Miracle-dz/UniFAR-FTUs huggingface dataset:
Impact of adequate empirical antibiotic therapy on the outcome of patients admitted to the intensive care unit with sepsis*

ObjectivesOur primary goal was to evaluate the impact on in-hospital mortality rate of adequate empirical antibiotic therapy, after controlling for confounding variables, in a cohort of patients admitted to the intensive care unit (ICU) with sepsis. The impact of adequate empirical antibiotic therapy on early (<3 days), 28-day, and 60-day mortality rates also was assessed. We determined the risk factors for inadequate empirical antibiotic therapy. DesignProspective cohort study. SettingICU of a tertiary hospital. PatientsAll the patients meeting criteria for sepsis at admission to the ICU. InterventionsNone. Measurements and Main ResultsFour hundred and six patients were included. Microbiological documentation of sepsis was obtained in 67% of the patients. At ICU admission, sepsis was present in 105 patients (25.9%), severe sepsis in 116 (28.6%), and septic shock in 185 (45.6%). By multivariate analysis, predictors of in-hospital mortality were Sepsis-related Organ Failure Assessment (SOFA) score at ICU admission (odds ratio [OR], 1.29; 95% confidence interval [CI], 1.19–1.40), the increase in SOFA score over the first 3 days in the ICU (OR, 1.40; 95% CI, 1.19–1.65), respiratory failure within the first 24 hrs in the ICU (OR, 3.12; 95% CI, 1.54–6.33), and inadequate empirical antimicrobial therapy in patients with “nonsurgical sepsis” (OR, 8.14; 95% CI, 1.98–33.5), whereas adequate empirical antimicrobial therapy in “surgical sepsis” (OR, 0.37; 95% CI, 0.18–0.77) and urologic sepsis (OR, 0.14; 95% CI, 0.05–0.41) was a protective factor. Regarding early mortality (<3 days), factors associated with fatality were immunosuppression (OR, 4.57; 95% CI, 1.69–13.87), chronic cardiac failure (OR, 9.83; 95% CI, 1.98–48.69) renal failure within the first 24 hrs in the unit (OR, 8.63; 95% CI, 3.31–22.46), and respiratory failure within the first 24 hrs in the ICU (OR, 12.35; 95% CI, 4.50–33.85). Fungal infection (OR, 47.32; 95% CI, 5.56–200.97) and previous antibiotic therapy within the last month (OR, 2.23; 95% CI, 1.1–5.45) were independent variables related to administration of inadequate antibiotic therapy. ConclusionsIn patients admitted to the ICU for sepsis, the adequacy of initial empirical antimicrobial treatment is crucial in terms of outcome, although early mortality rate was unaffected by the appropriateness of empirical antibiotic therapy.
tRNA Actively Shuttles Between the Nucleus and Cytosol in Yeast

Previous evidence suggested that transfer RNAs (tRNAs) cross the nuclear envelope to the cytosol only once after maturing in the nucleus. We now present evidence for nuclear import of tRNAs in yeast. Several export mutants accumulate mature tRNAs in the nucleus even in the absence of transcription. Import requires energy but not the Ran cycle. These results indicate that tRNAs shuttle between the nucleus and cytosol.
Physical predictors, behavioural/emotional attributes and neurochemical determinants of dominant behaviour

Significant differences in physical and behavioural/emotional/cognitive predictors and attributes, as well as of neurochemical inducers of behaviour, between dominant and subordinate animals are discussed. It is still unknown whether these factors are the causes of differences between dominants and subordinates, or vice versa whether the differences between dominants and subordinates are the origin of differences in these factors. The possibility is discussed that no differences exist among juveniles in the concentrations of neurochemical agents (known in the literature as determinants of dominance) between the brains of future dominants and future subordinates. We describe a study design that makes the assessment of the ‘original’ neurochemical profile of the brain possible.
Induction of Ventricular Fibrillation in Brugada Syndrome by Site‐Specific Right Ventricular Premature Depolarization

CHINUSHI, M. , et al.: Induction of Ventricular Fibrillation in Brugada Syndrome by Site‐Specific Right Ventricular Premature Depolarization. This patient was a 50‐year‐old man. Oral pilsicainide unmasked a Brugada‐type ECG abnormality and self‐terminating polymorphic VT was repetitively induced. The polymorphic VT always developed following a specific ventricular premature complex showing a left bundle branch block pattern suggesting a limited origin in the right ventricle.
Matrix metalloproteinases in pulpitis, chronic apical periodontitis and odontogenic jaw cysts

Matrix metalloproteinases (MMPs) form an enzyme family capable of degrading almost all extracellular matrix (ECM) and basement membrane (BM) components. They play an important role in normal tissue remodelling and growth, as well as in many destructive pathological conditions such as inflammation, tumour growth and metastasis. The expression of MMP-8 in cultured human mature pulpal cells and odontoblasts was evaluated with polymerase chain reaction-method (PCR). Mesenchyme-derived cells, pulp tissue cells and odontoblasts expressed MMP-8, which was down-regulated by transforming growth factor (TGF) in these cell cultures. Immunohistochemical staining revealed MMP-8 protein in the odontoblasts. These results suggest that MMP-8 may participate in dentin matrix organization during dentin formation. The presence of MMP-8 in inflammatory pulpal and periapical tissues and in root-canal exudate during root-canal treatment was further studied. Using immunohistochemistry, MMP-8 staining was detected in polymorphonuclear leukocytes (PMNs), macrophages and plasma cells in both pulpal and periapical lesions. MMP-8 has evidently a role in pulpal and periapical inflammation. MMP-8 levels in periapical exudate were significantly reduced during root canal treatment. Measuring MMP-8 levels in periapical exudate may be used as a biochemical indicator/ molecular marker to monitor the inflammatory activity and success in root canal treatment. Odontogenic keratocyst (KC) has special characteristics; its epithelium proliferates rapidly and detaches easily from connective tissue stroma, it recurs easily and forms daughter cysts. With this background, the differential expression of MMPs in odontogenic cysts was studied. The results revealed colocalization of MMP-2 and MMP-13 with laminin-5 (Ln-5) 2-chain in the KC basement membrane zone indicating that especially these MMPs may be responsible for the epithelial detachment of KC. In all odontogenic cysts, MMP-8 protein was detected not only in PMNs, but also macrophages and plasma cells by immunohistochemistry. In situ hybridization showed MMP-8 mRNA expression in the plasma cells of follicular cyst (FC). MMP-13 expression was also localized to plasma cells in periapical lesions, KCs and plasmacytoma (PLC) specimens by both immunohistochemical staining and in situ hybridization. Cultured multiple myeloma cells showed that the expression of MMP-8 and MMP-13 was enhanced by phorphol-12-myristate-13-acetate (PMA) and heparin combined with different cytokines like interleukin-6 (IL-6). Overall, these results show that MMPs play an important role in ECM and BM remodelling and destruction during dentin formation, inflammatory processes of pulpitis, apical periodontitis, and enlargement of odontogenic jaw cysts, as well as reflect the special characteristics of them.
Pulmonary fungal infection: emphasis on microbiological spectra, patient outcome, and prognostic factors.

STUDY OBJECTIVES To investigate the microbiological spectra, patient outcome, and prognostic factors of pulmonary fungal infection. DESIGN The medical and microbiological records of patients with pulmonary fungal infection were retrospectively analyzed. SETTING A university-affiliated tertiary medical center. PATIENTS AND METHODS From January 1988 to December 1997, all cases of pulmonary fungal infection were reviewed. The criteria for inclusion were obvious lung lesion shown on chest radiographs and one of the following: (1) the presence of fungi in or isolation of fungi from the biopsy specimen of open thoracotomy, thoracoscopy, transbronchial lung biopsy, or ultrasound-guided percutaneous needle aspiration/biopsy; or (2) isolation of fungi from pleural effusion or blood, with no evidence of extrapulmonary infection. RESULTS A total of 140 patients were included. Ninety-four cases of pulmonary fungal infection (67%) were community acquired. The most frequently encountered fungi were Aspergillus species (57%), followed by Cryptococcus species (21%) and Candida species (14%). There were 72 patients with acute invasive fungal infection, with a mortality rate of 67%. Multivariate logistic regression analysis showed that nosocomial infection (p = 0.014) and respiratory failure (p = 0.001) were significantly and independently associated with death of acute invasive fungal infection. CONCLUSIONS Pulmonary fungal infection of community-acquired origins is becoming a serious problem. It should be taken into consideration for differential diagnosis of community-acquired pneumonia. Furthermore, acute invasive fungal infection is associated with a much higher mortality rate for patients with nosocomial infection or complicating respiratory failure. Early diagnosis with prompt antifungal therapy, or even with surgical intervention, might be warranted to save patients' lives.
Reduced miR-125 a-5 p expression is associated with gastric carcinogenesis through the targeting of E 2 F 3

Emerging evidence suggests that altered expression of microRNAs (miRNAs) is involved in cancer progression. However, the role of miR-125a-5p in gastric carcinogenesis remains unknown. Quantitative real-time PCR analysis revealed that the expression of miR-125a-5p was significantly decreased in >80% of gastric cancer tissues compared with their adjacent non-tumor tissues, and was markedly reduced in ~95% of intestinal-type gastric cancer tissues. The downregulated miR-125a-5p was significantly associated with gastric cancer metastasis. Ectopic expression of miR-125a-5p substantially inhibited the proliferation, migration and invasion activities of gastric cancer cells. Furthermore, forced expression of miR-125a-5p repressed the activity of a luciferase reporter carrying the 3'-untranslated (3'-UTR) region of E2F3, which was eliminated by mutation of the predicted miR-125a-binding site, indicating that E2F3 may be a potential target gene of miR-125a-5p. These data suggest that by targeting E2F3, miR-125a-5p may be important as a potential tumor suppressor gene in gastric carcinogenesis.
Data-wise Routing in Virtualization Environment (DRIVE) with multiple level of security for tactical network

With the rapid advanced in network technology, Network Virtualization has come into existence as a new approach of Active/Programmable Network. This software defined network platform makes it possible to design revolutionary networking architectures that go beyond the current TCP/IP based network. Clearly, traditional network can suffer and fail under extreme environment such as disaster recovery or military tactical networks due to their wireless ad hoc nature and inherent node mobility. The peculiar characteristics of tactical networks call for the new network paradigms to realize complex, adaptive, and fault-tolerant applications to be deployed in the battlefield. However, none of approaches concerns about the significance of data which is crucial in the concept of military network operation. For advanced tactical network, it is necessary to provide multiple level of security that can accommodate the different sensitivity levels of information. This research is focused on the use of network virtualization technique to address the restricts of military communication in traditional network and proposes the routing mechanism based on the multi level of security for tactical network.
Image fusion & mining tools for a COTS environment

We have continued development of a system for multisensor image fision and interactive mining based on neural models of color vision processing, learning and pattern recognition. We pioneered this work while at MIT Lincoln Laboratory, initially for colorfirsed night vision (low-light visible and uncooled thermal imagery) and'later extended it to multispectral IR and 30 ladar. We also developed a proof-of-concept system for EO, IR, SAR firsion and mining. Over the last year we have generalized this approach and developed a user- Ji-iendly system integrated into a COTS exploitation environment known as ERDAS Imagine. In this paper, we will summarize the approach and the neural networh used, and demonstrate fusion and interactive mining (i.e., target learning and search) of low-light visible/S WIRhWINL WIR night imagery, and IKONOS multispectral and high-resolution panchromatic imagery. Zn addition, we will demonstrate how target learning and search can be enabled over extended operating conditions by allowing training over multiple scenes. This will be illustrated for the detection of small boats in coastal waters using firsed visible/MW.IIRL WIR imagery.
Evidence of autosomal dominant Leber congenital amaurosis (LCA) underlain by a CRX heterozygous null allele

Originally described by Theodore Leber in 1869, Leber congenital amaurosis (LCA, MIM 204000) is the most early and severe form of all hereditary retinal dystrophies, responsible for congenital blindness.1 The diagnosis is usually made at birth or during the first months of life in an infant with total blindness or greatly impaired vision, normal fundus, and unrecordable electroretinogram (ERG). 2 It is usually accepted that LCA accounts for 5% of all inherited retinal dystrophies.3 However, this frequency is an underestimate since it is now agreed that in some cases LCA could represent the extreme end of a spectrum of severity of retinal dystrophies.4–6 Hitherto, LCA was considered as an autosomal recessive, genetically heterogeneous condition. Eight LCA genes have been identified or mapped so far, namely (1) the retinal specific guanylate cyclase gene ( retGC1 ) at the LCA1 locus (17p13.1),7 (2) the gene encoding the 65 kDa protein specific to the retinal pigment epithelium ( RPE65 ) at the LCA2 locus (1p31),4,8 (3) the cone-rod homeobox containing gene ( CRX , 19q13.3),9–11 (4) the gene encoding the arylhydrocarbon receptor interacting protein-like 1 at the LCA4 locus (17p13.1),12 (5) the gene encoding the retinitis pigmentosa GTPase regulator-interacting protein 1 ( RPGRIP1 ) at the LCA6 locus (14q11),13,14 (6) the human homologue of the Drosophila melanogaster crumbs gene ( CRB1 , 1q31),15,16 (7) LCA3 on chromosome 14q24,17 and (8) LCA5 on chromosome 6q.18 The two last loci respectively account for the disease in a consanguineous Saudi Arabian LCA family and a multigenerational kindred of Old Order River Brethren, an isolate originating from Swiss immigrants to America in the 1750s.17,18 Altogether, the six identified genes account for about 48% of LCA cases in our series19 and are consistent with autosomal recessive inheritance. …
Electron mobility model for strained-Si devices

Strained-Si material has emerged as a strong contender for developing transistors for next-generation electronics, because this material system offers superior transport properties. We suggest a model describing the low-field bulk mobility tensor for electrons in strained-Si layers as a function of strain. Our analytical model includes the effect of strain-induced splitting of the conduction band valleys in Si, intervalley scattering, and doping dependence. Intervalley scattering has been modeled on the equilibrium electron distribution and the valley splitting for a given strain tensor. The effect of different substrate orientations is considered by performing coordinate transformations for the strain tensor and effective masses. Monte Carlo simulations accounting for various scattering mechanisms and the splitting of the anisotropic conduction band valleys due to strain in combination with an accurate ionized impurity scattering model were carried out to verify the results for the complete range of Ge contents and for a general orientation of the SiGe buffer layer. Our mobility model is suitable for implementation into a conventional technology CAD simulation tool.
MUD for overloaded CDMA system using Pseudo-user concept

Multiple access interference (MAI) is the major limiting factor for the channel capacity especially when it is desired to have large number of users (overloaded) in DS-CDMA system. We propose a scheme which removes MAI with very little computations. The scheme is based on two requirements, firstly, presence of a user called ‘Pseudo-user’ whose data is already known to the receiver and secondly, cross-correlation of the spreading code set for the users is the same throughout. To achieve the second requirement, we divide the users equally in groups, giving each group an identity through an orthogonal spreading code. Now the number of users is small in every group, thus making it possible to find a set of spreading codes with same cross-correlation. The bit error rate (BER) is almost independent of the number of users and MAI is removed elegantly with simple computations.
Robust current controller for three-phase inverter using finite-state automaton

A novel feedback current controller for a three-phase load driven by a power inverter is proposed. The main design specifications are robustness to load electrical parameters, fast dynamical response, reduced switching frequency, and simple hardware implementation. To meet previous specifications a multi-variable hysteresis type controller is proposed, designed as a finite-state automaton and implemented with a programmable logic device. After a general introduction, system analysis is performed, control targets are specified, and the proposed control strategy is presented and discussed. Further, actual controller architecture, based on simple analog-logic hardware, is shown and experimental results are presented using an induction motor as the inverter load. However, this does not limit the wider applicability of the proposed controller that is suitable for different types of three-phase AC loads. >
Parameter Identification of Multiphase Induction Machines With Distributed Windings—Part 1: Sinusoidal Excitation Methods

Multiphase induction machines (IMs) are gaining increasing interest in industry due to their numerous advantages over the conventional three-phase ones. A lot of different parameter estimation methods have been developed for three-phase IMs, but the existing literature regarding specific identification techniques for multiphase IMs is almost nonexistent at this point. This paper proposes simple offline methods to estimate the stator resistance and stator leakage inductance of multiphase IMs with distributed windings, under different conditions, utilizing the machine's degrees of freedom associated with the nonflux/torque producing current components. Once these parameters are identified, the rotor ones can be easily calculated by combination with the total values obtained from locked-rotor tests. The procedure enables segregation of the stator and rotor parameters in a simple manner, something that is very difficult to achieve in three-phase IMs where, usually, equality of leakage inductances and a constant stator resistance are assumed. In this manner, the magnetizing inductance can be then also more accurately assessed from no-load tests, because the error in its estimation that would be caused by assuming both leakage inductances to be equal is avoided. The proposed methods are experimentally tested on two different five-phase IMs.
Theory of mind deficit in people with schizophrenia during remission

Background. The authors' goal was to investigate the presence or absence of theory of mind impairments among people with schizophrenia during remission. Recent research results interpret theory of mind deficits as state rather than trait characteristics, connecting these impairments mainly to the acute episode of psychosis. Methods. Twenty patients with schizophrenia in remission and 20 matched control subjects were evaluated. Participants were presented with one first-order theory of mind task, one second-order theory of mind task, two metaphor and two irony tasks adapted from previous studies. Results. The schizophrenic patients performed a statistically significant impairment in the irony task, as there were no significant differences in the cases of the other evaluated tasks. Conclusions. These preliminary results suggest that theory of mind impairments can be detected not only in the acute phase as found in previous research studies, but also in remission.
The Efficacy and Safety of Pain Management Before and After Implementation of Hospital-Wide Pain Management Standards: Is Patient Safety Compromised by Treatment Based Solely on Numerical Pain Ratings?

Inadequate analgesia in hospitalized patients prompted the Joint Commission on Accreditation of Healthcare Organizations in 2001 to introduce standards that require pain assessment and treatment. In response, many institutions implemented treatment guided by patient reports of pain intensity indexed with a numerical scale. Patient safety associated with treatment of pain guided by a numerical pain treatment algorithm (NPTA) has not been examined. We reviewed patient satisfaction with pain control and opioid-related adverse drug reactions before and after implementation of our NPTA. Patient satisfaction with pain management, measured on a 1–5 scale, significantly improved from 4.13 to 4.38 (P < 0.001) after implementation of an NPTA. The incidence of opioid over sedation adverse drug reactions per 100,000 inpatient hospital days increased from 11.0 pre-NPTA to 24.5 post-NPTA (P < 0.001). Of these patients, 94% had a documented decrease in their level of consciousness preceding the event. Although there was an improvement in patient satisfaction, we experienced a more than two-fold increase in the incidence of opioid over sedation adverse drug reactions in our hospital after the implementation of NPTA. Most adverse drug reactions were preceded by a documented decrease in the patient's level of consciousness, which emphasizes the importance of clinical assessment in managing pain.
Gene expression levels as predictive markers of outcome in pancreatic cancer after gemcitabine-based adjuvant chemotherapy.

BACKGROUND AND AIMS The standard palliative chemotherapy for pancreatic ductal adenocarcinoma (PDAC) is gemcitabine-based chemotherapy; however, PDAC still presents a major therapeutic challenge. The aims of this study were to investigate the expression pattern of genes involved in gemcitabine sensitivity in resected PDAC tissues and to determine correlations of gene expression with treatment outcome. MATERIALS AND METHODS We obtained formalin-fixed paraffin-embedded (FFPE) tissue samples from 70 patients with PDAC. Of the 70 patients, 40 received gemcitabine-based adjuvant chemotherapy (AC). We measured hENT1, dCK, CDA, RRM1, and RRM2 messenger RNA (mRNA) levels by quantitative real-time reverse transcription-polymerase chain reaction and determined the combined score (GEM score), based on the expression levels of hENT1, dCK, RRM1, and RRM2, to investigate the association with survival time. By determining the expression levels of these genes in endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) cytologic specimens, we investigated the feasibility of individualized chemotherapy. RESULTS High dCK (P = .0067), low RRM2 (P = .003), and high GEM score (P = .0003) groups had a significantly longer disease-free survival in the gemcitabine-treated group. A low GEM score (<2) was an independent predictive marker for poor outcome to gemcitabine-based AC as shown by multivariate analysis (P = .0081). Altered expression levels of these genes were distinguishable in microdissected neoplastic cells from EUS-FNA cytologic specimens. CONCLUSIONS Quantitative analyses of hENT1, dCK, RRM1, and RRM2 mRNA levels using FFPE tissue samples and microdissected neoplastic cells from EUS-FNA cytologic specimens may be useful in predicting the gemcitabine sensitivity of patients with PDAC.