Miracle-dz/UniFAR-FTUs huggingface dataset:
Practical limitations of aerosol separation by a tandem differential mobility analyzer–aerosol particle mass analyzer

ABSTRACT A cavity ring-down spectrometer and condensation particle counter were used to investigate the limitations in the separation of singly and multiply charged aerosol particles by a tandem differential mobility analyzer (DMA) and aerosol particle mass analyzer (APM). The impact of particle polydispersity and morphology was investigated using three materials: nearly monodisperse polystyrene latex nanospheres (PSL); polydisperse, nearly spherical ammonium sulfate (AS), and polydisperse lacey fractal soot agglomerates. PSL and AS particles were easily resolved as a function of charge. For soot, the presence of multiply charged particles severely affects the isolation of the singly charged particles. In cases where the DMA–APM was unable to fully resolve the singly charged particles of interest, the peak mass deviated by up to 13% leading to errors in the mass specific extinction cross section of over 100%. For measurements of nonspherical particles, nonsymmetrical distributions of concentration as a function of mass were a sign of the presence of multiply charged particles. Under these conditions, the effects of multiply charged particles can be reduced by using a second charge neutralizer after the DMA and prior to the APM. Dilution of the aerosol stream serves to decrease the total number concentration of particles and does not remove the contributions of multiply charged particles.
Near real-time measurement of carbonaceous aerosol using microplasma spectroscopy: Application to measurement of carbon nanomaterials

ABSTRACT A sensitive, field-portable microplasma spectroscopy method has been developed for real-time measurement of carbon nanomaterials. The method involves microconcentration of aerosol on a microelectrode tip for subsequent analysis for atomic carbon using spark emission spectroscopy (SES). The spark-induced microplasma was characterized by measuring the excitation temperature (15,000–35,000 K), electron density (1.0 × 1017–2.2 × 1017 cm−3), and spectral responses as functions of time and interelectrode distance. The system was calibrated and detection limits were determined for total atomic carbon (TAC) using a carbon emission line at 247.856 nm (C I) for various carbonaceous materials including sucrose, EDTA, caffeine, sodium carbonate, carbon black, and carbon nanotubes. The limit of detection for total atomic carbon was 1.61 ng, equivalent to 238 ng m−3 when sampling at 1.5 L min−1 for 5 min. To improve the selectivity for carbon nanomaterials, which mainly consist of elemental carbon (EC), the cathode was heated to 300°C to reduce the contribution of organic carbon to the total atomic carbon. Measurements of carbon nanotube aerosol at elevated electrode temperature showed improved selectivity to elemental carbon and compared well with the measurements from the thermal optical method (NIOSH Method 5040). The study shows the SES method to be an excellent candidate for development of low-cost, hand-portable, real-time instrument for measurement of carbonaceous aerosols and nanomaterials.
Class II division 1 malocclusions treated with fixed lingual mandibular growth modificator (FLMGM): The mechanism of sagittal occlusal correction

Objectives: The objective of this study is to assess skeletal and dental changes contributing to sagittal correction of Class II malocclusion with fixed lingual mandibular growth modificator (FLMGM). Materials and Methods: A total of 38 patients with dental Class II division 1 malocclusion and retrognathic mandible comprised the study sample. All were in the pubertal growth spurt. While FLMGM was applied to the treatment group (n = 21, 13.2 years), no treatment was performed on the control group (n = 17, 12.5 years). Digital lateral cephalograms obtained at the beginning and end of treatment/observation period of 8 months were evaluated using sagittal occlusal analysis. Paired and independent t-tests were used to assess the differences within and between groups. Results: Fixed lingual mandibular growth modificator treatment resulted in the following significant changes: (1) Total mandibular length increased; (2) sagittal jaw relation enhanced due to chin advancement; (3) overjet reduced (4.06 mm) mainly as a result of skeletal mandibular advancement (83%) in combination with maxillary incisor retraction (17%); (4) Class II molar relation improved (5.56 mm) by a contribution of mandibular advancement (61%) and maxillary molar distalization (39%). Conclusions: Sagittal occlusal relationships efficiently improved by greater skeletal than dental changes. Stable horizontal position of lower molars and incisors was a benefit of FLMGM treatment.
Hypercapnic acidosis attenuates severe acute bacterial pneumonia-induced lung injury by a neutrophil-independent mechanism*

Objective:Deliberate induction of hypercapnic acidosis protects against lung injury after nonseptic lung injury. In contrast, concerns exist regarding the effects of hypercapnic acidosis in the setting of severe pulmonary sepsis. The potential for the effects of hypercapnic acidosis to be neutrophil-mediated remains to be determined. We investigated whether hypercapnic acidosis—induced by adding CO2 to inspired gas—would protect against severe acute lung injury induced by pulmonary Escherichia coli instillation and the role of neutrophils in mediating this effect. Design:Prospective randomized animal study. Setting:University Research Laboratory. Subjects:Adult male Sprague-Dawley rats. Interventions:In series 1, after induction of anesthesia and tracheostomy placement, animals were randomized to normocapnia (Fico2 0.00, n = 12) or hypercapnic acidosis (Fico2 0.05, n = 12). E. coli (0.5–3.0 × 1015 colony-forming units) was instilled intratracheally and the animals were ventilated for 6 hrs to allow a severe acute lung injury to evolve. In series 2, animals were randomized to neutrophil depletion or nondepletion before bacterial instillation, in a three-group design: normocapnia alone (Normo + polymorphonuclear neutrophils [PMN], n = 9), normocapnia with neutrophil depletion (Normo − PMN, n = 9), or hypercapnic acidosis with neutrophil depletion (hypercapnic acidosis − PMN, n = 9). After intratracheal E. coli administration these animals were also ventilated for 6 hrs. Results:Hypercapnic acidosis protected against evolving pneumonia-induced acute lung injury, attenuating the increase in airway pressure, and the decrement in lung compliance and arterial Po2. However, hypercapnic acidosis did not reduce histologic injury. Hypercapnic acidosis also protected against evolving pneumonia-induced acute lung injury in the presence of neutrophil depletion, reducing both physiologic and histologic indices of lung injury. Conclusions:Hypercapnic acidosis reduces indices of intratracheal E. coli induced lung injury by a mechanism that seems to be neutrophil-independent.
Paediatric and Psychological Aspects of Cerebral Palsy associated with Hydrocephalus

Paediatric Aspects CEREBRAL palsy is the name given to chronic disorders of motor function caused by non-progressive disease of the brain in young children. When hydrocephalus becomes arrested, either spontaneously or artificially as a result of clever operations, a proportion of patients show such chronic motor handicaps. They may be referred to clinics caring for children with cerebral palsy. I t is difficult to assess the contribution made by hydrocephalus to the numbers of cases of cerebral palsy. Often children come to the cerebral palsy clinic only at the age of four or five years, especially if they are not severely disabled. Information about the growth of their heads in infancy is often meagre and, unless their head sizes are outside the average range at the time of examination, it is not possible to classify them as cases of arrested hydrocephalus with any confidence. Amongst the last 700 patients with cerebral palsy we have seen, 26 or 3.7 per cent had heads with occipitofrontal circumferences above the 97th percentile for age at the time of examination and could certainly be considered to be cases of arrested hydrocephalus. But this is certainly a gross underestimate of the real proportion of patients with cerebral palsy who are hydrocephalic, for many of them have head circumferences within the average range, perhaps the 70th or 80th percentile by the time we see them for the first time. Our impression is that the psychological and neurological findings in these patients with arrested hydrocephalus are rather characteristic and we shall be interested to know if our impressions are confirmed or refuted by others. We shall review the clinical findings in 16 patients and the psychological findings in 20, 15 of whom are included in the clinical study.
Text Messaging for Addiction: A Review

Abstract Individuals seeking treatment for addiction often experience barriers due to cost, lack of local treatment resources, or either school or work schedule conflicts. Text-messaging-based addiction treatment is inexpensive and has the potential to be widely accessible in real time. We conducted a comprehensive literature review identifying 11 published, randomized controlled trials (RCTs) evaluating text-messaging-based interventions for tobacco smoking, four studies for reducing alcohol consumption, one pilot study in former methamphetamine (MA) users, and one study based on qualitative interviews with cannabis users. Abstinence outcome results in RCTs of smokers willing to make a quit attempt have been positive overall in the short term and as far out as at six and 12 months. Studies aimed at reducing alcohol consumption have been promising. More data are needed to evaluate the feasibility, acceptability, and efficacy of this approach for other substance use problems.
The effect of red blood cell transfusion on cerebral oxygenation and metabolism after severe traumatic brain injury*

Objective:There is evidence to suggest that anemia after severe traumatic brain injury (sTBI) is detrimental. However, there is a paucity of evidence supporting the use of transfusion of packed red blood cells in patients with sTBI. To understand the acute effect of packed red blood cell transfusion on cerebral oxygenation and metabolism in patients with sTBI. Design:Prospective clinical study. Setting:Addenbrooke’s Neurosciences Critical Care Unit, a 21-bed tertiary academic unit. Patients:Thirty patients with sTBI. Interventions:Patients were randomized by computer random number generator to one of three transfusion thresholds: 8, 9, or 10 g/dL. When the patients’ hemoglobin concentration fell below their assigned threshold, two units of packed red blood cells were transfused over 2 hours. A 1-hour period of stabilization was observed before final data collection. Measurements and Main Results:The primary outcome was change in brain tissue oxygen (Pbto2). Secondary outcomes included dependence of baseline hemoglobin concentration and baseline Pbto2 on the relationship of transfusion and Pbto2, and the effect of transfusion on lactate pyruvate ratio (LPR) and brain pH as markers of cerebral metabolic state. Fifty-seven percent of patients experienced an increase in Pbto2 during the course of the study, whereas in 43% of patients, Pbto2 either did not change or decreased. Multivariable generalized estimating equation analysis revealed change in hemoglobin concentration to significantly and positively associated with change in Pbto2 [0.10 kPa/(g/dL) 95% confidence interval 0.03–0.17, p = 0.003]. Improvement in Pbto2 was not associated with baseline hemoglobin concentration or low Pbto2 (<1 kPa). Fifty-six percent of patients experienced an increase in LPR. No significant relationship between change in LPR or transfusion on pHbt and change in hemoglobin could be demonstrated. Conclusions:Transfusion of packed red blood cells acutely results in improved brain tissue oxygen without appreciable effect on cerebral metabolism. Trial Registration:ISRCTN89085577.
Correlates of Amount Spent on Marijuana Buds During a Discrete Purchase at Medical Marijuana Dispensaries: Results from a Pilot Study

ABSTRACT Marijuana purchasing behaviors vary by the purchaser’s individual characteristics; however, little is known about patients’ purchasing behaviors when buying from medical marijuana dispensaries (MMDs). Our objective was to explore whether patient characteristics were associated with amount spent during one financial transaction at medical marijuana dispensaries. We conducted a pilot study of four purposively sampled MMD locations in Long Beach, California, in 2012. A total of 132 medical marijuana patients (33 patients per dispensary) participated in an exit survey about their demographic characteristics, conditions for their medical marijuana recommendation, amount spent at the dispensary, and cross-streets of where they lived. The sample reported amounts spent on discrete purchases of marijuana buds averaging $40.82 (ranging from $10 to $255). Multivariate regression analyses indicated average amount spent differed significantly by patient age and condition. An increase in 10 years of age was associated with a 10% higher amount spent. Receiving a recommendation for anxiety and/or sleeping problems or other nonspecified conditions was related to higher discrete purchase amounts than chronic pain. This pilot suggests that variations in patient purchasing behaviors from MMDs exist. These purchase behaviors can provide insight into variations in how patients use dispensaries, consume products, and allocate personal resources.
Effects of aging on the immunopathologic response to sepsis

Objective:Aging is associated with increased inflammation following sepsis. The purpose of this study was to determine whether this represents a fundamental age-based difference in the host response or is secondary to the increased mortality seen in aged hosts. Design:Prospective, randomized controlled study. Setting:Animal laboratory in a university medical center. Subjects:Young (6–12 weeks) and aged (20–24 months) FVB/N mice. Interventions:Mice were subjected to 2 × 25 or 1 × 30 cecal ligation and puncture (CLP). Measurements and Main Results:Survival was similar in young mice subjected to 2 × 25 CLP and aged mice subjected to 1 × 30 CLP (p = 0.15). Young mice subjected to 1 × 30 CLP had improved survival compared with the other groups (p < 0.05). When injury was held constant but mortality was greater, both systemic and peritoneal levels of tumor necrosis factor-α, interleukin (IL)-6, IL-10, and monocyte chemotactic protein-1 were elevated 24 hours after CLP in aged animals compared with young animals (p < 0.05). When mortality was similar but injury severity was different, there were no significant differences in systemic cytokines between aged mice and young mice. In contrast, peritoneal levels of tumor necrosis factor-α, IL-6, and IL-10 were higher in aged mice subjected to 1 × 30 CLP than young mice subjected to 2 × 25 CLP despite their similar mortalities (p < 0.05). There were no significant differences in either bacteremia or peritoneal cultures when animals of different ages sustained similar injuries or had different injuries with similar mortalities. Conclusions:Aged mice are more likely to die of sepsis than young mice when subjected to an equivalent insult, and this is associated with increases in both systemic and local inflammation. There is an exaggerated local but not systemic inflammatory response in aged mice compared with young mice when mortality is similar. This suggests that systemic processes that culminate in death may be age independent, but the local inflammatory response may be greater with aging.
Ligament‐induced sacral fractures of the pelvis are possible

Pelvic ring stability is maintained passively by both the osseous and the ligamentous apparatus. Therapeutic approaches focus mainly on fracture patterns, so ligaments are often neglected. When they rupture along with the bone after pelvic ring fractures, disrupting stability, ligaments need to be considered during reconstruction and rehabilitation. Our aim was to determine the influence of ligaments on open‐book injury using two experimental models with body donors. Mechanisms of bone avulsion related to open‐book injury were investigated. Open‐book injuries were induced in human pelves and subsequently investigated by anatomical dissection and endoscopy. The findings were compared to CT and MRI scans of open‐book injuries. Relevant structures were further analyzed using plastinated cross‐sections of the posterior pelvic ring. A fragment of the distal sacrum was observed, related to open‐book injury. Two ligaments were found to be responsible for this avulsion phenomenon: the caudal portion of the anterior sacroiliac ligament and another ligament running along the ventral surface of the third sacral vertebra. The sacral fragment remained attached to the coxal bone by this second ligament after open‐book injury. These results were validated using plastination and the structures were identified. Pelvic ligaments are probably involved in sacral avulsion caused by lateral traction. Therefore, ligaments should to be taken into account in diagnosis of open‐book injury and subsequent therapy. Clin. Anat. 27:770–777, 2014. © 2013 Wiley Periodicals, Inc.
Delirium and sedation in the intensive care unit: Survey of behaviors and attitudes of 1384 healthcare professionals*

Objective:A 2001 survey found that most healthcare professionals considered intensive care unit (ICU) delirium as a serious problem, but only 16% used a validated delirium screening tool. Our objective was to assess beliefs and practices regarding ICU delirium and sedation management. Design and Setting:Between October 2006 and May 2007, a survey was distributed to ICU practitioners in 41 North American hospitals, seven international critical care meetings and courses, and the American Thoracic Society e-mail database. Study Participants:A convenience sample of 1384 healthcare professionals including 970 physicians, 322 nurses, 23 respiratory care practitioners, 26 pharmacists, 18 nurse practitioners and physicians’ assistants, and 25 others. Results:A majority [59% (766 of 1300)] estimated that more than one in four adult mechanically ventilated patients experience delirium. More than half [59% (774 of 1302)] screen for delirium, with 33% of those respondents (258 of 774) using a specific screening tool. A majority of respondents use a sedation protocol, but 29% (396 of 1355) still do not. A majority (76%, 990 of 1309) has a written policy on spontaneous awakening trials (SATs), but the minority of respondents (44%, 446 of 1019) practice spontaneous awakening trials on more than half of ICU days. Conclusions:Delirium is considered a serious problem by a majority of healthcare professionals, and the percent of practitioners using a specific screening tool has increased since the last published survey data. Although most respondents have adopted specific sedation protocols and have an approved approach to stopping sedation daily, few report even modest compliance with daily cessation of sedation.
Coarctation of the Aorta: Experience at the University College Hospital, Ibadan

Between May 1977 and June 1998, 697 patients with congenital heart diseases were admitted to the cardiothoracic surgical unit (CTSU) at the University College Hospital, Ibadan. Eighteen (2.6 per cent) of the patients with 19 coarctations of the aorta (CoA) were retrospectively studied. The age range of all the patients with CoA was 18 days to 30 years (mean 7.2±8.2 years), but for the 15 patients who underwent surgery, it was one month to 30 years (mean 8.6±8.3 years). Three patients died preoperatively of congenital cardiac anomalies associated with infantile CoA. There were 16 thoracic and two abdominal CoA, while one patient had recurrent CoA. Resection and end-to-end anastomosis was performed in four patients, dacron tube interposition graft in three, and dacron patch graft in four patients. Other procedures were employed in five patients. Operative mortality was 25 per cent. Operative deaths occurred in two infants with isolated CoA, a neonate who had associated pulmonary hypertension and a 17-year old who had surgery for re-coarctation. Complications of surgery included post-operative haemorrhage in two patients, intra-operative hemorrhage in one and hoarseness of the voice in four patients. Paradoxical hypertension occurred in three patients, graft occlusion and wound dehiscence occurred together in one patient and two patients had chylothorax. It is concluded that CoA is a surgically correctable congenital anomaly which is probably less frequently diagnosed locally. Nigerian Journal of Paediatrics 2002;29:27-33.
First Responder Culture: Implications for Mental Health Professionals Providing Services Following a Natural Disaster

FULL DISCLOSURE POLICY In accordance with the Accreditation Council for Continuing Medical Education’s Standards for Commercial Support, all CME providers are required to disclose to the activity audience the relevant financial relationships of the planners, teachers, and authors involved in the development of CME content. An individual has a relevant financial relationship if he or she has a financial relationship in any amount occurring in the last 12 months with a commercial interest whose products or services are discussed in the CME activity content over which the individual has control. Relationship information appears at the beginning of each CME-accredited article in this issue.
Data quality and confirmatory factor analysis of the Danish EUROPEP questionnaire on patient evaluation of general practice

Objective. The Danish version of the 23-item EUROPEP questionnaire measuring patient evaluation of general practice has not been evaluated with regard to psychometric properties. This study aimed to assess data quality and internal consistency and to validate the proposed factorial structure. Setting. General practice in Denmark. Subjects. A total of 703 general practitioners (GPs). Some 83 480 questionnaires were distributed to consecutive patients aged 18 or more attending practice during the daytime. A total of 56 594 eligible patients responded (67.8%). Main outcome measures. Data quality (mean, median, item response, missing, floor and ceiling effects), internal consistency (Cronbach's alpha and average inter-item correlation), item-rest correlations. Model fit from confirmatory factor analysis (CFA). Results. The distribution was skewed to the left for almost all items with a small floor effect (0.1–9.3%) and a ceiling effect larger than 15% (18.6–56.3%). Item response was high. For seven items “not applicable/relevant” represented more than 10% of the answers. Internal consistency was good. Item-rest correlations were below 0.60 for three items, and four items had lower correlations with their own domain than with other domains. CFA showed that four domains were highly correlated and that model fit was good for two indices (TLI and SRMR), acceptable for one index (CFI), and poor for three indices (chi-squared, RMSEA and WRMR). Conclusions. This study revealed high ceiling effects, a few items with low item-rest correlation and low item discriminant validity, and an uncertain model fit. There seems to be a need for developing response categories to bring down the ceiling effect and it is also unclear how to use the proposed domains. Future research should focus on evaluating the factorial structure when ceiling effect has been lowered, on whether items should be deleted, and on assessing the unidimensionality of each domain.