction, which correlated with Akt dephosphorylation and induction of fibroblast apoptosis. In contrast, enforced activation of β1 integrin by activating antibody preserved ILK and Akt activity during collagen matrix contraction, and this is associated with protection from collagen contraction-induced apoptosis. Knock-down of ILK by small, interfering RNA (siRNA) attenuated Akt phosphorylation in response to ligation of β1 integrin by collagen or activating antibody and enhanced fibroblast apoptosis in response to collagen contraction. Kinase dead ILK attenuated Akt phosphorylation and enhanced fibroblast apoptosis, whereas hyperactive and wild type ILK augmented Akt phosphorylation and protected fibroblasts from apoptosis. Constitutively active Akt preserved Akt activity and rescued ILK siRNA-treated fibroblasts from collagen contraction-induced apoptosis. These data establish that matrix-derived mechanical forces sensed by β1 integrin are capable of modulating ILK activity which regulates fibroblast viability via an Akt-dependent mechanism.
Nitrogen constraints on terrestrial carbon uptake: Implications for the global carbon‐climate feedback

Carbon‐climate feedback has been identified as one of the key areas of synthesis for the next Inter‐governmental Panel on Climate Change (IPCC); however, most of the models on which the IPCC will rely are yet to consider vital interactions between nitrogen (N) and carbon (C) cycles. A major impediment to including N limitation in model predictions has been the lack of constraint to rates of N fixation worldwide. Here we use a theoretical framework that considers interactions of C and nutrients to estimate rates of terrestrial N fixation, and thereby examining how the constraints of N on land C uptake and global warming. We show that most global models without nutrient limitations significantly overestimated land C uptake, thus underestimating both the pace and magnitude of the predicted global warming. We suggest that the next IPCC assessment should consider nutrient constraints on carbon‐climate feedback and the pace of global warming.
Intraoperative Thrombolysis in a Patient with Cardiopulmonary Arrest Undergoing Caesarean Delivery

Thromboembolic events during pregnancy remain a major cause of morbidity and mortality with possible catastrophic sequelae for the patient. The decision whether to use high-risk therapeutic thrombolytics during pregnancy or perinatally is complicated and many considerations pertain. We report on the thrombolytic management of a 34-year-old woman who had an asystolic cardiac arrest secondary to massive pulmonary embolism while undergoing emergency caesarean delivery. The patient was thrombolysed during successful cardiopulmonary resuscitation. Return of spontaneous circulation was accompanied by massive uterine bleeding. Instead of performing a postpartum hysterectomy, the uterus was preserved through continuous manual pressure and packing for four hours by the obstetric team until haemostasis was achieved. The patient survived and was later discharged without any major neurological deficit.
Hyperglycinemia: A Defect in Glycine Cleavage Reaction

A girl with hyperglycinemia of nonketotic type was presented. The liver biopsied from the patient was studied for glycine metabolism. It was found that the yield of 14CO2 from glyeine-l-14C and the rate of 11C incorporation into serine from glyeine-l-14C as well as glycine-2-14C were extremely low in the patient's liver than in control livers, while the patient's liver showed normal activities of serine-hydroxyrnethylase and serine-dehydratase. These findings indicate that the primary lesion of hyperglycinemia of nonketotic type is a defect in the glyeine cleavage reaction which gives rise to the formation of CO2, methylene-tetrahydrofolate and ammonia from glyeine.
The pharmacokinetics and pharmacodynamics of pulmonary Mycobacterium avium complex disease treatment.

RATIONALE Currently recommended multidrug treatment regimens for Mycobacterium avium complex (MAC) lung disease yield limited cure rates. This results, in part, from incomplete understanding of the pharmacokinetics and pharmacodynamics of the drugs. OBJECTIVES To study pharmacokinetics, pharmacodynamics, and drug interactions of multidrug treatment regimens in a large cohort of patients with MAC lung disease. METHODS We retrospectively collected pharmacokinetic data of all patients treated for MAC lung disease in the Adult Care Unit at National Jewish Health, Denver, Colorado, in the January 2006 to January 2010 period; we retrospectively calculated areas under the time-concentration curve (AUC). Minimum inhibitory concentrations (MIC) of their MAC isolates were retrieved for pharmacodynamic calculations. MEASUREMENTS AND MAIN RESULTS We included 531 pharmacokinetic analyses, performed for 481 patients (84% females; mean age, 63 yr; mean body mass index, 21.6). Peak serum concentrations (C(max)) below target range were frequent for ethambutol (48% of patients); clarithromycin (56%); and azithromycin (35%). Concurrent administration of rifampicin led to 68%, 23%, and 10% decreases in C(max) of clarithromycin, azithromycin, and moxifloxacin. C(max)/MIC or AUC/MIC ratios associated with bactericidal activity were seldom met; 57% of patients achieved target ratios for ethambutol, versus 42% for clarithromycin, 19% for amikacin, 18% for rifampicin, and 11% for moxifloxacin. CONCLUSIONS Currently recommended regimens for MAC lung disease yield important pharmacologic interactions and low concentrations of key drugs including macrolides. Pharmacodynamic indices for rifampicin, clarithromycin, amikacin, and moxifloxacin are seldom met. This may partly explain the poor outcomes of currently recommended treatment regimens. Trials of new drugs and new dosing strategies are needed.
Management and Outcome of Ectopic Pregnancy in Developing Countries

Ectopic pregnancy is a common life-threatening emergency in the developing world and its frequency is still high. Ectopic pregnancy is the commonest cause of maternal morbidity and mortality in the first trimester of pregnancy (Airede & Ekele 2005, Grimes 1994, Okunlola et al 2006). Complications of early pregnancy are common clinical conditions that often require emergency care. The patient may or may not be aware that she is pregnant at the time of evaluation at the emergency department (Complications of pregnancy, 2007). Diagnosis is frequently missed and should be considered in any woman in the reproductive age group presenting with abdominal pain or vaginal bleeding especially when combined with an episode of collapse or syncope. Ectopic pregnancy is a complication of pregnancy in which the products of conception develop outside the uterine cavity. With rare exceptions, ectopic pregnancies are not viable. By far the commonest site is the fallopian tube (Hanretty, 2004). It is a tragedy of reproduction and a form of reproductive failure in the index pregnancy of affected women. Such women have a 7-15% chance of recurrence and only 40-60% chance of conceiving after surgery (Aboyeji et al, 2002). Ectopic pregnancy remains a major gynaecological problem in contemporary gynaecological practice. Not only do women die from this disease but also of greater clinical importance is the indirect morbidity of poor fertility prognosis and adverse outcome in subsequent pregnancies (Musa et al, 2009). Ectopic pregnancy may not necessarily be managed by a gynaecologist especially in hospitals in rural settings where there are no specialist doctors or if present are limited in number. In such district hospitals, general practitioners with surgical and gynaecological skills manage them in low-income countries where most patients present late as emergencies. Gynaecological emergencies form a large proportion of the workload of a gynaecologist. Gynaecological emergencies, diagnosis, and treatment have progressed in the light of evidence-based medicine combined with a good clinical assessment. This allows for appropriate management. Any primary health care doctor should be prepared to encounter and to handle gynaecological emergencies in patients even those in critical ill states. Ectopic pregnancy is a condition that occurs in all races, in all countries and in any socio-economic class of women during the reproductive years. It is a life threatening surgical gynaecological emergency in our environment (Nwagha et al 2007, Adesiyun et al 2001). Whilst there are many conditions that may lead to an emergency presentation, there are four emergencies, which account for the great majority. These are spontaneous abortion, pelvis sepsis
The Limiting Distribution of the Maximum Rank Correlation Estimator

Han's maximum rank correlation estimator is shown to be square-root n-consistent and asymptotically normal. The proof rests on a general method for determining the asymptotic distribution of a maximization estimator, a simple U-statistic decomposition, and a uniform bound for degenerate U-processes. A consistent estimator of the asymptotic covariance matrix is provided, along with a result giving the explicit form of this matrix for any model within the scope of the maximum rate correlation estimator. The latter result is applied to the binary choice model, and it is found that the maximum rate correlation estimator does not achieve the semiparametric efficiency bound. Copyright 1993 by The Econometric Society.
Surface roughness and staining susceptibility of composite resins after finishing and polishing.

PURPOSE The study aims to investigate the influence of filler size and finishing systems on the surface roughness and staining of three composite resins. METHODS Three composites, classified according to their filler size, were selected: Filtek Supreme Plus/nanofill (3M ESPE, St. Paul, MN, USA), Esthet-X/minifill (Dentsply Caulk, Milford, DE, USA), and Renamel Microfill/microfill (Cosmedent Inc., Chicago, IL, USA). Composite specimens were made in stainless steel split molds and polished with Sof-Lex (3M ESPE), Enhance+PoGo (Dentsply Caulk), or FlexiDiscs+Enamelize (Cosmedent Inc.). Finishing systems were used according to the manufacturers' instructions and polished surfaces were evaluated with a profilometer and then immersed in 2% methylene blue for 24 hours. Specimens were then prepared for spectrophotometric analysis and results were statistically analyzed by two-way analysis of variance and Tukey's test. RESULTS No significant differences in surface roughness among the composites were found when the surfaces were treated with Enhance+PoGo. In addition, no differences were observed when the Filtek Supreme Plus composite was submitted to surface staining evaluation. In general, the composites polished with the finishing systems from the same company demonstrated lower surface roughness and staining. CONCLUSION The results of this study recommend that composite resins could be finished and polished with finishing systems supplied by the composite's manufacturer. The surface roughness and staining of composite resins were not influenced solely by filler size. CLINICAL SIGNIFICANCE Dentists should finish and polish composite resin with the polishing agent supplied by the same manufacturer. The smallest filler size does not necessarily result in a low surface roughness and staining susceptibility.
Injuries reported on the Medical History Forms according to the event and site of injury

From Spine Technology and Rehabilitation, and Indiana University School of Medicine, Fort Wayne, IN. Address Correspondence: Joseph D. Fortin, DO, Spine Technology and Rehabilitation, 7230 Engle Road, Suite 210, Fort Wayne, IN 46804. Email: fortin@pol.net Funding: There was no external funding in preparation of this manuscript. The nature, type and frequency of injuries occurring at a national figure skating competition were examined. Data was compiled from the medical history form of all 208 participants and the on-site evaluations of the 55 skaters who presented for treatment. Twenty-six percent of all the skaters were injured during the competition. Senior skaters accounted for more injuries than their junior counterparts. Pairs skaters appeared to be more susceptible to injury, incurring significantly more injuries than singles or dance skaters. As in other reports, injuries to the lower extremities predominated. Low back injury comprised 14.6% of all injuries. Thirty-five (64%) of the 55 injuries were exacerbations of a pre-existing injury and twenty (36%) were new ones. Most competitive figure skating injuries are of the overuse type, suggesting a need to evaluate predisposing factors and methods of rehabilitation.
Antimicrobial susceptibility testing of Bilophila wadsworthia by using triphenyltetrazolium chloride to facilitate endpoint determination

Initial susceptibility studies of Bilophila wadsworthia indicated significant resistance to several beta-lactam antibiotics, including imipenem and cefoxitin. NO beta-lactamase production was detected. However, some B. wadsworthia strains may grow as a heavy "haze" at up to the highest concentration of an antibiotic on standard antimicrobial agent-containing plates, and it is often difficult to determine the point at which conventional growth stops and haze growth begins. We investigated the nature of the haze growth of B. wadsworthia by using triphenyltetrazolium chloride (TTC) as an indicator of viability during antimicrobial susceptibility testing, by determining viability counts on antimicrobial agent-containing plates at various times, and by microscopically inspecting stained preparations of the growth on the control plate and the haze area. TTC MICs were determined by applying a TTC solution over the growth on plates inside the anaerobic chamber or within 5 min after exposure to air (aerobic TTC MICs). The haze growth reduced TTC in the chamber but not under aerobic conditions, whereas TTC was reduced by the conventional growth in both atmospheres. The aerobic TTC MICs correlated with the viability counts. Separated proteins resolved by polyacrylamide gel electrophoresis and isoelectric focusing showed TTC-reactive bands only when stained under anaerobic conditions, further demonstrating the sensitivity of TTC reduction to aerobic conditions. Microscopic examination of the haze growth indicated spheroplast formation. A new antibiogram for B. wadsworthia has been established by use of aerobic TTC endpoints; we believe that the lower MICs obtained with the TTC method are likely the ones that are clinically relevant and should be used in tests of B. wadsworthia. Also, we found that when the organisms were grown on pyruvate-containing medium, 87% of 56 strains tested were Beta-lactamase positive.
AN ANALYSIS OF COGNITIVE DEFICITS IN CHRONIC ALCOHOLICS

Chronic alcoholics were administered the Wisconsin Card Sorting Test. It was found that those subjects who admitted to an alcoholism history of greater than 10 years were impaired at set persistence, set shifting, and error utilization relative to normal controls, while those subjects who described themselves as alcoholic for a period of less than 10 years were deficient in only set persistence. Neither group of alcoholics were impaired in their ability to identify simple concepts or in learning to learn capacity. The manifest behavioral deficits arc consistent with the anatomical and neurological evidence for a frontal-limbic focus of pathology in chronic alcoholism.
Selectivity and adaptation in the human auditory system

Two fundamental principles dominate the signal processing of the auditory system: selectivity and adaptation. The response of the auditory system is selective for various acoustic features and the representation of these acoustic features adapts over time. This thesis is concerned with the characterisation of selectivity and adaptation in the human auditory system. Initially, selectivity for modulation rate and adaptation to intensity are characterised in a central auditory model. Next, selectivity for temporalmodulation rate and selective adaptation to both intensity and temporal modulation rate are characterised in psychophysical data.
Bipolar radiofrequency ablation using wet-cooled electrodes: an in vitro experimental study in bovine liver.

OBJECTIVE Our aim was to evaluate the performance of hypertonic saline (HS)-enhanced bipolar radiofrequency ablation using wet-cooled electrodes versus monopolar radiofrequency ablation to create coagulation necrosis in explanted bovine liver. CONCLUSION HS-enhanced bipolar radiofrequency ablation using the wet-cooled electrodes shows better performance in creating coagulation necrosis than the monopolar mode.
Contrast enhanced transabdominal ultrasound in the characterisation of pancreatic lesions with cystic appearance.

CONTEXT Contrast enhanced ultrasound (CEUS) has been established for detection and characterisation of liver tumours and differential diagnosis of solid pancreatic lesions. The role of transabdominal CEUS in cystic pancreatic disease is less obvious. OBJECTIVE We prospectively evaluated CEUS for characterization of undetermined cystic pancreatic lesions with respect to the differential diagnosis of pseudocysts and cystic neoplasia and differentiation between benign and malignant disease (gold standard: histology or cytology). PATIENTS One-hundred and fourteen patients (63 males, 51 females; median age: 62 years, range: 33-87 years) were prospectively examined. INVESTIGATIONS Conventional B-mode and transabdominal CEUS. MAIN OUTCOME MEASURES Conventional B-mode (criteria: solid nodules, septae), and contrast enhancing features of cystic pancreatic lesions (microperfusion of solid nodules) were analysed. Final diagnoses were made by surgery (47 patients) or histology/cytology and follow-up of at least one year (67 patients). RESULTS Fifty patients proved to have neoplastic lesions (37 malignant, 13 of benign origin). Sixty-four patients had pseudocysts caused by acute (27 patients) or chronic pancreatitis (37 patients). Conventional B-mode had a sensitivity of 94% and a low specificity of 44% in the differentiation of pseudocysts versus neoplasia. CEUS had a higher specificity of 77% with the same sensitivity of conventional B-mode ultrasound. The combination of conventional ultrasound and CEUS improved the specificity even more to 97% with an unchanged sensitivity. CEUS was not reliable in the differentiation of benign and malignant neoplasia. CONCLUSION CEUS improves the differentiation between pseudocysts and pancreatic neoplasia in comparison to the conventional B-mode imaging. The microvascularisation visualised using CEUS even in small nodules (with or without septae) associated with cystic lesions is an indicator for cystic pancreatic neoplasia.