Miracle-dz/UniFAR-FTUs huggingface dataset:
Nurses' role in detecting deterioration in ward patients: systematic literature review.

AIM This paper is a report of a review conducted to identify and critically evaluate research investigating nursing practice in detecting and managing deteriorating general ward patients. BACKGROUND Failure to recognize or act on deterioration of general ward patients has resulted in the implementation of early warning scoring systems and critical care outreach teams. The evidence of effectiveness of these systems is unclear. Possible mechanisms for low effectiveness may be inconsistent recording of patient observations by ward staff, or inconsistent application of 'calling criteria' for outreach teams, even when observations have been recorded. METHODS The literature was searched between 1990 and 2007 using four sources: electronic databases, reference lists, key reports and experts in the field. Three broad search categories were used: nursing observations, physiological deterioration and general ward patients. All research designs describing nursing observations (vital signs) on deteriorating adult patients in general hospital wards were included. RESULTS Fourteen studies met the inclusion and quality criteria. The findings were grouped into four main themes: recognition; recording and reviewing; reporting; and responding and rescuing. The main findings suggest that intuition plays an important part in nurses' detection of deterioration, and vital signs are used to validate intuitive feelings. The process is highly complex and influenced by many factors, including the experience and education of bedside nurses and their relationship with medical staff. CONCLUSION Greater understanding of the context within which deterioration is detected and reported will facilitate the design of more effective education and support systems.
Rapid determination of spore chemistry using thermochemolysis gas chromatography-mass spectrometry and micro-Fourier transform infrared spectroscopy

Spore chemistry is at the centre of investigations aimed at producing a proxy record of harmful ultraviolet radiation (UV-B) through time. A biochemical proxy is essential owing to an absence of long-term (century or more) instrumental records. Spore cell material contains UV-B absorbing compounds that appear to be synthesised in variable amounts dependent on the ambient UV-B flux. To facilitate these investigations we have developed a rapid method for detecting variations in spore chemistry using combined thermochemolysis gas chromatography-mass spectrometry and micro-Fourier transform infrared spectroscopy. Our method was tested using spores obtained from five populations of the tropical lycopsid Lycopodium cernuum growing across an altitudinal gradient (650-1981 m a.s.l.) in S.E. Asia with the assumption that they experienced a range of UV-B radiation doses. Thermochemolysis and subsequent pyrolysis liberated UV-B pigments (ferulic and para -coumaric acid) from the spores. All of the aromatic compounds liberated from spores by thermochemolysis and pyrolysis were active in UV-B protection. The various functional groups associated with UV-B protecting pigments were rapidly detected by micro-FTIR and included the aromatic C? C absorption band which was exclusive to the pigments. We show increases in micro-FTIR aromatic absorption (1510 cm^−1) with altitude that may reflect a chemical response to higher UV-B flux. Our results indicate that rapid chemical analyses of historical spore samples could provide a record ideally suited to investigations of a proxy for stratospheric O_3 layer variability and UV-B flux over historical (century to millennia) timescales.
Ancient Egyptian Administration

The Study of Ancient Egyptian Administration Juan Carlos Moreno Garcia The Organization of a Nascent State : Egypt Until the Beginning of the Fourth Dynasty Eva-Maria Engel The Central Administration of the Resources in the Old Kingdom: Departments, Treasures, Granaries and Work Centres Hratch Papazian The Territorial Administration of the Kingdom in the Third Millennium Juan Carlos Moreno Garcia Kings, Viziers and Courtiers: Executive Power in the Third Millennium BC Miroslav Barta The Administration of the Funerary Royal Complexes Hana Vymazalova Balat, a Frontier Town and its Archive Laure Pantalacci Setting a State Anew: The Central Administration from the End of the Old Kingdom to the End of the Middle Kingdom Wolfram Grajetzki The Royal Command (wD-nsw): A Basic Deed of Executive Power Pascal Vernus Nomarchs and Local Potentates: The Provincial Administration in the Middle Kingdom Harco Willems The Organisation of the Pharaonic army (Old to New Kingdom) Anthony Spalinger Categorisation, Classification, and Social Reality: Administrative Control and Interaction with the Population Katalin Anna Kothay Crisis and Restructuring of the State: From the End of the Middle Kingdom to the Advent of the Ramesses J.J. Shirley The Raising Power of the House of Amun in the New Kingdom Ben J.J. Haring Coping with the Army: The Military and the State in the New Kingdom Andrea Gnirs The Administration of Institutional Agriculture in the New Kingdom Sally Katary A Bureaucratic Challenge? Archaeology and Administration in a Desert Environment (Second Millennium BCE) John Coleman Darnell The Ramessid State Pierre Grandet Administration of the Deserts and Oases: First Millennium BCE David Klotz From Conquered to Conqueror: The Organization of Nubia in the New Kingdom and the Kushite Administration of Egypt Robert Morkot The Saite Period: The Emergence of a Mediterranean Power Damien Agut-Labordere The 'Other' Administration: Patronage, Factions and Informal Networks of Power in Ancient Egypt Juan Carlos Moreno Garcia
Noise-Insensitive Contrast Enhancement for Rendering High-Dynamic-Range Images

The process of compressing the high luminance values into the displayable range inevitably incurs the loss of image contrasts. Although the local adaptation process, such as the two-scale contrast reduction scheme, is capable of preserving details during the HDR compression process, it cannot be used to enhance the local contrasts of image contents. Moreover, the effect of noise artifacts cannot be eliminated when the detail manipulation is subsequently performed. We propose a new tone reproduction scheme, which incorporates the local contrast enhancement and the noise suppression processes, for the display of HDR images. Our experimental results show that the proposed scheme is indeed effective in enhancing local contrasts of image contents and suppressing noise artifacts during the increase of the visibility of HDR scenes.
Molecular typing of Cryptococcus neoformans serotype D clinical isolates

Cryptococcus neoformans serotype A is responsible for the majority of cryptococcal infections in AIDS patients. In France, approximately 17% of the patients are infected with serotype D, regardless of their human immunodeficiency virus status. In a retrospective study of 273 patients, we found that serotype D was unevenly distributed in France. We wondered if this was related to the yeast's genetic background. We used karyotyping and DNA fingerprints generated by UT-4p to analyze 40 serotype D clinical isolates. We found an extensive polymorphism, with only two conserved karyotypes from drug-addicted patients living in the same area. Although highly variable, the DNA fingerprints were classified into 10 groups. Four pairs of isolates were identical; three of these pairs were from patients living in the same area, but there was no other correlation with the geographical area. The two isolates with identical karyotypes belonged to the same fingerprint group. Five of the six isolates that made up fingerprint group I were recovered from drug-addicted patients (P < 0.002; chi-square), and all five isolates found in fingerprint group III were from male homosexual patients (P < 0.02). Finally, five of the seven isolates from patients with cryptococcal pneumonia were classified as fingerprint group V (P < 0.04). These results suggest that there are possible relationships between characteristics of the isolates and body localization or even risk factors. Results of the present study warrant other studies on isolates of all serotypes and on isolates from clinical and environmental sources.
Time-course of leptin levels in term and preterm human milk.

OBJECTIVE To compare the time-course of breast milk leptin levels between term and preterm pregnancy. DESIGN Open longitudinal prospective randomised study. METHODS RIA of leptin levels in milk from 33 mothers (term pregnancy: n=24; preterm: n=9) at three postpartum intervals: 2-3 days, 4-5 days and 6 weeks (intervals A, B and C), combined with serum in 23 mothers (term: n=17; preterm: n=6) in interval A. Milk samples were sonicated before incubation. RESULTS Interval A leptin levels were approximately tenfold higher in serum than in milk (term: 13.24+/-2.48 vs 1.34+/-0.14 ng/ml, P<0.0001; preterm: 4.46+/-1.05 vs 0.63+/-0.18 ng/ml, P<0.0005), and higher in term than in preterm serum (P=0.03). Milk levels were higher in the term vs preterm group in intervals A (P<0.01) and B (P<0.05). In the term group they declined significantly from interval A to interval B (P<0.05) but did not vary significantly in the preterm group. Serum levels correlated with maternal body mass index; milk levels showed only moderate correlation with maternal and infant weight or body mass index. CONCLUSION The reasons for the presence and differential longitudinal expression of leptin in human milk after term and preterm pregnancy remain unknown. A hypothesis, requiring further study, is that persistently lower leptin levels in preterm milk act as a compensatory release of a brake on neonatal growth.
Predicting psychrometric conditions in biocontaminant microenvironments with a microclimate heat and moisture transfer model -- description and field comparison.

UNLABELLED A numerical model is described that is designed to model psychrometric conditions in biocontaminant microenvironments, such as in bedding and the base of carpets for dust-mites, and on the surface of linings for molds. The model is very general and can include room air, other room components, other zones including the outdoors, other rooms and any subfloor space. Mechanical plant can be modeled. Good agreement between modeled and field results are reported for the complex case of an occupied bed and for the microclimate in the base of a carpet, before and after its timber floor above a crawl space was retrofitted with insulation. PRACTICAL IMPLICATIONS Biocontaminants such as dust-mites and molds can pose serious health problems. Understanding microclimates in biocontaminant microhabitats, when coupled with biologic models, will make it possible to predict how the life cycles of these biocontaminants are affected as these conditions change. In turn, this will suggest which interventions that modify indoor climate and microclimate are likely to control these biocontaminants. Furthermore such interventions might include indoor humidity control, changing building insulation and ventilation levels, covering mattresses, use of electric blankets, use of carpet heating, etc. Such models will provide a fast way for screening for interventions that are likely to be effective in the control of biocontaminants.
Testing a conceptual model on early opening of the microcirculation in severe sepsis and septic shock: A randomised controlled pilot study

BACKGROUND Organ failure in severe sepsis and septic shock may be caused by microcirculatory failure. OBJECTIVE The objective of this study is to test a conceptual model of microcirculatory failure by using a resuscitation strategy targeting early opening of the constricted microcirculation with active vasodilatation. DESIGN A randomised controlled pilot study. SETTING Single-centre mixed medical and surgical tertiary ICU. PATIENTS Ninety severe sepsis and septic shock patients randomised to early opening microcirculation resuscitation group or standard resuscitation group. INTERVENTIONS Standard resuscitation group: fluids, noradrenaline, dobutamine and hydrocortisone were given to achieve a mean arterial pressure (MAP) of more than 60 mmHg, cardiac index more than 2.5 l min−1 m−2 and ScvO2 more than 70%. Microcirculation resuscitation group: nitroglycerin, enoximone, dopamine and dexamethasone targeting a microvascular flow index (MFI), measured by sublingual side-stream dark field imaging, more than 2.5. MAIN OUTCOME MEASURE A decrease in organ failure score (SOFA) on day four of ICU treatment. RESULTS Data from 37 microcirculation resuscitation and 28 standard resuscitation patients were analysed. In the microcirculation resuscitation group, MFI of more than 2.5 was achieved after a mean ± SD of 7.0 ± 4.6 h. The microcirculation resuscitation group received more fluids, and noradrenaline was equally prescribed in both groups. Per protocol, the decrease in SOFA score at day 4 was not different between groups (P = 0.64). There was a significant reduction in SOFA score in both groups compared with admission (1.2 and 1.6 in microcirculation resuscitation and standard resuscitation groups, respectively; P = 0.028 and P = 0.045). CONCLUSION Early opening of the microcirculation in patients with severe sepsis and septic shock using nitroglycerin, enoximone, dopamine and corticosteroids did not result in a faster reduction in organ failure than standard resuscitation. TRIAL REGISTRATION Clinicaltrials.gov identifier NCT00484133.
Different quantification algorithms may lead to different results: a comparison using proton MRS lipid signals

Proton magnetic resonance spectroscopy (MRS) is a sensitive method for investigating the biochemical compounds in a tissue. The interpretation of the data relies on the quantification algorithms applied to MR spectra. Each of these algorithms has certain underlying assumptions and may allow one to incorporate prior knowledge, which could influence the quality of the fit. The most commonly considered types of prior knowledge include the line‐shape model (Lorentzian, Gaussian, Voigt), knowledge of the resonating frequencies, modeling of the baseline, constraints on the damping factors and phase, etc.
Identification of JC virus variants in multiple tissues of pediatric and adult PML patients

The transcriptional control region (TCR) of JC virus (JCV), the causative agent of progressive multifocal leukoencephalopathy (PML), undergoes rearrangement during replication of the virus in its human host. The mechanism by which viral promoter/enhancer sequences are deleted and duplicated within the TCR of the archetype form of JCV is not understood, but it is hypothesized that the generation of JCV variants with rearranged TCRs contributes to the virus's pathogenic potential. In a recent study of a pediatric PML patient, we detected extensive rearrangement of the JCV TCR in multiple tissues, and the archetype TCR was amplified from sites other than the kidney. These findings differed from those of previous studies that had examined tissues from adult PML patients. Since exposure to JCV usually occurs early in life, it is likely that some pediatric cases of PML arise as the result of a primary infection, whereas adult cases of PML are thought to result from the reactivation of an infection suffered as an immuno‐ competent child. To investigate further whether rearrangement of the JCV TCR is affected by the host's age and immune status at the time of exposure, a second pediatric patient and two adult PML patients were examined. As in our first study, multiple tissues were found to contain JCV DNA; however, fewer rearranged variants were detected. In one adult patient, related rearranged variants were detected in the brain, while archetype JCV was found in the other tissues. Based on differences in their VP1 sequences, these two forms represented different JCV genotypes, indicating that this patient had suffered a dual infection. The relevance of these findings to the rearrangement process that alters the JCV TCR is discussed. J. Med. Virol. 58:79–86, 1999. © 1999 Wiley‐Liss, Inc.
Interaction between a novel F9-specific factor and octamer-binding proteins is required for cell-type-restricted activity of the fibroblast growth factor 4 enhancer

Understanding how diverse transcription patterns are achieved through common factor binding elements is a fundamental question that underlies much of developmental and cellular biology. One example is provided by the fibroblast growth factor 4 (FGF-4) gene, whose expression is restricted to specific embryonic tissues during development and to undifferentiated embryonal carcinoma cells in tissue culture. Analysis of the cis- and trans-acting elements required for the activity of the previously identified FGF-4 enhancer in F9 embryonal carcinoma cells showed that enhancer function depends on sequences that bind Sp1 and ubiquitous as well as F9-specific octamer-binding proteins. However, sequences immediately upstream of the octamer motif, which conform to a binding site for the high-mobility group (HMG) domain factor family, were also critical to enhancer function. We have identified a novel F9-specific factor, Fx, which specifically recognizes this motif. Fx formed complexes with either Oct-1 or Oct-3 in a template-dependent manner. The ability of different enhancer variants to form the Oct-Fx complexes correlated with enhancer activity, indicating that these complexes play an essential role in transcriptional activation of the FGF-4 gene. Thus, while FGF-4 enhancer function is octamer site dependent, its developmentally restricted activity is determined by the interaction of octamer-binding proteins with the tissue-specific factor Fx.
Upper-airway inflammation in relation to dust spiked with aldehydes or glucan.

OBJECTIVES Organic dust is associated with adverse effects on human airways. This study was done to investigate whether the addition of beta-(1,3)-D glucan or aldehydes to office dust causes enhanced inflammation in human airways. METHODS Thirty-six volunteers were exposed randomly to clean air, office dust, dust spiked with glucan, and dust spiked with aldehydes. The three dust exposures contained between 332 and 379 microg dust/m(3). Spiking with 1 gram of dust was done with 10 milligrams of glucan or 0.1 microliters of aldehydes. Acoustic rhinometry, rhinostereometry, nasal lavage, and lung function tests were applied. RESULTS After the exposures to dust spiked with the glucan and aldehydes, the nasal volume decreased (-1.33 and -1.39 cm(3) (mean), respectively) when compared with the -0.9 cm(3) after clean air or office dust (P=0.036 for a difference in decrease between exposures). After 2-3 hours the aldehyde-spiked dust caused a 0.6-mm swelling of the inferior turbinate, and glucan-spiked dust produced a 0.7-mm swelling (P=0.039 for a difference in the swelling between the four exposures). The preexposure nasal lavage cleaned off the mucosa, and lower cytokine concentrations were found after all of the exposures. For interleukin-8, this decrease in concentration was smaller after the dust exposures spiked with glucan and aldehydes (-2.9 and -25.8 pg/ml, respectively) than after office dust or clean air (-65.9 and -74.1 pg/ml, respectively) (P=0.042). The nasal eosinophil cell concentration increased after exposure to dust spiked with glucan (P=0.045). CONCLUSIONS beta-(1,3)-D glucan and aldehydes in office dust enhance the inflammatory effects of dust on the upper airways.
Hospital at home for chronic obstructive pulmonary disease: an integrated hospital and community based generic intermediate care service for prevention and early discharge

Recent randomized controlled studies have reported success for hospital at home for prevention and early discharge of chronic obstructive pulmonary disease (COPD) patients using hospital based respiratory nurse specialists. This observational study reports results using an integrated hospital and community based generic intermediate care service. The length of care, readmission within 60 days and death within 60 days in the early discharge (9.37 days, 21.1%, 7%) and the prevention of admission (five to six days, 34.1%, 3.8%) are similar to previous studies. We suggest that this generic community model of service may allow hospital at home services for COPD to be introduced in more areas.
Evidence that Ralstonia eutropha (Alcaligenes eutrophus) contains a functional homologue of the Ralstonia solanacearum Phc cell density sensing system

In the phytopathogen Ralstonia (Pseudomonas) solanacearum, control of many virulence genes is partly mediated by the Phc cell density sensing system. Phc uses a novel self‐produced signal molecule [3‐hydroxypalmitic acid methyl ester (3‐OH PAME)], an atypical two‐component system (PhcS/PhcR), and a LysR‐type activator (PhcA) to regulate a reversible switching between two different physiological states. While Phc is present in most R. solanacearum strains, it is apparently absent from other pseudomonad plant pathogens and prokaryotic genomes that have been sequenced. Here, we report discovery of a phcA orthologue in the non‐pathogenic, facultative chemolithoautotroph Ralstonia eutropha (Alcaligenes eutrophus) that fully complements R. solanacearum phcA mutants. We also demonstrate that some R. eutropha produce an extracellular factor that complements R. solanacearum mutants deficient in production of the 3‐OH PAME signal molecule that controls phcA. Additionally, Southern blot hybridization analysis suggested that R. eutropha harbours other Phc components, such as PhcB (a biosynthetic enzyme for 3‐OH PAME) and PhcS (a 3‐OH PAME‐responsive sensor kinase). Analysis of a phcA‐null mutant of R. eutropha showed that phcA (and probably Phc) positively activates motility, in contrast to R. solanacearum where it represses motility. Similarly, the R. eutropha phcA mutant was unaffected in siderophore production, whereas inactivation of phcA in R. solanacearum increases siderophore production. Although our data strongly suggest that R. eutropha has a functional Phc‐like system and support the phylogeny of Ralstonia, it implies that Phc may have a different physiological and ecological function in R. eutropha.
A Novel Routing Strategy Based on Fuzzy Theory for NGEO Satellite Networks

Non-geostationary (NGEO) satellite networks have a series of advantages over terrestrial networks. However, traditional routing algorithms such as the Dijkstra's Shortest Path (DSP) algorithm always lead to some Inter-Satellite Links (ISLs) heavily loaded. To guarantee a better distribution of traffic among satellites, this paper proposes a Fuzzy Satellite Congestion Indicator (FSCI) to estimate congestion status among neighboring satellites. Indeed, a satellite notifies its neighboring satellites of its FSCI. When it is about to get congested, it requests its neighboring satellites to decrease their data forwarding rates by sending them a self status notification signaling message. In response, the neighboring satellites search for less congested paths according to Fuzzy Route Determination. The routing strategy discussed above is Fuzzy Satellite Routing(FSR). This routing algorithm avoids both congestion and packet drops at the satellite. It also ensures a better traffic distribution over the entire satellite constellation. The mechanism of multiple traffic classes is also discussed in FSR. The good performance of FSR, in terms of short end-to-end delay, higher throughput, and lower packet drops, is verified via a set of simulations using the Network Simulator 2 (NS2).
Comparison of Methods for Intravenous Infusion of Fat Emulsion During Extracorporeal Membrane Oxygenation

Study Objectives. To characterize the effects of infusing fat emulsion during neonatal extracorporeal membrane oxygenation (ECMO) by comparing results from patients receiving fat emulsion through the ECMO circuit with those receiving fat emulsion through separate intravenous access. A second goal was to identify the optimal route for administration.