Miracle-dz/UniFAR-FTUs huggingface dataset:
Timing of Tracheostomy Placement among Children with Severe Traumatic Brain Injury: A Propensity-Matched Analysis.

BACKGROUND Early tracheostomy has been associated with shorter hospital stay and fewer complications in adult trauma patients. Guidelines for tracheostomy have not been established for children with severe TBI. The purpose of this study was to 1) define nationwide trends in time to extubation and time to tracheostomy; and 2) determine if early tracheostomy is associated with decreased length of stay and fewer complications in children with severe TBI. METHODS Records of children (<15 years) with severe TBI (head abbreviated injury severity, AIS ≥3) who were mechanically ventilated (>48h) were obtained from the National Trauma Data Bank (2007-2015). Outcomes after early (≤14 days) and late (≥15 days) tracheostomy placement were compared using 1:1 propensity score matching to control for potential confounding by indication. Propensity scores were calculated based on age, race, pulse, blood pressure, GCS-motor score, injury mechanism, associated injury AIS scores, TBI subtype, craniotomy, and ICP monitor placement. RESULTS Among 6,101 children with severe TBI, 5,740 (94%) were extubated or died without tracheostomy, 95% of the time within 18 days. Tracheostomy was performed in 361 children (6%) at a median [IQR] of 15 [10,22] days. Using propensity score matching, we compared 121 matched pairs with early or late tracheostomy. Early tracheostomy was associated with fewer ventilator days (14 [9,19] versus 25 [19,35]), ICU days (19 [14,25] versus 31 [24,43]), and hospital days (26 [19,41] versus 39 [31,54], all p<0.05). Pneumonia (24% versus 41%), venous thromboembolism (3% versus 13%) and decubitus ulcer (4% versus 13%) occurred less frequently with early tracheostomy (p<0.05). CONCLUSIONS Early tracheostomy is associated with shorter hospital stay and fewer complications among children with severe TBI. Extubation without tracheostomy is rare beyond 18 days after injury. LEVEL OF EVIDENCE III; Retrospective comparative study STUDY TYPE: Prognostic and Epidemiological.
Prostaglandin F2-Alpha Eye Drops (Bimatoprost) in Graves' Orbitopathy: A Randomized Controlled Double-Masked Crossover Trial (BIMA Trial).

BACKGROUND Previous in vitro experiments have demonstrated that prostaglandin F2-alpha (PF2α) reduced proliferation and adipogenesis in a murine cell line and human orbital fibroblasts derived from subjects with inactive Graves' orbitopathy (GO). The objective of this study was to determine if the PGF2α analogue bimatoprost is effective at reducing proptosis in this population. METHODS A randomized controlled double-masked crossover trial was conducted in a single tertiary care academic medical center. Patients with long-standing, inactive GO but persistent proptosis (>20 mm in at least one eye) were recruited. Allowing for a 15% dropout rate, 31 patients (26 females) were randomized in order to identify a treatment effect of 2.0 mm (p = 0.05; power 0.88). Following informed consent, participants were randomized to receive bimatoprost or placebo for three months, after which they underwent a two-month washout before switching to the opposite treatment. The primary outcome was the change in exophthalmometry readings over the two three-month treatment periods. RESULTS The mean exophthalmometer at baseline was 23.6 mm (range 20.0-30.5 mm), and the mean age of the patients was 55 years (range 28-74 years). The median duration of GO was 7.6 years (interquartile range 3.6-12.3 years). The majority were still suffering from diplopia (61.3%) with bilateral involvement (61.3%). Using multi-level modeling adjusted for baseline, period, and carry-over, bimatoprost resulted in a -0.17 mm (reduction) exophthalmometry change ([confidence interval -0.67 to +0.32]; p = 0.490). There was a mean change in intraocular pressure of -2.7 mmHg ([confidence interval -4.0 to -1.4]; p = 0.0070). One patient showed periorbital fat atrophy on treatment, which resolved on stopping treatment. Independent analysis of proptosis by photographic images (all subjects) and subgroup analysis on monocular disease (n = 12) did not show any apparent benefit. CONCLUSIONS In inactive GO, bimatoprost treatment over a three-month period does not result in an improvement in proptosis.
A Qualitative Analysis of Outpatient Medication Use in Community Settings: Observed Safety Vulnerabilities and Recommendations for Improved Patient Safety.

OBJECTIVE The aim of the study was to analyze diverse patients' experiences throughout the medication use process to inform the development of overarching interventions that support safe medication use in community settings. METHODS Using a qualitative observational approach, we conducted approximately 18 hours of direct observation of the medication use process across multiple settings for a sample of vulnerable, high-risk patients. Observers recorded detailed field notes during the observations. To enrich the observational findings, we also conducted six semistructured interviews with medication safety experts representing a diversity of perspectives. Barriers and facilitators to safe medication use were identified based on inductive coding of the data. RESULTS A variety of safety vulnerabilities plague all stages of the medication use process and many of the well-established evidence-based interventions aimed at improving the safety of medication use at key stages of the process have not been widely implemented in community settings observed in this study. Key safety vulnerabilities identified include: limited English proficiency, low health literacy, lack of clinician continuity, incomplete medication reconciliation and counseling, unsafe medication storage and disposal habits, and conflicting healthcare agendas with caregivers. CONCLUSIONS Our findings underscore a need for overarching, comprehensive interventions that span the entire process of medication use, including integrated communication systems between clinicians, pharmacies, and patients, and a "patient navigator" program that assists patients in navigating the entire medication-taking process. Collective ownership of the medication management system and mutual motivation for devising collaborative solutions is needed among key sectors.
Mediator and moderator effects on the relationship between HIV-positive status disclosure concerns and health-related quality of life

ABSTRACT HIV-related stigma and the effect on quality of life is an on-going public health concern despite decades of education, prevention, and intervention efforts. The main purposes of this study were to examine the mediating role of four coping styles and the moderating role of gender on the relationship between HIV-positive status disclosure concerns and eight health-related quality of life outcomes. Data were collected from 346 women and men living with HIV. Results indicated that two coping styles – acquiring social support and positive reframing – mediated the negative relationship between disclosure concerns and health-related quality of life outcomes. There was no support for a moderated mediation. Interventions aimed at helping people living with HIV should focus on identifying and acquiring coping styles that transform perceptions of HIV-related stigma to support disclosure and improve health-related quality of life.
DETERMINATION OF THE HOST RANGE OF TREE AND HERB RHIZOBIA FOR THEIR ALTERNATIVE LEGUMES

A series of experiments were conducted in the green house and in growth chamber to test the rhizobia of Leucaena leucocephala (Lam) de Wit, Sesbania sesban (L) Merr. Tephrosia purpurea (L) Pers. and Crotalaria medicaginea (Lam) to determine their host range in other tree and herb legumes as alternative host. Other tree legumes under this study included Albezzia lebbeck (L.) Benth. , Prosopis juliflora (Sw.) DC, Acacia nilotica (L.) Willd, Acacia senegal (L.) Willd, Acacia leucophloea and herb legumes included Vigna radiata (L.) R. Wilczek, Vigna mungo (L.) Hepper, Dolichos lablab (L.) Sweet, Pisum sativum (L.) and Indigofera tinctoria (L.). Promiscuity of L. leucocephala was observed for both tree and herb rhizobia but S. sesban and T. purpuria were very specific in their rhizobial requirement and could be nodulated only by their own rhizobia. However, Acacia spp. were not found be nodulated by any of the studied isolates. I neffective nodules have been observed in D. lablab. The cross infection of agriculturally important legumes with isolates from wild legumes may prove a useful mean of increasing nitrogen contents within these plants. Key words: Host range, Rhizobia, Nodulation, Legumes Syed Farook Ali et al. Determination of the Host Range of Tree and Herb Rhizobia for their Alternative Legumes. J Phytol 2/7 (2010) 101-106.
A macroscopical investigation of the portal veins of the Van cat

In this study veins that constituted the portal vein were investigated in eight adult Van cats. The portal vein of the Van cat was composed of five peripheral branches which supplied the abdominal organs and two intrahepatic branches at the hepatic porta. The peripheral branches were cranial mesenteric, splenic, gastroduo- denal, right gastric and cystic veins. The cranial mesenteric vein was the largest vessel that joined to the portal vein, and was constituted by the caudal pancreaticoduodenal, ileal, ileocolic and jejunal veins. The splenic vein was formed by the left gastric, left gastroepiploic, pancreatic and short gastric veins. The gastroduodenal vein was formed by the cranial pancreaticoduodenal and right gastroepiploic veins. The right gastric vein separately joined to the portal vein. The caudal mesenteric vein joined to the portal vein either alone or by a common trunk receiving either the caudal pancreaticoduodenal vein or ileocolic vein. The caudal mesenteric vein also opened rarely into the splenic vein. Intrahepatic branches were the right branch which gave off the ramus caudatus and ramus dexter lateralis, and the left branch which gave off the ramus dexter medialis, ramus quadratus, ramus sinister lateralis and ramus sinister medialis.
Pharmaceutical care of chloroquine phosphate in elderly patients with coronavirus pneumonia (COVID‐19)

1Department of Pharmacy, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Assessment of Clinical Drugs Risk and Individual Application Key Laboratory, Chinese Academy of Medical Sciences, Beijing, China 2Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China 3Clinical Trial Center, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Assessment of Clinical Drugs Risk and Individual Application Key Laboratory, Chinese Academy of Medical Sciences, Beijing, China
Deceased Prevalence of Rheumatic Heart Disease Confirmed Among HIV Positive Youth.

BACKGROUND There is geographical overlap between areas endemic for rheumatic heart disease (RHD) and those endemic for human immunodeficiency virus (HIV). A recent pilot study demonstrated that children living with HIV might be at less risk for RHD development however, the sample size was too small to make definitive conclusions. Our objective was to determine the prevalence of RHD among HIV positive children in Uganda. METHODS We conducted a prospective, cross-sectional study of HIV+ children (aged 5-15) receiving care at the Baylor Uganda HIV clinic, Kampala, Uganda. A focused echocardiogram and chart review was performed. A sample size of 988 children was needed to provide 80% power to detect a difference in population prevalence between HIV+ children and the general population, 2.97% (95% CI 2.70-3.24%), based on previous reports. RESULTS Screening echocardiography of 993 HIV+ children found 15 individuals (1.5%, 95% CI 0.88% - 2.54%) with RHD. Of these 15, 2 were classified as definite RHD and 13 as borderline RHD. The majority of children had isolated mitral valve disease (93%). Children found to have RHD were older than without, 12 years vs 10 years; p=0.004. When separated based on geographic location, the prevalence of RHD among HIV-positive children from Kampala was 1.28% (95% CI 0.63% - 2.51%) compared to 2.1% (95% CI 0.89% - 4.89%) in those from outside Kampala. CONCLUSIONS Children living with HIV have a lower prevalence of RHD than the general pediatric population. Further studies are needed to explore this protective association.
Sparse Associative Memory

Abstract It is still unknown how associative biological memories operate. Hopfield networks are popular models of associative memory, but they suffer from spurious memories and low efficiency. Here, we present a new model of an associative memory that overcomes these deficiencies. We call this model sparse associative memory (SAM) because it is based on sparse projections from neural patterns to pattern-specific neurons. These sparse projections have been shown to be sufficient to uniquely encode a neural pattern. Based on this principle, we investigate theoretically and in simulation our SAM model, which turns out to have high memory efficiency and a vanishingly small probability of spurious memories. This model may serve as a basic building block of brain functions involving associative memory.
Seasonal Variation of Essential Oil Yield and Composition of Sage (Salvia officinalis L.) Grown in Castilla - La Mancha (Central Spain)

Links between phenology, yield and composition of the essential oil of common sage, Salvia officinalis L. , grown in Guadalajara (Central Spain) were determined in the different phases of the biological cycle during one year. Data showed an average yield about 1.0%. The analysis of the oil components was carried out by GC-FID and GC/MS. The main oil constituent was alpha thujone (40.1-46.5%). Other identified compounds are beta pinene (2.6-4.5%), cineole (3.5-8.7%), beta thujone (4.1-5.6%), camphor (4.1-8.0%), borneol (1.3-3.7%), alpha humulene (3.8-7.3%), viridiflorol (3.4-12.6%) and manool (0.1-4.5%). The highest yield of oil was obtained in the period of full flowering and the highest concentration of alpha thujone in the period of initial flowering.
Assessing Changes in Ecological Quality Status of Sediment in Tri An Reservoir (Southeast Vietnam) by using Indicator of Nematode Communities

Nematode communities in Tri An Reservoir (Dong Nai Province, Southeast Vietnam) were explored in the dry season (March) and pre-rainy season (July) of 2019 and analyzed to evaluate their usage as bioindicators for ecological quality status of sediment. Nematode communities consisted of 23 genera belonging to 19 families, 8 orders for the dry and 24 genera, 17 families, 8 orders for the pre-rainy season. Several genera dominated in Tri An Reservoir such as Daptonema, Rhabdolaimus, Udonchus, and Neotobrilus indicated for organic enrichment conditions. The percentage of cp3&4 and MI (Maturity Index) value in the dry season was higher than that in the pre-rainy season expressed the ecological quality status of sediment in the dry season were better than those in the pre-rainy season. Furthermore, the result revealed that MI and c-p% composition can be used to evaluate the ecological quality status of sediment efficiently.
The Influence of Vanadium Additions on Isothermally Formed Bainite Microstructures in Medium Carbon Steels Containing Retained Austenite

The influence of V additions on isothermally formed bainite in medium carbon steels containing retained austenite has been investigated using in-situ high energy X-ray diffraction (HEXRD) and ex-situ electron energy loss spectroscopy (EELS) and energy dispersive X-ray analysis (EDX) techniques in the transmission electron microscope (TEM). No significant impact of V in solid solution on the bainite transformation rate, final phase fractions or on the width of bainite laths was seen for transformations in the range 375–430 °C. No strong influence on the dislocation density could be detected, although quantitative analysis was impeded by ferrite tetragonality. A reduction in the carbon content of retained austenite Cγ that is not believed to be due to competition with VC or cementite precipitation was observed. No influence of V on the carbon supersaturation in bainitic ferrite Cb could be directly measured, although carbon mass balance calculations suggest Cb slightly increases. A beneficial refinement of blocky MA and a corresponding size effect induced enhancement in austenite stability were found at the lowest transformation temperature. Overall, V additions result in a slight increase in strength levels.
Testing the Effectiveness of Transfer Interventions Using Solomon Four-Group Designs

How to enhance the transfer of training remains an important question, and to some extent, post-training interventions can provide an answer. The purpose of this study was to validate inconclusive findings on the effectiveness of two post-training transfer interventions. This study used Solomon four-group design to filter out the effects of pretest sensitization and history, which are threats to the internal and external validity but have rarely been checked in previous transfer studies. Management study undergraduate students were randomly divided into two groups: pretested and unpretested groups. After a time management workshop, the students were randomly subdivided into three additional groups based on the following conditions: full relapse prevention (RP); proximal plus distal goal setting (GS); and the control group. Although results from both intervention groups were not significantly different from those of the control group, a significant difference was found between full RP and proximal plus distal GS in terms of self-reported time-management behavioral change. It is difficult to conclude whether post-training interventions enhance the transfer of training. Further ideas for improving research designs were explored, such as increasing the time intervals between training and interventions so that trainees have opportunities to attempt transfers before the interventions.
Spectral clustering of risk score trajectories stratifies sepsis patients by clinical outcome and interventions received

Sepsis is not a monolithic disease, but a loose collection of symptoms with diverse outcomes. Thus, stratification and subtyping of sepsis patients is of great importance. We examine the temporal evolution of patient state using our previously-published method for computing risk of transition from sepsis into septic shock. Risk trajectories diverge into four clusters following early prediction of septic shock, stratifying by outcome: the highest-risk and lowest-risk groups have a 76.5% and 10.4% prevalence of septic shock, and 43% and 18% mortality, respectively. These clusters differ also in treatments received and median time to shock onset. Analyses reveal the existence of a rapid (30–60 min) transition in risk at the time of threshold crossing. We hypothesize that this transition occurs as a result of the failure of compensatory biological systems to cope with infection, resulting in a bifurcation of low to high risk. Such a collapse, we believe, represents the true onset of septic shock. Thus, this rapid elevation in risk represents a potential new data-driven definition of septic shock.
Diverging hydrological drought traits over Europe with global warming

Abstract. Climate change is anticipated to alter the demand and supply of water at the earth's surface. Since many societal impacts from a lack of water happen under drought conditions, it is important to understand how droughts may develop with climate change. This study shows how hydrological droughts will change across Europe with increasing global warming levels (GWLs of 1.5, 2, and 3 K above pre-industrial temperature). We employed a low-flow analysis based on river discharge simulations of the LISFLOOD (De Roo et al., 2000) spatially distributed physically based hydrological and water use model, which was forced with a large ensemble of regional climate model projections under high emissions (RCP8.5) and moderate mitigation (RCP4.5) Representative Concentration Pathways. Different traits of drought, including severity, duration, and frequency, were investigated using the threshold level method. The projected changes in these traits identify four main sub-regions in Europe that are characterized by somehow homogeneous and distinct behaviours with a clear south-west–north-east contrast. The Mediterranean and Boreal sub-regions (defined in Sect. 3.1.1) of Europe show strong but opposite changes at all three GWLs, with the former area mostly characterized by stronger droughts (with larger differences at 3 K), while the latter is expected to experience a reduction in all drought traits. In the Atlantic and Continental sub-regions, the changes are expected to be less marked and characterized by a larger uncertainty, especially at the 1.5 and 2 K GWLs. Combining the projections in drought hazard with population and agricultural information shows that with 3 K global warming an additional 11 million people and 4.5 ×106 ha of agricultural land are projected to be exposed to droughts every year, on average, with the most affected areas located in the Mediterranean and Atlantic regions of Europe.
Sponge diversity and community composition in Irish bathyal coral reefs

Sponge diversity and community composition in bathyal cold water coral reefs (CWRs) were examined at 500-900 m depth on the southeastern slopes of Rockall Bank and the northwestern slope of Porcupine Bank, to the west of Ireland in 2004 and 2005 with boxcores. A total of 104 boxcore samples, supplemented with 10 trawl/dredge attempts, were analyzed for the presence and abundance of sponges, using microscopical examination of (sub)samples of collected coral branches, and semi-quantitative macroscopic examination. Approximate minimum size of identifi ed and counted sponge individuals was 1 mm. Literature data were added to the Porcupine Bank results to compensate for a less intensive sampling program in that location. Species richness and abundance were determined at local (sample diversity, pooled-sample diversity, local reef diversity), between-reef (diversity of two reef areas at 15 km distance), and regional scales (diversity of three reef areas over a distance of 200 km). Abiotic and biotic parameters including depth, the presence and cover of live coral, dead coral and sand, local reef, and orientation towards the nearest reef mound summit, were included in a constrained ordination technique (RDA); a Monte Carlo forward selection procedure was used to obtain signifi cant predictors of variation in composition. The results of this analysis were compared with unconstrained ordination (PCA) and cluster analysis. The presence of live coral, depth and the local reefs C1 and C3 proved to be signifi cant predictors of variation in sponge composition. The PCA and cluster analysis confi rmed these results. Sample species richness was consistently heterogeneous from zero species and individuals up to 57 species and 90 individuals per (boxcore) sample. Species richness of local reefs determined from pooled samples showed the three localities studied to have similar species richness, namely 105-122 species in each location. Species richness was highest in samples with relatively low live coral cover. As in the RDA, live coral presence and depth appeared to be responsible for most of the variation observed in the cluster results. Cluster analysis of Bray-Curtis dissimilarity values of the pooled samples of all three reef localities using presence / absence data of all available samples indicated that distance appeared to structure the composition of the sponge assemblages of the three reef mound areas, but much less so within and among local reefs. Bathyal reefs of the regions to the west of Ireland were found to have a combined sponge species richness of 191 species, exceeding the richness of individual reef mound areas by c. 38-45%. Sponge presence in CWRs is clearly structured and controlled by biotic and abiotic factors. In particular, live coral presence appears a signifi cant predictor of CWR sponge composition and diversity.