Miracle-dz/UniFAR-FTUs huggingface dataset:
Blood Usage in an Australian Intensive Care Unit: Have We Met Best Practice Goals?

The transfusion of blood products, especially red cell concentrates, in critically ill patients is controversial and benefits of red cell concentrate transfusion in these patients have not been clearly demonstrated. We performed a prospective observational study to compare best evidence to actual practice of red cell concentrate and other blood product administration in an intensive care unit (ICU) in a university-associated tertiary hospital. All primary admissions during a 28-day period were included in the study and data collected included transfusion of red cells and blood products, patient demographics and ICU and hospital outcome. One hundred and seventy-five admissions were studied; 44% followed cardiac surgery. Forty-one patients (23%) received red cell concentrates in ICU, with 120 units transfused in 61 separate episodes. Other blood product usage was minimal. One third (20/61) of red cell concentrate transfusion episodes were of a single unit. The mean (±SD) pre-transfusion haemoglobin was 7.9±1.1 g/dl. Despite transfusion, such patients left ICU with a lower haemoglobin concentration compared with untransfused ICU patients (9.5±1.0 versus 10.5±2.1 g/dl; P<0.001). Cardiac surgical patients received similar red cell transfusion to general ICU patients. Univariate analysis showed no significant difference in mortality between patients who did or did not receive red cell concentrate transfusion (P=0.17). However, red cell concentrate transfusion was associated with a reduced adjusted mortality both in ICU (OR 0.13, 95% CI 0.02-0.73) and in hospital at 28 days (OR 0.10, 95% CI 0.02-0.58). The low red cell concentrate and blood product usage in our ICU were consistent with restrictive transfusion practice and selective red cell concentrate transfusion was associated with reduced mortality.
Somatosensory Evoked Potentials During Exclusion and Reperfusion of Critical Aortic Segments in Thoracoabdominal Aortic Aneurysm Surgery

Forty‐three patients undergoing repair of a thoracoabdominal aortic aneurysm were monitored to evaluate spinal cord ischemia, as evidenced by somatosensory evoked potentials (SEPs). All patients were operated on using left heart bypass. in 34 patients (80%), staged clamping was used. Except for cerebrospinal fluid (CSF) drainage in 15 patients (asyo), no other protective measures to preserve spinal cord function were used. The overall lncidence of immediate onset paraplegia was 7%, and of immediate onset paraparesis was 5%; neither was limited only to those patients In whom potentials were lost. In 18 patients (42%), no change in the evoked potentials occurred; one of these patients (5%) awoke paraplegic after operation, and two others had a delayed onset paraplegia. In 13 patients (30%), evoked potentials were lost despite adequate perfusion; in 12 of them, potentials returned gradually, with one immediate paraplegia (8%), and in one potentials did not return at all, with subsequent immediate paraplegia (100%). In 12 patients (28%), evoked potentials decreased without being lost completely, and then recovered; in this group there were no immediate parapleglas. No relationship could be demonstrated between the extinction time, the recovery time, or the duration of loss of evoked potentials with postoperative neurological outcome. lntraoperative monitoring of SEPs is a good indicator of spinal cord ischemia, although we found a 5% incidence of false negatives. SEP monitoring offers an improvement in surgical strategy, and allows safer operations for thoracoabdominal aneurysms. (J Card Surg 7994;9:692–702)
Amyloid-β Inhibits PDGFβ Receptor Activation and Prevents PDGF-BBInduced Neuroprotection.

BACKGROUND PDGFβ receptors and their ligand, PDGF-BB, are upregulated in vivo after neuronal insults such as ischemia. When applied exogenously, PDGF-BB is neuroprotective against excitotoxicity and HIV proteins. OBJECTIVE Given this growth factor's neuroprotective ability, we sought to determine if PDGF-BB would be neuroprotective against amyloid-β (1-42), one of the pathological agents associated with Alzheimer's disease (AD). METHODS AND RESULTS In both primary hippocampal neurons and the human-derived neuroblastoma cell line, SH-SY5Y, amyloid-β treatment for 24 h decreased surviving cell number in a concentrationdependent manner. Pretreatment with PDGF-BB failed to provide any neuroprotection against amyloid-β in primary neurons and only very limited protective effects in SH-SY5Y cells. In addition to its neuroprotective action, PDGF promotes cell growth and division in several systems, and the application of PDGFBB alone to serum-starved SH-SY5Y cells resulted in an increase in cell number. Amyloid-β attenuated the mitogenic effects of PDGF-BB, inhibited PDGF-BB-induced PDGFβ receptor phosphorylation, and attenuated the ability of PDGF-BB to protect neurons against NMDA-induced excitotoxicity. Despite the ability of amyloid-β to inhibit PDGFβ receptor activation, immunoprecipitation experiments failed to detect a physical interaction between amyloid-β and PDGF-BB or the PDGFβ receptor. However, G protein-coupled receptor transactivation of the PDGFβ receptor (an exclusively intracellular signaling pathway) remained unaffected by the presence of amyloid-β. CONCLUSIONS As the PDGF system is upregulated upon neuronal damage, the ability of amyloid-β to inhibit this endogenous neuroprotective system should be further investigated in the context of AD pathophysiology.
Caution Needed: Molecular Diagnosis of Pediatric Group A Streptococcal Pharyngitis

Among throat swabs processed in the microbiology laboratory as back-up for negative rapid antigen detection test results, we found a significant increase in the proportion that tested positive for group A streptococci after changing from throat culture to a molecular test.For group A streptococcus testing, our hospital laboratory replaced throat cultures with a stand-alone molecular diagnostic test that takes no more than 1 hour to perform. The prevalence of positive laboratory test results increased significantly (P < .0001) after the change to molecular testing, probably because of the extreme sensitivity of the molecular test.
Protein O-Linked Mannose β-1,4-N-Acetylglucosaminyl-transferase 2 (POMGNT2) Is a Gatekeeper Enzyme for Functional Glycosylation of α-Dystroglycan*

Disruption of the O-mannosylation pathway involved in functional glycosylation of α-dystroglycan gives rise to congenital muscular dystrophies. Protein O-linked mannose β-1,4-N-acetylglucosaminyltransferase 2 (POMGNT2) catalyzes the first step toward the functional matriglycan structure on α-dystroglycan that is responsible for binding extracellular matrix proteins and certain arenaviruses. Alternatively, protein O-linked mannose β-1,2-N-acetylglucosaminyltransferase 1 (POMGNT1) catalyzes the first step toward other various glycan structures present on α-dystroglycan of unknown function. Here, we demonstrate that POMGNT1 is promiscuous for O-mannosylated peptides, whereas POMGNT2 displays significant primary amino acid selectivity near the site of O-mannosylation. We define a POMGNT2 acceptor motif, conserved among 59 vertebrate species, in α-dystroglycan that when engineered into a POMGNT1-only site is sufficient to convert the O-mannosylated peptide to a substrate for POMGNT2. Additionally, an acceptor glycopeptide is a less efficient substrate for POMGNT2 when two of the conserved amino acids are replaced. These findings begin to define the selectivity of POMGNT2 and suggest that this enzyme functions as a gatekeeper enzyme to prevent the vast majority of O-mannosylated sites on proteins from becoming modified with glycan structures functional for binding laminin globular domain-containing proteins.
Comparison of 5 Health-Related Quality-of-Life Indexes Using Item Response Theory Analysis

Background. Five health-related quality-of-life (HRQoL) indexes—EQ-5D, HUI2, HUI3, QWB-SA, and SF-6D—are each used to assign community-based utility scores to health states, although these scores differ. Objective. The authors transform these indexes to a common scale to understand their interrelationships. Methods. Data were from the National Health Measurement Study, a telephone survey of 3844 US adults. The 5 indexes were analyzed using item response theory analysis to estimate scores on an underlying construct of summary health, θ. Unidimensionality was evaluated using nonlinear principal components analysis. Index scores were plotted against the estimated scores on the common underlying construct. In addition, scores on the Health and Activities Limitation Index (HALex), the Centers for Disease Control and Prevention Healthy Days questions, and self-rated health on a 5-category scale ranging from excellent to poor were plotted. Results. SF-6D and QWB-SA are nearly linear across the range of θ but with a shallow slope; EQ-5D, HUI2, and HUI3 are linear with a steep slope from low θ (poor health) into midrange of θ, then approximately linear with a less steep slope for higher θ (health just below to well above average), although the inflection points differ by index. Conclusion. Simple linear functions may serve as crosswalks among these indexes only for lower health states, albeit with low precision. Ceiling effects make crosswalks among most of the indexes ill specified above a certain level of health. Although each index measures generic health on a utility scale, these indexes are not identical but are relatively simply, if imprecisely, related.
Use of graphene-based films for hot spot cooling

Efficient heat dissipation is becoming an urgent demand in electronics and optoelectronics because of increasing power density, which is generating more heat than ever. Graphene, an atomic layer of carbon, has been shown to have high thermal conductivity, which makes this material a promising candidate for heat dissipation in electronics. Here, we demonstrate a new type of graphene-based film on a test platform to alleviate the thermal issues. Taking advantage of its high in-plane thermal conductivity, CVD-grown graphene has been observed to possess a strong heat-spreading ability. In this paper, a chemical conversion process, including chemical oxidation, exfoliation and reduction, is utilised to fabricate the graphene-based films. Additionally, functionalisation of the film was also performed to diminish the interface thermal resistance between the chip surface and the graphene-based films. Thermal characterisation showed a capacity for effective heat removal, which was indicated by the decrease in the hot spot temperature at the same power loading. In summary, this facile approach may technologically enable large-scale fabrication of graphene-based films for thermal management in high power density devices.
Low‐iron conditions induces the hypersensitive reaction and pathogenicity hrp genes expression in Xanthomonas and is involved in modulation of hypersensitive response and virulence

Expression of hrp (hypersensitive reaction and pathogenicity) genes inside the host is crucial for virulence of phytopathogenic bacteria. The hrp genes encode components of type3 secretion system (T3SS), HR elicitors and several regulators, which are involved in the co-ordinated expression of hrp genes in the host environment and in hrp inducing chemically defined medium. However, little is known about specific host or environmental factors which may play a role in the induction of hrp gene expression. In this study, we show that iron-limiting condition elicits induced expression of hrp genes, including type3 secretion system (T3SS) and effectors (T3E). Expression analysis using qRT-PCR and promoter probe strains suggest significant induction in the expression of Hrp and T3S-associated genes of Xanthomonas campestris pv. campestris (Xcc) under low-iron condition, and is suppressed by exogenous supplementation of iron. Furthermore, we show that with exogenous iron supplementation, wild type Xcc exhibited reduced disease symptoms in host-plant, and exhibited significant reduction in HR and callose deposition in the non-host plants. Xanthomonas oryzae and oryzicola pathovars also exhibited the iron affect, albeit to a lesser extend compared with the Xcc. Overall, our results suggest that low-iron condition inside the host may play a crucial role in pathogenicity.
The role of inter-professional relationships and support for nurse prescribing in acute and chronic pain.

AIM This paper is a report of a study to explore nurse prescribers' views on the role of inter-professional relationships and other means of support for nurse prescribing for patients in acute and chronic pain. BACKGROUND Research indicates that good team relationships are important for supporting nurse prescribing but that poor understanding of the role by other healthcare professionals can act as a barrier. While collaborative working is central to the role of pain nurses, there is a lack of research on the impact of nurse prescribing on inter-professional working or the support needs of these nurses. METHOD A qualitative approach was adopted using thematic analysis of semi-structured interview data collected during 2006 and 2007. Participants were 26 nurses who prescribed medicines for patients with acute and/or chronic pain. FINDINGS Nurses' believed that prescribing encouraged collaborative working and sharing of knowledge across professional boundaries and that this helped to broaden understanding of the wider remit of pain management. Collaboration with doctors served a number of functions, including support and continuous learning. Barriers to effective nurse prescribing were a lack of understanding of its role amongst healthcare professionals and inadequate support. Formal support structures, such as regular clinical supervision, were seen as crucial to meeting nurses' ongoing learning. CONCLUSION Factors that promote understanding of nurse prescribing and support inter-professional relationships are likely to have a positive impact on the effectiveness of nurse prescribing. A more consistent approach is required within organisations to support nurse prescribing.
Mesangiocapillary glomerulonephritis: A long‐term study of 40 cases

Forty cases of mesangiocapillary glomerulonephritis are reviewed for whom both light and electron microscopy and full clinical data were available. Immunofluorescence microscopy (IF) was performed on 23 cases and complement screening (CH50, C4 and C3) on 25 cases, with follow‐up period of 5–22 y. The results of EM revealed 17 cases (42 per cent.) of Type I and 23 cases (58 per cent.) of Type II MCGN but only 52 per cent. of Type II cases were correctly identified by light microscopy. Epimembranous deposits were seen as frequently in Type II as in Type I (26 per cent. and 30 per cent.) and fragmentation of glomerular capillary basement membranes (GBM) was seen in 27 per cent. of Type I cases. Overall patient survival was 49 per cent. at 10 y and that of patients who presented with nephrotic syndrome was poor (39 per cent. at 10 y). Persistent hypo‐complementaemia with C3 Nephritic Factor was present in 40 per cent. ; the survival of these patients was less than those with normal complement levels (70 per cent. vs 100 per cent. at 5 y) and they were also more likely to develop renal failure. Renal failure was more likely to develop in those with a creatinine clearance of < 100 ml/min at presentation and where the biopsy showed substantial crescents in >20 per cent. of glomeruli. Mean CH50, C3 and C4 was lower in the hypocomplementaemic as compared to normocomplementaemic patients, and there were no differences between Type I and Type II. IF showed immuno‐globulins and fibrin as well as C3 in both Type I and Type II cases. Our results support the concept of an immune‐complex mediated phase in both types of MCGN, and we further suggest that (a) epimembranous deposits are common in both Type I and Type II and (b) cases with fragmentation of the GBM should be designated Type Ia.
Rural women veterans demographic report: defining VA users' health and health care access in rural areas.

PURPOSE While many women choose to live in rural areas after retiring from active military duty, a paucity of studies examine rural women veterans' health care needs. This report is the first of its kind to describe the population demographics and health care utilization of rural female veteran patients enrolled in the Department of Veterans Affairs (VA). METHODS Using the National Patient Care Datasets (n = 327,785), we ran adjusted regression analyses to examine service utilization between (1) urban and rural and (2) urban and highly rural women veterans. FINDINGS Rural and highly rural women veterans were older and more likely to be married than their urban counterparts. Diagnostic rates were generally similar between groups for several mental health disorders, hypertension, and diabetes, with the exception of nonposttraumatic stress anxiety that was significantly lower for highly rural women veterans. Rural and highly rural women veterans were less likely to present to the VA for women's specific care than urban women veterans; highly rural women veterans were less likely to present for mental health care compared to urban women veterans. Among the users of primary care, mental health, women's specific, and all outpatient services, patients' annual utilization rates were similar. CONCLUSIONS Improved service options for women's specific care and mental health visits may help rural women veterans access care. Telehealth technologies and increased outreach, perhaps peer-based, should be considered. Other recommendations for VA policy and planning include increasing caregiver support options, providing consistency for mental health services, and revising medical encounter coding procedures.
First line treatment with newer tyrosine kinase inhibitors in chronic myeloid leukemia associated with deep and durable molecular response – systematic review and meta-analysis

Abstract Background: The choice of a specific tyrosine kinase inhibitor (TKI) as first line treatment in chronic myeloid leukemia (CML) is complex and influenced by multiple factors. We published a meta-analysis examining the role of newer TKIs as first line treatment in chronic phase CML. In view of the recently published data, we decided to update it. Methods: We conducted a systematic review and meta-analysis of randomized controlled trials comparing first line treatment with imatinib to the newer TKIs (nilotinib, dasatinib, bosutinib and ponatinib). We searched MEDLINE, conference proceedings and databases of ongoing trials up to August 2015. Results: Our search yielded eight trials including 3554 patients. Treatment with the newer TKIs significantly improved major molecular response (MMR) at all time points and increased the rate of complete molecular response (CMR) at 12 and 24 months [relative risk (RR) 2.58, 95% CI 1.98–3.37, six trials and RR 2.05, 95% CI 1.63–2.58, three trials, respectively]. Early molecular response at three months was better with the newer TKIs (RR 1.33, 95% CI 1.26–1.40, six trials). Importantly, progression rate to accelerated or blastic phase was significantly lower with the newer TKIs at 12, 24 months and 5 years. Yet, there was no difference in all-cause mortality. The risk of adverse events requiring treatment discontinuation increased with the newer TKIs. Conclusions: With a longer follow-up, the newer TKIs remain more potent than imatinib, yet with no significant effect on survival. As CMR is a prerequisite for treatment discontinuation and cure, the newer TKIs favor treatment cessation.
A multi-echo airborne LiDAR-based method for estimating leaf area density distribution of individual trees

We demonstrate a method for estimating the leaf area density (LAD) distribution of individual trees using multi-echo airborne light detection and ranging (LiDAR). This method improves upon the previously developed method which calculates LAD based on the contact frequency between the laser beams and leaves by tracing the paths of the laser beams. The proposed method exploits the last and intermediate echoes in addition to the first and single echoes to capture the foliage distribution in the inner part of the crown. We verify the estimation accuracy using terrestrial LiDAR data of a single tree. The estimated LAD distribution is compared to the terrestrial LiDAR-derived LAD distribution. We confirmed that using the last and intermediate echoes improves the estimation accuracy of the entire crown area.
Developmental Biology of the Innate Immune Response: Implications for Neonatal and Infant Vaccine Development

Molecular characterization of mechanisms by which human pattern recognition receptors (PRRs) detect danger signals has greatly expanded our understanding of the innate immune system. PRRs include Toll-like receptors, nucleotide oligomerization domain-like receptors, retinoic acid inducible gene-like receptors, and C-type lectin receptors. Characterization of the developmental expression of these systems in the fetus, newborn, and infant is incomplete but has yielded important insights into neonatal susceptibility to infection. Activation of PRRs on antigen-presenting cells enhances costimulatory function, and thus PRR agonists are potential vaccine adjuvants, some of which are already in clinical use. Thus, study of PRRs has also revealed how previously mysterious immunomodulators are able to mediate their actions, including the vaccine adjuvant aluminum hydroxide that activates a cytosolic protein complex known as the Nacht domain leucine-rich repeat and pyrin domain-containing protein 3 inflammasome leading to interleukin-1β production. Progress in characterizing PRRs is thus informing and expanding the design of improved adjuvants. This review summarizes recent developments in the field of innate immunity emphasizing developmental expression in the fetus, newborn, and infant and its implications for the design of more effective neonatal and infant vaccines.
Incidence of pyrethroid-resistant oilseed rape pests in Germany.

BACKGROUND Failures in pollen beetle control using pyrethroids since 2005 indicated pyrethroid resistance in Germany. Therefore, resistance monitoring using bioassays was established in Germany for oilseed rape pest insects. RESULTS The spread and intensity of pyrethroid resistance of Meligethes aeneus increased from 2005 onwards, with no sensitive samples left in any region of Germany in 2011. Sensitivity also declined for the newly introduced actives bifenthrin, etofenprox (both class-I pyrethroids) and tau-fluvalinate; all three claimed to be less affected by resistance, although there was no clear cross-resistance to lambda-cyhalothrin (class-II pyrethroid). In the German region with the longest tradition and high intensity of oilseed rape production, pyrethroid resistance of Psylliodes chrysocephala and Ceutorhynchus obstrictus, with resistance factors of up to 81 and 140 respectively, was detected. CONCLUSION The intensive use of only one mode of action for many years is risky, because even pest insects with a low intrinsic resistance risk may develop resistance. Therefore, resistance strategies need to include several control options for pest insects needing regular treatments.