Miracle-dz/UniFAR-FTUs huggingface dataset:
Extracorporeal Life Support Organization Registry Report 2012

In this article, summary data from the annual international Extracorporeal Life Support Organization (ELSO) Registry Reports through July 2012 are presented. Nearly 51,000 patients have received extracorporeal life support (ECLS). Of the patients, 50% (>25,000) were neonatal respiratory failure, with a 75% overall survival to discharge or transfer. Congenital diaphragmatic hernia remains a major use of ECLS in this population with 51% survival. Extracorporeal life support use for pediatric respiratory failure has nearly doubled since 2000, with approximately 350 patients treated per year in the past 3 years examined (56% survival). Previously stable at about 100 cases a year for a decade, adult respiratory failure ECLS cases increased dramatically in 2009 with the H1N1 influenza pandemic and publication of the Conventional ventilation or ECMO for Severe Adult Respiratory failure (CESAR) trial results and have remained at approximately 400 cases a year through 2011 (55% survival). Use of ECLS for cardiac support represents a large area of consistent growth. Approximately 13,000 patients have been treated with survival to discharge rates of 40%, 49%, and 39% for neonates, pediatric, and adults, respectively.
Hospital Strategies for Insulin Therapy with Rapid-Acting Insulin Analogs

This article presents strategies on how to meet the challenges presented by the use of insulin in the hospital setting and describes trends seen in current hospital practice. Insulin provides the greatest flexibility in the hospital setting to achieve optimal blood glycemic control in patients with known type 2 diabetes, thereby reducing complications and death. Important challenges include implementing protocols for use of subcutaneous insulin injection (including optimal use of insulin pens), conversion from continuous subcutaneous insulin infusion or intravenous infusion to subcutaneous administration by multiple injections, and dosing of insulin in patients receiving corticosteroids. One important trend is a move away from the use of sliding-scale insulin to the use of correction-dose insulin as an adjunct to basal/bolus insulin. In this approach, insulin treatment is closely tailored to changing levels of glycemia, and a protocol is put in place for administration of a correction dose of rapid-acting insulin in response to a glycemic excursion. Insulin analogs can more closely mimic physiological insulin profiles than regular insulin, and rapid-acting analogs are invaluable agents as correction insulin administered by pump or in transition to multiple daily injections and as part of basal/bolus therapy. Good glycemic control can improve outcomes of hospital patients in several ways, including facilitating more rapid recovery from infections, shortening intensive care stays, and minimizing costs. Strategies employed to meet the challenges of insulin use in the hospital setting include the increasing use of continuous glucose monitoring systems and the development of insulin dosing algorithms.
Amperometric determination of cadmium, lead, and mercury metal ions using a novel polymer immobilised horseradish peroxidase biosensor system

This work was undertaken to develop a novel Pt/PANI-co-PDTDA/HRP biosensor system for environmental applications to investigate the inhibition studies by specific heavy metals, to provide data suitable for kinetic studies and further application of the biosensor to environmental samples. The newly constructed biosensor was compared to the data of the well-researched Pt/PANI/HRP biosensor. Optimised experimental conditions, such as the working pH for the biosensor was evaluated. The functionality of the amperometric enzyme sensor system was demonstrated by measuring the oxidation current of hydrogen peroxide followed by the development of an assay for determination of metal concentration in the presence of selected metal ions of Cd2+, Pb2+ and Hg2+. The detection limits were found to be 8 × 10−4 μg L−1 for cadmium, 9.38 × 10−4 μg L−1 for lead and 7.89 × 10−4 μg L−1 for mercury. The World Health Organisation recommended that the maximum safety level of these metals should not exceed 0.005 mg L−1 of Cd2+, 0.01 mg L−1 of Pb2+ and 0.001 mg L−1 of Hg2+. , respectively. The analytical and detection data for the metals investigated were observed to be lower than concentrations recommended by several bodies including World Health Organisation and Environmental Protection Agencies. Therefore the biosensors developed in this study can be used to screen the presence of these metals in water samples because of its low detection limit. The modes of inhibition of horseradish peroxidase by Pb2+, Cd2+ and Hg2+ as analysed using the double reciprocal plots of the Michaelis–Menten equation was found to be reversible and uncompetitive inhibition. Based on the Kmapp and Imax values for both biosensors the results have shown smaller values. These results also proved that the enzyme modified electrode is valuable and can be deployed for the determination or screening of heavy metals.
In vitro metabolism studies on mephedrone and analysis of forensic cases.

The stimulant designer drug mephedrone is a derivative of cathinone - a monoamine alkaloid found in khat - and its effect resembles that of 3,4-Methylenedioxymethamphetamine (MDMA). Abuse of mephedrone has been documented since 2007; it was originally a 'legal high' drug, but it has now been banned in most Western countries. Using cDNA-expressed CYP enzymes and human liver microsomal preparations, we found that cytochrome P450 2D6 (CYP2D6) was the main responsible enzyme for the in vitro Phase I metabolism of mephedrone, with some minor contribution from other NAPDH-dependent enzymes. Hydroxytolyl-mephedrone and nor-mephedrone were formed in vitro, and the former was purified and identified by nuclear magnetic resonance (NMR). In four forensic traffic cases where mephedrone was detected, we identified hydroxytolyl-mephedrone and nor-mephedrone again; as well as 4-carboxy-dihydro-mephedrone, which has been previously described; and two new metabolites: dihydro-mephedrone and 4-carboxy-mephedrone. Fragmentation patterns for all detected compounds were determined by a UPLC-QTOF/MS(E) system, and a fragmentation pathway via a conjugated indole structure was proposed for most of the metabolites. Blood concentrations in the forensic traffic cases ranged from 1 to 51 µg/kg for mephedrone, and from not detected to 9 µg/kg for hydroxytolyl-mephedrone. In one case, urine concentrations were also determined to be 700 µg/kg for mephedrone and 190 µg/kg for hydroxytolyl-mephedrone. All compounds were detected or quantified with an ultra performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) system and an ultra performance liquid chromatography-time of flight/mass spectrometry (UPLC-TOF/MS) system.
Response to Bugnicourt et al. letter: intracranial artery calcification and outcome in ischaemic stroke patients

Sir, We thank Dr. Bugnicourt and colleagues for their interest in our article [1]. They refer to their recent publication on intracranial artery calcification (IAC) and ischaemic stroke outcome [2] and suggest that differences in assessment of IAC may explain the dissimilarity in the results. As stated in our paper [1], we assessed the reliability of our method for IAC evaluation using the Cohen kappa statistics and found moderate (k = 0.6) intraand interobserver agreement. The prevalence of IAC in our patients (69%) was the same as reported in a previous study on consecutive Chinese patients referred for brain CT [3]. Regarding the definition of chronic kidney disease (CKD), we defined CKD as an estimated glomerular filtration rate <60 ml/min/ 1.73 m based on the MDRD equation, similarly to Bugnicourt et al. The prevalence of CKD in our study was 37%, very similar to the prevalence reported in the study by Tsukamoto et al. [4]. CKD in our cohort was in fact a strong independent predictor of mortality and poor outcome [5], but only a small proportion of our patients had high stages of CKD. Although rates of both IAC and CKD in our sample are consistent with previous reports, it is important to remember that replication of results in observational epidemiological studies is challenging. Lack of consistency in results may be explained by methodological differences between studies. Indeed, in their paper, Bugnicourt et al. [2]. defined both the exposure and the outcome variables differently from us: while they defined IAC as present/absent for each artery, we defined a 3-level calcification variable for each artery. Their study outcome was a major clinical event (MCE), including death or vascular ischaemic events: cerebral ischaemic event (ischaemic stroke/ transient ischaemic attack), cardiovascular ischaemic event and peripheral artery event [2], whilst we defined three separate outcomes (i) all-cause mortality, (ii) Barthel Index 60 or death and (iii) living in a nursing facility or death [1]. It is not surprising that studies using different definitions of exposure and outcome show different results. Additionally, it is important to keep in mind that populations may truly differ in health indicators. Last, Bugnicourt et al. state that two recent reports on the relationship between IAC and outcome were not mentioned in our study: they overlooked our reference to the study by Mak et al. [6]. (reference no. 20), and their study [2], though indeed relevant, was published only three months after the submission of our article.
B-cell-activating factor, a proliferation inducing ligand and co-stimulatory molecules in the pathogenesis of immune thrombocytopenia in childhood

The aim of this study was to measure the levels of B-cell-activating factor (BAFF), a proliferation-inducing ligand (APRIL), and co-stimulatory molecules in immune thrombocytopenia (ITP) of childhood to investigate the interaction between T and B lymphocytes and the impact of proliferation of B lymphocytes in the pathogenesis. Twenty newly diagnosed ITPs, 20 chronic ITPs, and 20 healthy controls between 2 and 18 years were enrolled in this study. Hemogram, BAFF, APRIL, interleukin-4, and interferon (IFN)-&ggr; levels in sera and expressions of CD19, CD 3, CD21, CD40, and CD 154 on leukocytes were measured by ELISA and flow cytometry. Mean BAFF level in newly diagnosed ITP group was higher than the mean BAFF level in other groups. BAFF levels were significantly decreased after the treatment in newly diagnosed ITP group. APRIL, interleukin-4, and IFN-&ggr; in newly diagnosed ITP group and BAFF, APRIL, interleukin-4, and IFN-&ggr; in chronic ITP group were similar before and after treatment. There was no statistical difference for expressions of CD 19 and CD3 on lymphocytes, CD40 on leukocytes, CD154 on T cells, and for percentages of CD21+/CD40+, CD21−/CD40+, CD21+/CD40− B cells, and CD19−/CD3− lymphocytes for pretreatment and posttreatment levels in both ITP groups. In conclusion, our study strongly demonstrated that BAFF has an important role in the pathogenesis of newly diagnosed childhood ITP. It may be important in the follow-up and in novel therapy modalities of these patients.
Clients' perception of quality of family planning services in urban and rural health facilities in Lagos State

Background: High quality of care of family planning services has been known to affect contraceptive uptake and continued usage of methods. The objective of this study was to compare clients perception of the quality of family planning services among women attending health facilities in Surulere (urban) and Ikorodu (rural) Local Government Areas in Lagos State. Methodology: A cross sectional descriptive study was carried out among women accessing family planning services from March to June 2005 in Surulere and Ikorodu Local Government Areas. Data collection was by exit interview of clients. Consecutive recruitment was done until the desired sample size (120) in each Local Government Areas was achieved. Results: The mean age of respondents was 34.3 years (Surulere) and 33.6 years (Ikorodu) while all 100% (Surulere) and 98% (Ikorodu) were currently married. Clients rating of the clinic visited includes; mean waiting time of 25.8 minutes (Surulere) and 32.4 minutes (Ikorodu) statistically significant differences observed were; sufficient privacy (100% and 92%) clean clinic area (98% and 85%) waiting time too long (4% and 18.4%) while for services providers; satisfaction with overall treatment (94% and 60%) comfortable to ask questions (99% and 80%) keeping of information shared (86% and 56%) (p<0.05) in Surulere and Ikorodu Local Government Areas respectively. Conclusion: Respondents that visited the urban health facilities were more satisfied. Retraining of providers in rural health facilities on interpersonal relationship counseling and communication skills is recommended.
Our children and the metabolic syndrome

The metabolic syndrome is a cluster of metabolic disturbances that result in an increased risk of type 2 diabetes and cardiovascular disease in adults. Despite the lack of a uniform definition of the syndrome for children, several studies have reported an overall prevalence of 3 to 4% among children. Among obese adolescents, the prevalence can be as high as 30 to 50%. Besides insulin resistance and obesity, the intrauterine environment and genetic factors also seem to play a role in the pathogenesis of the syndrome in children. In view of the current obesity epidemic and since an increasing amount of evidence shows that obesity during adolescence is significantly associated with insulin resistance, abnormal serum lipid levels, and elevated blood pressure during adulthood, there is a great need for a clear definition, for the development of screening guidelines, and for appropriate prevention and treatment strategies for the metabolic syndrome in the pediatric population. Drug Dev. Res. 67:602–606, 2006. © 2006 Wiley‐Liss, Inc.
A Preliminary Survey of Codependency Traits and Family of Origin Status of Nursing Students

&NA; This descriptive research study surveyed nursing students to determine what percentage presented a history of being reared in a dysfunctional family of origin and demonstrated codependency traits. A convenience sample of (n = 91) from two nursing schools was used. Data from the demographic questionnaire indicated that 69% were reared in a family where there was either alcoholism, sexual abuse, physical or family violence, with more than 58% reporting multiple factors related to dysfunction factors. Of those surveyed, 74% reported codependency traits, as identified by the Friel Co‐Dependency Assessment Inventory. Of the total sample, 67% reported they had never sought counseling. It is suggested that integrating curriculum content focused on care for the care‐giver may be advantageous for the physical and psychosocial well‐being of nursing students and future practitioners.
Congener profiles of polychlorinated dibenzo-p-dioxins and polychlorinated dibenzofurans (PCDD/Fs) in sediment, water, and fish at a soil contamination site in Taiwan

ABSTRACT The relationship of polychlorinated dibenzo-p-dioxins and polychlorinated dibenzofurans (PCDD/Fs) in sediment, water, and fish was studied for 55 fish farms near a contaminated site in Tainan, Taiwan. Samples were collected from the farms and analyzed for seventeen 2,3,7,8-substituted PCDD/Fs congeners. High correlations were found between PCDD/Fs in water and sediment in regard to both concentration and toxicity (R2 = 0.933 for concentration and R2 = 0.832 for toxicity). The congener profiles of the 17 PCDD/Fs in water were similar to those in the sediment. However, the PCDD/Fs congener composition in the fish and fish belly samples were different from those in the sediment and water samples obtained from the same fish farm and were also different among the fish samples. It is thus suggested that the biotic PCDD/Fs distribution is more complex than the abiotic PCDD/Fs distribution. Among the seven factors analyzed, only the lipid percentage presented a relationship with the PCDD/Fs congener composition in the fish and fish bellies. A multiple linear regression of the concentration of each congener in the fish was conducted using the concentration of each congener in the site-matched sediment and the lipid content of the fish as independent variables. The results showed that only seven PCDD/Fs congeners with a lower degree of chlorination, which were 4-6 chlorine substitutes, in the fish presented a significant correlation with the lipid content in the fish and their concentration in sediment (r > 0.65, P < 0.005 for both independent variables). In addition, the octanol-water partition coefficients were not significantly related to this distribution behavior.
Buprenorphine and nor-buprenorphine levels in head hair samples from former heroin users under Suboxone® treatment.

In the current study, buprenorphine (BUP) and its major metabolite, nor-buprenorphine (NBUP), were determined in hair samples from former heroin users following Suboxone® treatment. Hair samples from 36 subjects were analyzed. The drugs of interest were isolated from hair by solid-liquid extraction with methanol and were determined by liquid chromatography-mass spectrometry, using an electrospray ionization interface. The analytical parameters of the method (such as linearity, limits of quantification, recovery, accuracy, and precision) were determined. The inter-quartile range of BUP levels was from 11.4 to 37.4 pg/mg (mean value 56.6 pg/mg) for the proximal hair segment, from 5.8 to 43.3 pg/mg for the middle hair segment (mean value 25.3 pg/mg), while a range from 4.3 to 33.9 pg/mg (mean value 105.2 pg/mg) for the distant to the root hair segment was determined. For NBUP the corresponding inter-quartile range was from 27.0 to 147.6 for the proximal segment (mean value 95.4 pg/mg), from 21.5 to 164.7 pg/mg for the middle segment (mean value 102.0 pg/mg) and from 20.4 to 103.6 pg/mg for the distant segment (mean value 156.8 pg/mg). The mean BUP/NBUP concentration ratio was 0.5. The daily dose of Suboxone® correlated significantly with BUP and NBUP levels in hair (p = 0.001 and p = 0.023) as well as with the BUP/NBUP ratio (p = 0.010). No significant correlation was found between the levels of BUP and NBUP and the duration of Suboxone® administration. The developed and validated method was successfully used for the determination of BUP and NBUP in hair samples collected from former heroin users under Suboxone® treatment.
Caenorhabditis elegans as a model to study the impact of exposure to light emitting diode (LED) domestic lighting

ABSTRACT This study aimed to investigate the biological impact of exposure on domestic light emitting diodes (LED) lighting using the free-living nematode Caenorhabditis elegans as a model. Nematodes were separately exposed to white LED light covering the range of 380–750 nm, blue light at 450 nm and black light at 380–420 nm for one life cycle (egg to adult) with dark exposure as the control. Each light range induced stress to the nematode C. elegans such as reducing the number of the hatched eggs and/or delayed the maturation of the hatched eggs to the adult stage. In addition, it lowered or prevented the ability of adults to lay eggs and impaired the locomotion in the exposed worms. The observed type of biological stress was also associated with the production of reactive oxygen species (ROS) as compared to nematodes grown in the dark. It is concluded that the blue light component of white LED light may cause health problems, and further investigation is required to test commercial brands of white LEDs that emit different amounts of blue light.
Methylhexanamine is not detectable in Pelargonium or Geranium species and their essential oils: A multi-centre investigation.

In an earlier study, we developed two sensitive and reliable procedures for gas chromatography-mass spectrometry (GC-MS) and liquid chromatography-tandem mass spectrometry (LC-MS/MS) analysis of methylhexaneamine (MHA) in P. graveolens plant materials and volatile oils. None of the analyzed plant materials or oils showed any detectable levels of MHA which was further substantiated by high resolution liquid chromatography-quantum time of flight-mass spectrometry (LC-QTOF-MS) analysis with a limit of detection of 10 ppb. However, other laboratories (two studies) reported the presence of MHA in some samples of P. graveolens and pelargonium oil acquired by the investigators from China. Because of the controversy of whether Pelargonium species or pelargonium oil contains MHA, it was recommended that splits of multiple samples be analyzed by different laboratories. In this investigation, multiple plant materials and oil samples were collected from around the world. These samples were submitted to four different sites for analysis. All sites adopted a similar extraction method. All the analysis sites used LC-MS/MS or LC-QTOF-MS and detection limit was set close to the 10 ng/mL as previously reported. A total of 18 plant samples belonging to 6 different Pelargonium species and 9 oils from different locations around the world were split among 4 different analytical laboratories for analysis (each lab received the same samples). None of the laboratories detected MHA in any of the samples at or around the 10 ppb detection level of the procedure used.
Spatial distribution of polycyclic aromatic hydrocarbon and polychlorinated biphenyl sources in the Nakdong River Estuary, South Korea

ABSTRACT Our research team investigated the elemental composition and the presence of various toxic organic compounds, such as polycyclic aromatic hydrocarbons (PAHs) and polychlorinated biphenyls (PCBs), in estuary surface sediments to trace the spatial distribution of the sources of pollution deposited in Nakdong River, Busan, South Korea. The spatial patterns of elemental composition and toxic organic compounds were determined from the measurements of total organic carbon (TOC), total nitrogen, total sulfur, PAHs, and PCBs. The sediments had TOC contents of between 0.02 and 1.80 wt% (avg. 0.34 wt%), depending on the amount of clay-sized particles. The concentrations of PAHs and PCBs (10.8–167.7 ng g−1 dry wt and 197.0–754.0 pg g−1 dry wt, respectively) in surface sediments revealed different spatial patterns for these compounds, suggesting that they partially originated from the combustion of fossil fuels and from the use of commercial PCB products at adjacent industrial complexes. Although these concentrations were far below the Sediment Quality Guideline (SQG) of the National Oceanic and Atmospheric Administration (NOAA), the sediments at one site contained PCBs at concentrations close to the response level (754.0 pg g−1 dry wt), and were dominated by low-molecular-weight PAHs. The PAHs and PCBs in Nakdong River Estuary sediments were likely to have originated from the combustion of fossil fuels and biomass at the adjacent industrial complexes. The primarily analyzed results determined that PAHs originated from the combustion of fossil fuels and biomass, and overall concentrations were related to the contributions of individual PAHs in most sediment samples. Based on the SQG of the NOAA, our results indicate that the anthropogenic activity should be considered on the future-sustainable management of this estuary system.