Miracle-dz/UniFAR-FTUs huggingface dataset:
Interventions to Improve Rates of Successful Extubation in Preterm Infants: A Systematic Review and Meta-analysis

Importance Clinicians aim to extubate preterm infants as early as possible, to minimize the risks of mechanical ventilation. Extubation is often unsuccessful owing to lung disease or inadequate respiratory drive. Objective To conduct a systematic review and meta-analysis of interventions to improve rates of successful extubation in preterm infants. Data Sources Searches were undertaken in PubMed and The Cochrane Library. Study Selection The review was conducted using the methods of the Cochrane Collaboration and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies were included if they were randomized clinical trials published in English, enrolled intubated preterm infants (born <37 weeks’ gestation), and reported 1 or both of the primary outcomes. Data Extraction and Synthesis One thousand three hundred seventy-nine titles were screened independently by 2 investigators to assess need for full-text review. Disagreements were resolved via consensus of all authors. Where no Cochrane Review existed for an intervention, or not all identified studies were included, a new pooled analysis was performed. Main Outcomes and Measures Primary outcomes were treatment failure or reintubation within 7 days of extubation. Results Fifty studies were eligible for inclusion. Continuous positive airway pressure reduced extubation failure in comparison with head-box oxygen (risk ratio [RR], 0.59; 95% CI, 0.48-0.72; number needed to treat [NNT], 6; 95% CI, 3-9). Nasal intermittent positive pressure ventilation was superior to continuous positive airway pressure in preventing extubation failure (RR, 0.70; 95% CI, 0.60-0.81; NNT, 8; 95% CI, 5-13). High-flow nasal cannula therapy and continuous positive airway pressure had similar efficacy (RR, 1.11; 95% CI, 0.84-1.47). Methylxanthines reduced extubation failure (RR, 0.48; 95% CI, 0.32-0.71; NNT, 4; 95% CI, 2-7) compared with placebo or no treatment. Corticosteroids (RR, 0.18; 95% CI, 0.04-0.97; NNT, 12; 95% CI, 6-100) and chest physiotherapy (RR, 0.32; 95% CI, 0.13-0.82; NNT, 15; 95% CI, 7-50) both reduced extubation failure rates but were associated with significant adverse effects. Doxapram did not aid successful extubation (RR, 0.80; 95% CI, 0.22-2.97). Conclusions and Relevance Preterm infants should be extubated to noninvasive respiratory support. Caffeine should be used routinely, while corticosteroids should be used judiciously, weighing up the competing risks of bronchopulmonary dysplasia and neurodevelopmental harm.
Dengue Virus and Zika Virus Serological Cross-reactivity and Their Impact on Pathogenesis in Mice

Preexisting immunity to Zika virus (ZIKV) or dengue virus (DENV) may alter the course of their infection, and here we use robust mouse models to examine pathological outcomes following passive immunization, sequential cross-infection, or vaccination with inactivated virus. DENV infection was enhanced (through antibody-dependent enhancement [ADE]) or was suppressed by both DENV and ZIKV immunity. Notably, inactivated ZIKV vaccination enhanced dengue disease severity, although it was highly protective against ZIKV infection. On the other hand, ADE was not observed upon ZIKV infection in mice that were passively immunized or preinfected with DENV. Surprisingly, however, we found that vaccination with inactivated DENV enhanced ZIKV infection, mainly in the mesenteric lymph node, indicating the potential for DENV immunity to cause ADE in vivo. Collectively, our data call for greater attention to detail in the design of ZIKV or DENV vaccines.
Direct and indirect effects of elevated atmospheric CO2 on net ecosystem production in a Chesapeake Bay tidal wetland

The rapid increase in atmospheric CO2 concentrations (Ca) has resulted in extensive research efforts to understand its impact on terrestrial ecosystems, especially carbon balance. Despite these efforts, there are relatively few data comparing net ecosystem exchange of CO2 between the atmosphere and the biosphere (NEE), under both ambient and elevated Ca. Here we report data on annual sums of CO2 (NEEnet) for 19 years on a Chesapeake Bay tidal wetland for Scirpus olneyi (C3 photosynthetic pathway)‐ and Spartina patens (C4 photosynthetic pathway)‐dominated high marsh communities exposed to ambient and elevated Ca (ambient + 340 ppm). Our objectives were to (i) quantify effects of elevated Ca on seasonally integrated CO2 assimilation (NEEnet = NEEday + NEEnight, kg C m−2 y−1) for the two communities; and (ii) quantify effects of altered canopy N content on ecosystem photosynthesis and respiration. Across all years, NEEnet averaged 1.9 kg m−2 y−1 in ambient Ca and 2.5 kg m−2 y−1 in elevated Ca, for the C3‐dominated community. Similarly, elevated Ca significantly (P < 0.01) increased carbon uptake in the C4‐dominated community, as NEEnet averaged 1.5 kg m−2 y−1 in ambient Ca and 1.7 kg m−2 y−1 in elevated Ca. This resulted in an average CO2 stimulation of 32% and 13% of seasonally integrated NEEnet for the C3‐ and C4‐dominated communities, respectively. Increased NEEday was correlated with increased efficiencies of light and nitrogen use for net carbon assimilation under elevated Ca, while decreased NEEnight was associated with lower canopy nitrogen content. These results suggest that rising Ca may increase carbon assimilation in both C3‐ and C4‐dominated wetland communities. The challenge remains to identify the fate of the assimilated carbon.
Effects of recent and past climatic shifts on the genetic structure of the high mountain Yellow‐spotted ringlet butterfly Erebia manto (Lepidoptera, Satyrinae): a conservation problem

Mountain species have evolved important genetic differentiation due to past climatic fluctuations. The genetic uniqueness of many of these lineages is now at risk due to global warming. Here, we analyse allozyme polymorphisms of 1306 individuals (36 populations) of the mountain butterfly Erebia manto and perform Species Distribution Models (SDMs). As a consensus of analyses, we obtained six most likely genetic clusters: (i) Pyrenees with Massif Central; (ii) Vosges; (iii–v) Alps including the Slovakian Carpathians; (vi) southern Carpathians. The Vosges population showed the strongest genetic split from all other populations, being almost as strong as the split between E. manto and its sister species Erebia eriphyle. The distinctiveness of the Pyrenees‐Massif Central group and of the southern Carpathians group from all other groups is also quite high. All three groups are assumed to have survived more than one full glacial–interglacial cycle close to their current distributions with up‐hill and down‐slope shifts conforming climatic conditions. In contrast with these well‐differentiated groups, the three groups present in the Alps and the Slovakian Carpathians show a much shallower genetic structure and thus also should be of a more recent origin. As predicted by our SDM projections, rising temperatures will strongly impact the distribution of E. manto. While the populations in the Alps are predicted to shrink, the survival of the three lineages present here should not be at risk. The situation of the three other lineages is quite different. All models predict the extinction of the Vosges lineage in the wake of global warming, and also the southern Carpathians and Pyrenees‐Massif Central lineages might be at high risk to disappear. Thus, albeit global warming will therefore be unlikely to threaten E. manto as a species, an important proportion of the species’ intraspecific differentiation and thus uniqueness might be lost.
Climate‐driven uncertainties in modeling terrestrial energy and water fluxes: a site‐level to global‐scale analysis

We used a land surface model constrained using data from flux tower sites, to analyze the biases in ecosystem energy and water fluxes arising due to the use of meteorological reanalysis datasets. Following site‐level model calibration encompassing major vegetation types from the tropics to the northern high‐latitudes, we repeated the site and global simulations using two reanalysis datasets: the NCEP/NCAR and the CRUNCEP. In comparison with the model simulations using observed meteorology from sites, the reanalysis‐driven simulations produced several systematic biases in net radiation (Rn), latent heat (LE), and sensible heat (H) fluxes. These include: (i) persistently positive tropical/subtropical biases in Rn using the NCEP/NCAR, and gradually transitioning to negative Rn biases in the higher latitudes; (ii) large positive H biases in the tropics/subtropics using the NCEP/NCAR; (iii) negative LE biases using the NCEP/NCAR above 40°N; (iv) high tropical LE using the CRUNCEP in comparison with observationally derived global estimates; and (v) flux‐partitioning biases from canopy and ground components. Across vegetation types, we investigated the role of the meteorological drivers (shortwave and longwave radiation, atmospheric humidity, temperature, precipitation) and their seasonal biases in controlling these reanalysis‐driven uncertainties. At the global scale, our site‐level analysis explains several model‐data differences in the LE and H fluxes when compared with observationally derived global estimates of these fluxes. Using our results, we discuss the implications of site‐level model calibration on subsequent regional/global applications to study energy and hydrological processes. The flux‐partitioning biases presented in this study have potential implications on the couplings among terrestrial carbon, energy, and water fluxes, and for the calibration of land–atmosphere parameterizations that are dependent on LE/H partitioning.
Sensitivity to thermal extremes in Australian Drosophila implies similar impacts of climate change on the distribution of widespread and tropical species

Climatic factors influence the distribution of ectotherms, raising the possibility that distributions of many species will shift rapidly under climate change and/or that species will become locally extinct. Recent studies have compared performance curves of species from different climate zones and suggested that tropical species may be more susceptible to climate change than those from temperate environments. However, in other comparisons involving responses to thermal extremes it has been suggested that mid‐latitude populations are more susceptible. Using a group of 10 closely related Drosophila species with known tropical or widespread distribution, we undertake a detailed investigation of their growth performance curves and their tolerance to thermal extremes. Thermal sensitivity of life history traits (fecundity, developmental success, and developmental time) and adult heat resistance were similar in tropical and widespread species groups, while widespread species had higher adult cold tolerance under all acclimation regimes. Laboratory measurements of either population growth capacity or acute tolerance to heat and cold extremes were compared to daily air temperature under current (2002–2007) and future (2100) conditions to investigate if these traits could explain current distributions and, therefore, also forecast future effects of climate change. Life history traits examining the thermal sensitivity of population growth proved to be a poor predictor of current species distributions. In contrast, we validate that adult tolerance to thermal extremes provides a good correlate of current distributions. Thus, in their current distribution range, most of the examined species experience heat exposure close to, but rarely above, the functional heat resistance limit. Similarly, adult functional cold resistance proved a good predictor of species distribution in cooler climates. When using the species’ functional tolerance limits under a global warming scenario, we find that both tropical and widespread Drosophila species will face a similar proportional reduction in distribution range under future warming.
Unexpected role of winter precipitation in determining heat requirement for spring vegetation green‐up at northern middle and high latitudes

Heat requirement, expressed in growing degree days (GDD), is a widely used method to assess and predict the effect of temperature on plant development. Until recently, the analysis of spatial patterns of GDD requirement for spring vegetation green‐up onset was limited to local and regional scales, mainly because of the sparse and aggregated spatial availability of ground phenology data. Taking advantage of the large temporal and spatial scales of remote sensing‐based green‐up onset data, we studied the spatial patterns of GDD requirement for vegetation green‐up at northern middle and high latitudes. We further explored the correlations between GDD requirement for vegetation green‐up and previous winter season chilling temperatures and precipitation, using spatial partial correlations. We showed that GDD requirement for vegetation green‐up onset declines towards the north at a mean rate of 18.8 °C‐days per degree latitude between 35°N and 70°N, and vary significantly among different vegetation types. Our results confirmed that the GDD requirement for vegetation green‐up is negatively correlated with previous winter chilling, which was defined as the number of chilling days from the day when the land surface froze in the previous autumn to the day of green‐up onset. This negative correlation is a well‐known phenomenon from local studies. Interestingly, irrespective of the vegetation type, we also found a positive correlation between the GDD requirement and previous winter season precipitation, which was defined as the sum of the precipitation of the month when green‐up onset occur and the precipitation that occurred during the previous 2 months. Our study suggests that GDD requirement, chilling and precipitation may have complex interactions in their effects on spring vegetation green‐up phenology. These findings have important implications for improving phenology models and could therefore advance our understanding of the interplay between spring phenology and carbon fluxes.
Recent IV-drug users with chronic hepatitis C can be efficiently treated with daily high dose induction therapy using consensus interferon: An open-label pilot study

AIM: To investigate the use of high dose consensus-interferon in combination with ribavirin in former iv drug users infected with hepatitis C. METHODS: We started, before pegylated (PEG)-interferons were available, an open-label study to investigate the efficacy and tolerability of high dose induction therapy with consensus interferon (CIFN) and ribavirin in treatment of naiive patients with chronic hepatitis C. Fifty-eight patients who were former iv drug users, were enrolled receiving 18 μg of CIFN daily for 8 wk, followed by 9 μg daily for up to wk 24 or 48 and 800 mg of ribavirin daily. End point of the study was tolerability and eradication of the virus at wk 48 and sustained virological response at wk 72. RESULTS: More than 62% of patients responded to the treatment with CIFN at wk 24 or 48, respectively, showing a negative qualitative PCR [genotype 1 fourteen patients (56%), genotype 2 five (50%), genotype 3 thirteen (87%), genotype 4 four (50%)]. Forty-eight percent of genotype 1 patients showed sustained virological response (SVR) six months after the treatment. CONCLUSION: CIFN on a daily basis is well tolerated and side effects like leuko- and thrombocytopenia are moderate. End of therapy (EOT) rates are slightly lower than the newer standard therapy with pegylated interferons. CIFN on a daily basis might be a favourable therapy regimen for patients with GT1 and high viral load or for non-responders after failure of standard therapy.
In situ adaptive response to climate and habitat quality variation: spatial and temporal variation in European badger (Meles meles) body weight

Variation in climatic and habitat conditions can affect populations through a variety of mechanisms, and these relationships can act at different temporal and spatial scales. Using post‐mortem badger body weight records from 15 878 individuals captured across the Republic of Ireland (7224 setts across ca. 15 000 km2; 2009–2012), we employed a hierarchical multilevel mixed model to evaluate the effects of climate (rainfall and temperature) and habitat quality (landscape suitability), while controlling for local abundance (unique badgers caught/sett/year). Body weight was affected strongly by temperature across a number of temporal scales (preceding month or season), with badgers being heavier if preceding temperatures (particularly during winter/spring) were warmer than the long‐term seasonal mean. There was less support for rainfall across different temporal scales, although badgers did exhibit heavier weights when greater rainfall occurred one or 2 months prior to capture. Badgers were also heavier in areas with higher landscape habitat quality, modulated by the number of individuals captured per sett, consistent with density‐dependent effects reducing weights. Overall, the mean badger body weight of culled individuals rose during the study period (2009–2012), more so for males than for females. With predicted increases in temperature, and rainfall, augmented by ongoing agricultural land conversion in this region, we project heavier individual badger body weights in the future. Increased body weight has been associated with higher fecundity, recruitment and survival rates in badgers, due to improved food availability and energetic budgets. We thus predict that climate change could increase the badger population across the Republic of Ireland. Nevertheless, we emphasize that, locally, populations could still be vulnerable to extreme weather variability coupled with detrimental agricultural practice, including population management.
Thermal niche predicts tolerance to habitat conversion in tropical amphibians and reptiles

Habitat conversion is a major driver of the biodiversity crisis, yet why some species undergo local extinction while others thrive under novel conditions remains unclear. We suggest that focusing on species' niches, rather than traits, may provide the predictive power needed to forecast biodiversity change. We first examine two Neotropical frog congeners with drastically different affinities to deforestation and document how thermal niche explains deforestation tolerance. The more deforestation‐tolerant species is associated with warmer macroclimates across Costa Rica, and warmer microclimates within landscapes. Further, in laboratory experiments, the more deforestation‐tolerant species has critical thermal limits, and a jumping performance optimum, shifted ~2 °C warmer than those of the more forest‐affiliated species, corresponding to the ~3 °C difference in daytime maximum temperature that these species experience between habitats. Crucially, neither species strictly specializes on either habitat – instead habitat use is governed by regional environmental temperature. Both species track temperature along an elevational gradient, and shift their habitat use from cooler forest at lower elevations to warmer deforested pastures upslope. To generalize these conclusions, we expand our analysis to the entire mid‐elevational herpetological community of southern Costa Rica. We assess the climatological affinities of 33 amphibian and reptile species, showing that across both taxonomic classes, thermal niche predicts presence in deforested habitat as well as or better than many commonly used traits. These data suggest that warm‐adapted species carry a significant survival advantage amidst the synergistic impacts of land‐use conversion and climate change.
Parents’ perceptions on parental involvement in preparatory secondary vocational school health education

Name Berber Marenne Kerkhof Student Number 3853640 Research Internship 2 Graduation research. Definite version Date 02-07-2014 Mentor Dr. Rob de Leeuw. Julius Centre for Health Science and Primary Care, University Medical Center Utrecht. Course Tutor Dr. Janneke de Man Number of Words 3463 Dutch abstract 296 English abstract 296 Intended Journal Health Promotion International 3000 Words for body of text 250 Words for abstract 1000 Words for references Total of 3 tables or figures (500 words each) Reference Style APA 6 edition
Temperature extremes: geographic patterns, recent changes, and implications for organismal vulnerabilities

Extreme temperatures can injure or kill organisms and can drive evolutionary patterns. Many indices of extremes have been proposed, but few attempts have been made to establish geographic patterns of extremes and to evaluate whether they align with geographic patterns in biological vulnerability and diversity. To examine these issues, we adopt the CLIMDEX indices of thermal extremes. We compute scores for each index on a geographic grid during a baseline period (1961–1990) and separately for the recent period (1991–2010). Heat extremes (temperatures above the 90th percentile during the baseline period) have become substantially more common during the recent period, particularly in the tropics. Importantly, the various indices show weak geographic concordance, implying that organisms in different regions will face different forms of thermal stress. The magnitude of recent shifts in indices is largely uncorrelated with baseline scores in those indices, suggesting that organisms are likely to face novel thermal stresses. Organismal tolerances correlate roughly with absolute metrics (mainly for cold), but poorly with metrics defined relative to local conditions. Regions with high extreme scores do not correlate closely with regions with high species diversity, human population density, or agricultural production. Even though frequency and intensity of extreme temperature events have – and are likely to have – major impacts on organisms, the impacts are likely to be geographically and taxonomically idiosyncratic and difficult to predict.
Psychometric evaluation of an instrument to assess patient-reported 'psychosocial care by physicians': a structural equation modeling approach.

OBJECTIVE The objective of our study was to develop a theory-based and empirically tested instrument for measuring patient-reported 'psychosocial care by physicians'. We propose a model integrating patients' perceptions with respect to: (i) devotion by physicians, (ii) support by physicians, (iii) information by physicians and (iv) shared decision-making (SDM). DESIGN Data were gathered during 2001 within a cross-sectional, retrospective mail survey. PARTICIPANTS AND SETTING A total of 4192 inpatients of six German hospitals. MAIN OUTCOME MEASURE Specific scales of the Cologne Patient Questionnaire were used. A two-step structural equation model procedure was applied. In the first structural equation model, all items were modeled as indicators of the intended underlying latent construct, 'psychosocial care by physicians'. In the second structural equation model, criterion-related validity of the intended construct was tested with respect to patients' 'satisfaction', 'trust in physicians' and the 'image of the hospital'. RESULTS The results confirmed that the aspects of psychosocial care provided by physicians measured by the scale items are indeed indicators of the same construct. Furthermore, indicator reliabilities and selectivities revealed that the content of all 13 items was highly representative of the underlying construct. The second structural equation model showed that 'psychosocial care by physicians' is related to 'patients' satisfaction', 'trust in physicians' and 'hospital-image' in a significant and relevant manner. CONCLUSION On the basis of our instrument's reported psychometric characteristics and of the initial validity indicators, it may be regarded as an adequate measure for further use in outcome and intervention research, and as a quality indicator for the physician-patient relationship.