Miracle-dz/UniFAR-FTUs huggingface dataset:
Approaches to ventilation in intensive care.

BACKGROUND Mechanical ventilation is a common and often life-saving intervention in intensive care medicine. About 35% of all patients in intensive care are mechanically ventilated; about 15% of these patients develop a ventilation-associated pneumonia. The goal of ventilation therapy is to lessen the work of respiration and pulmonary gas exchange and thereby maintain or restore an adequate oxygen supply to the body's tissues. Mechanical ventilation can be carried out in many different modes; the avoidance of ventilation-induced lung damage through protective ventilation strategies is currently a major focus of clinical interest. METHOD This review is based on pertinent articles retrieved by a selective literature search. RESULTS Compared to conventional lung-protecting modes of mechanical ventilation, the modern modes of ventilation presented here are further developments that optimize lung protection while improving pulmonary function and the synchrony of the patient with the ventilator. In high-frequency ventilation, tidal volumes of 1-2 mL/kgBW (body weight) are given, at a respiratory rate of up to 12 Hz. Assisted forms of spontaneous respiration are also in use, such as proportional assist ventilation (PAV), neurally adjusted ventilatory assist (NAVA), and variable pressure-support ventilation. Computer-guided closed-loop ventilation systems enable automated ventilation; according to a recent meta-analysis, they shorten weaning times by 32% . CONCLUSION The currently available scientific evidence with respect to clinically relevant endpoints is inadequate for all of these newer modes of ventilation. It appears, however, that they can lower both the invasiveness and the duration of mechanical ventilation, and thus improve the care of patients who need ventilation. Randomized trials with clinically relevant endpoints must be carried out before any final judgments can be made.
Urban Policy Making and Subjective Service Evaluations: Are They Compatible?

1978). 15. The approach is spelled out in some detail in Bahl, Schroeder and Zorn, "Local Government Revenue and Expenditure Forecasting: Dallas, Texas. " 16. Note that there is no attempt to forecast future policy changes; this hesitancy to predict future political actions is, in general, the approach used in each of the major cities currently forecasting expenditures. See Bahl and Schroeder, "Forecasting Local Government Budgets. " 17. For an interesting discussion of these issues, in general, see Garry D. Brewer, "Where the Twain Meet: Reconciling Science and Politics in Analysis," Policy Sciences, Vol. 13 (June 1981), pp. 269-279. 18. The City of Portland, Oregon further restricts this assumption by assuming that "wage increases will not offset the previous year's purchasing power loss when inflation is above 8.0 percent. " City of Portland, Bureau of Management and Budget, "Preliminary Five Year Projection," Memorandum dated January 9, 1981, p. 8. 19. Although its forecasts were public, the approach used in New York City in the late 1970s was to include no increases in money wages in the projections other than those already included in multi-year union contracts. While the technique divulged no information of strategic value to the unions, it also greatly limited the reasonableness of the forecast results. 20. Indeed, William Ascher, Forecasting, An Appraisal for PolicyMakers and Planners (Baltimore: The Johns Hopkins University Press, 1978), p. 199, argues that the assumptions underlying a forecast are more important than choice of forecast methodology in determining forecast accuracy. 21. San Antonio Department of Budget and Research, City of San Antonio, Long-Range Financial Forecast, Fiscal Years 19811986 (San Antonio, Texas: December, 1980), pp. 10-14. San Antonio's document also issues repeated warnings to the reader that the projected budgetary shortfalls are not prophecies of such outcomes but only indicators that policies must be undertaken to ensure that they will not arise. 22. City of Shreveport, MultiYear Forecast, 1981-1985 (Shreveport, Louisiana: 1981), pp. 6-10.
General-Purpose, Parallel and Reversible Microfluidic Interconnects

The packaging of microfluidic chips is a limiting factor in their ease of use and widespread application. A simple and versatile casting procedure to fabricate a parallel minimal dead-volume connector using polydimethylsiloxane elastomers without the application of any adhesive materials is demonstrated. The interconnections reversibly join standard-sized teflon, glass, or plastic tubing to modular microfluidic systems with minimal dead volume for biological and chemical applications. Parallel port connectors with 18 and 35 channels have been developed to illustrate the applicability of this novel universal fluidic interface to the large-scale integration of microfluidic (chip) devices, which will scale without problem to 100 parallel channels. The advantages of this novel interface are evaluated in relation to a comprehensive classification and analysis of other world to chip interconnection technologies.
Visuospatial mnemonic load modulates event‐related slow potentials

ELECTROENCEPHALOGRAPHIC slow wave potentials were recorded during the performance of visuospatial working memory tasks. The aim was to study the effects of varying mnemonic loads on slow potentials, and to dissociate the contribution of mnemonic and motor components. Subjects were tested with three spatial delayed matching-to-sample tasks in which the mnemonic load varied while the preparatory motor demands remained constant. The delay-related slow potential was more negative during the tasks in which the subjects had to memorize the locations of six or four stimuli than when only one location had to be memorized. Significant differences between the slow potentials in the tasks with different mnemonic loads were recorded at frontal and temporal recording sites. Since the preparatory motor requirements were similar in all tasks, the modulation of slow potentials reflects working memory processing rather than motor preparatory activity.
Cerebrovascular response to arousal from NREM and REM sleep.

STUDY OBJECTIVE To determine the effect of arousal from sleep on cerebral blood flow velocity (CBFV) in relation to associated ventilatory and systemic hemodynamic changes. PARTICIPANTS Eleven healthy individuals (6 men, 5 women). MEASUREMENTS Pulsed Doppler ultrasonography was used to measure CBFV in the middle cerebral artery with simultaneous measurements of sleep state (EEG, EOG, and EMG), ventilation (inductance plethysmography), heart rate (ECG), and arterial pressure (finger plethysmography). Arousals were induced by auditory tones (range: 40-80 dB; duration: 0.5 sec). Cardiovascular responses were examined beat-by-beat for 30 sec before and 30 sec after auditory tones. RESULTS During NREM sleep, CBFV declined following arousals (-15% +/- 2%; group mean +/- SEM) with a nadir at 9 sec after the auditory tone, followed by a gradual return to baseline. Mean arterial pressure (MAP; +20% +/- 1%) and heart rate (HR; +17% +/- 2%) increased with peaks at 5 and 3 sec after the auditory tone, respectively. Minute ventilation (VE) was increased (+35% +/- 10%) for 2 breaths after the auditory tone. In contrast, during REM sleep, CBFV increased following arousals (+15% +/- 3%) with a peak at 3 sec. MAP (+17% +/- 2%) and HR (+15% +/- 2%) increased during arousals from REM sleep with peaks at 5 and 3 sec post tone. VE increased (+16% +/- 7%) in a smaller, more sustained manner during arousals from REM sleep. CONCLUSIONS Arousals from NREM sleep transiently reduce CBFV, whereas arousals from REM sleep transiently increase CBFV, despite qualitatively and quantitatively similar increases in MAP, HR, and VE in the two sleep states.
Multidecadal Modulation of the ENSO Teleconnection to Precipitation and Tree Growth Over Subtropical North America

The teleconnection of the El Niño/Southern Oscillation (ENSO) to instrumental precipitation and temperature during the cool season over North America is strongest and most temporally stable in the TexMex sector of northern Mexico and the borderlands of southwestern United States. The ENSO impact on North American hydroclimate expands and contracts out of this region on multidecadal timescales, possibly associated with the positive and negative phases of the Atlantic Multidecadal Oscillation. A subset of tree‐ring chronologies from the TexMex sector also has the strongest and most stable ENSO signal detected in the North American network, similar to the strong ENSO signal measured in instrumental climate data from the same region. This subset of chronologies is used to reconstruct the multivariate ENSO index (MEI) as a measure of ENSO impact on North American hydroclimate during the instrumental and preinstrumental eras. The reconstruction exhibits improved fidelity in the frequency domain and better registration of spatial changes in ENSO signal over North America when compared to an MEI reconstruction based on all ENSO‐correlated tree‐ring chronologies irrespective of temporal stability of correlation. When correlated with gridded instrumental and tree‐ring reconstructed Palmer drought indices across North America, the stable MEI estimate reproduces the changes in spatial impact of ENSO signal measured with instrumental data, and it reveals similar multidecadal changes in prehistory, potentially linked to the Atlantic Multidecadal Oscillation. The Great Plains drought of the 1850s and 1860s may have been an example of this Pacific‐Atlantic configuration.
Nonrigid registration of multiple sclerosis brain images using lesion inpainting for morphometry or lesion mapping

Morphometric studies of medical images often include a nonrigid registration step from a subject to a common reference. The presence of white matter multiple sclerosis lesions will distort and bias the output of the registration. In this article, we present a method to remove this bias by filling such lesions to make the brain look like a healthy brain before the registration. We finally propose a dedicated method to fill the lesions and present numerical results showing that our method outperforms current state of the art method. Hum Brain Mapp, 2009. © 2008 Wiley‐Liss, Inc.
Money laundering as a factor of economic destabilization in national and international measures

Money laundering is a complex criminal act, in fact performed by all organized crime groups for the purpose of legalizing illegally acquired assets. Globally, this phenomenon represents an important challenge, particularly in the domain of financing terrorism. Similar to other states worldwide, Serbia is not immune to this phenomenon. There are a number of strong indicators that display the prevalence, variety of forms and specificity of this derivate criminal act on the territory of the Republic of Serbia. In order to update the system of money laundering suppression and correspond to the international standards, Serbia developed a legal framework recognizing that the suppression of this phenomenon represents one of the most effective tools in combating organized crime. Money laundering is commonly performed in the international array for the purpose of concealing the origins of the resources. Thus, undertaking measures at national level would have limited effects without international cooperation and coordination.
Erythromycin and Position Facilitated Placement of Postpyloric Feeding Tubes in Burned Patients

Background: One of the main difficulties encountered in enteral nutrition in critically ill patients is the impaired gastric emptying: while the small bowel is ready the stomach is still ‘lazy’. This paper describes a simple bedside method for postpyloric feeding tube placement, using a gastric prokinetic agent, erythromycin, and patient positioning. Methods: In eight critically ill, burned patients a gastric feeding tube was placed in a reverse Trendelenburg, right lateral decubitus position. A dose of 250 mg of erythromycin was administered intravenously. Results: In 13 out of 14 attempts, the tube passed into the duodenum, a success rate of 92%. Conclusions: Combining the prokinetic effects of erythromycin with proper patient positioning allows a rapid bedside transpyloric placement of feeding tubes.
High‐sensitivity Detection of Autoantibodies Against Proteinase‐3 by a Novel Third‐generation Enzyme‐linked Immunosorbent Assay

The aim of this study was to evaluate a novel third‐generation enzyme‐linked immunosorbent assay (ELISA) for the high‐sensitivity detection of autoantibodies to proteinase‐3 (PR3) in patients with Wegener's granulomatosis (WG). First‐ and second‐generation ELISA for the detection of antineutrophil cytoplasmic antibodies (ANCA) frequently demonstrate insufficient sensitivity due to inadequate presentation of autoantigenic epitopes. Human PR3 was immobilized on the solid phase of ELISA plates by anchoring technique. Anti‐PR3 reactivity was measured in 34 C‐ANCA positive patients with WG, 11 MPO‐ANCA–positive patients with other autoimmune vasculitides, 65 patients with systemic lupus erythematosus (SLE), and 137 healthy blood donors. Thirty‐three of 34 patients with WG (97.1%) showed positive anti‐PR3 IgG antibody reactivity. None of 11 MPO‐ANCA positive vasculitis patients, none of 137 blood donors, and 3 of 65 SLE patients expressed elevated IgG reactivity to PR3 (specificity: 98.4%). Comparison with another third‐generation ELISA did not reveal different qualitative results. However, there was no significant correlation between quantitative results of both assays. Receiver operating characteristic (ROC) curve analysis revealed a significantly better assay performance compared with first (direct)‐ and second (capture)‐generation assays (P= 0.011 and P= 0.001, respectively). Third‐generation (anchor) anti‐PR3 ELISA exhibit significantly higher sensitivity than previous generation assays. Anchoring of PR3 renders the granulocyte protein more autoantigenic compared with direct or capture immobilization.
Misidentification of Burkholderia cepacia in US cystic fibrosis treatment centers: an analysis of 1,051 recent sputum isolates.

BACKGROUND Burkholderia cepacia remains a significant pathogen in persons with cystic fibrosis (CF). The medical and psychosocial consequences of pulmonary colonization with this bacterium are enormous. However, B cepacia may be frequently misidentified from CF sputum culture. STUDY OBJECTIVES To determine the rate of misidentification of B cepacia recently recovered from CF sputum culture of persons receiving care in US treatment centers. DESIGN Bacterial isolates cultured from CF sputum and putatively identified as B cepacia or other related nonlactose-fermenting Gram-negative species were referred from participating treatment centers. Isolates underwent polyphasic analyses employing phenotypic (selective media and biochemical testing) and genotypic (polymerase chain reaction) assays to determine species identification. Taxonomic evaluations were performed by using sodium dodecyl sulfate-polyacrylamide gel electrophoresis of whole-cell proteins and amplified-fragment length polymorphism analysis. MEASUREMENTS AND RESULTS A total of 1,051 isolates recovered from 608 patients were received from 115 treatment centers in 91 US cities. Among the isolates identified as B cepacia by referring laboratories, 11% could not be confirmed as B cepacia by polyphasic analyses. In addition, 36% of isolates not specifically identified by the referring laboratory or identified as a species other than B cepacia were, in fact, found to be members of the B cepacia complex. CONCLUSIONS Rates of misidentification of B cepacia remain unacceptably high among US treatment centers. These data suggest the need for increased awareness of this problem among CF centers and their affiliated laboratories, better adherence to recommended protocols for evaluation of CF sputum, and greater use of reference laboratories equipped to provide advanced analyses.
Determination of Diffusion Lengths With the Use of EBIC From a Diffused Junction With Any Values of Junction Depths

Minority carrier diffusion lengths determine the performance of bipolar and photodiode devices. An electron-beam- induced-current (EBIC) method has been widely used to extract this parameter. The extraction of the diffusion lengths involves a p-n junction to collect the minority carriers. The most used configuration, which is called the normal collector, assumes that the junction has an infinitely large junction depth. However, in planar devices, the junction depth is comparable to the diffusion lengths of the material. This paper presents a simple and yet accurate method to determine the diffusion lengths of the material from a diffused junction with any values of junction depths. The diffusion length of the material is extracted from the negative reciprocal of the slope of the EBIC profile in semi-logarithmic plot. It was found that the proposed method is able to extract the diffusion lengths accurately for any values of the junction depths and surface recombination velocities. The maximum error in using this method is about 6%
Emotional Intelligence: A Driving Force towards Organizational Development

The review was aimed to extract the findings of studies on emotional intelligence specifically in context of personnel performance in the organizations. The review consist of citing over fifty published articles (available online) covering the studies on emotional intelligence and connected it with the significance of EI on overall performance of individuals in organizations specifically. The review provides substantial support to the work of several researchers who have argued that EI is a significant predictor of work-related outcomes including motivation, creativity, managing stress and work-life balance. Moreover it is found in the review that emotionally intelligent teams can build social capital while emotionally intelligent leaders can strengthen the teams and cultivate a conducive work environment to achieve any milestone. The review strongly recommends to the leadership and the workforce of the modern organizations to acquire benefits of emotional intelligence in individual as well as social life through a dynamic learning attitude towards its components.Key Words: Emotional Intelligence, Organizational performance, Leadership
Molecular Basis of Rifampin Resistance inStreptococcus pneumoniae

ABSTRACT Rifampin resistance among South African clinical isolates ofStreptococcus pneumoniae was shown to be due to missense mutations within the rpoB gene. Sequence analysis of 24 rifampin-resistant isolates revealed the presence of mutations within cluster I as well as novel mutations in an area designated pneumococcus cluster III. Of the 24 isolates characterized, only 1 resistant isolate did not contain any mutations in the regions sequenced. Either the cluster I or the cluster III mutations separately conferred MICs of 32 to 128 μg/ml. Clinical isolate 55, for which the MIC was 256 μg/ml, was noted to contain 9 of the 10 mutations identified, which included the cluster I and cluster III mutations. As in Escherichia coli, it is possible that cluster I (amino acids 406 to 434) and cluster III (amino acids 523 to 600) of S. pneumoniaeinteract to form part of the antibiotic binding site, thus accounting for the very high MIC observed for isolate 55. PCR products containing cluster I or cluster III mutations were able to transform rifampin-susceptible S. pneumoniae to resistance. Although many of the isolates studied displayed identical sequences, pulsed-field gel electrophoresis analysis revealed that the isolates were not of clonal origin.
Lean and Green: The Move to Environmentally Conscious Manufacturing

This article presents the results of a national survey of environmental manufacturing practices. Efforts by firms to improve manufacturing processes and increase productivity create substantial opportunities for environmental improvement. The adoption of advanced manufacturing process innovations provides incentives for the adoption of environmentally conscious manufacturing strategies. Close relationships across the production chain, between end-users and suppliers in particular, facilitate the adoption of this related bundle of environmental and industrial innovations. Firms and plants that are R&D-intensive and manufacturing innovators possess the capacity to both improve productivity and reduce environmental costs and risks.
Blood pressure estimation using maximum slope of oscillometric pulses

A new oscillometric pulse index (OPI) derived from the maximum slope (MS) of each pulse in the oscillometric blood pressure waveform is proposed for blood pressure estimation. Maximum slope for each pulse is obtained using the first derivative of the pulse and an envelope of the values corresponding to the maximum slopes is obtained. The maximum of the envelope is taken as the mean arterial pressure (MAP) and the systolic blood pressure (SBP) and diastolic blood pressure (DBP) estimates are obtained as a fraction of the MAP, similar to the traditional maximum amplitude algorithm (MAA). The proposed algorithm is tested on 18 healthy subjects. The MAP, SBP and DBP estimates obtained from the proposed algorithm are compared with those obtained from a commercial blood pressure device and with the estimates obtained using the MAA and morphological qualitative measures available in the literature.
Adding insult to injury: neural sensitivity to social exclusion is associated with internalizing symptoms in chronically peer-victimized girls.

Despite evidence documenting activation of the social pain network in response to social rejection and its link to temporary distress, far less is known regarding its role in pervasive emotional difficulties. Moreover, research has not considered the intersection between neural activation to experimentally induced social exclusion and naturally occurring social adversity. This study examined an integrated social pain model of internalizing symptoms, which posits that (i) neural sensitivity in the social pain network is associated with internalizing symptoms, (ii) this linkage is more robust in youth with than without a history of social adversity, and (iii) heightened avoidance motivation serves as one pathway linking neural sensitivity and internalizing symptoms. During a functional magnetic resonance imaging scan, 47 adolescent girls (M age = 15.46 years, SD = .35) with well-characterized histories of peer victimization were exposed to social exclusion. Whole-brain analyses revealed that activation to exclusion in the social pain network was associated with internalizing symptoms. As anticipated, this linkage was stronger in chronically victimized than non-victimized girls and was partially accounted for by avoidance motivation. This research indicates the importance of integrating neural, social and psychological systems of development in efforts to elucidate risk for internalizing symptoms among adolescent girls.
Trajectory and surface modeling of LSF for low rate speech coding

In low rate speech coders, frame-based speech spectral parameters, represented by line spectral frequencies (LSF), are typically encoded by vector quantization without exploiting explicitly the temporal correlation between frames. Recently, however, methods have been proposed that model the temporal trajectory of each LSF over a speech segment by a low-order polynomial function. In the present work, we propose a method that exploits the joint spectro-temporal correlation across a speech segment. The LSF values are treated as points on a smooth surface obtained by fitting a loworder bivariate polynomial function of the variables, frame index and LSF index. The issues that arise in incorporating such joint modeling in a low bit rate coder are identified, and some comparative results of performance are presented.