Miracle-dz/UniFAR-FTUs huggingface dataset:
Does the addition of glutamine to enteral feeds affect patient mortality?*

Objective:Studies have failed to consistently demonstrate improved survival in intensive care unit (ICU) patients receiving immune-modulating nutrient-enhanced enteral feeds when compared with standard enteral feeds. The objective was to study in a prospective fashion the effects of adding glutamine to standard or immune-modulated (supplemented with omega-3 fatty acids, β-carotene, and amino acids such as glutamine and arginine) tube feeds. Design:Prospective, unblinded study using sequential allocation. Setting:A university surgical trauma ICU. Patients:All surgical and trauma patients admitted to the surgical trauma ICU at a university hospital over a 3-yr period who were to receive enteral feeds (n = 185). Interventions:Sequential assignment to three isocaloric, isonitrogenous diets was performed as follows: standard 1-kcal/mL feeds with added protein (group 1), standard feeds with the addition of 20–40 g/day (0.6 g/kg/day) glutamine (group 2), or an immune-modulated formula with similar addition of glutamine (group 3). The goal for all patients was 25–30 kcal/kg/day and 2 g/kg/day protein. Measurements and Main Results:Patients were followed until discharge from the hospital. The primary end point was in-hospital mortality, and multiple secondary end points were recorded. In-hospital mortality for group 1 was 6.3% (four of 64) vs. 16.9% (ten of 59, p = .09) for group 2 and 16.1% (ten of 62, p = .09) for group 3. After controlling for age and severity of illness, the difference in mortality between patients receiving standard tube feeds and all patients receiving glutamine was not significant (p ≤ .11). There were no statistically significant differences between the groups for secondary end points. Conclusions:The addition of glutamine to standard enteral feeds or to an immunomodulatory formula did not improve outcomes. These findings suggest that enteral glutamine should not be routinely administered to patients with surgical critical illness.
Procalcitonin as a Mediator of Chronic Inflammation in Obese Women with PCOS

Background: Polycystic ovary syndrome (PCOS), a common reproductive endocrine condition characterized by hyperandrogenism, chronic anovulation, and obesity. Obesity is associated with a lowgrade inflammation of white adipose tissue resulting from chronic activation of the innate immune system and can subsequently lead to insulin resistance, impaired glucose tolerance and even diabetes. In the last few years, adipose tissue emerged as an important source of proinflammato ry mediators including TNF- , IL-6, and procalcitonin. Objective: to investigate procalcitonin as a marker of chronic inflammation in obese women with PCOS. Method: a case control study conducted from January 2010 till July 2010. The study involved 20 women with PCOS and 20 control women matched for age and BMI. Waist to hip ratio was measured and blood was drawn from patients and controls and serum levels of FSH, LH, prolactin, testosterone and procalcitonin were estimated by VIDAS using VIDAS kits provided by Biomerieux (France). Student t test was used to evaluate the difference in serum procalcitonin level between the two groups. Results: compared with control group, patients with PCOS had a significantly higher waist to hip ratio (mean 0.95 ± 0.2 versus 0.8 ± 0.13). Serum procalcitonin level was significantly higher in women with PCOS compared to control group (1.43 ± 0.42 ng/mL Vs 0.19 ± 0.13 ng/mL) P value was < 0.0001. Serum levels of FSH, LH, prolactin and testosterone all were significantly higher in women with PCOS than in the control group (P value < 0.05). Conclusion: The increase in low-grade chronic inflammation in women with PCOS is primarily associated with increased central fat excess. Procalcitonin represents a novel marker of the inflammatory activity of body fat in PCOS.
Enhancing beta-carotene production in Saccharomyces cerevisiae by metabolic engineering.

Beta-carotene is known to exhibit a number of pharmacological and nutraceutical benefits to human health. Metabolic engineering of beta-carotene biosynthesis in Saccharomyces cerevisiae has been attracting the interest of many researchers. A previous work has shown that S. cerevisiae successfully integrated with phytoene synthase (crtYB) and phytoene desaturase (crtI) from Xanthophyllomyces dendrorhous could produce beta-carotene. In the present study, we achieved around 200% improvement in beta-carotene production in S. cerevisiae through specific site optimization of crtI and crtYB, in which five codons of crtI and eight codons of crtYB were rationally mutated. Furthermore, the effects of the truncated HMG-CoA reductase (tHMG1) from S. cerevisiae and HMG-CoA reductase (mva) from Staphylococcus aureus on the production of beta-carotene in S. cerevisiae were also evaluated. Our results indicated that mva from a prokaryotic organism might be more effective than tHMG1 for beta-carotene production in S. cerevisiae.
The Application of the Neural Network Model Inspired by the Immune System in Financial Time Series Prediction

This paper presents a novel application of the self-organised multilayer perceptrons inspired by the immune algorithm in financial time series prediction. The simulation results were compared with the multilayer perceptrons and the functional link neural networks. The prediction capability of the various neural networks was tested on ten different data sets; the US/UK exchange rates, the JP/US exchange rate, the US/EU exchange rates, NASDAQO time series, NASDAQC time series, DJIAO time series, DJIAC time series, DJUAO time series, DJUAC time series and the oil price. A new training algorithm was utilized with the self-organised multilayer perceptrons neural network that is inspired by the immune using weight decay, the simulation results indicated significant improvement of the proposed training over the standard network
Eosinophilic cellulitis (Wells’ syndrome) as a cutaneous reaction to the administration of adalimumab

A 72 year old female patient had a 30 year history of progressive rheumatoid arthritis treated ultimately with a combination of ciclosporin A plus corticosteroids and anti-inflammatory agents. Adalimumab was started as anti-tumour necrosis factor (TNF) monotherapy because the disease persisted. Ciclosporin A was discontinued 3 months before the initiation of adalimumab. At the site of the first adalimumab injection, a mild local reaction developed 6–8 hours later, not accompanied by general symptoms. Three to 4 hours after the second adalimumab injection (15 days later), the patient presented at the emergency department with chest discomfort, epigastralgia, fever (38.4°C), rigor, fatigue, and malaise. At the same time, at the injection site (left thigh), a violaceous plaque (10×9 cm) had developed, emerging as an erythematous urticarial oedema (fig 1A). Laboratory investigation …
Preventable deaths in patients admitted from emergency department

Background: There is limited data about how appropriate medical care is in the emergency department (ED). Objectives: To investigate the rate and types of preventable deaths among patients with early mortality after emergency admission from the ED. Methods: We retrospectively reviewed charts of early mortality (defined as mortality which occurred within 24 hours after admission from the ED) over a 3 year period. Those patients with terminal cancer or out of hospital cardiac arrest (OHCA) at presentation were excluded. Two independent assessors reviewed each eligible chart and determined whether early mortality was preventable. Any disagreements were resolved through discussion between the investigators. A mortality event was considered preventable if actions or missed actions were identified that would have prevented the death. The types of preventability were categorised as misdiagnosis, delayed diagnosis, and inappropriate medical management. Interrater reliability in the initial determination was assessed using Cohen κ statistic. Results: Over a 3 year period, 210 early mortality cases were identified. Excluding patients with terminal cancer or OHCA, the rate of preventable deaths was 25.8% (32/124). The types of preventability were inappropriate medical management (17 patients), delayed diagnosis (eight), and misdiagnosis (seven). There was good agreement between assessors with a Cohen κ statistic of 0.81. Conclusions: Preventable deaths in emergency admitted patients with early mortality are not uncommon. Analysis and identification of preventability early mortality by using a chart based method may be used as a quality assurance index in emergency medical care.
The systemic lupus erythematosus (SLE) disease autoantigen—calreticulin can inhibit C1q association with immune complexes

Following its release from cells during infection and inflammation, calreticulin (CRT) can act as an autoantigen in diseases such as SLE. Why CRT is a target of protective immunity and whether it may interfere with innate immunity once released from cells during inflammation is unclear. In the present study, we found that CRT was detected more frequently in SLE sera and in higher amounts than found in control sera. Approximately 40% of SLE sera tested contained autoantibodies against CRT as detected by ELISA and immunoblotting. CRT was found to be predominantly in the sera of SLE patients associated with immune complexes and C1q, and only bound to the surfaces of neutrophils in the presence of low levels of calcium and magnesium. In order to further investigate the C1q–CRT interaction, recombinant CRT and its discrete domains (N‐, P‐, and C‐domains) were produced in Escherichia coli. CRT binds to globular head region of C1q primarily via its N‐ and P‐domains. The N‐domain was shown to be the most autoantigenic region of CRT, as the anti‐CRT autoantibodies from most patients reacted against this region. CRT also altered C1q‐mediated immune functions. The P‐domain of CRT bound to C1q and reduced the binding of immune complexes in SLE sera to immobilized C1q. Full length CRT and its N‐ and P‐domains were able to reduce the C1q‐dependent binding of immune complexes to neutrophils and solid‐phase bound C1q. We conclude that CRT, once released from leucocytes during inflammation, may not only induce an antigenic reaction, but also interfere with C1q‐mediated inflammatory processes.
MR Imaging Evaluation of the Lisfranc Ligament in Cadaveric Feet and Patients With Acute to Chronic Lisfranc Injury

Background: Magnetic resonance (MR) imaging is known to be useful to demonstrate Lisfranc ligament injury. There are few studies that report differences in MR imaging findings of acute or chronic Lisfranc ligament injuries. We applied oblique MR imaging planes parallel to the Lisfranc ligament for better visualization of the entire course of the ligament and assessed the detailed MR imaging appearances of the Lisfranc ligament in cadavers and patients with presumed Lisfranc injuries. Methods: Twelve preserved cadaveric feet were examined using a small-diameter surface coil. Long axis, oblique sagittal, and oblique short axis cross sections parallel to the Lisfranc ligament, dorsal ligament, and plantar ligament were obtained. Twenty-six MR examinations from 23 patients with suspected Lisfranc joint injuries were evaluated. Results: In the cadaveric study, the Lisfranc ligament was satisfactorily visible along its entire course in a single slice on long axis and oblique sagittal MR images. The dorsal ligament and the plantar ligament were visible separately from the Lisfranc ligament in oblique sagittal and oblique short axis planes. In the patient study, 11 MR examinations led to diagnoses of complete tears of the Lisfranc ligament that were acute injuries (3-21 days after trauma) mostly associated with disruption of the dorsal and plantar ligaments. Nine studies led to diagnoses of incomplete tears of the Lisfranc ligament that were chronic injuries (2-14 months after trauma). Recovery of the continuity of the disrupted ligament was observed in 3 patients. Conclusion: MR imaging demonstrated the integrity of the ligaments and was useful for diagnosing an acute Lisfranc injury. Fibrous healing of the torn ligament was observed in a chronic injury. Level of Evidence: Level IV, case series.
Barrier Height at the Graphene and Carbon Nanotube Junction

Graphene/carbon nanotube (CNT) junction barrier height was investigated using all-carbon field-effect transistor structure with graphene and single-walled CNT (SWCNT) network as source (S)/drain (D)/gate electrodes and as channel, respectively. SWCNT network channel was formed by dielectricphoresis process at the prepatterned graphene S/D electrodes. By analyzing the measured current-voltage characteristics by the diode circuit model, the Schottky barrier height at the graphene and CNT junction was found to be approximately 0.5 eV.
Afferent and efferent connections of the oculomotor region of the fastigial nucleus in the macaque monkey

Afferent and efferent connections of the fastigial oculomotor region (FOR) were studied in macaque monkeys by using axonal transport of wheat germ agglutinin conjugated horseradish peroxidase (WGA‐HRP). When injected HRP is confined to the FOR, retrogradely labeled cells appear in lobules VIc and VII of the ipsilateral vermis and in group b of the contralateral medial accessory olive (MAO). In reference to the maps of topographical organization, the extent of the effective site in the fastigial nucleus (FN) could be assessed from the distributions of labeled Purkinje cells (P cells) in the vermis and labeled olivary neurons in the MAO.
Long-Term Results of Midcarpal Arthrodesis in the Treatment of Scaphoid Nonunion Advanced Collapse (SNAC-Wrist) and Scapholunate Advanced Collapse (SLAC-Wrist)

Summary:Outcome evaluation of midcarpal arthrodesis in the treatment of scaphoid nonunion advanced collapse (SNAC-wrist) and scapholunate advanced collapse (SLAC-wrist). Purpose:Scaphoid nonunion or scapholunate ligament instability results in carpal collapse and subsequent arthrosis. These conditions, termed SLAC-wrist and SNAC-wrist, are the most common patterns of arthrosis in the wrist. The purpose of this retrospective study was the evaluation of functional outcomes following midcarpal arthrodesis and of patients’ satisfaction with these outcomes. Methods:Forty-nine patients were reexamined at a mean follow-up time of 47 months. Active range of motion (AROM) was verified with a goniometer; grip strength was measured with a JAMAR-Dynamometer II. Pain was evaluated by a visual analogue scale from zero to 100 (VAS 0–100) for stress and under resting conditions. Patients’ upper-extremity functioning was captured with the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. Radiographic evaluation of bony consolidation was verified by conventional x-ray. Results:Postoperative AROM was 56% and grip strength was 76% compared with the contralateral side. The DASH score was 29 points. Pain relief was 34% at rest and 31% after stress. Forty-five patients demonstrated bony consolidation in x-ray control. Six patients (12%) further required a total arthrodesis of the wrist because of pain or absence of bony consolidation. Conclusion:Our data demonstrate that midcarpal arthrodesis is a reliable procedure for treating SLAC- and SNAC-wrists in stages II and III and, furthermore, one which preserves some range of motion. Total wrist fusion should only be used in exceptional circumstances.
Relevance of BRAF(V600E) mutation testing versus RAS point mutations and RET/PTC rearrangements evaluation in the diagnosis of thyroid cancer.

BACKGROUND A molecular profile including BRAF and RAS mutations as well as RET/PTC rearrangement evaluation has been proposed to provide an accurate presurgical assessment of thyroid nodules and to reduce the number of unnecessary diagnostic surgeries, sparing patients' health and saving healthcare resources. However, the application of such molecular analyses may provide different results among different centers and populations in real-life settings. Our aims were to evaluate the diagnostic utility of assessing the presence of BRAF and RAS mutations and RET/PTC1 and RET/PTC3 rearrangements in all cytological categories in an Italian group of thyroid nodule patients assessed prospectively, and to understand whether and which mutation testing might be helpful in cytologically indeterminate nodules. METHODS A total of 911 patients were submitted to ultrasound and fine-needle aspiration biopsy examination. Cytological evaluation was performed in parallel with molecular testing and compared to pathological results in 940 thyroid nodules, including 140 indeterminate lesions. RESULTS BRAF mutation testing provided the best contribution to cancer diagnosis, allowing the disease to be detected at an early stage, and identifying indeterminate nodules in which diagnostic lobectomy could be spared. On the contrary, RAS and RET/PTC analysis did not further increase diagnostic sensitivity for thyroid cancer. In addition, we found RET/PTC rearrangements in benign lesions, indicating that this molecular marker might not be useful for the detection of thyroid cancer. CONCLUSION BRAF(V600E) mutation analysis is superior to RAS point mutations and evaluation of RET/PTC rearrangements in the diagnosis of thyroid cancer, even in indeterminate lesions.
Association between carriage of Streptococcus pneumoniae and Staphylococcus aureus in Children.

CONTEXT Widespread pneumococcal conjugate vaccination may bring about epidemiologic changes in upper respiratory tract flora of children. Of particular significance may be an interaction between Streptococcus pneumoniae and Staphylococcus aureus, in view of the recent emergence of community-acquired methicillin-resistant S aureus. OBJECTIVE To examine the prevalence and risk factors of carriage of S pneumoniae and S aureus in the prevaccination era in young children. DESIGN, SETTING, AND PATIENTS Cross-sectional surveillance study of nasopharyngeal carriage of S pneumoniae and nasal carriage of S aureus by 790 children aged 40 months or younger seen at primary care clinics in central Israel during February 2002. MAIN OUTCOME MEASURES Carriage rates of S pneumoniae (by serotype) and S aureus; risk factors associated with carriage of each pathogen. RESULTS Among 790 children screened, 43% carried S pneumoniae and 10% carried S aureus. Staphylococcus aureus carriage among S pneumoniae carriers was 6.5% vs 12.9% in S pneumoniae noncarriers. Streptococcus pneumoniae carriage among S aureus carriers was 27.5% vs 44.8% in S aureus noncarriers. Only 2.8% carried both pathogens concomitantly vs 4.3% expected dual carriage (P =.03). Risk factors for S pneumoniae carriage (attending day care, having young siblings, and age older than 3 months) were negatively associated with S aureus carriage. CONCLUSIONS Streptococcus pneumoniae carriage, specifically of vaccine-type strains, is negatively associated with S aureus carriage in children. The implications of these findings in the pneumococcal vaccine era require further investigation.
Foreign Direct Investment and its Role in Economic Development: Do We Need a New Agenda?

Despite globalisation, the essential role of foreign direct investment (FDI) in economic development has not changed. However, many mechanisms and dynamics of FDI-assisted development have changed: there is greater variation in the kinds of FDI, the benefits each offers, and the manner in which each interacts with the host economy. This introductory article attempts to place the discussions and issues raised in this special issue of The European Journal of Development Research within the wider literature on FDI and development. The articles here analyse the role of multinational enterprises (MNEs) in industrial development in a ‘learning system’ perspective. They also analyse the policy tools available for using FDI for economic development in a liberalising, post-World Trade Organisation world, and the constraints to doing this. While this is a nascent debate, this special issue points to a variety of ‘soft’ policy options that provide a pragmatic response to the complexities of globalisation. Malgré la mondialisation, le rôle essentiel des investissements directs étrangers (IDE) pour le développement économique n'a pas changé. Cependant, de nombreux mécanismes et la dynamique du développement basé sur les IDE ont, eux, bien changé: les types d'IDE sont plus variés, de même les bénéfices offerts par chacun et la manière dont chaque type interagit avec l'économie locale. Cet article d'introduction tente de placer les discussions et les thèmes soulevés dans ce numéro spécial du European Journal of Development Research dans le contexte de la littérature sur les investissements directs étrangers et le développement. Les articles analysent l'importance des entreprises multinationales (EMN) pour le développement industriel à partir d'une perspective de «système d'apprentissage». Ils analysent également les instruments politiques qui, dans un monde de plus en plus libéralisé et «post-Organisation Mondiale du Commerce», pourraient servir à utiliser les IDE dans le sens du développement économique; les contraintes existantes sont également relevées. Alors qu'il s'agit d'un débat naissant, ce numéro spécial relève un nombre d'options politiques modérées qui donnent une réponse pragmatique aux complexités de la mondialisation.
The role of surface glycoconjugates in Leishmania midgut attachment examined by competitive binding assays and experimental development in sand flies

SUMMARY Binding of promastigotes to the sand fly midgut epithelium is regarded as an essential part of the Leishmania life cycle in the vector. Among Leishmania surface molecules putatively involved in attachment to the sand fly midgut, two GPI-anchored molecules are the most prominent: lipophosphoglycan (LPG) and promastigote surface protease gp63. In this work, we examined midgut attachment of Leishmania lines mutated in GPI-anchored molecules and compared results from 2 different techniques: in vivo development in sand flies and in vitro competitive binding assays using fluorescently labelled parasites. In combination with previous studies, our data provide additional support for (1) an LPG-independent parasite-binding mechanism of Leishmania major within the midgut of the permissive vector Phlebotomus perniciosus, and provide strong support for (2) the crucial role of L. major LPG in specific vector Phlebotomus papatasi, and (3) a role for Leishmania amazonensis gp63 in Lutzomyia longipalpis midgut binding. Moreover, our results suggest a critical role for GPI-anchored proteins and gp63 in Leishmania mexicana attachment to L. longipalpis midguts, as the wild type (WT) line accounted for over 99% of bound parasites.
/ rainbow trout, Oncorhynchus mykiss Walbaum , to emamectin benzoate, a new orally administered treatment for sea lice

Atlantic salmon weight range 289-484 g and rainbow trout weight range 166-387 g , held in seawater, were fed medicated diets containing graded levels of emamectin benzoate for 7 days. y1 y1 Nominal dose rates were 0, 100, 250 and 500 mg kg body weight day equivalent to 0, 2, 5 . and 10 times recommended dose rate for treatment of sea lice . Fish were observed for a further 7 days to determine the effects of treatment. Calculated actual dose rates, compensated for feed concentrations determined by chemical analysis, feed intake and weight gain during the course of the study, were 0, 70, 173 and 356 m gk g y1 body weight day y1 for Atlantic salmon, and 0, 88, 218 and 413 m gk g y1 body weight day y1 for rainbow trout. No mortality was observed, which could be related to treatment and unequivocal signs of toxicity were recorded only at the highest dose used in these studies. Signs of emamectin benzoate toxicity in both species included lethargy, dark coloration and inappetance. Atlantic salmon also showed loss of coordination. Fish in the high-dose groups exhibiting signs of toxicity showed no evidence of recovery during the 7-day post-treatment period. No pathognomonic signs of emamectin benzoate toxicity were identified