Miracle-dz/UniFAR-FTUs huggingface dataset:
Use of hemoadsorption in sepsis-associated ECMO-dependent severe ARDS: A case series

Introduction Acute respiratory distress syndrome in the context of severe sepsis and septic shock represents a serious clinical disorder. A recent case series in patients with septic shock and renal failure receiving hemoadsorption treatment showed rapid hemodynamic stabilization and increased survival, particularly in pneumonia patients and in those where therapy was started early. We hypothesized that patients suffering from pneumonia and refractory acute respiratory distress syndrome to the extent that they required extracorporeal membrane oxygenation support could possibly demonstrate the most pronounced benefit from the treatment. Methods We assessed the association of hemoadsorption treatment with hemodynamics, ventilation, and outcome variables in a set of patients with septic shock, acute respiratory distress syndrome, need for veno-venous extracorporeal membrane oxygenation, and continuous renal replacement therapy. Results Key observations include a significant stabilization in hemodynamics as evidenced by a marked decrease in catecholamine need, which was paralleled by a clear reduction in hyperlactatemia. Respiratory variables improved significantly. In addition, severity of illness and overall organ dysfunction showed a considerable decrease during the course of treatment. Observed mortality was approximately half as predicted by APACHE II. Treatment with CytoSorb was safe and well tolerated with no device-related adverse events. Discussion This is the first case series reporting on outcome variables associated to CytoSorb therapy in critically ill patients with septic shock, acute respiratory distress syndrome, veno-venous extracorporeal membrane oxygenation, and continuous renal replacement therapy. Based on our observations in this small case series, CytoSorb might represent a potentially promising therapy option for patients with refractory extracorporeal membrane oxygenation-dependent acute respiratory distress syndrome in the context of septic shock.
Secure Audit in Support of an Adrenal Cancer Registry

This paper describes the use of blockchain technology to ensure the integrity of data logs for a clinical registry, providing a technological means for a secure audit of that registry. The characteristics of a secure audit - tamper-resistance, verifiability, searchability and privacy - are described in their application to this registry, then an evaluation is performed detailing the use of blockchain to achieve these audit goals. The clinical registry tested - supporting ENSAT (the European Network for the Study of Adrenal Tumors) - is a production repository of clinical, phenotypic and genetic information about patients with adrenal cancer, a rare but often serious condition that affects approximately 1 in 600,000 of the world population. The registry is implemented using a standard n-tier web application, with a MySQL database back-end, and Java/JSP business logic and user interface. The information contributing to the full audit of data and usage of the registry, is captured in the application log-files, which are stored in two "mirrored" formats: ASCII text files compiled through the Java log4j project and in a MongoDB NoSQL database. Following a discussion of the relevant supporting features, the fully implemented solution - a private blockchain known as "ensatChain" - is evaluated for overall security, using the Microsoft "STRIDE" threat model.
Healthcare Professional’s Knowledge about Cost Related Medication Information in Saudi Arabia

Purpose: To explore the Healthcare Professionals and Knowledge of Medications cost in Saudi Arabia. Methods: It is a 4-months cross-sectional survey of healthcare professionals and knowledge of medicines. The survey consisted of two-part, demographic information and second part forty-nine questions divided into four domains. It included domain one: Primary or essential information about healthcare providers medication, domain two: healthcare professionals information about the drug-related problem, domain three: healthcare professionals information about drug-related cost and domain four: Healthcare providers perception of medications. All type of healthcare professionals included in the study. Medline Plus health information and DailyMed-INH elements information from National Institute of Health United State of America were used. The 5-point Likert response scale system was used. The questions were open and closed-ended. The survey was distributed through social media by using what’s App to more than one thousand healthcare professionals overall Kingdom of Saudi Arabia. The survey was made in an electronic format and it analyzed domain three: healthcare professional’s information about drug-related cost through survey monkey system. Results: The total responders were (188) Healthcare professionals. Of those 177 (95.16%) were Saudi and 9 (4.84%) were non-Saudi. The gender distribution 120 (63.83%) were females and 68 (36.17%) were males. The most of Healthcare professionals were pharmacist 93 (71.54%), followed by nurses 18 (13.85%) and physicians 15 (11.54%). The most type of medications used was anti-hypertension medicines, anti-diabetic medicines, Skin medications and drugs for Respiratory Diseases. Also, the most number of medications taken either one 29 (15.85%) or two 17 (9.29%). The healthcare professionals showed good knowledge with both complete and incomplete information about drug storage at room temperature 148 (81.3%) or refrigerator 143 (77.7%), protect medication from light exposures 133 (72.3%) and how to behave with an expired medication 127 (70.5%). The healthcare professionals had not adequate information with both complete and incomplete information about prescription prices 110 (59.78%) and imperfect knowledge about Health insurance coverage of medications 69 (37.9%). The healthcare professional’s knowledge about missing of medications, led patient visit doctor clinic 35 (18.72%), visit the pharmacy 50 (27.47%), visit hospital emergency 17 (9.24%) hospital admission 20 (10.87%) or intensive care admission 8 (4.79%). Conclusion: Healthcare professional missed medication-related cost knowledge. Healthcare professionals may implicate in drug-related problems with burden cost. Healthcare providers demanded of Drug-related prices and drug cost awareness program in Saudi Arabia. Keyword: Healthcare professional, Knowledge, Cost, Medications, Ministry of Health, Saudi Arabia.
Anti-Halitosis Tooth Paste: From Persian Manuscripts toward Clinic

Background and objectives: Halitosis as a common dentistry ailment which has a prevalence of around 50% of the adult population. There are many dental formulations in traditional Persian pharmacy called “Gharagher”, “Mazmazeh”, “Sonoun”, etc for treatment of halitosis. In the present study, we have tried to describe the step by step modernization of traditional herbal advices for treatment of halitosis. Methods: Traditional Persian manuscripts were reviewed and dome herbs were selected for formulation of toothpaste. Qualitative and quantitative controls were performed on raw materials and toothpaste was formulated using the selected herbs. Pharmaceutical control tests including squeeze, centrifuge, conductivity, particle size, spreading, temperature related stability, and microbial limit tests were performed on the toothpastes. Results: A total of 31 medicinal plants from 24 plant families and 12 anti-halitosis “Sonoun”s possessing anti-halitosis related properties were found. Syzygium aromaticum, Pistacia atlantica var. mutica, and Punica granatum var. pleniflora were selected for the formulation. Results of quality contril assays were in the accepted range of pharmacopeias. GC-MS analysis showed 15 and 16 components in P. atlantica and S. aromaticum oils, respectively. GC-FID results showed 85.15% α-pinene in P. atlantica and 5.28% eugenol in S. aromaticum. ATR-IR spectrum was used for control of P. granatum flowers. The organoleptic properties, phase separation, particle size and microbial tests of formulations showed an accepted shelf life for performing clinical trials. The results proved a good texture property as well as desirable abrasive properties of the toothpaste. Post production quality control tests indicated the proper feature of final product after packaging. Conclusion: Such model would be a straight forward rout from traditional medical manuscripts toward clinic.
A 3D mixed reality visualization of network topology and activity results in better dyadic cyber team communication and cyber situational awareness

Background Cyber defense decision-making during cyber threat situations is based on human-to-human communication aiming to establish a shared cyber situational awareness. Previous studies suggested that communication inefficiencies were among the biggest problems facing security operation center teams. There is a need for tools that allow for more efficient communication of cyber threat information between individuals both in education and during cyber threat situations. Methods In the present study, we compared how the visual representation of network topology and traffic in 3D mixed reality vs. 2D affected team performance in a sample of cyber cadets (N = 22) cooperating in dyads. Performance outcomes included network topology recognition, cyber situational awareness, confidence in judgements, experienced communication demands, observed verbal communication, and forced choice decision-making. The study utilized network data from the NATO CCDCOE 2022 Locked Shields cyber defense exercise. Results We found that participants using the 3D mixed reality visualization had better cyber situational awareness than participants in the 2D group. The 3D mixed reality group was generally more confident in their judgments except when performing worse than the 2D group on the topology recognition task (which favored the 2D condition). Participants in the 3D mixed reality group experienced less communication demands, and performed more verbal communication aimed at establishing a shared mental model and less communications discussing task resolution. Better communication was associated with better cyber situational awareness. There were no differences in decision-making between the groups. This could be due to cohort effects such as formal training or the modest sample size. Conclusion This is the first study comparing the effect of 3D mixed reality and 2D visualizations of network topology on dyadic cyber team communication and cyber situational awareness. Using 3D mixed reality visualizations resulted in better cyber situational awareness and team communication. The experiment should be repeated in a larger and more diverse sample to determine its potential effect on decision-making.
Secondary symbionts affect aphid fitness and the titer of primary symbiont

Bacterial symbionts associated with aphids are important for their ecological fitness. The corn leaf aphid, Rhopalosiphum maidis (Fitch), is one of the most damaging aphid pests on maize and has been reported to harbor Hamiltonella defensa and Regiella insecticola while the effects of the secondary symbionts (S-symbionts) on host ecology and primary symbiont Buchnera aphidicola remain unclear. Here, four aphid strains were established, two of which were collected from Langfang - Hebei Province, China, with similar symbiont pattern except for the presence of H. defensa. Two other aphid strains were collected from Nanning - Guangxi Province, China, with the same symbiont infection except for the presence of R. insecticola. Phylogenetic analysis and aphid genotyping indicated that the S-symbiont-infected and free aphid strains from the same location had identical genetic backgrounds. Aphid fitness measurement showed that aphid strain infected with H. defensa performed shortened developmental duration for 1st instar and total nymph stages, reduced aphid survival rate, offspring, and longevity. While the developmental duration of H-infected strains was accelerated, and the adult weight was significantly higher compared to the H-free strain. Infection with R. insecticola did not affect the aphid’s entire nymph stage duration and survival rate. As the H-strain does, aphids infected with R. insecticola also underwent a drop in offspring, along with marginally lower longevity. Unlike the H-infected strain, the R-infected strain performed delayed developmental duration and lower adult weight. The B. aphidicola titers of the H-infected strains showed a steep drop during the aphid 1st to 3rd instar stages, while the augmentation of B. aphidicola titers was found in the R-infected strain during the aphid 1st to 3rd instar. Our study investigated for the first time the effect of the S-symbionts on the ecology fitness and primary symbiont in R. maidis, indicating that infection with secondary symbionts leads to the modulation of aphid primary symbiont abundance, together inducing significant fitness costs on aphids with further impact on environmental adaptation and trophic interactions.
Comparative study of surface integral methods in aeroacoustic prediction

Introduction: Surface integral methods based on the acoustic analogy and Kirchhoff formulation are widely employed in computational aeroacoustics. The computational accuracy is usually highly dependent on the selections of the acoustic prediction method and of the integral surfaces. Methods: This paper analyzes the pros and cons of each aeroacoustic prediction method and studies numerically sound generated from flow past a circular cylinder by employing different surface integral methods. The acoustic analogy based on the impermeable solid surfaces either ignores the quadrupole contribution or needs high computational cost to calculate the quadrupole contribution, and the acoustic analogy based on the permeable integral surfaces usually suffers from the spurious source issue. Results: Both the pressure-based or density-based Kirchhoff formulations can be used in aeroacoustic prediction, however, the numerical results indicate that the pressure-based Kirchhoff formulation also suffers from the issue of the spurious sound because the pressure fluctuations at the permeable integral surfaces are contaminated by hydrodynamic component. Discussion: It seems that only the density-based Kirchhoff formulation does not suffer from the issue of the spurious sound, but this formulation requires the acoustic sources should be extracted from compressible flow simulations.
Impact of large-scale photovoltaic-energy storage power generation system access on differential protection of main transformer under symmetrical faults

The low voltage ride-through (LVRT) requirements demand large-scale photovoltaic (PV) power generation system remain connected to the grid during faults. It results in considerable impact on the characteristics of fault current. This paper combines charge-discharge characteristics of the energy storage (ES) with PV generation system to enhance the LVRT capability. Based on the inverter control strategy and specific LVRT requirements, fault current characteristics of the PV-ES power generation system is discussed in this paper. In order to analyze the fault characteristic, the fault current expression as three-phase short-circuit faults occurs on both sides of the main transformer is calculated. Furthermore, taking the winding connection of the transformer into account, the ratio of differential current to braking current is further derived to find out the factors influencing the performance of the transformer differential protection. It is found that factors influencing the transformer differential protection include the rated capacity of the PV-ES generation system, fault severity, the length of transmission line and so on. And as the rated capacity of the PV-ES power generation system increase, the transformer differential protection would experience reduced sensitivity or even do not trip. The findings of this paper can lay a foundation for further improvement of the transformer differential protection. The elaborate performance evaluation of transformer differential protection, including the operation condition of the second harmonic braking element, is presented and verified by simulation using MATLAB/Simulink.
Association between N-terminal Pro-Brain Natriuretic Peptide levels, glomerular filtration rate, and heart failure in the Multi-Ethnic Study of Atherosclerosis

Background: This study examined the complementary prognostic role of NT-proBNP and eGFR for predicting heart failure (HF) in adults with and without chronic kidney disease (CKD) defined as eGFR<60 ml/min/1.73m2. Methods: We used data from the Multi-Ethnic Study of Atherosclerosis, a cohort of 6814 adults without baseline clinical cardiovascular disease. Five-year risk prediction of HF based on clinical HF risk variables (HFRV) plus NT-proBNP, eGFR or both was assessed using the C-statistic and the net reclassification index (NRI) after stratifying by CKD status. Results: Mean age at baseline was 62.3±10.3 years and CKD were present in 5.9%. A total of 39 and 180 HF events occurred in participants with and without CKD, respectively. Among adults with CKD, the C-statistic for HF risk prediction increased significantly (P =0.04) from 0.71 (95% CI 0.64, 0.78) with HFRV alone to 0.78 (95% CI 0.71, 0.85) with addition of NT-proBNP. In the non-CKD group, the C-statistic increased from 0.77 (95% CI 0.74, 0.80) with HFRV alone to 0.83 (95% CI 0.80, 0.85) with addition of NT-proBNP. Further addition of eGFR to the model did not alter the C-statistic regardless of CKD status. NRI improved by 23.1% and 10.2% in CKD and non-CKD, respectively, with the addition of NT-proBNP alone and findings were similar when both eGFR and NT-proBNP were both added to model. Conclusions: In adults without clinical cardiovascular disease, the addition of NT-proBNP but not eGFR to established HFRV improves HF risk prediction in adults with and without CKD.
Proceedings of the 10th annual deep brain stimulation think tank: Advances in cutting edge technologies, artificial intelligence, neuromodulation, neuroethics, interventional psychiatry, and women in neuromodulation

The deep brain stimulation (DBS) Think Tank X was held on August 17–19, 2022 in Orlando FL. The session organizers and moderators were all women with the theme women in neuromodulation. Dr. Helen Mayberg from Mt. Sinai, NY was the keynote speaker. She discussed milestones and her experiences in developing depression DBS. The DBS Think Tank was founded in 2012 and provides an open platform where clinicians, engineers and researchers (from industry and academia) can freely discuss current and emerging DBS technologies as well as the logistical and ethical issues facing the field. The consensus among the DBS Think Tank X speakers was that DBS has continued to expand in scope however several indications have reached the “trough of disillusionment. ” DBS for depression was considered as “re-emerging” and approaching a slope of enlightenment. DBS for depression will soon re-enter clinical trials. The group estimated that globally more than 244,000 DBS devices have been implanted for neurological and neuropsychiatric disorders. This year’s meeting was focused on advances in the following areas: neuromodulation in Europe, Asia, and Australia; cutting-edge technologies, closed loop DBS, DBS tele-health, neuroethics, lesion therapy, interventional psychiatry, and adaptive DBS.
Suggesting a mechanism for acupuncture as a global percutaneous needle fasciotomy that respects tensegrity principles for treating fibromyalgia

Acupuncture is a minimally invasive therapeutic method that uses small caliber needles while inserting them through the skin into various areas of the body. Some empirical studies find evidence to support the use of acupuncture as a treatment for certain medical conditions, however, this peculiar practice is widely considered as the domain of alternative and non-evidence-based medicine. Several mechanisms have been suggested in an attempt to explain the therapeutic action of acupuncture, but the way in which acupuncture alleviates chronic non-cancer pain or psychosomatic and psychiatric disorders is not fully understood. A recent study suggested a theoretical model (coined “Fascial Armoring”) with a cellular pathway to help explain the pathogenesis of myofascial pain/fibromyalgia syndrome and functional psychosomatic syndromes. It proposes that these syndromes are a spectrum of a single medical entity that involves myofibroblasts with contractile activity in fascia and aberrant extracellular matrix (ECM) remodeling, which may lead to widespread mechanical tension and compression. This can help explain diverse psycho-somatic manifestations of fibromyalgia-like syndromes. Fascia is a continuous interconnected tissue network that extends throughout the body and has qualities of bio-tensegrity. Previous studies show that a mechanical action by needling induces soft tissue changes and lowers the shear modulus and stiffness in myofascial tissue. This hypothesis and theory paper offers a new mechanism for acupuncture therapy as a global percutaneous needle fasciotomy that respects tensegrity principles (tensegrity-based needling), in light of the theoretical model of “Fascial Armoring. ” The translation of this model to other medical conditions carries potential to advance therapies. These days opioid overuse and over-prescription are ubiquitous, as well as chronic pain and suffering.
A review on the methane emission detection during offshore natural gas hydrate production

Due to the high energy density, large potential reserves and only release CO2 and water after combustion, natural gas hydrate (NGH) is considered as the most likely new clean energy source to replace traditional fossil energy (crude oil, natural gas, etc.). However, unlike the exploitation of traditional fossil energy, the essence of natural gas hydrate exploitation is to induce the production of methane by artificially decompose the natural gas hydrate and to simultaneously collect the generated methane. Because of the uncontrollable decomposition, the methane percolation and the gas collection efficiency, methane emission is inevitably occurred during natural gas hydrate exploitation, which could significantly affect the environmental friendliness of natural gas hydrate. In this review, the methane emission detection was divided into three interfaces: Seafloor and sediment, seawater, atmosphere. Meanwhile, according the summary and analysis of existing methane emission detection technologies and devices, it was concluded that the existing detection technologies can identify and quantify the methane emission and amount in the three interfaces, although the accuracy is different. For natural gas hydrate exploitation, quantifying the environmental impact of methane emission and predicting the diffusion path of methane, especially the methane diffusion in strata and seawater, should be the focus of subsequent research.
Lectotypification of Symphytum anatolicum (Boraginaceae)

Symphytum anatolicum Boiss. is an endemic species in the Flora of Turkey and the East Aegean Islands. It was first collected by d'Urville on the island of Cos in 1820 and named Symphytum asperrimum d'Urv. The plant was again collected by Boissier near Izmir (Smyrna) in 1842, and described by him as S. anatolicum in 1844. There are 4 collections mentioned in the protologue in Boissier's Flora Orientalis (1879). The herbarium specimen "Hab. in umbrosis montium circa Smyrnam", housed in G-Boiss. Herbarium, was chosen as lectotype as it best represents the species description.