Miracle-dz/UniFAR-FTUs huggingface dataset:
"not these scissors, the other scissors." - a multi-center study comparing surgical instrument descriptions used by scrub nurses

Deep analysis of common aspects influencing the surgical process is an important prerequisite for the work on training and supports systems for the operating room (OR) of the future. The surgical instrument descriptions used by scrub nurses play an important role in the daily interaction with the surgeon. One common interruption of the surgical flow is a delay caused by a misunderstanding between the surgeon and the scrub nurse when requesting a certain surgical instrument. This paper presents the evaluation of a multi-center study, which was conducted to analyze and compare the instrument descriptions for 35 surgical instruments from four surgical domains given by 15 scrub nurses of three different clinics. The study results indicate central factors which affect the common understanding of surgical instrument descriptions.
Role of Arginine Deiminase of Streptococcus cristatus in Porphyromonas gingivalis Colonization

ABSTRACT The ability to attach to a variety of oral surfaces is an important characteristic of Porphyromonas gingivalis. Previous studies have demonstrated that expression and production of FimA, a major subunit protein of the long fimbriae, is required for P. gingivalis colonization. Here we report that a surface protein, arginine deiminase (ArcA) of Streptococcus cristatus, represses FimA production and inhibits biofilm formation of P. gingivalis. This inhibitory function of ArcA is also observed in the formation of heterotypic P. gingivalis-Streptococcus gordonii biofilms. P. gingivalis is released from streptococcal substrates in the presence of ArcA, likely due to an inhibition of FimA production. This work suggests that ArcA may have the potential to be a specific antibiofilm agent to fight P. gingivalis infections.
Evolution and Modern Approaches for Thermal Analysis of Electrical Machines

In this paper, the authors present an extended survey on the evolution and the modern approaches in the thermal analysis of electrical machines. The improvements and the new techniques proposed in the last decade are analyzed in depth and compared in order to highlight the qualities and defects of each. In particular, thermal analysis based on lumped-parameter thermal network, finite-element analysis, and computational fluid dynamics are considered in this paper. In addition, an overview of the problems linked to the thermal parameter determination and computation is proposed and discussed. Taking into account the aims of this paper, a detailed list of books and papers is reported in the references to help researchers interested in these topics.
Standardization of digital legislative documents: a case study

The paper describes research in analysing legislative documents handled in the Finnish parliament and government and studies means for developing standards for the documents. The current document management status in the Finnish parliament and government as well as problems in management are described. The paper discusses the special features of legislative documents and shows that, as an application area of document standardization, legislative documents are extremely difficult. Because of the difficulties, a major task in the project is to develop suitable methods for the document analysis and standardization. The project has started the development of an analysis method from the basis of an object-oriented method. The initial results of the project are introduced and the future directions are discussed.
Role of ampD Homologs in Overproduction of AmpC in Clinical Isolates of Pseudomonas aeruginosa

ABSTRACT AmpD indirectly regulates the production of AmpC β-lactamase via the cell wall recycling pathway. Recent publications have demonstrated the presence of multiple ampD genes in Pseudomonas aeruginosa and Escherichia coli. In the prototype P. aeruginosa strain, PAO1, the three ampD genes (ampD, ampDh2, and ampDh3) contribute to a stepwise regulation of ampC β-lactamase and help explain the partial versus full derepression of ampC. In the present study, the roles of the three ampD homologs in nine clinical P. aeruginosa isolates with either partial or full derepression of ampC were evaluated. In eight of nine isolates, decreased RNA expression of the ampD genes was not associated with an increase in ampC expression. Sequence analyses revealed that every derepressed isolate carried mutations in ampD, and in two fully derepressed strains, only ampD was mutated. Furthermore, every ampDh2 gene was of the wild type, and in some fully derepressed isolates, ampDh3 was also of the wild type. Mutations in ampD and ampDh3 were tested for their effect on function by using a plasmid model system, and the observed mutations resulted in nonfunctional AmpD proteins. Therefore, although the sequential deletion of the ampD homologs of P. aeruginosa can explain partial and full derepression in PAO1, the same model does not explain the overproduction of AmpC observed in these clinical isolates. Overall, the findings of the present study indicate that there is still an unknown factor(s) that contributes to ampC regulation in P. aeruginosa.
Cognitive reserve and patient-reported outcomes in multiple sclerosis

Background: Adaptation and compensation in the face of changing pathology may be better understood by considering the concept of cognitive reserve, which may protect against disability in multiple sclerosis (MS). Objectives: The present work investigates the relationship between cognitive reserve and demographic characteristics, health behaviors, and patient-reported outcomes (PROs). Methods: Cross-sectional data (n=1142) were drawn from the North American Research Committee on MS (NARCOMS) Registry, from whom additional survey data were collected. Cognitive reserve was measured using the Stern and Sole-Padulles measures, the O*NET occupational classification system, and the Godin Leisure-Time Exercise Questionnaire. PROs were assessed using generic (SF -12v2, Perceived Deficits Questionnaire, Ryff Psychological Well-Being, Diener Satisfaction with Life Scale) and disease-specific (Patient-Determined Disease Steps, Performance Scales) measures. Psychometric analysis created unidimensional cognitive reserve subscales. Regression models examined relationships between cognitive reserve, demographic characteristics, and PROs. Results: The cognitive reserve measures assessed distinct but related constructs. Individuals with high cognitive reserve were more likely to report lower levels of perceived disability and perceived cognitive deficits, and higher levels of physical health, mental health, and well-being. Both active and passive reserve are associated with better outcomes, independent of demographic factors, and these associations apply to both generic and disease-specific outcomes. Conclusions: This expanded measurement of cognitive reserve captures both the passive and active aspects of the construct, and there is a consistent and substantial relationship with PROs. Individuals with high passive and/or active reserve are healthier and experience higher levels of well-being.
The Quorum-Sensing Molecule Farnesol Is a Modulator of Drug Efflux Mediated by ABC Multidrug Transporters and Synergizes with Drugs in Candida albicans

ABSTRACT Overexpression of the CaCDR1-encoded multidrug efflux pump protein CaCdr1p (Candida drug resistance protein 1), belonging to the ATP binding cassette (ABC) superfamily of transporters, is one of the most prominent contributors of multidrug resistance (MDR) in Candida albicans. Thus, blocking or modulating the function of the drug efflux pumps represents an attractive approach in combating MDR. In the present study, we provide first evidence that the quorum-sensing molecule farnesol (FAR) is a specific modulator of efflux mediated by ABC multidrug transporters, such as CaCdr1p and CaCdr2p of C. albicans and ScPdr5p of Saccharomyces cerevisiae. Interestingly, FAR did not modulate the efflux mediated by the multidrug extrusion pump protein CaMdr1p, belonging to the major facilitator superfamily (MFS). Kinetic data revealed that FAR competitively inhibited rhodamine 6G efflux in CaCdr1p-overexpressing cells, with a simultaneous increase in an apparent Km without affecting the Vmax values and the ATPase activity. We also observed that when used in combination, FAR at a nontoxic concentration synergized with the drugs at their respective nonlethal concentrations, as was evident from their <0.5 fractional inhibitory concentration index (FICI) values and from the drop of 14- to 64-fold in the MIC80 values in the wild-type strain and in azole-resistant clinical isolates of C. albicans. Our biochemical experiments revealed that the synergistic interaction of FAR with the drugs led to reactive oxygen species accumulation, which triggered early apoptosis, and that both could be partly reversed by the addition of an antioxidant. Collectively, FAR modulates drug extrusion mediated exclusively by ABC proteins and is synergistic to fluconazole (FLC), ketoconazole (KTC), miconazole (MCZ), and amphotericin (AMB).
Control of the Reactive Power Supplied by a WECS Based on an Induction Generator Fed by a Matrix Converter

In this paper, a new control system to regulate the reactive power supplied by a variable-speed wind energy conversion system (WECS), based on an induction generator fed by a matrix converter (MC), is presented. The control system discussed in this paper is based on an input current observer, implemented using an estimation of the modulation matrix, and a nonlinear control loop that regulates the displacement angle at the MC input. The reactive power capability of the proposed system is also investigated. The work presented in this paper demonstrates that, for the proposed WECS, the maximum reactive power supplied to the grid is about 40% of the nominal value. Experimental results obtained from an experimental prototype are presented in this paper. The performance of the system using a wind turbine emulator and typical wind profiles is discussed in this paper.
Prospective Study of Fecal Colonization by Extended-Spectrum-β-Lactamase-Producing Escherichia coli in Neutropenic Patients with Cancer

ABSTRACT Fecal colonization by extended-spectrum-β-lactamase-producing Escherichia coli in 912 stool samples collected from 154 neutropenic patients with cancer, hospitalized at two teaching institutions, was prospectively studied. Forty-nine (31.8%) patients were colonized, 22 of them at hospital admission. Most strains were clonally unrelated and carried a CTX-M-9 group enzyme.
Maraviroc and Other HIV-1 Entry Inhibitors Exhibit a Class-Specific Redistribution Effect That Results in Increased Extracellular Viral Load

ABSTRACT HIV entry inhibitors, such as maraviroc (MVC), prevent cell-free viruses from entering the cells. In clinical trials, patients who were treated with MVC often displayed viral loads that were above the limit of conventional viral load detection compared to efavirenz-based regimens. We hypothesize that viruses blocked by entry inhibitors may be redistributed to plasma, where they artificially increase viral load measurements compared to those with the use of antiretroviral drugs (ARVs) that act intracellularly. We infected PM-1 cells with CCR5-tropic HIV-1 BaL or CXCR4-tropic HIV-1 NL4-3 in the presence of inhibitory concentrations of efavirenz, raltegravir, enfuvirtide, maraviroc, and AMD3100, the latter three being entry inhibitors. Supernatant viral load, reverse transcriptase enzyme activity, and intracellular nucleic acid levels were measured at times up to 24 h postinfection. Infectivity of redistributed dual-tropic HIV-1 was assessed using TZM-bl cells. Extracellular viral load analysis revealed that entry inhibitor-treated cells had higher levels of virus in the supernatant than the cells treated with other ARVs at 8 h postinfection. By 24 h, the supernatant viral load was still higher for entry inhibitors than other ARVs. We observed a correlation between viral load and the step of entry inhibition. Dual-tropic virus infectivity was undiminished utilizing the CCR5 coreceptor following redistribution by CXCR4 entry inhibition. This in vitro model indicates that entry inhibitors exhibit a redistribution effect unseen with intracellular ARV drugs. Based on these results, the effectiveness of some entry inhibitors may be underestimated if plasma viral load is used as a sole indicator of clinical success.
Aerosol Therapy with Colistin Methanesulfonate: a Biopharmaceutical Issue Illustrated in Rats

ABSTRACT The aim of this study was to evaluate the biopharmaceutical behavior of colistin methanesulfonate (CMS) with special focus on colistin presystemic formation after CMS nebulization in rats. CMS was administered (15 mg·kg−1 of body weight) either intravenously for systemic pharmacokinetic studies (n = 6) or as an intratracheal nebulization for systemic pharmacokinetic studies (n = 5) or for CMS and colistin concentration measurements in epithelial lining fluid (ELF) at 30, 120, and 240 min after nebulization (n = 14). CMS and colistin concentrations were determined by a new liquid chromatography (LC)-tandem mass spectrometry (MS/MS) assay. Pharmacokinetic parameters were estimated by noncompartmental analysis. CMS and colistin pharmacokinetic data were consistent with previously published values when comparisons were possible. The fraction of the CMS dose converted systematically into colistin after intravenous CMS administration was estimated to be 12.5% on average. After CMS nebulization it was estimated that about two-thirds of the dose was directly absorbed within the systemic circulation, whereas one-third was first converted into active colistin, which was eventually absorbed. As a consequence, the colistin area under curve (AUC) reflecting systemic availability was about 4-fold greater after CMS intratracheal nebulization (607 ± 240 μg·min·ml−1) than after CMS intravenous administration (160 ± 20 μg·min·ml−1). CMS concentrations in ELF at 30 min and 120 min postnebulization were very high (in the order of several mg/ml) due to the limited volume of ELF but were considerably reduced at 240 min. Although lower (15% ± 5% at 120 min) in relative terms, colistin concentrations in ELF could be high enough for being active against microorganisms following CMS nebulization.
Group support systems in primary processes

Software has migrated from large mainframe based support to personal computer support and more recently to groupware or, more specifically, group support systems (GSS). GSS products (e.g., GroupSystems) have undergone transitions or waves over the past ten years as application has evolved. This paper examines the waves that have occurred and are occurring with application and diffusion of GSS in organizational contexts. We suggest that GroupSystems has experienced three waves of users: 1st: scientists (innovation driven), 2nd: consultants (facilitator driven) and 3rd: into primary processes (application driven). Examples are provided to illustrate application. Special attention is given to the use of GSS for software inspection and the use of GSS in the classroom. The paper also provides an explanation for the discrepancy between the potential of GSS technology and its rather limited use to date.
Relative Strengths of Promoters Provided by Common Mobile Genetic Elements Associated with Resistance Gene Expression in Gram-Negative Bacteria

ABSTRACT Comparison of green fluorescent protein expression from outward-facing promoters (POUT) of ISAba1, ISEcp1, and ISAba125 revealed approximate equivalence in strength, intermediate between PCS (strong) and PCWTGN-10 (weak) class 1 integron promoter variants, >30-fold stronger than POUT of ISCR1, and >5 times stronger than Ptac. Consistent with its usual role, PCWTGN-10 produces more mRNA from a “downstream” gfp gene transcriptionally linked to a “usual” PCWTGN-10-associated gene cassette than does POUT of ISAba1.
Modulation Techniques to Eliminate Leakage Currents in Transformerless Three-Phase Photovoltaic Systems

In some photovoltaic (PV) applications, it is possible to remove the transformer of a system in order to reduce losses, cost, and size. In transformerless systems, the PV module parasitic capacitance can introduce leakage currents in which the amplitude depends on the converter topology, on the pulsewidth modulation, and on the resonant circuit comprised by the system components. Based on the common-mode voltage model, modulation techniques are proposed to eliminate the leakage current in transformerless PV systems without requiring any modification on the converter and any additional hardware. The main drawback is that the proposed modulation technique for two-level inverters can only be used with 650-V dc link in the case of a 110-V (rms) grid phase voltage. Comparisons among the modulation techniques are discussed, and it is proven that the proposed modulation for two- and three-level inverters presents the best results. To validate the models used in the simulations, an experimental three-phase inverter is used.
Relationship between Ceftolozane-Tazobactam Exposure and Drug Resistance Amplification in a Hollow-Fiber Infection Model

ABSTRACT In an era of rapidly emerging antimicrobial-resistant bacteria, it is critical to understand the importance of the relationships among drug exposure, duration of therapy, and selection of drug resistance. Herein we describe the results of studies designed to determine the ceftolozane-tazobactam exposure necessary to prevent the amplification of drug-resistant bacterial subpopulations in a hollow-fiber infection model. The challenge isolate was a CTX-M-15-producing Escherichia coli isolate genetically engineered to transcribe a moderate level of blaCTX-M-15. This organism's blaCTX-M-15 transcription level was confirmed by relative quantitative reverse transcription-PCR (qRT-PCR), β-lactamase hydrolytic assays, and a ceftolozane MIC value of 16 mg/liter. In these studies, the experimental duration (10 days), ceftolozane-tazobactam dose ratio (2:1), and dosing interval (every 8 h) were selected to approximate those expected to be used clinically. The ceftolozane-tazobactam doses studied ranged from 125-62.5 to 1,500-750 mg. Negative- and positive-control arms included no treatment and piperacillin-tazobactam at 4.5 g every 6 h, respectively. An inverted-U-shaped function best described the relationship between bacterial drug resistance amplification and drug exposure. The least- and most-intensive ceftolozane-tazobactam dosing regimens, i.e., 125-62.5, 750-375, 1,000-500, and 1,500-750 mg, did not amplify drug resistance, while drug resistance amplification was observed with intermediate-intensity dosing regimens (250-125 and 500-250 mg). For the intermediate-intensity ceftolozane-tazobactam dosing regimens, the drug-resistant subpopulation became the dominant population by days 4 to 6. The more-intensive ceftolozane-tazobactam dosing regimens (750-375, 1,000-500, and 1,500-750 mg) not only prevented drug resistance amplification but also virtually sterilized the model system. These data support the selection of ceftolozane-tazobactam dosing regimens that minimize the potential for on-therapy drug resistance amplification.
Reducing survey burden: feasibility and validity of PROMIS measures in multiple sclerosis

Background: Patient-reported outcomes are important for clinical research and care, yet administering and scoring the questionnaires requires considerable effort and time. The Patient Reported Outcomes Measurement Information System (PROMIS) could considerably reduce administrative obstacles and lessen survey burden for participants. Objective: Assess the feasibility and validity of PROMIS, compared to commonly-used legacy measures for multiple sclerosis (MS). Methods: In this cross-sectional survey, 133 participants with confirmed MS completed legacy surveys and PROMIS Computerized Adaptive Tests (CATs) for depression, anxiety, pain, fatigue and physical function. We conducted a multi-trait, multi-method analysis and verified results with confirmatory factor analysis. Results: The correlations between PROMIS and the corresponding legacy measures were large (0.67 to 0.87). The multi-trait, multi-method criteria were generally well met, providing good evidence of the validity of PROMIS measures. PROMIS surveys asked fewer questions and required substantially less time to complete than the legacy scales. Conclusions: Our results provide evidence of the construct validity of PROMIS for use with MS patients. Several aspects of the PROMIS CATs made them an important resource, including: (a) less time was required to complete them; (b) missing data was reduced; and (c) the automatic scoring referenced the general population. Our findings support the use of PROMIS in MS research and may have broader implications for clinical care, as well.
Real-Time Electrical Load Emulator Using Optimal Feedback Control Technique

This paper presents a method of emulating electrical loads using power electronic converters. The loads include machines such as induction motors and their associated mechanical load and also more complex machine systems such as wind-driven generators. The load emulator is, effectively, a dynamically controllable source or sink which is capable of bidirectional power exchange with either a grid or another power electronic converter system. Using load emulation, the feasibility of connecting a particular machine to a grid under various load conditions can be examined without the need for any electromechanical machinery. This paper considers the case of a power electronic voltage source inverter (VSI) emulating a three-phase induction motor connected to a three-phase ac grid. The VSI is operated in a mode where the current drawn from the ac grid is controlled by closed-loop control. The consistency of the experimental results with the simulation results proves the ability of the emulator and the proposed testing approach.
Development of a Novel Formulation with Hypericin To Treat Cutaneous Leishmaniasis Based on Photodynamic Therapy in In Vitro and In Vivo Studies

ABSTRACT An evaluation of the leishmanicidal activity in vitro and in vivo of hypericin, an expanded-spectrum photosensitizer found in Hypericum perforatum, is presented. Hypericin was evaluated against intracellular amastigotes in vitro of Leishmania (Viannia) panamensis. A topical formulation containing 0.5% hypericin was developed and assayed in vivo in a hamster model of cutaneous leishmaniasis. Results demonstrate that hypericin induces a significant antiamastigote effect in vitro against L. panamensis by decreasing the number of parasites inside infected cells. The topical formulation of 0.5% hypericin allows healing of L. panamensis-induced lesions upon a topical application of 40 mg/day plus visible-light irradiation (5 J/cm2, 15 min), twice a week for 3 weeks.
An Online Control Algorithm for Application of a Hybrid ESS to a Wind–Diesel System

Energy storage systems (ESSs) can be applied to mitigate some of the negative impacts associated with a variable power generation source such as wind energy. The control of ESS power must be accomplished over numerous time frames to meet system objectives and respect ESS capacity constraints. This paper proposes a two-level ESS control structure for use with a wind-diesel system, which is suitable for online implementation. The control is developed to coordinate power delivered from the two ESS levels in order to minimize diesel fuel consumption and limit up/down rates of the diesel plant. Different control modes are evaluated by simulation, and a subset of the results are validated using a hardware-in-the-loop representation. The controller that combines all three functionalities-minimizing dump load, limiting intrahour diesel ramp rates, and maximizing ESS utilization-demonstrates superior performance as measured by defined metrics and is proven to work online.