Miracle-dz/UniFAR-FTUs huggingface dataset:
Critical limb ischemia: medical and surgical management

Abstract Chronic critical limb ischemia (CLI), defined as > 2 weeks of rest pain, ulcers, or tissue loss attributed to arterial occlusive disease, is associated with great loss of both limb and life. Therapeutic goals in treating patients with CLI include reducing cardiovascular risk factors, relieving ischemic pain, healing ulcers, preventing major amputation, improving quality of life and increasing survival. These aims may be achieved through medical therapy, revascularization, or amputation. Medical therapy includes administration of analgesics, local wound care and pressure relief, treatment of infection, and aggressive therapy to modify atherosclerotic risk factors. For patients who are not candidates for revascularization, and who are unwilling or unable to undergo amputation, treatments such as intermittent pneumatic compression or spinal cord stimulation may offer symptom relief and promote wound healing. Revascularization offers the best option for limb salvage. The decision to perform surgery, endovascular therapy, or a combination of the two modalities (‘hybrid’ therapy) must be individualized. Patients who are relatively fit and able to withstand the rigors of an open procedure may benefit from the long-term durability of surgical repair. In contrast, frail patients with a limited life expectancy may experience better outcomes with endovascular reconstruction. Hybrid therapy is an attractive option for patients with limited autologous conduit, as it permits complete revascularization with a less extensive procedure, shorter duration of operation, and decreased risk of peri-operative complications. Amputation should be considered for patients who are non-ambulatory, demented, or unfit to undergo revascularization.
Periodic Economic Control of a Nonisolated Microgrid

This paper presents the application of economic predictive control to minimize the cost of operating a nonisolated microgrid connected to an electric utility (EU) subject to a periodic internal demand. The microgrid considered is composed of a set of photovoltaic panels and two storage systems and it can buy and sell energy to an EU. The first storage system is composed of a cluster of batteries of lead acid, and the second storage system is based on hydrogen storage. A function that describes the economic cost of operating the plant taking into account aspects such as electric market costs, degradation of the microgrid, and amortization costs is proposed. Based on this cost and considering the periodic nature of the plant, an economic predictive controller capable of adapting to sudden changes on the cost function while guaranteeing stability and recursive feasibility has been successfully tested on a realistic nonlinear model of an experimental configurable testbed located in the laboratories of the University of Seville.
Mechanisms of Macrolide Resistance among Streptococcus pneumoniae Isolates from Russia

ABSTRACT Among 76 macrolide-nonsusceptible Streptococcus pneumoniae isolates collected between 2003 and 2005 from Central Russia, the resistance mechanisms detected in the isolates included erm(B) alone (50%), mef alone [mef(E), mef(I), or a different mef subclass; 19.7%], or both erm(B) and mef(E) (30.3%). Isolates with dual resistance genes [erm(B) and mef(E)] belonged to clonal complex CC81 or CC271.
Clinical Nutrition Service in Korean Tertiary Hospitals and General Hospitals: Result of Nationwide Cross-Sectional Survey

The purpose of this study was to investigate the status of clinical nutrition services provided at tertiary hospitals and general hospitals in Korea. In total, 157 questionnaires were distributed to the departments of nutrition at hospitals on September 2013. The results of this study are as follows. The median number of beds was 607 and average length of stay was 8 days. 63.1% of dietitians had over 5 years of career experience. Nutritional screening rate was 97% in tertiary hospitals but only 67.2% in general hospitals (P< 0.001). The rate of equipment with computerized nutritional screening system was 100% in tertiary hospitals but 71.9% in general hospitals (P<0.001). Hospitals with the best regarding nutritional care were hospitals accredited by JCI (Joint Commission International). On the other hand, hospitals not accredited by the JCI but KOIHA (Korea Institute for Healthcare Accreditation) showed the lowest performance rate of nutritional care. Nutrition support teams (NSTs) were established in all tertiary hospitals but in only 73% of general hospitals (P<0.001). The rate of actively operating NSTs was 89% in tertiary hospitals but only 62% in general hospitals (P<0.001). There is a need to provide proper standardized clinical nutrition services as a primary treatment and we observed large variations in the quality of nutritional service between hospitals. Therefore, local solutions are needed to implement nutritional programs and policies for improved service and care.
Slow Cortical Responses Evoked by Acoustic Stimuli

Evoked responses of the waking human brain to acoustic stimuli can easily be recorded from external electrodes by means of an average response computer. The clearest responses are anatomically diffuse (strongest from frontal and vertex), long in latency, and are evoked by visual or tactile as well as auditory stimuli. Their amplitude varies quite widely across subjects, with the state of the subject, with the interval between stimuli (up to 10 seconds), and from one individual stimulus to the next. The average of a set of successive responses is sufficiently related to the intensity of the stimulus, however, to make the niethod useful for “objective” audiometry on a purely empirical basis, even though the response does not arise from the primary auditory cortical area.Our thresholds of detection of the average evoked responses of fifty severely hard-of-hearing children, 7 to 16 years old, were conipared with the children's subjective thresholds for the same filtered clicks. The mean difference was only 2.
A Reference Guide to Cloud Computing Dimensions: Infrastructure as a Service Classification Framework

Recently, a growing development and use of Cloud computing services has been observed generally and also in the area of government. Despite initial positive results, it is challenging in theory and practice to find an appropriate provider matching the individual requirements of a company or a government. Moreover, the number of new entrants as well as non-transparent service offers, which sometimes differ significantly, make it difficult to migrate into the Cloud. Due to the lack of adequate possibilities to compare and classify Cloud providers we are presenting in this paper a provider independent classification framework for Infrastructure as a Service (IaaS) which can be used in e-Government. For this purpose, the target dimensions for Cloud Computing from a customer perspective were defined, based on expert interviews and an international literature review. The relevance of the target dimensions was evaluated with an additional survey conducted among IT managers. Extended by a provider market analysis the classification framework was designed and finally checked for applicability and can be used to create concrete cloud procurement processes, refine Cloud strategies or develop migration requirements for governments.
ARG-ANNOT, a New Bioinformatic Tool To Discover Antibiotic Resistance Genes in Bacterial Genomes

ABSTRACT ARG-ANNOT (Antibiotic Resistance Gene-ANNOTation) is a new bioinformatic tool that was created to detect existing and putative new antibiotic resistance (AR) genes in bacterial genomes. ARG-ANNOT uses a local BLAST program in Bio-Edit software that allows the user to analyze sequences without a Web interface. All AR genetic determinants were collected from published works and online resources; nucleotide and protein sequences were retrieved from the NCBI GenBank database. After building a database that includes 1,689 antibiotic resistance genes, the software was tested in a blind manner using 100 random sequences selected from the database to verify that the sensitivity and specificity were at 100% even when partial sequences were queried. Notably, BLAST analysis results obtained using the rmtF gene sequence (a new aminoglycoside-modifying enzyme gene sequence that is not included in the database) as a query revealed that the tool was able to link this sequence to short sequences (17 to 40 bp) found in other genes of the rmt family with significant E values. Finally, the analysis of 178 Acinetobacter baumannii and 20 Staphylococcus aureus genomes allowed the detection of a significantly higher number of AR genes than the Resfinder gene analyzer and 11 point mutations in target genes known to be associated with AR. The average time for the analysis of a genome was 3.35 ± 0.13 min. We have created a concise database for BLAST using a Bio-Edit interface that can detect AR genetic determinants in bacterial genomes and can rapidly and easily discover putative new AR genetic determinants.
Factors Affecting Individual Flaming in Virtual Communities

This study explores key factors affecting flaming in virtual communities. Drawing on computer-mediated communication, socio-psychological, and organizational management perspectives, the study develops and tests a research model that predicts an individual's flaming behavior and flaming restraints. Results of hierarchical regression analyses, based on a 300-person survey, show that regulated anonymity (institutional control) does not have any significant influence on the curbing of flaming. In contrast, technological controls (e.g., persistent labeling, deep profiling) and managerial control significantly inhibit individuals' flaming. Social identity increases flaming due to group conformity in the context of deindividuation. Personal traits (impulsive/temper tendencies) are also significant drivers of flaming. Notably, virtual community type (utilitarian vs. hedonic virtual communities) moderates the factors affecting flaming.
Chemical Genetic Interaction Profiling Reveals Determinants of Intrinsic Antibiotic Resistance in Mycobacterium tuberculosis

ABSTRACT Chemotherapy for tuberculosis (TB) is lengthy and could benefit from synergistic adjuvant therapeutics that enhance current and novel drug regimens. To identify genetic determinants of intrinsic antibiotic susceptibility in Mycobacterium tuberculosis, we applied a chemical genetic interaction (CGI) profiling approach. We screened a saturated transposon mutant library and identified mutants that exhibit altered fitness in the presence of partially inhibitory concentrations of rifampin, ethambutol, isoniazid, vancomycin, and meropenem, antibiotics with diverse mechanisms of action. This screen identified the M. tuberculosis cell envelope to be a major determinant of antibiotic susceptibility but did not yield mutants whose increase in susceptibility was due to transposon insertions in genes encoding efflux pumps. Intrinsic antibiotic resistance determinants affecting resistance to multiple antibiotics included the peptidoglycan-arabinogalactan ligase Lcp1, the mycolic acid synthase MmaA4, the protein translocase SecA2, the mannosyltransferase PimE, the cell envelope-associated protease CaeA/Hip1, and FecB, a putative iron dicitrate-binding protein. Characterization of a deletion mutant confirmed FecB to be involved in the intrinsic resistance to every antibiotic analyzed. In contrast to its predicted function, FecB was dispensable for growth in low-iron medium and instead functioned as a critical mediator of envelope integrity.
Multiple-AVF Cross-Feedback-Network-Based Position Error Harmonic Fluctuation Elimination for Sensorless IPMSM Drives

To diminish the position estimation error with harmonic fluctuations for position sensorless interior permanent-magnet synchronous motor (IPMSM) drives, a multiple adaptive vector filter (AVF) cross-feedback network (CFN) is proposed for a model-based position observer. A full-order Luenberger observer is utilized to obtain back electromotive force (EMF) information. The harmonic fluctuations in the position estimation error caused by inverter nonlinearities and flux spatial harmonics are analyzed. Accordingly, a newly proposed multiple-AVF CFN with an easy-to-implement structure is adopted to detect and compensate the back-EMF harmonic distortions and, hence, to eliminate the position error harmonic fluctuations. Consequently, the position estimation accuracy can be enhanced, which improves the position sensorless control performance. The proposed scheme was verified on a 2.2-kW sensorless IPMSM drive. Experimental results confirm the effectiveness of the method in eliminating the harmonic fluctuations in the position estimation error.
Emergence of NDM-5- and MCR-1-Producing Escherichia coli Clones ST648 and ST156 from a Single Muscovy Duck (Cairina moschata)

ABSTRACT Two Escherichia coli clones (sequence type 648 [ST648] and ST156) that coproduce NDM-5 and MCR-1 were detected from a single fowl in China. The blaNDM-5 gene was found on the two indistinguishable IncX3 plasmids from the two different E. coli isolates, whereas the mcr-1 gene was located on IncHI2 and IncI2 plasmids, respectively, suggesting that blaNDM-5 and mcr-1 have spread in avian intestinal flora. Also, the two strains harbor blaTEM-1, blaCTX-M-55, fosA3, and aac(6′)-Ib. The multiresistant E. coli strains (especially the epidemic clone ST648) might raise a potential threat to human health via food chain transmission.
A Stereoscopic Camera.

Denver, Colo. , Aug. 30, 1905. To the Editor: —In making portraits of my patients for the purpose of keeping an accurate record of their condition, I have found it of great advantage to make use of a stereoscopic camera. As ordinarily furnished, these cameras are hardly satisfactory for the purpose, as the portrait is rather small to show details of many lesions. I put on each lens a little portrait attachment sold by photo dealers; this enables me to come close to the subject, giving me a good-sized portrait; but in coming close the images are thrown almost off the plate; this is overcome by putting on the front of the lens carrier a brass sheet, in which a hole has been cut in front of the lenses, and over these holes I placed ten-degree-plane prisms with the bases out, thus bringing the images back on the plate. I make
Clonal Spread of Levofloxacin-Resistant Streptococcus pneumoniae Invasive Isolates in Madrid, Spain, 2007 to 2009

ABSTRACT Among 1,349 Streptococcus pneumoniae invasive isolates, 45 (3.3%) were levofloxacin resistant. Serotype distribution was as follows: 8 (n = 32 isolates), 19A (n = 4 isolates), 7F (n = 3 isolates), 9V (n = 2 isolates), 10A (n = 1 isolate), 19F (n = 1 isolate), 6B (n = 1 isolate), and nontypeable (n = 1 isolate). Levofloxacin-resistant isolates had dual mutations in the gyrA and parC genes. Serotype 8 strains corresponded to a capsular switching of the Sweden15A-25 clone. Levofloxacin resistance was also detected among multiresistant (ST27619A, Spain9V-ST156, ST8819F, and ST15426B) and among usually antibiotic-susceptible (Netherlands7F-ST191, ST120119A, and ST263910A) clones.
Novel Antibiofilm Chemotherapy Targets Exopolysaccharide Synthesis and Stress Tolerance in Streptococcus mutans To Modulate Virulence Expression In Vivo

ABSTRACT Fluoride is the mainstay of dental caries prevention, and yet current applications offer incomplete protection and may not effectively address the infectious character of the disease. Therefore, we evaluated the effectiveness of a novel combination therapy (CT; 2 mM myricetin, 4 mM tt-farnesol, 250 ppm of fluoride) that supplements fluoride with naturally occurring, food-derived, antibiofilm compounds. Treatment regimens simulating those experienced clinically (twice daily for ≤60 s) were used both in vitro over a saliva-coated hydroxyapatite biofilm model and in vivo with a rodent model of dental caries. The effectiveness of CT was evaluated based on the incidence and severity of carious lesions (compared to fluoride or vehicle control). We found that CT was superior to fluoride (positive control, P < 0.05); topical applications dramatically reduced caries development in Sprague-Dawley rats, all without altering the Streptococcus mutans or total populations within the plaque. We subsequently identified the underlying mechanisms through which applications of CT modulate biofilm virulence. CT targets expression of key Streptococcus mutans genes during biofilm formation in vitro and in vivo. These are associated with exopolysaccharide matrix synthesis (gtfB) and the ability to tolerate exogenous stress (e.g., sloA), which are essential for cariogenic biofilm assembly. We also identified a unique gene (SMU.940) that was severely repressed and may represent a potentially novel target; its inactivation disrupted exopolysaccharide accumulation and matrix development. Altogether, CT may be clinically more effective than current anticaries modalities, targeting expression of bacterial virulence associated with pathogenesis of the disease. These observations may have relevance for development of enhanced therapies against other biofilm-dependent infections.
Surgical Intuition: What It Is and How to Get It

Surgical Intuition completes the trilogy launched by the senior author, who unfortunately died before its publication. The first volume was Surgical Secrets . The second volume, Surgical Scripts , went to press the day he died. This final book is the culmination of ideas Dr Abernathy developed over a long period. In collaboration with Robert M. Hamm, a cognitive psychologist, he attempts to explain how clinical surgeons think and how most effectively to teach this to others. Abernathy was attempting to formulate a paradigm to both explain and teach decision making and diagnosis. He considered three general methods. The decision analysis method he found too analytical, and although there was some support for this model and even a Society for Medical Decision Making, Abernathy believed it did not truly capture the way medical experts thought. He attributed this to three factors: "(1) doctors do not immediately know how to do it; (2)
Association between low ankle-brachial index and accelerometer-derived sedentary and exercise time in the asymptomatic general population

Sedentary behavior is an adverse health risk factor that is independent of physical activity. The relationship between sedentary behavior, exercise activity and the ankle-brachial index (ABI) is not well understood. We analyzed data from the National Health and Nutrition Examination Survey (NHANES) 2003–2004. Accelerometer data were used to quantify exercise and sedentary time for each participant. A low ABI was defined as a value <1.0 (including borderline values). Multi-variable adjusted logistic regression analyses were performed with sedentary and exercise times as independent variables, adjusting for important confounders. There were 1443 asymptomatic participants (mean age 61 years, 49% female, 55% current/prior smokers) with mean daily sedentary and exercise times of 454±144 and 18±20 minutes, respectively. Of the participants, 23% had an ABI <1.0 (8.7% with ABI <0.9). Sedentary time was positively associated with a low ABI (odds ratio [OR] 1.22 per 1 standard deviation [SD], [95% confidence interval (CI), 1.03–1.43]; p=0.02) while exercise time was inversely associated with a low ABI (OR 0.71 per 1 SD, [95% CI, 0.57–0.89]; p=0.003). Sedentary time is associated with low ABI values in the asymptomatic population. This association appears to be independent of exercise time and warrants further investigation.
AbaR5, a Large Multiple-Antibiotic Resistance Region Found in Acinetobacter baumannii

ABSTRACT A multiply antibiotic-resistant Acinetobacter baumannii strain, 3208, contains the aacC1-orfP-orfP-orfQ-aadA1 gene cassette array; sul1, tetA(A), and aphA1b genes; and a mer operon in a large region containing a novel transposon, Tn6020, and segments of Tn1696, Tn21, Tn1721, and Tn5393. This region is part of a genomic resistance island, AbaR5, related to and found in the same chromosomal position as AbaR1. This strain is the first European clone I isolate detected in Australia.
Azithromycin Alters Macrophage Phenotype and Pulmonary Compartmentalization during Lung Infection with Pseudomonas

ABSTRACT Infection with mucoid strains of Pseudomonas aeruginosa in chronic inflammatory diseases of the airway is difficult to eradicate and can cause excessive inflammation. The roles of alternatively activated and regulatory subsets of macrophages in this pathophysiological process are not well characterized. We previously demonstrated that azithromycin induces an alternatively activated macrophage-like phenotype in vitro. In the present study, we tested whether azithromycin affects the macrophage activation status and migration in the lungs of P. aeruginosa-infected mice. C57BL/6 mice received daily doses of oral azithromycin and were infected intratracheally with a mucoid strain of P. aeruginosa. The properties of macrophage activation, immune cell infiltration, and markers of pulmonary inflammation in the lung interstitial and alveolar compartments were evaluated postinfection. Markers of alternative macrophage activation were induced by azithromycin treatment, including the surface expression of the mannose receptor, the upregulation of arginase 1, and a decrease in the production of proinflammatory cytokines. Additionally, azithromycin increased the number of CD11b+ monocytes and CD4+ T cells that infiltrated the alveolar compartment. A predominant subset of CD11b+ cells was Gr-1 positive (Gr-1+), indicative of a subset of cells that has been shown to be immunoregulatory. These differences corresponded to decreases in neutrophil influx into the lung parenchyma and alteration of the characteristics of peribronchiolar inflammation without any change in the clearance of the organism. These results suggest that the immunomodulatory effects of azithromycin are associated with the induction of alternative and regulatory macrophage activation characteristics and alteration of cellular compartmentalization during infection.
Clinical Child Psychology and Psychiatry

The journal Clinical Child Psychology and Psychiatry was established to provide a forum for articles relevant to clinicians who work with children and families. Published four times a year, it is intended to balance a perceived overemphasis on quantitative measurement. This peer-reviewed journal prefers qualitative research over quantitative research. The editor, the book review editor, and all associate editors are from London. Assessors on the panel are from the United States, Canada, the Netherlands, Japan, and Italy. These assessors represent the disciplines of child psychiatry, child psychology, pediatrics, social work, education, psychotherapy, nursing, ethics, sociology, and anthropology. No professional society sponsors this journal. Topics covered in the first three issues of the journal are timely and important, including child abuse, suicide, HIV and AIDS in children, and eating disorders.
Predictive Control in Power Converters and Electrical Drives - Part I

The papers in this special section focus on predictive control in power converters and electrical drives. With the fast microcontrollers available today, applications of predictive control in power converters and electrical drives are a very powerful and attractive alternative to classical controllers. The use of predictive control offers a number of advantages: very intuitive approach, no need for linear controllers and modulators, easy inclusion of nonlinearities and restrictions, etc. However, predictive control schemes in power converters and electrical drives have not yet been implemented in industrial applications. Nevertheless, after some further progress, it can be expected that the advantages of predictive algorithms will lead to an increased number of industrial applications in the future.