Miracle-dz/UniFAR-FTUs huggingface dataset:
[Effect of continuous aspiration of subglottic secretions on the prevention of ventilator-associated pneumonia in mechanically ventilated patients: a prospective, randomized, controlled clinical trial].

OBJECTIVE To evaluate the effect of continuous aspiration of subglottic secretions (CASS) on the prevention of ventilator-associated pneumonia (VAP) in mechanically ventilated patients. METHODS Patients ventilated mechanically at the ICU from October, 2004 to April, 2006 were randomly divided into 2 groups: one group received CASS and the other did not (NASS group). CASS was performed immediately after admission for patients in the CASS group. The diagnosis of VAP was made based on clinical presentations, and the evaluation of VAP was done using simplified version of the clinical pulmonary infection score (CPIS). The general status of the patients, days of ventilated treatment, the volume of daily aspirated subglottic secretions, the morbidity and timing of VAP, days of stay in ICU and mortality within 28 days of hospitalization were recorded. RESULTS One hundred and one patients were included in the study. There were 48 patients in the CASS group who were treated with mechanical ventilation more than 48 hours, and 43 patients in the NASS group. There was no significant difference in the general status of the patients and days of ventilation between 2 groups with the averaged score of APACHE II being 20.8 +/- 6.1. The average of CPIS was of 5.6 +/- 1.0 when VAP was diagnosed. The mean volume of aspirated subglottic secretions within the first 24 hours in the CASS group (n = 48) was (27.2 +/- 21.2) ml. The morbidity of VAP in the CASS and the NASS groups was 25.0% and 46.5% respectively (P = 0.032), and the length of time before the onset of VAP in these 2 groups was (7.3 +/- 4.2) days and (5.1 +/- 3.0) days respectively (P = 0.100). There was a significant increase in the percentage of gram-positive cocci from the lower respiratory tracts in the NASS group compared with that in the CASS group (P = 0.004). In the CASS group, the volume of the first daily aspirated subglottic secretions in patients with VAP was significantly less than that in patients without VAP (P = 0.006). The morbidity of VAP in patients with failed early aspiration (the volume of first daily aspirated secretions < or = 20 ml) was significantly higher than that in patients in whom the aspiration was effective (P < 0.01). The length of mechanical ventilation in patients with VAP was significantly longer than that in patients without VAP (P = 0.000). The in-hospital mortality in patients with VAP was significantly higher than that in patients without VAP (P = 0.009), and the mortality in 28 days after admission in patients with VAP was significantly higher than that in patients without VAP (P = 0.035). CONCLUSION Effective continuous aspiration of subglottic secretions could significantly reduce the morbidity of early-onset VAP.
Complex multiple cosmogenic nuclide concentration and histories in the arid Rio Lluta catchment, northern Chile

Terrestrial cosmogenic nuclide (TCN) concentrations measured in river sediments can be used to estimate catchment‐wide denudation rates. By investigating multiple TCN the steadiness of sediment generation, transport and depositional processes can be tested. Measurements of 10Be, 21Ne and 26Al from the hyper‐ to semi‐arid Rio Lluta catchment, northern Chile, yield average single denudation rates ranging from 12 to 75 m Myr–1 throughout the catchment. Paired nuclide analysis reveals complex exposure histories for most of the samples and thus the single nuclide estimates do not exclusively represent catchment‐wide denudation rates. The lower range of single nuclide denudation rates (12–17 m Myr–1), established with the noble gas 21Ne, is in accordance with palaeodenudation rates derived from 21Ne/10Be and 26Al/10Be ratio analysis. Since this denudation rate range is measured throughout the system, it is suggested that a headwater signal is transported downstream but modulated by a complex admixture of sediment that has been stored and buried at proximal hillslope or terrace deposits, which are released during high discharge events. That is best evidenced by the stable nuclide 21Ne, which preserves the nuclide concentration even during storage intervals.
Transcriptome sequencing analysis of alfalfa reveals CBF genes potentially playing important roles in response to freezing stress

Abstract Alfalfa (Medicago sativa L.) is an important perennial forage, with high nutritional value, which is widely grown in the world. Because of low freezing tolerance, its distribution and production are threatened and limited by winter weather. To understand the complex regulation mechanisms of freezing tolerance in alfalfa, we performed transcriptome sequencing analysis under cold (4 °C) and freezing (-8 °C) stresses. More than 66 million reads were generated, and we identified 5767 transcripts differentially expressed in response to cold and/or freezing stresses. These results showed that these genes were mainly classified as response to stress, transcription regulation, hormone signaling pathway, antioxidant, nodule morphogenesis, etc., implying their important roles in response to cold and freezing stresses. Furthermore, nine CBF transcripts differentially expressed were homologous to CBF genes of Mt-FTQTL6 site, conferring freezing tolerance in M. truncatula, which indicated that a genetic mechanism controlling freezing tolerance was conservative between M. truncatula and M. sativa. In summary, this transcriptome dataset highlighted the gene regulation response to cold and/or freezing stresses in alfalfa, which provides a valuable resource for future identification and functional analysis of candidate genes in determining freezing tolerance.
Dolocretes and Associated Palygorskite Occurrences in Siliciclastic Red Mudstones of the Sariyer Formation (Middle Miocene), Southeastern Side of the Çanakkale Strait, Turkey

The origins of dolocrete and associated palygorskite in the Çanakkale region of Turkey have been little studied, but are of fundamental importance for a more complete understanding of the mineralogy of this region. The present study was undertaken in order to narrow this gap. Siliciclastic red mudstones within alluvial-fan deposits of the Middle Miocene Sariyer Formation locally contain dolocretes in various forms (powdery, nodular, and fracture-filling) and scarce matte-brown, authigenic clay lenses. The mineralogical characteristics of dolocrete and authigenic clay lenses were examined using polarized-light microscopy, X-ray diffraction, differential thermal analysis and thermal gravimetry, scanning-electron microscopy, and infrared spectroscopy, as well as by chemical and isotopic methods. These analyses indicate that the dolocretes are indeed predominantly dolomite, coexisting with variable amounts of palygorskite. The authigenic clay lenses are composed mainly of palygorskite. Dolomite appears as euhedral crystals, whereas palygorskite developed authigenically as interwoven fibers on and between resorbed dolomite crystals, rimming euhedral crystals, and as fiber bundles (where dolomite ± magnesite is absent). The stable-isotope values and some petrographic features, such as alveolar texture and dolomite needles, support a pedogenic origin for the dolocretes. In the initial stage, dolomite formed by replacement of siliciclastic red mudstones and/or by precipitation from percolating soil-derived water in a near-surface setting. Subsequently, palygorskite either precipitated on the dolomite crystals from relatively more evaporative water, replaced the host-rock mudstone in the presence of Al + Fe, or formed directly from solution where the Ca/Mg ratio decreased and the Al + Fe increased. In view of the large Cr and Ni contents of the bulk-rock samples, the elements required for the crystallization of dolomite and palygorskite (namely Mg, Ca, Si, Al, and Fe) may have been supplied by weathering of ophiolitic rocks that crop out in the area.
Source parameter scaling and radiation efficiency of microearthquakes along the Irpinia fault zone in southern Apennines, Italy

We analyzed the P and S wave displacement spectra of 717 microearthquakes in the moment range 4 × 109 − 2 × 1014 N m recorded at the dense networks operating in southern Apennines (Italy) and deployed along the 1980 Ms 6.9 Irpinia earthquake fault zone. Source, attenuation, and site parameters are estimated by using a parametric modeling approach, which is combined with a multistep, nonlinear inversion strategy. We found that in the analyzed frequency band, an attenuation model with constant Q has to be preferred to frequency‐dependent Q models. Consistent estimates of the median P and S quality factors Q˜P=167 (90; 296) and Q˜S=226 (114; 417) are obtained from two different techniques and relatively high values of QS/QP (median value 1.3, (0.8; 2.1)) are found in the same depth range where high VP/VS and a peak in seismicity distribution are observed. This is the evidence for a highly fractured, partially, or completely fluid‐saturated medium embedding the Irpinia fault zone, down to crustal depths of 15–20 km. A nearly constant stress drop ( Δσ˜=1.4MPa , (0.4; 5.0)) and apparent stress ( τa˜=0.1MPa , (0.03, 0.4)) scaling of P and S corner frequencies and seismic energies is observed above a seismic moment value of about 1011 N m. The measured radiation efficiency is low ( ηSW˜=0.06,0.030.13 ), e.g., the radiated energy is only a small fraction of the whole energy spent by friction and fracture development. A large positive dynamic overshoot (high dynamic shear strength) can be the dominant mechanism controlling the microearthquake fractures along the Irpinia fault zone.
Evaluation of prediction intervals for expressing uncertainties in groundwater flow model predictions

We tested the accuracy of 95% individual prediction intervals for hydraulic heads, streamflow gains, and effective transmissivities computed by groundwater models of two Danish aquifers. To compute the intervals, we assumed that each predicted value can be written as the sum of a computed dependent variable and a random error. Testing was accomplished by using a cross‐validation method and by using new field measurements of hydraulic heads and transmissivities that were not used to develop or calibrate the models. The tested null hypotheses are that the coverage probability of the prediction intervals is not significantly smaller than the assumed probability (95%) and that each tail probability is not significantly different from the assumed probability (2.5%). In all cases tested, these hypotheses were accepted at the 5% level of significance. We therefore conclude that for the groundwater models of two real aquifers the individual prediction intervals appear to be accurate.
The Life-Cycle Costs of School Water, Sanitation and Hygiene Access in Kenyan Primary Schools

Water, Sanitation and Hygiene (WASH) programs in schools can increase the health, dignity and comfort of students and teachers. Understanding the costs of WASH facilities and services in schools is one essential piece for policy makers to utilize when budgeting for schools and helping to make WASH programs more sustainable. In this study we collected data from NGO and government offices, local hardware shops and 89 rural primary schools across three Kenyan counties. Current expenditures on WASH, from school and external (NGO, government, parent) sources, averaged 1.83 USD per student per year. After reviewing current expenditures, estimated costs of operations and maintenance for bringing schools up to basic WASH standards, were calculated to be 3.03 USD per student per year. This includes recurrent costs, but not the cost of installing or setting up WASH infrastructure, which was 18,916 USD per school, for a school of 400 students (4.92 USD per student, per year). These findings demonstrate the need for increases in allocations to schools in Kenya, and stricter guidance on how money should be spent on WASH inputs to enable all schools to provide basic WASH for all students.
Physical Activity Characteristics across GOLD Quadrants Depend on the Questionnaire Used

Background The GOLD multidimensional classification of COPD severity combines the exacerbation risk with the symptom experience, for which 3 different questionnaires are permitted. This study investigated differences in physical activity (PA) in the different GOLD quadrants and patient’s distribution in relation to the questionnaire used. Methods 136 COPD patients (58±21% FEV1 predicted, 34F/102M) completed COPD assessment test (CAT), clinical COPD questionnaire (CCQ) and modified Medical Research Council (mMRC) questionnaire. Exacerbation history, spirometry and 6MWD were collected. PA was objectively measured for 2 periods of 1 week, 6 months apart, in 5 European centres; to minimise seasonal and clinical variation the average of these two periods was used for analysis. Results GOLD quadrants C+D had reduced PA compared with A+B (3824 [2976] vs. 5508 [4671] steps.d-1, p<0.0001). The choice of questionnaire yielded different patient distributions (agreement mMRC-CAT κ = 0.57; CCQ-mMRC κ = 0.71; CCQ-CAT κ = 0.72) with different clinical characteristics. PA was notably lower in patients with an mMRC score ≥2 (3430 [2537] vs. 5443 [3776] steps.d-1, p <0.001) in both the low and high risk quadrants. Conclusions Using different questionnaires changes the patient distribution and results in different clinical characteristics. Therefore, standardization of the questionnaire used for classification is critical to allow comparison of different studies using this as an entry criterion. Clinical Trial Registration ClinicalTrials.gov NCT01388218
Team climate and job satisfaction in a Mobile Emergency Care Service

ABSTRACT Objective: to identify the team climate and job satisfaction in a Mobile Emergency Care Service (SAMU). Method: this is a quantitative, exploratory-descriptive study. The sample corresponded to 95 workers, allocated in 40 teams of a SAMU in the Metropolitan Region of the city of São Paulo. We applied three instruments: sociodemographic/labor characterization; Team Climate Inventory; and Job Satisfaction Scale-S20/23, validated for Brazil. Descriptive statistics were used for data analysis. Results: the total score of team climate was high both among workers (194.5 points; SD = 21) and among teams (197.7 points; SD = 18.4). Satisfaction had a mean total score of 4.5 (SD = 0.4), for workers, and 4.6 points (SD = 0.6), for teams. As for the climate, “Team participation” and “Support for new ideas” obtained agreement percentages >70% in all propositions. Regarding job satisfaction, there was a percentage of concordance >80% in the three dimensions. Conclusion: the findings show a positive perception of workers about team climate and job satisfaction, supporting SAMU management in promoting a favorable environment for professional practice.
Risk work or resilience work? A qualitative study with community health workers negotiating the tensions between biomedical and community-based forms of health promotion in the United Kingdom

Emplaced health promotion interventions, delivered by community health workers are increasingly being used internationally. However, the application of epidemiological risk knowledge to individuals within such communities is not straightforward and creates tensions for community health workers who are part of the communities that they are serving. Situated qualitative interview data were co-produced with community health workers employed in a superdiverse, deprived, post-industrial region of the United Kingdom, using photo-voice methods, to develop an account of how they made sense of the challenges of their work. The analysis draws on and develops theories of risk work and resilience work, which draw on practice theory. The key findings were that, first, being a critical insider enabled community health workers to make sense of the diverse constraints on health and lifestyles within their community. Second, they understood their own public health role as limited by operating within this context, so they articulated their occupational identity as focused on supporting clients to make small but sustainable changes to their own and their families’ lifestyles. Third, the uncertainties of translating population based risk information to individual clients were (at least partially) resolved at an embodied level, with the community health workers identifying as accessible and trusted role models for the value of changed lifestyles. The article is important for policy and practice as it provides a critique of a rapidly evolving new mode of delivery of public health services, and insights on the development of this new public health workforce.
Processes Controlling Water Vapor in the Winter Arctic Tropopause Region

[1] This work describes transport and thermodynamic processes that control water vapor near the tropopause during the SAGE III—Ozone Loss and Validation Experiment (SOLVE), held during the Arctic 1999/2000 winter season. Aircraft-based water vapor, carbon monoxide, and ozone measurements are analyzed so as to establish how deeply tropospheric air mixes into the Arctic lowermost stratosphere and what the implications are for cloud formation and water vapor removal in this region of the atmosphere. There are three major findings. First, troposphere-to-stratosphere exchange extends into the Arctic stratosphere to about 13 km. Penetration is to similar levels throughout the winter; however, because ozone increases with altitude most rapidly in the early spring, tropospheric air mixes with the highest values of ozone in that season. The effect of this upward mixing is to elevate water vapor mixing ratios significantly above their prevailing stratospheric values of about 5 ppmv. Second, the potential for cloud formation in the stratosphere is highest during early spring, with about 20% of the parcels which have ozone values of 300–350 ppbv experiencing ice saturation in a given 10 day period. Third, during early spring, temperatures at the tropopause are cold enough so that 5–10% of parcels experience relative humidities above 100%, even if the water content is as low as 5 ppmv. The implication is that during this period, dynamical processes near the Arctic tropopause can dehydrate air and keep the Arctic tropopause region very dry during early spring.
Changes in total soil organic carbon stocks and carbon fractions in sugarcane systems as affected by tillage and trash management in Queensland, Australia

The use of sugarcane trash (tops and residue) retention systems has been reported to lead to increases in total soil organic carbon (TOC) stocks. However, these increases have generally been small and confined to the top 0.05 m of the soil profile. It has been hypothesised that the amount of TOC sequestered could be increased if the intensive tillage that occurs at the end of a sugarcane ratoon cycle, which is known to decrease TOC, could be eliminated. This research examined the effect of no-till management and/or trash retention on four trial sites throughout Queensland, to assess the ability of this management to increase TOC stocks. Management effects on particulate organic carbon (POC), humus organic carbon (HOC), and resistant organic carbon (ROC) stocks were also assessed using mid-infrared spectroscopy. No significant changes in TOC, POC, HOC, or ROC were observed over either 0–0.1 or 0–0.3 m depth at any of the sites examined, when sites were considered as a whole. The results indicate that these management practices currently have limited capacity to increase TOC stocks on these soil types over 0–0.1 or 0–0.3 m depth for the purposes of carbon sequestration.
First direct evidence of ammonoid ovoviviparity

Ammonoids had high evolutionary rates and diversity throughout their entire history and played an important role in the high-resolution sub-division of the Mesozoic, but much of their palaeobiology remains unclear, including the brooding habitat. We present our study of the first recorded ammonite embryonic shell clusters preserved with calcified embryonic aptychi in situ within the body chambers of mature macroconch shells of the Early Aptian (Early Cretaceous) ammonite Sinzovia sazonovae. The following support the idea that the clusters are egg masses, which developed inside ammonite body chambers: the absence of post-embryonic shells and any other fossils in these clusters, the presence of the aptychi in all embryonic shell apertures and peculiarities of adult shells preservation. These facts confirm earlier speculations that at least some ammonoids could have been ovoviviparous and that, like many modern cephalopods, they could have reproduced in mass spawning events. The aptychi of ammonite embryonic shells are observed here for the first time, indicating that they were already formed and calcified before hatching. Our results are fully congruent with the peculiar modes of ammonoid evolution: quick recovery after extinctions, distinct evolutionary rates, pronounced sexual dimorphism and the nearly constant size of embryonic shells through ammonoid history. We assume that adaptation to ovoviviparity may be the reason for the presence of these features in all post-Middle Devonian ammonoids.
Subjective well-being and mortality in Chinese oldest old

The present study investigates the relationship between subjective well-being (SWB) and mortality risk, using a large sample (N=7852) from the Chinese Longitudinal Healthy Longevity Study (age range 80-105) conducted in 2000 and 2002. Initially, we intended to contribute to the understanding of system relations between SWB, mortality risk, and unobserved heterogeneity by treating SWB as an endogenous variable, using a multi-process model. However, failure to identify unobserved heterogeneity in the mortality equation prevents us from employing this model. Given this limitation, the study examines three issues. First, we argue that the mortality model with duration dependency on the age of the study subjects is specified and that the model with duration dependency on time since the interview is misspecified. Second, we address problems associated with the identification of unobserved heterogeneity in the mortality equation. Third, we examine the association between SWB and mortality risk in the Chinese oldest old as well as the risk pattern by gender, without considering unobserved heterogeneity. We find that SWB is not a significant predictor of mortality risk when we control for socio-demographic characteristics and health status. Health plays a very important role in the relationship between SWB and mortality risk in the oldest old. Gender differences in the predictive pattern of SWB on this risk are negligible in the sample.
Aeolian Geomorphology: An Introduction

Provides a concise, up-to-date and highly readable introduction to the subject. It covers deserts and coastlines, as well as periglacial and planetary landforms. The text spans the full range of aeolian features to include soil erosion and its consequences, continental scale dust storms, sand dunes and loess. It discusses the importance of aeolian processes in the past, and the application of knowledge about aeolian geomorphology in environmental management