Miracle-dz/UniFAR-FTUs huggingface dataset:
The Anesthesia Perioperative “Call for Help”—Experience at a Quaternary Pediatric Medical Center: Analysis of 67,564 Anesthesia Encounters

BACKGROUND: During the past several decades, anesthesia has become increasingly safe. Truly major adverse events are rare, and anesthesia quality researchers have instituted programs to evaluate “near miss” or less critical adverse events to evaluate the safety of anesthesia delivery. In this study, we aimed to evaluate calls for emergency help in our institution as a surrogate for pending critical events. We hypothesized that calls would be more common in patients with high American Society of Anesthesiologists (ASA) physical status, history of prematurity, and children with recent respiratory illness compared to those without these characteristics. METHODS: We analyzed emergent calls for help initiated by perioperative personnel (“STAT” calls) between August 2011 and September 2015 at Boston Children’s Hospital. Our analysis had 2 phases: (1) All 193 STAT calls that occurred during this time period were analyzed for demographic variables (age, ASA physical status, gender) and specific features of the STAT calls (provider who initiated the call, anesthetic phase, presence of recent respiratory illness, location). We further categorized the STAT calls as “complicated” or “uncomplicated” based on an unexpected change in patient disposition, and analyzed how demographic factors and specific features related to the likelihood of a STAT call being complicated. (2) A subset of the total calls (108), captured after introduction of electronic intraoperative medical record in July 2012, were analyzed for the incidence of STAT calls by comparing the number and nature of the STAT calls to the number of surgical/diagnostic procedures performed. RESULTS: Univariable and multivariable analysis of the entire cohort of STAT calls (193 cases) identified several characteristics that were more likely to be associated with a complicated STAT call: higher ASA physical status; history of respiratory illness; cardiac inciting event; occurrence during induction phase of general anesthesia; postanesthesia care unit location; and calls initiated by an attending physician or a pediatric anesthesia fellow. Multivariable analysis of the subset of 108 indicated that age <1 year and a history of prematurity were independent predictors of a higher incidence of STAT calls. Offsite anesthesia services were associated with a lower frequency of STAT calls independent of the other variables. CONCLUSIONS: Our study offers the most comprehensive analysis of emergent perioperative calls for help in pediatric anesthesia to date. We identified several characteristics, independently associated with more complicated and frequent perioperative STAT calls. Further research is required to evaluate the utility of this information in preventing and treating adverse events in children undergoing surgery and anesthesia.
Molecular Characterization of Extended-Spectrum Beta-Lactamase Producing Urinary Escherichia coli Isolated in Brong-Ahafo Regional Hospital, Ghana

Introduction. Antimicrobial resistance is a growing international problem resulting from the enzyme β-lactamase production by bacteria, to degrade antibiotics, especially β-lactam antibiotics. In Brong Ahafo Regional Hospital, Sunyani, these antibiotics are heavily depended upon for the treatment of serious infections, but unfortunately high proportions of bacterial isolates in the hospital, have been found to be resistant to the commonly prescribed antibiotics. This study aims to determine the prevalence of ESBL-producing E. coli so as to determine if ESBL are responsible for the high antimicrobial resistance seen at the Brong-Ahafo Regional Hospital, Sunyani. Methods. The study was a cross sectional study, involving 51 E. coli isolates from urine samples of both inand out-patients between January and December, 2014. Antimicrobial susceptibility profiles of the isolates were determined by the Kirby Bauer disc diffusion method against 12 antibiotics. The isolates were screened for ESBL production, and then confirmed by the combined disc method. The isolates were tested for the presence of ESBL blaCTX-M and blaTEM by conventional PCR. Results. Non-repeat 1,302 midstream urine samples were cultured from which 200 different pathogens were isolated. Of the 200 isolates 51 were E. coli. Isolates obtained from Community isolates were 16(37.2) and isolates from in-patients were 27(62.8). Resistant strains were detected to all the 12 antimicrobials tested. Low proportions were sensitive to cephalosporins (cefotaxime and ceftazidime), both recording 8/51(15.7%), and quinolones (nalidixic acid and ciprofloxacin), 7/51(13.7%) and 8/51(15.7%) respectively. The isolates had varied susceptibility to aminoglycosides, with European Scientific Journal March 2017 edition vol.13, No.9 ISSN: 1857 – 7881 (Print) e ISSN 18577431 366 low sensitivity of 1/32(2.0%) to gentamicin, but a high proportion of 47/51(92.2%) was sensitive to amikacin. High proportion of the isolates [43/51(84.3%)] were ESBL phenotype, and was found to be significantly associated (p<0.001) with antimicrobial resistance among the isolates. The most prevalent ESBL genotype was BlaTEM with 26 (66.7%) and blaCTX-M 28(71.8%), but 9(23.1%) ESBL phenotypes tested negative for both blaTEM and blaCTX-M genes. 22 (56.4%) of the isolates had both blaTEM and blaCTX-M genes. Conclusion. High proportions of E. coli isolates from urine in Sunyani produce ESBLs. Both blaTEM and blaCTX-M were prevalent and linked to the high levels of drug resistance found in the locality. Increased antibiotic stewardship and stringent infection control measures along with the testing for ESBL must be instituted in the hospital.
Efficient Design for Mendelian Randomization Studies: Subsample and 2-Sample Instrumental Variable Estimators

Mendelian randomization (MR) is a method for estimating the causal relationship between an exposure and an outcome using a genetic factor as an instrumental variable (IV) for the exposure. In the traditional MR setting, data on the IV, exposure, and outcome are available for all participants. However, obtaining complete exposure data may be difficult in some settings, due to high measurement costs or lack of appropriate biospecimens. We used simulated data sets to assess statistical power and bias for MR when exposure data are available for a subset (or an independent set) of participants. We show that obtaining exposure data for a subset of participants is a cost-efficient strategy, often having negligible effects on power in comparison with a traditional complete-data analysis. The size of the subset needed to achieve maximum power depends on IV strength, and maximum power is approximately equal to the power of traditional IV estimators. Weak IVs are shown to lead to bias towards the null when the subsample is small and towards the confounded association when the subset is relatively large. Various approaches for confidence interval calculation are considered. These results have important implications for reducing the costs and increasing the feasibility of MR studies.
The Server Allocation Problem for Session-Based Multiplayer Cloud Gaming

Advances in cloud computing and GPU virtualization are allowing the game industry to move into a cloud gaming era. In this paper, we consider multiplayer cloud gaming (MCG), which is the natural integration of multiplayer online gaming and cloud gaming paradigms. With MCG, a game server and a set of rendering servers for the players need to be located and launched in the clouds for each game session. We formulate an MCG server allocation problem with the objective of minimizing the total server rental and bandwidth cost charged by the cloud to support an MCG session. The MCG server allocation problem is hard to solve optimally. We propose several efficient heuristics to address the problem and carry out theoretical analysis for the proposed hill-climbing algorithm. We conduct extensive experiments using real Internet latency and cloud pricing datasets to evaluate the effectiveness of our proposed algorithms as well as several alternatives. Experimental results show that our best algorithm can achieve near-optimal cost under real-time latency constraints.
Sequence and Expression Analyses of Ethylene Response Factors Highly Expressed in Latex Cells from Hevea brasiliensis

The AP2/ERF superfamily encodes transcription factors that play a key role in plant development and responses to abiotic and biotic stress. In Hevea brasiliensis, ERF genes have been identified by RNA sequencing. This study set out to validate the number of HbERF genes, and identify ERF genes involved in the regulation of latex cell metabolism. A comprehensive Hevea transcriptome was improved using additional RNA reads from reproductive tissues. Newly assembled contigs were annotated in the Gene Ontology database and were assigned to 3 main categories. The AP2/ERF superfamily is the third most represented compared with other transcription factor families. A comparison with genomic scaffolds led to an estimation of 114 AP2/ERF genes and 1 soloist in Hevea brasiliensis. Based on a phylogenetic analysis, functions were predicted for 26 HbERF genes. A relative transcript abundance analysis was performed by real-time RT-PCR in various tissues. Transcripts of ERFs from group I and VIII were very abundant in all tissues while those of group VII were highly accumulated in latex cells. Seven of the thirty-five ERF expression marker genes were highly expressed in latex. Subcellular localization and transactivation analyses suggested that HbERF-VII candidate genes encoded functional transcription factors.
Real-time market-based coordination mechanism for transmission and distribution networks

Distributed energy resources (DERs) such as renewable generation, energy storage and flexible loads have been acknowledged as the key drivers to transform the passive distribution networks into proactive players in the electricity market. In order to reduce the communication and computational complexity of integrating the huge number of DERs into the power system operation, the distribution system operator (DSO) is considered as the central controller to take charge of the dispatch of all the DERs within a distribution network. Through the exchange of boundary power flows and control signals, the independent system operator (ISO) coordinates all the DSOs to achieve certain social objective. In this paper, we study the interactions between the ISO and all the DSOs in both the day-ahead market and the real-time balancing market. Particularly, we identify that the locational marginal price (LMP) based real-time market is unfair and discourages the integration of DERs. To achieve a win-win solution for both the ISO and the DSOs, we propose a real-time coordination mechanism to determine the power dispatch and the corresponding charge/payments via a Nash bargaining problem. Numerical results show that our proposed mechanism guarantees that the ISO and all the DSOs can cooperatively maximize the social welfare and share the benefits fairly due to the cooperation.
The Transcriptome of an Amphioxus, Asymmetron lucayanum, from the Bahamas: A Window into Chordate Evolution

Cephalochordates, the sister group of tunicates plus vertebrates, have been called “living fossils” due to their resemblance to fossil chordates from Cambrian strata. The genome of the cephalochordate Branchiostoma floridae shares remarkable synteny with vertebrates and is free from whole-genome duplication. We performed RNA sequencing from larvae and adults of Asymmetron lucayanum, a cephalochordate distantly related to B. floridae. Comparisons of about 430 orthologous gene groups among both cephalochordates and 10 vertebrates using an echinoderm, a hemichordate, and a mollusk as outgroups showed that cephalochordates are evolving more slowly than the slowest evolving vertebrate known (the elephant shark), with A. lucayanum evolving even more slowly than B. floridae. Against this background of slow evolution, some genes, notably several involved in innate immunity, stand out as evolving relatively quickly. This may be due to the lack of an adaptive immune system and the relatively high levels of bacteria in the inshore waters cephalochordates inhabit. Molecular dating analysis including several time constraints revealed a divergence time of ∼120 Ma for A. lucayanum and B. floridae. The divisions between cephalochordates and vertebrates, and that between chordates and the hemichordate plus echinoderm clade likely occurred before the Cambrian.
Cognitive and Behavioral Consequences of Sleep Disordered Breathing in Children

There is now a plethora of evidence that children with sleep disordered breathing (SDB) show deficits in neurocognitive performance, behavioral impairments, and school performance. The following review will focus on the neurobehavioral impacts of SDB, pediatric sleep investigation challenges, potential mechanisms of behavioral and cognitive deficits in children with SDB, and the impact of SDB treatment.
A Web-Based Tool for Economic Analysis of Sediment Control on Rangeland Watersheds

This study presents a web-based spatial decision support system (SDSS) that supports watershed analysis from an economic perspective. The SDSS is intended to aid the development of sediment TMDLs sediment on rangeland watersheds. The SDSS architecture consists of three parts: the interface tier, the application tier, and the data tier. Middleware is used to integrate these three parts into one system. Dynamic web pages are used to support customized access to the system, including defining inputs, running analysis and viewing results. The middleware is used to glue the interface, model, and database together seamlessly. The embedded models include geospatial models and a watershed optimization model. The database is used to manage all the data through web-based interfaces. The SDSS supports spatial inputs, such as pasture boundaries, water points and stock ponds, and nonspatial inputs, such as cost scenarios, sediment control objectives and policy options. An embedded representative ranch model is used to optimize management options to meet profit and sediment yield objective. The screenshot for of the SDSS for the Walnut Gulch Experimental Watershed are used to illustrate the major functionality of the SDSS in assessment of Best Management Practices (BMPs) in soil conservation plans.
D-FES: Deep facial expression recognition system

In this computer era, the most interesting thing is to determine the human emotions with machines. Human relies on emotion for conveying their response to others. With advancement in the field of artificial intelligence, machines are also learning to understand these human emotions. With the evolution of deep learning in the field of computer vision, computers are used for solving problems like object detection, motion recognition, anomaly detection, and video surveillance. With our work, we tried to employ same deep learning methods to tackle the problem of emotion detection. Some of the previous works explored the capabilities of deep learning and achieved the efficiency like never before. Therefore, to make the interaction between human and computer more realistic we trained the machine to understand non-verbal communication in form of emotions. In this paper, we used a novel approach to detect the emotion based on the lips structure over the period of time. The use of the recurrent neural network to analyze the pattern with time provided the classification of emotions into 6 different classes. The qualitative, as well as quantitative evaluation, is done in order to compare the performances of our proposed model and state-of-the-art models. D-FES can perform in the real-time environment for accurate tracking and classification of emotions.
Stability analysis and error estimates of arbitrary Lagrangian–Eulerian discontinuous Galerkin method coupled with Runge–Kutta time-marching for linear conservation laws

In this paper, we discuss the stability and error estimates of the fully discrete schemes for linear conservation laws, which consists of an arbitrary Lagrangian–Eulerian discontinuous Galerkin method in space and explicit total variation diminishing Runge–Kutta (TVD-RK) methods up to third order accuracy in time. The scaling arguments and the standard energy analysis are the key techniques used in our work. We present a rigorous proof to obtain stability for the three fully discrete schemes under suitable CFL conditions. With the help of the reference cell, the error equations are easy to establish and we derive the quasi-optimal error estimates in space and optimal convergence rates in time. For the Euler-forward scheme with piecewise constant elements, the second order TVD-RK method with piecewise linear elements and the third order TVD-RK scheme with polynomials of any order, the usual CFL condition is required, while for other cases, stronger time step restrictions are needed for the results to hold true. More precisely, the Euler-forward scheme needs τ ≤ ρh2 and the second order TVD-RK scheme needs $ \tau \le \rho {h}^{\frac{4}{3}}$ for higher order polynomials in space, where τ and h are the time and maximum space step, respectively, and ρ is a positive constant independent of τ and h.
Deferoxamine ameliorates adipocyte dysfunction by modulating iron metabolism in ob/ob mice

Objective The mechanisms underlying obesity and anti-obesity processes have garnered remarkable attention as potential therapeutic targets for obesity-associated metabolic syndromes. Our prior work has shown the healing efficacy of iron reduction therapies for hepatic steatosis in a rodent model of diabetes and obesity. In this study, we investigated how iron depletion by deferoxamine (DFO) affected adipocyte dysfunction in the epididymal adipose tissues of ob/ob mice. Methods Male ob/ob mice were assigned to either a vehicle-treated or DFO-treated group. DFO (100 mg/kg body weight) was injected intraperitoneally for 15 days. Results We confirmed that iron deposits were statistically increased in the epididymal fat pad of 26-week-old ob/ob mice compared with wild-type (WT) mice. DFO significantly improved vital parameters of adipose tissue biology by reducing reactive oxygen species and inflammatory marker (TNFα, IL-2, IL-6, and Hepcidin) secretion, by increasing the levels of antioxidant enzymes, hypoxia-inducible factor-1α (HIF-1α) and HIF-1α-targeted proteins, and by altering adipocytic iron-, glucose- and lipid-associated metabolism proteins. Meanwhile, hypertrophic adipocytes were decreased in size, and insulin signaling pathway-related proteins were also activated after 15 days of DFO treatment. Conclusions These findings suggest that dysfunctional iron homeostasis contributes to the pathophysiology of obesity and insulin resistance in adipose tissues of ob/ob mice. Further investigation is required to develop safe iron chelators as effective treatment strategies against obesity, with potential for rapid clinical application.
An Account of Interference in Associative Memory: Learning the Fan Effect

Associative learning is an essential feature of human cognition, accounting for the influence of priming and interference effects on memory recall. Here, we extend our account of associative learning that learns asymmetric item-to-item associations over time via experience (Thomson, Pyke, Trafton, & Hiatt, 2015) by including link maturation to balance associations between longer-term stability while still accounting for short-term variability. This account, combined with an existing account of activation strengthening and decay, predicts both human response times and error rates for the fan effect (Anderson, 1974; Anderson & Reder, 1999) for both target and foil stimuli.
Interrill Soil Erosion - Part I: Development of Model Equations

ABSTRACT EQUATIONS describing overland flow depth, rainfall induced soil detachment and sediment transport capacity on interrill areas were identified. The Darcy-Weisbach equation which included a parameter for predicting flow resistance caused by rainfall was used to calculate depth of overland flow. Soil detachment was determined from an equation incorporating raindrop induced, impact pressure estimates. The product of a soil transport factor, bottom shear stress and flow velocity was used to calculate sediment transport capacity. Nondimensional forms of the model equations were evaluated using existing experimental data.
Performance analysis of conventional and digital PWM control scheme for speed control of BLDC motor drives

This paper presents the performance analysis of conventional and digital pulse width modulation (PWM) control scheme for speed control of electronically commuted trapezoidal Brushless dc (BLDC) motor. Both these methods follow the PWM speed control strategy, only difference is in the controller part. One drive system consist of conventional PI controller and the other have digital controller. This paper includes discussion on the implementation of both the techniques and their performances are compared. Co-simulation of closed loop control systems are modeled by using Xilinx Integrated Software Environment (ISE) simulator and MATLAB/Simulink. Experimental test setup is carried out using field-programmable gate arrays (FPGA). Simulation results and effectiveness of the methods are proved and validated by experimental results. The results of the two techniques are compared and conclusions are made.
Acute exacerbation of COPD: is it the “stroke of the lungs”?

Chronic obstructive pulmonary disease (COPD) is one of the top five major causes of morbidity and mortality worldwide. Despite worldwide health care efforts, costs, and medical research, COPD figures demonstrate a continuously increasing tendency in mortality. This is contrary to other top causes of death, such as neoplasm, accidents, and cardiovascular disease. A major factor affecting COPD-related mortality is the acute exacerbation of COPD (AECOPD). Exacerbations and comorbidities contribute to the overall severity in individual patients. Despite the underestimation by the physicians and the patients themselves, AECOPD is a really devastating event during the course of the disease, similar to acute myocardial infarction in patients suffering from coronary heart disease. In this review, we focus on the evidence that supports the claim that AECOPD is the “stroke of the lungs”. AECOPD can be viewed as: a Semicolon or disease’s full-stop period, Triggering a catastrophic cascade, usually a Relapsing and Overwhelming event, acting as a Killer, needing Emergent treatment.