Miracle-dz/UniFAR-FTUs huggingface dataset:
Protocol-driven ventilator weaning reduces use of mechanical ventilation, rate of early reintubation, and ventilator-associated pneumonia.

BACKGROUND Mechanical ventilation is the defining event of intensive care unit management. To reduce use, a literature-based protocol was introduced to facilitate weaning. The effect of protocol-driven ventilator weaning on ventilator use, ventilator-associated pneumonia (VAP), and intensive care unit (ICU) length of stay (LOS) is described in a survey of 2 years' activity in a multidisciplinary surgical ICU. METHODS Data were gathered from April to September 2000 and from April to September 2002 before and after introduction of nurse/therapist-driven weaning. VAP was identified by chest radiography, clinical presentation, Gram's stains, and cultures from tracheal aspirates or bronchoalveolar lavage. Infection control practitioners diagnosed VAP. Failed extubation was defined as reintubation within 72 hours. RESULTS Overall, there was a 2:1 ratio of male patients to female patients. The total number of patients and days of mechanical ventilation increased, but the use ratio (ventilator days/ICU days) fell from 0.47 to 0.33. Patients failing extubation fell from 43 (in 2000) to 25 (in 2002). From these patients, 17 cases of VAP occurred in 2000 and 5 in 2002. Mean age (40 years), Injury Severity Score (24), and ICU LOS (5.7-7.4 days; p = not significant) were unchanged in injured patients. ICU discharge was frequently delayed because of the need for subsequent respiratory care. CONCLUSION Protocol-driven weaning reduces use of mechanical ventilation and VAP. Injured and general surgical patients show reduction in complications, but shorter ICU LOS depends on resources elsewhere in the health care system.
Neck circumference and clustered cardiovascular risk factors in children and adolescents: cross-sectional study

Objective Early detection of cardiovascular disease (CVD) risk factors, such as obesity, is crucial to prevent adverse long-term effects on individuals’ health. Therefore, the aims were: (1) to explore the robustness of neck circumference (NC) as a predictor of CVD and examine its association with numerous anthropometric and body composition indices and (2) to release sex and age-specific NC cut-off values to classify youths as overweight/obese. Design Cross-sectional study. Setting 23 primary schools and 17 secondary schools from Spain. Participants 2198 students (1060 girls), grades 1–4 and 7–10. Measures Pubertal development, anthropometric and body composition indices, systolic and diastolic blood pressure (SBP and DBP, respectively), cardiorespiratory fitness, blood sampling triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c), glucose and inflammatory markers. Homoeostasis model assessment (HOMA-IR) and cluster of CVD risk factors were calculated. Results NC was positively correlated with all anthropometric and body composition indices. NC was negatively associated with maximum oxygen consumption (R2=0.231, p<0.001 for boys; R2=0.018, p<0.001 for girls) and positively associated with SBP, DBP, TC/HDL-c, TG, HOMA, complement factors C-3 and C-4, leptin, adiponectin and clustered CVD risk factor in both sexes (R2 from 0.035 to 0.353, p<0.01 for boys; R2 from 0.024 to 0.215, p<0.001 for girls). Moreover, NC was positively associated with serum C reactive protein, LDL-c and visfatin only in boys (R2 from 0.013 to 0.107, p<0.05). Conclusion NC is a simple, low-cost and practical screening tool of excess of upper body obesity and CVD risk factors in children and adolescents. Paediatricians can easily use it as a screening tool for overweight/obesity in children and adolescents. For this purpose, sex and age-specific thresholds to classify children and adolescents as normal weight or overweight/obese are provided.
Pension reform in a worst case scenario: public finance versus political feasibility*

Abstract This paper uses a quantitative overlapping generation model to suggest a pension reform able to sustain a retirement system, in the face of deep demographic changes. We derive the reform design from an optimization program that selects one or more policy instruments – and their values – among a predefined set, to minimize the welfare loss of the median voter while keeping sound public finances, sustaining gross domestic product growth and considering the welfare of the newborn generation. We calibrate the model to the Luxembourg economy. The European Commission (2012) forecasts that, among all euro area countries, Luxembourg will experience the largest increase in pension costs between now and 2060. Our simulations show that a single instrument reform would imply severe backlashes on the rest of the economy. The suggested pension reform instead consists of a policy mix including taxation, benefits and the effective retirement age. We stress the need to design pension reforms based on optimization programs that lead to the achievement of desired targets. Indeed, the reform implemented by the Luxembourg government in 2013, which does not result from an optimization program, will not keep public finances sound over the medium term.
Correlation of clinical characteristics and outcomes with injury scoring in blunt cardiac trauma.

BACKGROUND Clinical sequelae from blunt cardiac trauma (BCT) may range from minor electrocardiographic abnormalities to death from free-wall rupture. There are no established clinical characteristics or injury scoring systems that are able to predict survival in these patients. METHODS A retrospective review of medical records from a Level I trauma center identified 47 patients with BCT. A grade assigned on the basis of the American Association for the Surgery of Trauma Organ Injury Scale (OIS) was assigned to each case studied. Clinical data, including the Injury Severity Score (ISS), and outcomes were analyzed for association with OIS grade. RESULTS The average ISS was 27.9, and the overall mortality rate was 31.9%. The majority of patients were either grade II or IV, with the latter having the highest mortality. Hypotension at admission, cardiac arrest, lack of vital signs at admission, ISS, hours to diagnosis, and death all had significant association with assigned OIS grade. Factors associated with mortality included ISS; OIS grade; shorter time to diagnosis; cardiac tamponade; cardiac rupture; lack of vital signs at admission; and concomitant injury to either the thoracic aorta or to the liver, spleen, or kidneys. CONCLUSION The OIS grade, assigned on the basis of anatomic site of injury and electrocardiographic abnormalities, appears to correlate with severity of injury and survival. Although injury scoring should not be used exclusively to guide management in trauma patients, the grading system studied may be useful in predicting outcomes in patients with BCT.
Novel frequency domain finite element formulation for optical circuits in nonlinear photonic crystals

An efficient technique based on the finite element method in the frequency domain for the analysis of nonlinear photonic crystals based optical circuits is here presented. The solution of the nonlinear Helmholtz equation is obtained by an iterative process involving linear problem solutions. The present approach uses isoparametric curvilinear elements for the spatial discretization and perfectly matched layers to truncate the computational domain. Numerical examples are presented in order to validate the efficiency of the present method.
Insulin Effects on Glucose Metabolism, Memory, and Plasma Amyloid Precursor Protein in Alzheimer's Disease Differ According to Apolipoprotein‐E Genotype

Abstract: Higher fasting plasma insulin levels and reduced CSF‐to‐plasma insulin‐ratios, suggestive of insulin resistance, have been observed in patients with Alzheimer's disease (AD) who do not possess an apolipoprotein E (ApoE)‐ɛ4 allele. Insulin has also been implicated in processing of β‐amyloid and amyloid precursor protein (APP). We examined the effects of intravenous insulin administration while maintaining euglycemia on insulin‐mediated glucose disposal, memory, and plasma APP in patients with AD and normal adults of varying ApoE genotypes. AD subjects without an ɛ4 allele had significantly lower insulin‐mediated glucose disposal rates than did AD patients with an ɛ4 allele (p < 0.03) or than did normal adults without an ɛ4 allele (p < 0.02). AD subjects without an ɛ4 allele also showed significant memory facilitation with insulin administration (p < 0.04), whereas the AD‐ɛ4 group did not. Insulin reduced APP levels for AD patients without an ApoE ɛ4 allele, but raised APP for AD patients with an ApoE ɛH4 allele These results document ApoE‐related differences in insulin metabolism in AD that may relate to disease pathogenesis.
Consumer attitudes, knowledge, and behavior related to salt consumption in sentinel countries of the Americas.

OBJECTIVE To describe individual attitudes, knowledge, and behavior regarding salt intake, its dietary sources, and current food-labeling practices related to salt and sodium in five sentinel countries of the Americas. METHODS A convenience sample of 1 992 adults (≥ 18 years old) from Argentina, Canada, Chile, Costa Rica, and Ecuador (approximately 400 from each country) was obtained between September 2010 and February 2011. Data collection was conducted in shopping malls or major commercial areas using a questionnaire containing 33 questions. Descriptive estimates are presented for the total sample and stratified by country and sociodemographic characteristics of the studied population. RESULTS Almost 90% of participants associated excess intake of salt with the occurrence of adverse health conditions, more than 60% indicated they were trying to reduce their current intake of salt, and more than 30% believed reducing dietary salt to be of high importance. Only 26% of participants claimed to know the existence of a recommended maximum value of salt or sodium intake and 47% of them stated they knew the content of salt in food items. More than 80% of participants said that they would like food labeling to indicate high, medium, and low levels of salt or sodium and would like to see a clear warning label on packages of foods high in salt. CONCLUSIONS Additional effort is required to increase consumers' knowledge about the existence of a maximum limit for intake and to improve their capacity to accurately monitor and reduce their personal salt consumption.
Substrate receptors of proteasomes

Proteasomes are responsible for the turnover of most cellular proteins, and thus are critical to almost all cellular activities. A substrate entering the proteasome must first bind to a substrate receptor. Substrate receptors can be classified as ubiquitin receptors and non‐ubiquitin receptors. The intrinsic ubiquitin receptors, including proteasome regulatory particle base subunits 1, 10 and 13 (Rpn1, Rpn10, and Rpn13), determine the capability of the proteasome to recognize a ubiquitin chain, and thus provide selectivity for the 26S proteasome. However, the non‐ubiquitin receptors, including proteasome activator 200 (PA200) and PA28γ, have received great attention due to their remarkable compensatory roles relative to canonical ubiquitin‐mediated proteasomal degradation. Herein we review recent advances in understanding the contributions of these substrate receptors to proteasomal degradation, and introduce their substrates and interacting factors. We also provide insights into their biological functions related to spermatogenesis, immune responses, cellular homeostasis, and tumour development. Finally, we summarize advances in developing small‐molecule inhibitors of these substrate receptors and discuss their potential as drug targets.
Adenovirus early region 1B 58,000-dalton tumor antigen is physically associated with an early region 4 25,000-dalton protein in productively infected cells

In soluble protein extracts obtained from adenovirus productively infected cells, monoclonal antibodies directed against the early region 1B 58,000-dalton (E1B-58K) protein immunoprecipitated, in addition to this protein, a polypeptide of 25,000 molecular weight. An analysis of tryptic peptides derived from this 25K protein demonstrated that it was unrelated to the E1B-58K protein. The tryptic peptide maps of the 25K protein produced in adenovirus 5 (Ad5)-infected HeLa cells and BHK cells were identical, whereas Ad3-infected HeLa cells produced a different 25K protein. The viral origin of this 25K protein was confirmed by an amino acid sequence determination of five methionine residues in two Ad2 tryptic peptides derived from the 25K protein. The positions of these methionine residues in the 25K protein were compared with the nucleotide sequence of Ad2 and uniquely mapped the gene for this protein to early region 4, subregion 6 of the viral genome. A mutant of Ad5 was obtained (Ad5 dl342) which failed to produce detectable levels of the E1B-58K protein. In HeLa cells infected with this mutant, monoclonal antibodies directed against the E1B-58K protein failed to detect the associated 25K protein. In 293 cells infected with Ad5 dl342, which contain an E1B-58K protein encoded by the integrated adenovirus genome, the mutant produced an E4-25K protein which associated with the E1B-58K protein derived from the integrated genome. Extracts of labeled Ad5 dl342-infected HeLa cells (E1B-58K-) were mixed in vitro with extracts of unlabeled Ad5 wild type-infected HeLa cells or 293 cells (E1B-58K+). When the mixed extracts were incubated with the E1B-58K monoclonal antibody, a labeled E4-25K protein was coimmunoprecipitated. When extracts of Ad5 dl342-infected HeLa cells and uninfected HeLa cells (both E1B-58K-) were mixed, the E1B-58K monoclonal antibody failed to immunoselect the E4-25K protein. These data provide evidence that the E1B-58K antigen is physically associated with an E4-25K protein in productively infected cells. This is the same E1B-58K protein that was previously shown to be associated with the cellular p53 antigen in adenovirus-transformed cells.
Danger-Associated Peptides Close Stomata by OST1-Independent Activation of Anion Channels in Guard Cells

A microbial pathogen induces endogenous plant elicitor peptides that close stomata through a PRR-dependent but OST1-independent pathway. The plant elicitor peptides (Peps), a family of damage/danger-associated molecular patterns (DAMPs), are perceived by two receptors, PEPR1 and PEPR2, and contribute to plant defense against pathogen attack and abiotic stress. Here, we show that the Peps-PEPR signaling pathway functions in stomatal immunity by activating guard cell anion channels in Arabidopsis thaliana. The mutant plants lacking both PEPR1 and PEPR2 (pepr1 pepr2) displayed enhanced bacterial growth after being sprayed with Pseudomonas syringae pv tomato (Pst) DC3000, but not after pathogen infiltration into leaves, implicating PEPR function in stomatal immunity. Indeed, synthetic Arabidopsis Peps (AtPeps) effectively induced stomatal closure in wild-type but not pepr1 pepr2 mutant leaves, suggesting that the AtPeps-PEPR signaling pathway triggers stomatal closure. Consistent with this finding, patch-clamp recording revealed AtPep1-induced activation of anion channels in the guard cells of wild-type but not pepr1 pepr2 mutant plants. We further identified two guard cell-expressed anion channels, SLOW ANION CHANNEL1 (SLAC1) and its homolog SLAH3, as functionally overlapping components responsible for AtPep1-induced stomatal closure. The slac1 slah3 double mutant, but not slac1 or slah3 single mutants, failed to respond to AtPep1 in stomatal closure assays. Interestingly, disruption of OPEN STOMATA1 (OST1), an essential gene for abscisic acid-triggered stomatal closure, did not affect the AtPep1-induced anion channel activity and stomatal response. Together, these results illustrate a DAMP-triggered signaling pathway that, unlike the flagellin22-FLAGELLIN-SENSITIVE2 pathway, triggers stomata immunity through an OST1-independent mechanism.
CAMPATH-1H in multiple sclerosis

In a pilot study, seven patients with multiple sclerosis were treated with CAMPATH-1H which targets the CD52 antigen present on lymphocytes and monocytes. There was a substantial reduction in disease activity as measured by gadoliunium-enhancing lesions on MRI. Encouraged by this result a further seven patients have been treated with CAMPATH-1H; four also received anti-CD4 antibody. Lymphopaenia developed rapidly and was sustained for at least one year. In 12 patients, the first infusion of antibody was characterised by significant exacerbation or re-awakening of pre-existing symptoms lasting several hours. These clinical effects of antibody treatment correlated with increased levels of circulating cytokines. Peak levels of tumour necrosis factor alpha (TNFα) and interferon gamma (IFNγ) occurred at 2 h whereas the rise in interleukin-6 (IL-6) was significantly delayed and peaked at 4 h after starting antibody treatment The neurological symptoms could not be attributed directly to pyrexia and were not provoked (in one patient) by an artificial rise in temperature. In the remaining two patients, a single pre-treatment with intravenous methylprednisolone (500 mg) prevented both the transient increase in neurological symptoms and the cytokine release. Our results suggest that soluble immune mediators contribute to symptom production in multiple sclerosis by directly or indirectly blocking conduction through partially demyelinated pathways.
Response of different date palm cultivars to salinity and osmotic stresses using tissue culture technique.

The date palm (Phœnix dactylifera L.) is moderately tolerant to salinity and drought. However, information about the variation in salinity and drought tolerance among the date palm cultivars is limited. Thus, a method of in vitro propagation via somatic embryogenesis from shoot tips of date palm cvs. Barhi and Khalas under polyethylene glycol (PEG) induced osmotic stress or NaCl was applied. Highest induction frequencies of embryogenic calli occurred after 12 months on MS medium supplemented with 10 mg L 2,4-D, 3 mg L 2iP and 2 g L activated charcoal. Optimum MS medium for higher frequency of matured somatic embryos and plant regeneration was recorded using 0.5 mg L NAA, 3.0 mg L 2iP of cv. Barhi and 1.0 mg L NAA, 4.0 mg L 2iP of cv. Khalas. The embryogenic callus of both cultivars was cultured on different levels of NaCl or PEG-induced stresses after 12 weeks for three subcultures. There were considerable differential responses between date palm cultivars with regard to tolerance to salinity and osmotic stresses. However, the growth of cv. Barhi was completely ceased at levels above 300 mM NaCl or 25 g L PEG while cv. Khalas continued to grow. This indicates that cv. Khalas is more tolerant to high salinity and osmotic stresses than the cv. Barhi. This study also showed that use of tissue callus is an effective way to monitor the response of date palm cultivars to salinity and osmotic stresses. © 2018 Friends Science
Hearing Managers of Deaf Workers: A Phenomenological Investigation in the Restaurant Industry

Abstract:The study examined the experiences of hearing managers of Deaf restaurant employees regarding accommodation and social integration. Deaf workers who use American Sign Language have different social and accommodation needs than hearing coworkers, but most hearing managers are unfamiliar with these needs. Using stigma theory to frame issues of workplace accommodation and social integration, the researchers collected data through site observation and in-depth semistructured interviews with 6 hearing managers of high-volume restaurants and 6 Deaf employees. It was found that while demonstrably unknowledgeable about Deaf workers' accommodation needs and work abilities, managers held Deaf workers in high esteem and positive social regard. Deaf workers largely felt respected by hearing managers and regarded them positively, but consistently expressed a desire for better, more frequent accommodations for on-the-job communication. The findings have implications for hearing managers, Deaf workers, and intermediary employment advocates.
The motherhood penalty and female employment in urban India

Since the 1990s, India has seen robust economic growth, rising wages, steady fertility decline, increased urbanization, and expanded educational attainment for males and females. But unlike other countries that have undergone similar transitions, urban women's employment has refused to budge, never crossing the 25 percent mark. This paper fills a critical gap in policy research on women's employment in India. The discussion is situated in the normative construction of motherhood and the gendered nature of caregiving in India. The analysis uses pooled data from six rounds of the National Sample Surveys to examine the effects of having a young child on mothers' employment in urban India over 1983-2011. The analysis also looks at household structure, and analyzes the effects of other household members on women's labor supply. The results show that although the onus of childbearing may have reduced, that of caregiving has increased. Having a young child in the home depresses mothers' employment, an inverse relationship that has intensified over time. Further, living in a household with older children and women over the age of 50 is positively associated with women's employment. These results show that the care of young children is an increasingly important issue in women's employment decisions, in a context where formal childcare is practically nonexistent. These results have significant implications for policy to raise women’s labor force participation in India.
Transition From Heparin to Citrate Anticoagulation for Continuous Renal Replacement Therapy: Safety, Efficiency, and Cost

Regional citrate anticoagulation (RCA) for continuous renal replacement therapy (CRRT) has recently been recommended as first‐line over heparin. Evidence suggests that RCA prolongs filter life and may reduce bleeding risk, but there is little research on the benefits to dialysis dose delivery or cost, or the effectiveness of transitioning to RCA first‐line. The aim of the present study was to assess the effect on dialysis delivery, cost and safety when transitioning from systemic heparin to RCA for first‐line anticoagulation for CRRT. A single‐center, retrospective observational study was conducted from 2006 to 2012, during which a transition from heparin to a simplified RCA protocol occurred. Demographic and dialysis data, pathology results and costs were obtained. Data were analyzed for both heparin and RCA, and for before and after the transition. 166 patients had 992 dialysis days (heparin 334 vs. RCA 658); demographics were well matched; RCA used less filters per day (P = 0.03), had more days when prescribed dialysis was achieved (85% vs. 60%, P < 0.001), and less filter “down‐time” per day (2.4 vs. 6.1 h, P = 0.02). RCA was estimated to cost AU$487 per day, compared to heparin at $479 per day. When the data were analyzed, comparing before and after the transition, these results remained statistically significant. There was no statistical difference in clinical safety events. Transition to first‐line RCA was safe, provided more time on filter and consumed less filter circuits using a simple and user friendly protocol. The adjusted cost difference appears negligible.