Miracle-dz/UniFAR-FTUs huggingface dataset:
Prognostic Value of B-Type Natriuretic Peptide, Leukocytosis, and Hyperglycemia in Children with Severe Hand, Foot, and Mouth Disease

Objective: Our goal is to determine the prognostic value of serum N-terminal prohormone of brain natriuretic peptide (NT-proBNP), leukocytosis, and hyperglycemia in patients with severe hand, foot, and mouth disease (HFMD). Design: This is a prospective cohort study conducted from March 2011 through October 2012 at Hunan Children's Hospital. Setting: Hunan Children's Hospital, a large children's teaching hospital with 1,500-beds located in the Changsha region of Hunan Province in China. Patients: 295 children who were presented with clinical manifestation of severe HFMD, and required hospitalization. Interventions: Standard supportive treatment for HFMD as recommended by the national guidelines. Measurements: Admission blood samples were analyzed for NT-proBNP, leukocyte count, and serum glucose. Independent prognostic value of NT-proBNP for predicting mortality was evaluated using the Cox proportional hazard model adjusting for various covariates. Main Results: Area under the curve of receiver operating characteristic (AUROC) analysis suggested that a serum concentration of NT-proBNP concentration more than 1,500 pg/mL is an optimal cutoff point. Twenty-four patients (8.1%) had an NT-proBNP more than 1,500 pg/mL, and a 3-day mortality of 46% (11/24). Adjusted for tachycardia, tachypnea, hypertension, hyperglycemia, leukocytosis, and conscious disturbance on presentation, elevated NT-proBNP was associated with a 22.5-fold (95% confidence interval, 3.56–142.66) increased risk of 3-day mortality. We have further improved the specificity and AUROC values by the HFMD laboratory score, which combines NT-proBNP, leukocytosis, and hyperglycemia. Conclusions: Routine admission surveillance for NT-proBNP is useful for identifying patients with HFMD at risk for mortality. Further studies are needed to determine whether early intervention in patients with highly elevated NT-proBNP can improve outcome.
Adolescents at Risk: Prevalence and Prevention

PART I: High risk behaviour: The setting: A description of adolescence in the United States Prevalence of delinquency Prevalence of substance abuse Prevalence of adolescent pregnancy Prevalence of school failure The overlap in high-risk behaviours PART II: Prevention interventions: Classification and organization of programs Prevention of delinquency Prevention of substance abuse Prevention of adolescent pregnancy Prevention of school failure and dropping out PART III: Shaping a strategy to prevent high-risk behaviour: Common concepts of successful prevention programs Strategies for preventing high-risk behaviour.
Where's the Leak in Vascular Barriers? A Review

ABSTRACT Edema is typically presented as a secondary effect from injury, illness, disease, or medication, and its impact on patient wellness is nested within the underlying etiology. Therefore, it is often thought of more as an amplifier to current preexisting conditions. Edema, however, can be an independent risk factor for patient deterioration. Improper management of edema is costly not only to the patient, but also to treatment and care facilities, as mismanagement of edema results in increased lengths of hospital stay. Direct tissue trauma, disease, or inappropriate resuscitation and/or ventilation strategies result in edema formation through physical disruption and chemical messenger-based structural modifications of the microvascular barrier. Derangements in microvascular barrier function limit tissue oxygenation, nutrient flow, and cellular waste removal. Recent studies have sought to elucidate cellular signaling and structural alterations that result in vascular hyperpermeability in a variety of critical care conditions to include hemorrhage, burn trauma, and sepsis. These studies and many others have highlighted how multiple mechanisms alter paracellular and/or transcellular pathways promoting hyperpermeability. Roles for endothelial glycocalyx, extracellular matrix and basement membrane, vesiculo-vacuolar organelles, cellular junction and cytoskeletal proteins, and vascular pericytes have been described, demonstrating the complexity of microvascular barrier regulation. Understanding these basic mechanisms inside and out of microvessels aid in developing better treatment strategies to mitigate the harmful effects of excessive edema formation.
The PlA1/A2 polymorphism of glycoprotein IIIa and cerebrovascular events in hypertension: increased risk of ischemic stroke in high-risk patients

Objective The platelet GPIIIa plays a pivotal role in platelet aggregation. Previous studies showed an association between the GPIIIa PlA1/A2 polymorphism and coronary thrombosis, while there is only contrasting evidence about its role in stroke. We explored the possibility that this polymorphism represents a risk factor for stroke in hypertensive patients. Methods We studied two populations. In loco, we genotyped 140 hypertensive control individuals and 28 hypertensive patients with ischemic stroke. Furthermore, we performed an analysis of previously published data of 451 Sardinian hypertensive patients, already characterized and genotyped. Results Association analysis revealed that the PlA2 distribution was similar between hypertensive patients with and without stroke, but when considering a more homogeneous population of high-risk hypertensive patients, defined according to ESH/ESC 2003 guidelines, we observed that the frequency of the PlA2 allele was higher among stroke versus nonstroke patients (stroke, 46.4%; nonstroke, 22.6%; P = 0.01). The multiple regression analysis taking into account this polymorphism among other factors known to contribute to ischemic stroke confirmed the PlA2 allele as an additive risk factor for stroke (B = 0.986, Wald = 4.943, P < 0.03), increasing the risk of stroke by 2.9 (95% confidence interval = 1.23–6.85, P < 0.02). Similar results were obtained in the Sardinian population: in hypertensive patients with three or more risk factors, PlA2 increases the risk (odds ratio = 2.8, 95% confidence interval = 1.3–6.0, P < 0.001) and is an additive risk factor for stroke (B = 1.073, Wald = 6.920, P < 0.01). Conclusions Our data suggest that the PlA2 polymorphism is a genetic determinant of ischemic stroke in a selected high-risk hypertensive population.
Late Therapeutic Intervention with Antibiotics and Fluid Resuscitation Allows for a Prolonged Disease Course with High Survival in a Severe Murine Model of Sepsis

Abstract Current animal models of sepsis often incorporate antibiotics to be consistent with clinical standards for treatment of patients in the intensive care unit. However, such experimental intervention is commonly initiated very early after infectious insult, which likely blunts the progression of systemic inflammation and downstream pathology. The objective of this study was to establish an animal model of sepsis with delayed therapeutic intervention, allowing a longer disease course and downstream pathology, but still resulting in a high survival rate. Severe lethal abdominal infection was initiated in young adult (17–18-week-old) C57BL/6 mice by cecal slurry (CS) injection. When initiated early (1- or 6-h post-CS injection), antibiotic treatment (imipenem, 1.5 mg/mouse i.p., twice/day for 5 days) rescued the majority of mice; however, few of these mice showed evidence of bacteremia, cytokinemia, or organ injury. When antibiotic treatment was delayed until late time-points (12- or 24-h post-CS injection) the majority of animals did not survive beyond 48 h. When fluid resuscitation (physiological saline, s.c.) was performed in combination with antibiotic treatment (twice daily) beginning at these late time-points, the majority of mice survived (75%) and showed bacteremia, cytokinemia, organ dysfunction, and prolonged body weight loss (<90% for 4 weeks). We recommend that this new repeated combination treatment with antibiotics and fluids resuscitation be initiated at a late time point after bacteremia becomes evident because this model more closely mimics the downstream pathological characteristics of severe clinical sepsis yet maintains a high survival rate. This model would be advantageous for studies on severe sepsis and postintensive care illness.
Cell-Derived Nanoparticles are Endogenous Modulators of Sepsis With Therapeutic Potential

ABSTRACT Cell-derived nanoparticles (CDNPs) containing cytosolic proteins and RNAs/DNAs can be isolated from stressed eukaryotic cells. Previously, CDNPs isolated from cultured cells exerted immunomodulatory activities in different infections. Here, we sought to elucidate the role of CDNPs using a murine model of cecal ligation and puncture (CLP). We hypothesized that CDNPs influence the immune response at the site of infection, where severe cellular stress occurs. We observed early CDNP accumulation in the peritoneum after 4 h and continued CDNP presence 24 h after CLP. To determine whether CDNPs influence the host response to sepsis, we isolated CDNPs from a murine fibroblast cell line stressed by nutrient-deprivation, and injected them into septic mice. CDNP-treated mice demonstrated decreased peritoneal interleukin 6 levels and an approximately 2-log lower bacterial load compared with control mice 24 h after CLP. Additionally, a 20% CFU reduction was observed when incubating CDNPs with Pseudomona aeroginosa, indicating that CDNPs are bactericidal. To identify CDNP-responsive cells, CFSE-labeled CDNPs were injected into mice at the time of CLP. We observed that CDNPs were preferentially ingested by F4/80+ macrophages, and to a lesser degree, associated with inflammatory monocytes and neutrophils. Strikingly, CDNP-ingesting cells demonstrated elevated CD11b and MHCII expression compared with control cells. Altogether, our data indicate that CDNPs enhance the immune response at the site of infection and promote bacterial clearance, by direct bacterial killing and increasing phagocyte activation. Thus, CDNPs represent a novel, unexplored endogenous sepsis modulator with therapeutic potential.
Comparison of clinical effectiveness of the emergent colonoscopy in patients with hematochezia according to the type of bowel preparation

Colonoscopy (CFS) is a valuable diagnostic tool in patients with hematochezia. However, the optimal preparation method of emergent CFS for hematochezia has not been defined. We investigated the clinical effectiveness of bowel preparation of patients with hematochezia using polyethylene glycol (PEG) solution and glycerin or water enemas.
The importance of cellular internalization of antibody-targeted carbon nanotubes in the photothermal ablation of breast cancer cells

Single-walled carbon nanotubes (CNTs) convert absorbed near infrared (NIR) light into heat. The use of CNTs in the NIR-mediated photothermal ablation of tumor cells is attractive because the penetration of NIR light through normal tissues is optimal and the side effects are minimal. Targeted thermal ablation with minimal collateral damage can be achieved by using CNTs attached to tumor-specific monoclonal antibodies (MAbs). However, the role that the cellular internalization of CNTs plays in the subsequent sensitivity of the target cells to NIR-mediated photothermal ablation remains undefined. To address this issue, we used CNTs covalently coupled to an anti-Her2 or a control MAb and tested their ability to bind, internalize, and photothermally ablate Her2 + but not Her2 − breast cancer cell lines. Using flow cytometry, immunofluorescence, and confocal Raman microscopy, we observed the gradual time-dependent receptor-mediated endocytosis of anti-Her2–CNTs whereas a control MAb–CNT conjugate did not bind to the cells. Most importantly, the Her2 + cells that internalized the MAb–CNTs were more sensitive to NIR-mediated photothermal damage than cells that could bind to, but not internalize the MAb–CNTs. These results suggest that both the targeting and internalization of MAb–CNTs might result in the most effective thermal ablation of tumor cells following their exposure to NIR light.
Non-fullerene acceptors based on central naphthalene diimide flanked by rhodanine or 1,3-indanedione.

Through the combination of central naphthalene diimide and terminal rhodanine or 1,3-indanedione functionalities, two new non-fullerene electron acceptors, coded as N3 and N4, were designed, synthesized and characterized. Both of the materials exhibited good solubility, thermal stability, and displayed energy levels matching those of the conventional and routinely used donor polymer poly(3-hexyl thiophene) (P3HT). A high power conversion efficiency of 4.76% was obtained in simple, solution-processable bulk-heterojunction devices (P3HT : N3 1 : 1.2) which is the best result for central NDI-based small molecular non-fullerene acceptors.
THE USE OF SMALL DEEP SKIN GRAFTS

The object of this paper is to call attention again to the value of very small grafts, especially to those which contain more of the true skin than the superficial grafts advocated by Reverdin. I have called these grafts "small deep grafts. " The hastening of the healing of granulating wounds by the use of small detached bits of skin was first demonstrated by J.-L. Reverdin.1His report to the Societe Imperiale de Chirurgie, Dec. 8, 1869, caused universal interest. He showed a patient on whom he had practiced "epidermic grafting," and described the grafts as consisting of the epidermis only. He says, "I raised with the point of a lancet two little flaps of epidermis from the right arm, taking care not to cut the dermis. " Grafts obtained by Reverdin's method are usually thought of as pure epidermic grafts, and in his articles Reverdin always spoke of them asgreffe epidermique
Nickel-assisted growth and selective doping of spinel-like gallium oxide nanocrystals in germano-silicate glasses for infrared broadband light emission

The target of taking advantage of the near-infrared light-emission properties of nickel ions in crystals for the design of novel broadband optical amplifiers requires the identification of suitable nanostructured glasses able to embed Ni-doped nanocrystals and to preserve the workability of a glass. Here we show that Ni doping of Li2O–Na2O–Ga2O3–GeO2–SiO2 glass (with composition 7.5:2.5:20:35:35 and melting temperature 1480 °C, sensibly lower than in Ge-free silicates) enables the selective embedding of nickel ions in thermally grown nanocrystals of spinel-like gallium oxide. The analysis of transmission electron microscopy and x-ray diffraction data as a function of Ni-content (from 0.01 to 1 mol%) indicates that Ni ions promote the nanophase crystallization without affecting nanoparticle size (∼6 nm) and concentration (∼4 × 1018 cm − 3). Importantly, as shown by optical absorption spectra, all nickel ions enter into the nanophase, with a number of ions per nanocrystal that depends on the nanocrystal concentration and ranges from 1 to 102. Photoluminescence data indicate that fast non-radiative decay processes become relevant only at mean ion–ion distances shorter than 1.4 nm, which enables the incorporation of a few Ni ions per nanoparticle without too large a worsening of the light-emission efficiency. Indeed, at 0.1 mol% nickel, the room temperature quantum yield is 9%, with an effective bandwidth of 320 nm.
A survey of liaison psychiatry services in the south-west of England

AIMS AND METHOD A postal survey was conducted to establish an overview of liaison psychiatry services in the south-west of England. Questionnaires were sent to all clinical directors of medicine, accident and emergency, and mental health in trusts which provide acute medical services. RESULTS Thirty-six questionnaires were returned (77%), covering 17 out of 18 trusts providing acute services. Five trusts (28%) have a comprehensive dedicated liaison psychiatry service. A further six trusts (33%) have a service for deliberate self-harm only. Many respondents were critical of what they perceived to be an inadequate service. Five trusts had introduced a service in the 12 months preceding the survey. CLINICAL IMPLICATIONS An unmet need for liaison psychiatry services is clearly perceived across the south-west of England.
Synthesis, characterization and photocatalytic evaluation of visible light activated C-doped TiO2 nanoparticles

We have demonstrated heterogeneous photocatalytic degradation of microcystin-LR (MC-LR) by visible light activated carbon doped TiO2 (C–TiO2) nanoparticles, synthesized by a modified sol–gel route based on the self-assembly technique exploiting oleic acid as a pore directing agent and carbon source. The C–TiO2 nanoparticles crystallize in anatase phase despite the low calcination temperature of 350 °C and exhibit a highly porous structure that can be optimized by tuning the concentration of the oleic acid surfactant. The carbon modified nanomaterials exhibited enhanced absorption in the broad visible light region together with an apparent red shift in the optical absorption edge by 0.5 eV (2.69 eV), compared to the 3.18 eV of reference anatase TiO2. Carbon species were identified by x-ray photoelectron spectroscopy analysis through the formation of both Ti–C and C–O bonds, indicative of substitution of carbon for oxygen atoms and the formation of carbonates, respectively. Electron paramagnetic resonance spectroscopy revealed the formation of two carbon related paramagnetic centers in C–TiO2, whose intensity was markedly enhanced under visible light illumination, pointing to the formation of localized states within the anatase band gap, following carbon doping. The photocatalytic activity of C–TiO2 nanomaterials was evaluated for the degradation of MC-LR at pH 3.0 under visible light (λ > 420 nm) irradiation. The doped materials showed a higher MC-LR degradation rate than reference TiO2, behavior that is attributed to the incorporation of carbon into the titania lattice.
EFFECTS OF CARVEDILOL ON MORTALITY AND INFLAMMATORY RESPONSES TO SEVERE HEMORRHAGIC SHOCK IN RATS

The nonselective &bgr;-adrenoceptor and the selective &agr;1-adrenoceptor blocker carvedilol are widely used in hypertensive and/or cardiac failure patients because of its efficacy. However, there have been few studies regarding the effects of carvedilol on severe hemorrhagic shock. The present study was performed to evaluate the effects of carvedilol on severe hemorrhagic shock in rats. Twenty-four male Sprague-Dawley rats were randomly assigned to 1 of the following 2 groups (n = 12 per group): control group, no medication; and treatment group, oral administration of carvedilol (10 mg/kg per day) for 5 days. All animals were anesthetized with i.p. pentobarbital. Severe hemorrhagic shock was induced by partial exsanguination. Eight minutes after shock, all removed blood was returned to the animal. No other treatments were administered before, during, or after shock. Hemodynamics and arterial blood gases were recorded, mortality was calculated for the 5-h observation period, and plasma cytokine concentrations were measured at 5 h after shock. The mortality rates at 5 h after cardiac arrest were 8% and 50% for control and treatment groups, respectively. The increases in base deficit and lactate concentrations were less in the control group than that in the treatment group. Moreover, the increases in TNF-&agr; concentrations were less in the control group than in the treatment group. The present study indicated that oral administration of carvedilol had adverse effects on mortality and inflammatory responses to severe hemorrhagic shock in rats. These findings suggest that carvedilol may adversely affect recovery from severe hemorrhagic shock.
A superconducting nanowire single photon detector on lithium niobate

Superconducting nanowire single photon detectors (SNSPDs) are a key enabling technology for optical quantum information science. In this paper we demonstrate a SNSPD fabricated on lithium niobate, an important material for high speed integrated photonic circuits. We report a system detection efficiency of 0.15% at a 1 kHz dark count rate with a maximum of ∼1% close to the critical current at 1550 nm wavelength for a parallel wire SNSPD with front side illumination. There is clear scope for improving on this performance with further materials optimization. Detector integration with a lithium niobate optical waveguide is simulated, demonstrating the potential for high single photon detection efficiency in an integrated quantum optic circuit.
Prophylactic aromatherapy for supervening infections in patients with chronic bronchitis. Statistical evaluation conducted in clinics against a placebo

A controlled clinical trial was conducted during the winter 1985–1986 with 182 patients with chronic bronchitis living in institutions to evaluate the effectiveness of ‘Gouttes aux Essences’ (Essence Drops), a well known mixture in aromatherapy to prevent supervening bronchial infections. Although the overall number of supervening infections and their characteristics were not modified by the treatment, the frequency of relapse at least appears to have been significantly lowered in the group receiving treatment compared to the group receiving placebo.
Reduced Activity of Glyceraldehyde 3‐Phosphate Dehydrogenase in Pancreas of Two Patients with Cystic Fibrosis

Post‐mortem studies of some enzymes connected to glucose metabolism were performed on pancreas, liver and adipose tissue from two patients with cystic fibrosis and from two age‐matched controls. The activity of glyceraldehyde 3‐phosphate dehydrogenase in the cystic fibrosis patients was markedly reduced in the pancreas, reduced to a lesser extent in the liver and increased in the adipose tissue. The activity of α‐glycerophosphate dehydrogenase was extremely high in cystic fibrosis pancreas, moderately higher in adipose tissue and considerably lower in the liver. Pyruvate kinase was decreased in CF pancreas and liver and increased in the adipose tissue. Glucose‐6‐phosphate dehydrogenase activity was detectable in cystic fibrosis pancreas, not detectable in the controls and lower in CF‐liver. All enzyme activities were compared with activities from organs of matched controls.
Preemptive Application of Airway Pressure Release Ventilation Prevents Development of Acute Respiratory Distress Syndrome in a Rat Traumatic Hemorrhagic Shock Model

ABSTRACT Background: Once established, the acute respiratory distress syndrome (ARDS) is highly resistant to treatment and retains a high mortality. We hypothesized that preemptive application of airway pressure release ventilation (APRV) in a rat model of trauma/hemorrhagic shock (T/HS) would prevent ARDS. Methods: Rats were anesthetized, instrumented for hemodynamic monitoring, subjected to T/HS, and randomized into two groups: (a) volume cycled ventilation (VC) (n = 5, tidal volume 10 mL/kg; positive end-expiratory pressure 0.5 cmH2O) or (b) APRV (n = 4, Phigh = 15–20 cmH2O; Thigh = 1.3–1.5 s to achieve 90% of the total cycle time; Tlow = 0.11–0.14 s, which was set to 75% of the peak expiratory flow rate; Plow = 0 cmH2O). Study duration was 6 h. Results: Airway pressure release ventilation prevented lung injury as measured by PaO2/FIO2 (VC 143.3 ± 42.4 vs. APRV 426.8 ± 26.9, P < 0.05), which correlated with a significant decrease in histopathology as compared with the VC group. In addition, APRV resulted in a significant decrease in bronchoalveolar lavage fluid total protein, increased surfactant protein B concentration, and an increase in epithelial cadherin tissue expression. In vivo microscopy demonstrated that APRV significantly improved alveolar patency and stability as compared with the VC group. Conclusions: Our findings demonstrate that preemptive mechanical ventilation with APRV attenuates the clinical and histologic lung injury associated with T/HS. The mechanism of injury prevention is related to preservation of alveolar epithelial and endothelial integrity. These data support our hypothesis that preemptive APRV, applied using published guidelines, can prevent the development of ARDS.