Miracle-dz/UniFAR-FTUs huggingface dataset:
Feeding critically ill patients: What is the optimal amount of energy?

Hypermetabolism and malnourishment are common in the intensive care unit. Malnutrition is associated with increased morbidity and mortality, and most intensive care unit patients receive specialized nutrition therapy to attenuate the effects of malnourishment. However, the optimal amount of energy to deliver is unknown, with some studies suggesting that full calorie feeding improves clinical outcomes but other studies concluding that caloric intake may not be important in determining outcome. In this narrative review, we discuss the studies of critically ill patients that examine the relationship between dose of nutrition and clinically important outcomes. Observational studies suggest that achieving targeted caloric intake might not be necessary since provision of approximately 25% to 66% of goal calories may be sufficient. Randomized controlled trials comparing early aggressive use of enteral nutrition compared with delayed, less aggressive use of enteral nutrition suggest that providing increased calories with early, aggressive enteral nutrition is associated with improved clinical outcomes. However, energy provision with parenteral nutrition, either instead of or supplemental to enteral nutrition, does not offer additional benefits. In summary, the optimal amount of calories to provide critically ill patients is unclear given the limitations of the existing data. However, evidence suggests that improving adequacy of enteral nutrition by moving intake closer to goal calories might be associated with a clinical benefit. There is no role for supplemental parenteral nutrition to increase caloric delivery in the early phase of critical illness. Further high-quality evidence from randomized trials investigating the optimal amount of energy intake in intensive care unit patients is needed.
A Coupled Thermal–Electromagnetic Analysis for a Rapid and Accurate Prediction of IM Performance

The design of electrical machines for extreme operating conditions must include a thermal analysis coupled with the magnetic analysis. However, the traditional coupling of the thermal and the magnetic models can result in an unacceptable increase in computation time, particularly if finite elements (FEs) are used for the machine analysis. This paper proposes a coupled thermal-magnetic analysis of an induction motor (IM) with the primary goal of achieving a rapid and accurate prediction of the IM performance. Only a minimum set of FE magnetic analyses is carried out so as to determine the parameters of the IM equivalent circuit. These parameters are nonlinear and are adjusted on the basis of the operating point. Then, this equivalent circuit is coupled with a lumped-parameter thermal network to predict the temperature in each part of the IM. Since both the equivalent circuit and thermal network solutions are analytic, the analysis converges very rapidly. At the same time, the FE analysis yields a precise estimation of the IM parameters used in the equivalent circuit. Some experimental results are reported, showing the accurate prediction of the proposed methodology.
Spontaneous trpY Mutants and Mutational Analysis of the TrpY Archaeal Transcription Regulator

ABSTRACT Over 90% of Methanothermobacter thermautotrophicus mutants isolated as spontaneously resistant to 5-methyl tryptophan had mutations in trpY. Most were single-base-pair substitutions that identified separate DNA- and tryptophan-binding regions in TrpY. In vivo and in vitro studies revealed that DNA binding was sufficient for TrpY repression of trpY transcription but that TrpY must bind DNA and tryptophan to assemble a complex that represses trpEGCFBAD.
A role for glycogen synthase kinase‐3 in antagonizing mycobacterial immune evasion by negatively regulating IL‐10 induction

Mtb dysregulates monocyte/macrophage functions to produce a large amount of the immunosuppressive cytokine IL‐10. An important function of IL‐10 in promoting Mtb survival is the suppression of antigen presentation of monocytes/macrophages to T cells. This dampens the host immune responses and provides an opportunity for immune evasion. GSK3 has been shown to control the balance between pro‐ and anti‐inflammatory cytokine productions. Here, we investigated whether GSK3 regulates IL‐10 expression and mediates a protective role upon live mycobacterial challenge using BCG as a model. Our results showed that BCG increased Akt phosphorylation and inhibited GSK3 activity, resulting in increased IL‐10 production. We confirmed further that suppression of GSK3 activities by a specific chemical inhibitor strongly enhanced BCG‐induced IL‐10 production. We also showed that IL‐10 secreted by BCG‐infected human PBMo was a major suppressor of subsequent IFN‐γ production by PBMC and HLA‐DR expression on PBMo in response to BCG. Neutralization of PBMo‐secreted IL‐10 by anti‐IL‐10 antibodies restored the IFN‐γ production and HLA‐DR surface expression. Taken together, GSK3 negatively regulates mycobacteria‐induced IL‐10 production in human PBMo. The kinase may play a role in restoring IFN‐γ secretions and subsequent antigen presentation in response to mycobacterial infection. In conclusion, our results suggest a significant role for GSK3 in guarding against mycobacterial evasion of immunity via IL‐10 induction in the host.
Hemiepiphyseodesis for Juvenile and Adolescent Tibia Vara Utilizing Percutaneous Transphyseal Screws.

BACKGROUND In juvenile and adolescent tibia vara patients with sufficient growth remaining, implant-controlled hemiepiphyseodesis, or guided growth, can be used to correct deformity. Recent reports have described hardware failure of certain hemiepiphyseodesis implants in overweight patients with tibia vara. We describe our experience using transphyseal screws to correct deformity in this patient population. METHODS A retrospective chart and radiograph review was conducted on all juvenile and adolescent tibia vara patients who underwent lateral proximal tibial hemiepiphyseodesis using a single transphyseal screw. Charts were queried for preoperative and postoperative mechanical axis deviation, medial proximal tibial angle, lateral distal femoral angle, and postoperative complications or need for further surgery. RESULTS In total, 14 affected limbs in 9 patients (6 males) who underwent lateral proximal tibial transphyseal screw hemiepiphyseodesis were considered. Average chronologic age at implantation was 10.4 years and average body mass index was 31.7 kg/m. At average 23-month follow-up, the average mechanical axis deviation improved from 46 to 0 mm (P<0.001), and the average medial proximal tibial angle improved from 81 to 92 degrees (P<0.001). No limbs underwent further surgery to correct residual deformity. There were no complications or instances of implant failure associated with the transphyseal screws. CONCLUSIONS Hemiepiphyseodesis using transphyseal screws is an effective technique to correct deformity in juvenile and adolescent tibia vara patients with sufficient growth remaining. This method can be used safely with few complications and with minimal risk of mechanical failure, even in overweight patients. LEVEL OF EVIDENCE Level IV-therapeutic.
Glucose reduces endothelin inhibition of voltage‐gated potassium channels in rat arterial smooth muscle cells

Prolonged hyperglycaemia impairs vascular reactivity and inhibits voltage‐activated K+ (Kv) channels. We examined acute effects of altering glucose concentration on the activity and inhibition by endothelin‐1 (ET‐1) of Kv currents of freshly isolated rat arterial myocytes. Peak Kv currents recorded in glucose‐free solution were reversibly reduced within 200 s by increasing extracellular glucose to 4 mm. This inhibitory effect of glucose was abolished by protein kinase C inhibitor peptide (PKC‐IP), and Kv currents were further reduced in 10 mm glucose. In current‐clamped cells, membrane potentials were more negative in 4 than in 10 mm glucose. In 4 mm d‐glucose, 10 nm ET‐1 decreased peak Kv current amplitude at +60 mV from 23.5 ± 3.3 to 12.1 ± 3.1 pA pF−1 (n= 6, P < 0.001) and increased the rate of inactivation, decreasing the time constant around fourfold. Inhibition by ET‐1 was prevented by PKC‐IP. When d‐glucose was increased to 10 mm, ET‐1 no longer inhibited Kv current (n= 6). Glucose metabolism was required for prevention of ET‐1 inhibition of Kv currents, since fructose mimicked the effects of d‐glucose, while l‐glucose, sucrose or mannitol were without effect. Endothelin receptors were still functional in 10 mm d‐glucose, since pinacidil‐activated ATP‐dependent K+ (KATP) currents were reduced by 10 nm ET‐1. This inhibition was nearly abolished by PKC‐IP, indicating that endothelin receptors could still activate PKC in 10 mm d‐glucose. These results indicate that changes in extracellular glucose concentration within the physiological range can reduce Kv current amplitude and can have major effects on Kv channel modulation by vasoconstrictors.
Inorganic nanocrystals as contrast agents in MRI: synthesis, coating and introduction of multifunctionality

Inorganic nanocrystals have myriad applications in medicine, including their use as drug or gene delivery complexes, therapeutic hyperthermia agents, in diagnostic systems and as contrast agents in a wide range of medical imaging techniques. In MRI, nanocrystals can produce contrast themselves, with iron oxides having been the most extensively explored, or can be given a coating that generates MR contrast, for example gold nanoparticles coated with gadolinium chelates. These MR‐active nanocrystals can be used for imaging of the vasculature, liver and other organs, as well as molecular imaging, cell tracking and theranostics. As a result of these exciting applications, the synthesis and rendering of these nanocrystals as water soluble and biocompatible are therefore highly desirable. We discuss aqueous phase and organic phase methods for the synthesis of inorganic nanocrystals, such as gold, iron oxides and quantum dots. The pros and cons of the various methods are highlighted. We explore various methods for making nanocrystals biocompatible, i.e. direct synthesis of nanocrystals coated with biocompatible coatings, ligand substitution, amphiphile coating and embedding in carrier matrices that can be made biocompatible. Various examples are highlighted and their applications explained. These examples signify that the synthesis of biocompatible nanocrystals with controlled properties has been achieved by numerous research groups and can be applied to a wide range of applications. Therefore, we expect to see reports of preclinical applications of ever more complex MRI‐active nanoparticles and their wider exploitation, as well as in novel clinical settings. Copyright © 2013 John Wiley & Sons, Ltd.
Effects of Pulmonary Blood Flow and Mixed Venous O2 Tension on Gas Exchange in Dogs

The authors investigated whether the increases in venous admixture and intrapulmonary shunt which occur with increases in cardiac output (Qt) result from an effect mediated by mixed venous PO2 (P&OV0456;O2) or an effect mediated by the increase in pulmonary blood flow. Using a veno-venous bypass system they were able to alter P&OV0456;O2 independent of variations in Qt and vice versa. During room air ventiliation of dogs with normal lungs at constant Qt, an increase in P&OV0456;O2 from 33 ± 7 (mean ± SD) to 54 ± 9 mmHg (P < 0.05) resulted in a decrease in venous admixture from 22 ± 11 to 13 ± 4% (P < 0.05). During room air ventilation of normal dogs at a constant P&OV0456;O2, raising Qt from 2.16 ± . 53 to 3.49 ± 0.91 1/min (P < 0.05) increased venous admixture from 10 ± 5 to 16 ± 5%). During oxygen ventilation in these two groups of dogs, changes in P&OV0456;O2 and Qt had no effect on shunt.During oxygen ventilation of dogs with significant shunts from oleic-acid-induced pulmonary edema, independent increases in either P&OV0456;O2 or pulmonary blood flow resulted in increased shunt. At constant Qt, an increase in P&OV0456;O2 from 30 ± 8 to 52 ± 3 mmHg (P < 0.05) resulted in an increase in shunt from 39 ± 12 to 43 ± 12% (P < 0.05). When P&OV0456;O2 remained constant, increasing Qt from 1.97 pm 0.42 to 3.61 ± 0.50 1/min (P < 0.05) resulted in an increase in shunt from 47 ± 17 to 53 ± 15% (P < 0.05). The authors conclude that during oxygen ventilation, normal dogs have shunts which are unaffected by changes in blood flow or P&OV0456;O2. Increases in pulmonary blood flow increase venous admixture during room air ventilation, while increases in P&OV0456;O2 decrease venous admixture during air ventilation. In edematous lungs, increases in either P&OV0456;O2 or pulmonary blood flow increase shunt.
SOA Nonlinear Polarization Rotation With Linear Polarization Maintenance: Characterization and Applications

We present characterization and applications of the nonlinear polarization rotation (NPR) with linear polarization maintenance arising in polarization-insensitive semiconductor optical amplifiers (SOAs). The NPR with linear polarization maintenance is characterized in terms of probe and pump power, bias current, pump polarization, as well as wavelength. The NPR with linear polarization maintenance is then exploited for simultaneous inverted and noninverted polarization-insensitive wavelength conversions (WCs) with 2R regeneration using a single polarization beam splitter (PBS). WC of 10 Gb/s with 2R regeneration is experimentally demonstrated in the whole C-band with a power penalty reduction of 1.2 dB for the inverted WC and 0.8 dB for the noninverted WC. The NPR with linear polarization maintenance is also applied to perform on-off-keying (OOK) to polarization-shift-keying (PolSK) format conversion in conjunction with WC function, where the power fluctuation caused by the SOA cross gain modulation (XGM) is successfully mitigated using two cascaded SOAs. The power fluctuation of the converted PolSK signal is reduced to less than 0.6 dB, while the extinction ratio (ER) of polarization modulation is maintained at larger than 30 dB.
Phosphorylation of Xanthine Dehydrogenase/Oxidase in Hypoxia*

The enzyme xanthine oxidase (XO) has been implicated in the pathogenesis of several disease processes, such as ischemia-reperfusion injury, because of its ability to generate reactive oxygen species. The expression of XO and its precursor xanthine dehydrogenase (XDH) is regulated at pre- and posttranslational levels by agents such as lipopolysaccharide and hypoxia. Posttranslational modification of the protein, for example through thiol oxidation or proteolysis, has been shown to be important in converting XDH to XO. The possibility of posttranslational modification of XDH/XO through phosphorylation has not been adequately investigated in mammalian cells, and studies have reported conflicting results. The present report demonstrates that XDH/XO is phosphorylated in rat pulmonary microvascular endothelial cells (RPMEC) and that phosphorylation is greatly increased (∼50-fold) in response to acute hypoxia (4 h). XDH/XO phosphorylation appears to be mediated, at least in part, by casein kinase II and p38 kinase as inhibitors of these kinases partially prevent XDH/XO phosphorylation. In addition, the results indicate that p38 kinase, a stress-activated kinase, becomes activated in response to hypoxia (an ∼4-fold increase after 1 h of exposure of RPMEC to hypoxia) further supporting a role for this kinase in hypoxia-stimulated XDH/XO phosphorylation. Finally, hypoxia-induced XDH/XO phosphorylation is accompanied by a 2-fold increase in XDH/XO activity, which is prevented by inhibitors of phosphorylation. In summary, this study shows that XDH/XO is phosphorylated in hypoxic RPMEC through a mechanism involving p38 kinase and casein kinase II and that phosphorylation is necessary for hypoxia-induced enzymatic activation.
Site-directed Mutagenesis of Vacuolar H+-pyrophosphatase

A characteristic feature of the vacuolar H+-translocating inorganic pyrophosphatase (V-PPase) of plant cells is its high sensitivity to irreversible inhibition by N-ethylmaleimide (NEM) and other sulfhydryl reagents. Previous investigations in this laboratory have demonstrated that the primary site for substrate-protectable covalent modification of the V-PPase by 14C-labeled NEM maps to a single Mr 14,000 V8 protease fragment (V814K) (Zhen, R.-G., Kim, E. J., and Rea, P. A.(1994) J. Biol. Chem. 269, 23342-23350). Here, we describe site-directed mutagenesis of the cDNA encoding the V-PPase from Arabidopsis thaliana, its heterologous expression in Saccharomyces cerevisiae and single substitution of all 9 conserved Cys residues to either Ser or Ala. In all cases, except one, Cys mutagenesis exerts little or no effect on either the catalytic activity or susceptibility of the enzyme to inhibition by NEM. By contrast, and in complete agreement with the results of peptide mapping experiments, substitution of Cys634, the sole conserved cysteine residue encompassed by V814K, with Ser or Ala generates enzyme that is insensitive to NEM but active in both PPi hydrolysis and PPi-dependent H+ translocation. The specific requirement for Cys634 for inhibition by NEM and the dispensability of all of the conserved Cys residues, including Cys634, for V-PPase function indicate that the inhibitory action of maleimides reflects steric constraints imposed by the addition of a substituted alkyl group to the side chain of Cys634 rather than direct participation of this amino acid residue in catalysis.
Endogenous sensory discrimination and selection by a fast brain switch for a high transfer rate brain-computer interface

In this study, we present a novel multi-class brain-computer interface (BCI) for communication and control. In this system, the information processing is shared by the algorithm (computer) and the user (human). Specifically, an electro-tactile cycle was presented to the user, providing the choice (class) by delivering timely sensory input. The user discriminated these choices by his/her endogenous sensory ability and selected the desired choice with an intuitive motor task. This selection was detected by a fast brain switch based on real-time detection of movement-related cortical potentials from scalp EEG. We demonstrated the feasibility of such a system with a four-class BCI, yielding a true positive rate of ~ 80% and ~ 70%, and an information transfer rate of ~ 7 bits/min and ~ 5 bits/min, for the movement and imagination selection command, respectively. Furthermore, when the system was extended to eight classes, the throughput of the system was improved, demonstrating the capability of accommodating a large number of classes. Combining the endogenous sensory discrimination with the fast brain switch, the proposed system could be an effective, multi-class, gaze-independent BCI system for communication and control applications.
Prevalence of Depression and Posttraumatic Stress Disorder After Acute Orthopaedic Trauma: A Systematic Review and Meta-Analysis

Objectives: This study aims to systematically assess the existing literature and to derive a pooled estimate of the prevalence of depression and posttraumatic stress disorder (PTSD) in adult patients after acute orthopaedic trauma. Data Sources: A comprehensive search of databases, including MEDLINE, Embase, PsycINFO, and Cochrane Central Register of Controlled Trials databases was conducted through June 2015. Study Selection: We included studies that assessed the prevalence of depression or PTSD in patients who experienced acute orthopaedic trauma to the appendicular skeleton or pelvis. Studies with a sample size of ⩽10 were excluded. Data Extraction: Two authors independently extracted data from the selected studies and the data collected were compared with verify agreement. Data Synthesis: Twenty-seven studies and 7109 subjects were included in the analysis. Using a random-effects model, the weighted pooled prevalence of depression was 32.6% (95% CI, 25.0%–41.2%) and the weighted pooled prevalence of PTSD was 26.6% (95% CI, 19.0%–35.9%). Six studies evaluated the prevalence of both depression and PTSD in patients with acute orthopaedic injuries. The weighted pooled prevalence of both depression and PTSD for those patients was 16.8% (95% CI, 9.0%–29.4%). Conclusions: Nearly one-third of patients suffer from depression and more than one-quarter of patients suffer from PTSD after an acute orthopaedic injury suggesting that strategies to address both the mental and physical rehabilitation after an orthopaedic injury should be considered to optimize patient recovery. Level of Evidence: Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Measurement of Intraocular Pressure in a Porcine Ex Vivo Model Eye

Aims: To compare the pressure inside and outside the pig eye in relation to the location of cannulation for the injection of liquid into the anterior or vitreous chamber. Method: Eleven enucleated pig eyes were used. 46 measurements of intraocular pressure IOP were taken with a Perkins tonometer when the eye was cannulated in the anterior chamber. 49 measurements were taken when the eye was cannulated in the vitreous chamber. The eyeball was connected to a low -pressure transducer to control, maintain and modify the pressure in the eyeball. Results: No significant difference ( P=0.138) was found between the Perkins pressure measurements from cannulations in the anterior and vitreous chambers. A linear relationship between transducer and Perkins measurements was found when the eye was cannulated in the anterior chamber (IOP= -7.749+0.763 transducer;R2=0.940, p<0.001) and when it was cannulated in the vitreous chamber (IOP= -7.476+0.730 transducer, R2=0.885, p<0.001). No difference was found between the Perkins/transducer pressure ratios ( P=0.500 ANOVA) from cannulations in anterior and vitreous chambers. There were no differences in the measurements among eyes that could affect pressure outcomes. A direct relationship between the insufflate pressure inside the eyeball and the Perkins OriginalResearch Article
Evaluation of DNMT3A genetic polymorphisms as outcome predictors in AML patients

DNMT3A mutation is known as a recurrent event in acute myelogenous leukemia (AML) patients. However, association between DNMT3A genetic polymorphisms and AML patients' outcomes is unknown. DNMT3A 11 SNPs (rs11695471, rs2289195, rs734693, rs2276598, rs1465825, rs7590760, rs13401241, rs7581217, rs749131, rs41284843 and rs7560488) were genotyped in 344 diagnostic non-FAB-M3 AML patients from southern China. Patients underwent combined chemotherapy with cytarabine and anthracyclines. DNMT3A mRNA expression was analyzed in PBMCs from randomly selected AML patients. Multivariate analysis and combined genotype analysis showed that rs2276598 was associated with increased while rs11695471 and rs734693 were associated with decreased chemosensitivity (P<0.05), while rs11695471 (worse for OS), rs2289195 (favorable for OS and DFS) and rs2276598 (favorable for DFS) were significantly associated with disease prognosis (P<0.05). In conclusion, DNMT3A polymorphisms may be potential predictive markers for AML patients' outcomes, which might improve prognostic stratification of AML.