Miracle-dz/UniFAR-FTUs huggingface dataset:
Significance of routine cerebrospinal fluid analysis in subarachnoid hemorrhage.

BACKGROUND The aim of this paper was to determine the diagnostic value of cerebrospinal fluid (CSF) analysis in the setting of aneurysmal subarachnoid hemorrhage (aSAH), hypothesizing that CSF analysis is only critical in confirming suspected infection and may be useful in predicting and/or detecting delayed cerebral ischemia (DCI). METHODS Retrospective review of consecutive adult patients diagnosed with aSAH from 1/2000 to 12/2013 at Mayo Clinic, Rochester, MN, USA with cerebral aneurysm(s) identified by vascular imaging, and CSF drawn within 14 days of the date of hemorrhage. RESULTS We identified 741 patients during the study period, 167 met inclusion criteria and 356 samples were collected. First Median CSF samples were taken 5 (4-8) days postbleed. Multiple samples were taken in 94 (54.5%) patients and the mean number of samples per patient was 2.1. Ventriculitis, confirmed by growth of organism from CSF culture was present in 2 (1.2%) patients and one patient (0.6%) developed meningitis. CSF WBC count remained elevated throughout the 14 days, even when corrected for red blood cell count (RBC). Peak CSF RBCs occurred 2-4 days post bleed, and then gradually normalized. Maximum CSF RBCs did not correlate with modified Fisher grades (P=0.422). Delayed cerebral ischemia (DCI) was present in 86 (51.5%) patients and there was no difference in the CSF profile of patients with DCI compared with those without. CONCLUSIONS Routine CSF sampling for cell count and chemistry in the setting of temporary diversion following aSAH appears to have little clinical benefit beyond the evaluation for infection.
Simulation-based learning in nurse education: systematic review.

AIM This paper is a report of a review of the quantitative evidence for medium to high fidelity simulation using manikins in nursing, in comparison to other educational strategies. BACKGROUND Human simulation is an educational process that can replicate clinical practices in a safe environment. Although endorsed in nursing curricula, its effectiveness is largely unknown. REVIEW METHODS A systematic review of quantitative studies published between 1999 and January 2009 was undertaken using the following databases: CINAHL Plus, ERIC, Embase, Medline, SCOPUS, ProQuest and ProQuest Dissertation and Theses Database. The primary search terms were 'simulation' and 'human simulation'. Reference lists from relevant papers and the websites of relevant nursing organizations were also searched. The quality of the included studies was appraised using the Critical Appraisal Skills Programme criteria. RESULTS Twelve studies were included in the review. These used experimental or quasi-experimental designs. All reported simulation as a valid teaching/learning strategy. Six of the studies showed additional gains in knowledge, critical thinking ability, satisfaction or confidence compared with a control group (range 7-11%). The validity and reliability of the studies varied due to differences in design and assessment methods. CONCLUSION Medium and/or high fidelity simulation using manikins is an effective teaching and learning method when best practice guidelines are adhered to. Simulation may have some advantage over other teaching methods, depending on the context, topic and method. Further exploration is needed to determine the effect of team size on learning and to develop a universal method of outcome measurement.
Identification of ZNF200 as a novel binding partner of histone H3 methyltransferase G9a

G9a belongs to the subfamily of histone H3 lysine 9 (H3‐K9)‐specific methyltransferases. On amino acid sequence alignment of human and Drosophila G9a, we found that the N‐terminal region from amino acids 532–605 to be evolutionarily conserved and named this the G9a homology domain (GHD). Using the GHD of human G9a (hG9a) as a bait, we isolated cDNA encoding a zinc finger protein 200 (ZNF200), which contains five C2H2‐type zinc finger domains in tandem arrays. Interaction between G9a and ZNF200 could be demonstrated by in vitro binding assays and immunoprecipitation experiments using cultured human HEK293 cell extracts. GST pull‐down assays using deletion derivatives of ZNF200 revealed that the interaction is through a region encompassing three of the five zinc finger domains. Furthermore, ZNF200 appear to co‐localize with G9a in the nucleoplasm of HEK293 cells as discrete speckles. These results demonstrate that ZNF200 is a novel binding partner of G9a.
Obstructive sleep apnea syndrome: are we missing an at-risk population?

STUDY OBJECTIVES While age and body-mass index (BMI) are well-established risk factors for obstructive sleep apnea syndrome (OSAS), this disorder occurs across a wide spectrum of ages and weights. Preconceptions regarding "classic" patients with OSAS may lead to underdiagnosis in at-risk populations, particularly younger nonoverweight individuals. We hypothesized that the severity of OSAS is independent of age and BMI in a younger less-obese population. METHODS Prospective study of consecutive patients diagnosed with OSAS. Active-duty military, National Guardsmen, and civilians were compared to determine if age and BMI correlated with disease severity. RESULTS Two hundred seventy subjects (120 active-duty, 80 National Guardsmen, 70 civilians) were included. Active-duty military members were significantly younger and less overweight than both National Guardsmen and civilians. Of the civilians, 64.3% and, of National Guardsmen, 48.8% were obese, whereas only 19.2% of active-duty had a BMI > or = 30 kg/m2 (p < .001). However, the prevalence of severe disease did not differ between groups. Disease severity showed no correlation with BMI among active-duty subjects (r = 0.09, p = .33). Of the active-duty subjects, 37.5% had severe disease, as compared with 42.5% of National Guard and 45.7% of civilian subjects (p = .18 and .09, respectively). BMI did not differ between active-duty subjects with severe disease and those with mild to moderate OSAS (26.7 kg/m2 versus 26.9 kg/m2, p = .40). There was a low but significant correlation between age and AHI (r = 0.21, p = .02) among all subjects. CONCLUSIONS OSAS occurs in young nonobese individuals and should be considered in patients reporting excessive daytime sleepiness, regardless of age or BMI.
The effect of the surface characteristics of various substrates on fluorapatite crystal growth, alignment, and spatial orientation.

BACKGROUND Fluorapatite-coated materials have potential application for dental and medical implants. In tooth development, the prism-like structure in enamel is thought to be created by the cells and proteins involved in enamel formation and maturation. This study investigated whether the substrate itself on which the films are grown, without the inclusion of cells or proteins, may affect their crystal alignment and three-dimensional morphology. MATERIAL/METHODS Human dentin/enamel junction (DEJ), dentin, stainless steel plates, etched stainless steel plates, etched titanium plates, glass, and mica were used as substrates to grow fluorapatite (FA) crystals using a hydrothermal method. FA crystal growth on these substrates was observed using scanning electron microscopy. RESULTS Under hydrothermal conditions, enamel prism-like structure could not be seen when the crystals were grown on mica or glass. Organized bundles of FA were created using DEJ, but not dentin, although it supported crystal growth. Etched stainless steel and titanium supported the growth of aligned FA crystals, but without the prism structure. CONCLUSIONS The surface properties of the substrate on which the nanocrystals grow appear to affect their alignment, organization, and consequently the formation of a prism structure.
Osteocutaneous free flaps: a critical analysis of quantitative evaluation of bone microcirculation with contrast-enhanced high resolution ultrasound (hrCEUS) and TIC analysis.

PURPOSE Osteocutaneous free flaps (OFF) are widely used to reconstruct large bone defects in trauma and cancer surgery. Currently no monitoring method is available to detect blood circulation around and inside the bone after transplantation. Therefore we used for the first time contrast-enhanced high-resolution ultrasound (hrCEUS) to gain evidence for the microcirculation of the transplanted bone. MATERIALS AND METHODS 15 patients transplanted with OFF because of large bone defects at different sites were examined postoperatively with hrCEUS with a high resolution linear probe (6-9 MHz, LOGIQ E9/GE) and a bolus injection of 2.4 ml of contrast agent (SonoVue®, Bracco, Italy). Operation and examination were performed by either an experienced plastic surgeon or an experienced ultrasound examiner. Microcirculation of the periost and bone was analyzed in different regions of interest (ROIs) and quantitative microcirculation analysis was performed using time intension curve analysis (TIC). We further analyzed clinical outcome of the patients in respect to revision-surgery, necrosis of the OFF and flap survival as well as viability on standard x-rays 2 months after surgery. RESULTS The most representative parameter by TIC analysis of hrCEUS were the area under the curve (AUC) and the time to peak (Ttop). The AUC of the periost and central part of the bone showed a high correlation (Pearson's r = 0.831). Mean AUC for the periost was 163.92 dB ± 49.44 and for the central part of the bone 70.42 dB ± 25.33. The Ttop of the periosteal ROI was 33.04 sec. ± 6.71 and the bone ROI 41.01 sec. ± 9.24. There was a high correlation of the Ttop of the periost and bone (Pearson's r = 0.937). One revision had to be performed due to haematoma and microcirculation defect of the distal part of the transplanted bone graft which was detected early by hrCEUS and the distal part of the avital bone could be removed timely. CONCLUSION For the first time we could show that hrCEUS is a reliable method to evaluate the viability of OFF. The AUC and Ttop seem to be a valuable parameter to detect the microcirculation around and inside the bone transplant.
Dissolution of ionizable water-insoluble drugs: the combined effect of pH and surfactant.

This study reports the results of the combined effect of pH and surfactant on the dissolution of piroxicam (PX), an ionizable water-insoluble drug in physiological pH. The intrinsic dissolution rate (J(total)) of PX was measured in the pH range from 4.0 to 7.8 with 0%, 0.5%, and 2.0% sodium lauryl sulfate (SLS) using the rotating disk apparatus. Solubility (c(total)) was also measured in the same pH and SLS concentration ranges. A simple additive model including an ionization (PX <--> H(+) + PX(-)) and two micellar solubilization equilibria (PX + micelle <--> [PX](micelle), PX(-) + micelle <--> [PX(-)](micelle)) were considered in the convective diffusion reaction model. J(total) and c(total) of PX increased with increasing pH and SLS concentration in an approximately additive manner. Nonlinear regression analysis showed that observed experimental data were well described with the proposed model (r(2) = 0.86, P < 0.001 for J(total) and r(2) = 0.98, P < 0.001 for c(total)). The pK(a) value of 5.63 +/- 0.02 estimated from c(total) agreed well with the reported value. The micellar solubilization equilibrium coefficient for the unionized drug was estimated to be 348 +/- 77 L/mol, while the value for the ionized drug was nearly equal to zero. The diffusion coefficients of the species PX, PX(-), and [PX](micelle) were estimated from the experimental results as (0. 93 +/- 0.35) x 10(-5), (1.4 +/- 0.30) x 10(-5), and (0.59 +/- 0.21) x 10(-5) cm(2)/s, respectively. The total flux enhancement is less than the total solubility enhancement due to the smaller diffusion coefficients of the micellar species. This model may be useful in predicting the dissolution of an ionizable water insoluble drug as a function of pH and surfactant and for establishing in vitro-in vivo correlations, IVIVC, for maintaining bioequivalence of drug products.
High Incidence of Macrolide and Tetracycline Resistance among Streptococcus Agalactiae Strains Isolated from Clinical Samples in Tehran, Iran.

BACKGROUND Streptococcus agalactiae or Group B Streptococci (GBS) is an important bacterial pathogen that causes a wide range of infections including neonatal sepsis, meningitis, pneumonia and soft tissue or urinary tract infections. MATERIAL AND METHODS One hundred and fifteen isolates of Streptococcus agalactiae collected from urine specimens of patients attending a hospital in Tehran. All isolates were screened for their capsular types and genes encoding resistance to the macrolide and tetracycline antibiotics by PCR and multiplex PCR-based methods. RESULTS Most of isolates belonged to capsular types III (49%), V (19%), II (16%), and Ib (6%). Twelve isolates (10%) were nontypable. All isolates were susceptible to penicillin and Quinupristin-dalfopristin, but were resistant to clindamycin (35%), chloramphenicol (45%), erythromycin (35%), linezolid (1%) and tetracycline (96%). The most prevalent antimicrobial resistance gene was tetM found in 93% of the isolates followed by ermTR, ermB, and tetK, found in 23%, 16%, and 16% of isolates, respectively. The genes, tetL, tetO, ermA, ermC and mefA were not detected in any of the S. agalactiae isolates. Of the 110 tetracycline resistant S. agalactiae, 89 isolates harbored the tetM gene alone and eighteen isolates carried the tetM gene with the tetK gene. All erythromycin-resistant isolates exhibited cMLSB resistance phenotype, 22 isolates harbored the ermTR gene alone and five isolates carried the ermTR gene with the ermB gene. The rate of coexistence of genes encoding the erythromycin and tetracycline resistance determinants was 34%. CONCLUSION The present study demonstrated that S. agalactiae isolates obtained from urine samples showed a high rate of resistance to tetracycline, chloramphenicol and macrolide antibiotics and were commonly associated with the resistance genes temM, ermTR or ermB.
Requirement for the MAP kinase kinase/MAP kinase cascade in Xenopus oocyte maturation.

MAP kinase kinase (MAPKK) has been identified as a protein factor that can induce phosphorylation and activation of inactive MAP kinase in vitro. In this study, we produced an anti‐Xenopus MAPKK antibody that can specifically inhibit Xenopus MAPKK activity in vitro. Microinjection of this antibody into immature oocytes prevented progesterone‐induced MAP kinase activation. Moreover, progesterone‐induced histone H1 kinase activation and germinal vesicle breakdown (GVBD) were inhibited in the oocytes injected previously with this antibody. Furthermore, when a bacterially expressed Mos was introduced into immature oocytes, Mos‐induced MAP kinase activation and GVBD were blocked in the oocytes injected with the anti‐MAPKK antibody. These results show that MAPKK is responsible for the activation of MAP kinase in vivo and that the MAPKK/MAP kinase cascade plays a pivotal role in the MPF activation during the oocyte maturation process.
Economic Design of Three-Phase Induction Motor by Particle Swarm Optimization

A Particle Swarm Optimization (PSO) based design of three-phase induction motors are proposed. The induction motor design is treated as a non-linear and multivariable constrained optimization problem. The annual material cost and the total annual cost of the motor are chosen as two different objective functions. The PSO is used to find a set of optimal design variables of the motor which are then used to predict performance indices and the objective functions. The proposed method is demonstrated for two sample motors, and it is compared with the genetic algorithm (GA) and the conventional design methods. The results show that the PSO-based method effectively solved the induction motor design problems and outperforms the other methods in both the solution quality and computation efficiency.
Granulocyte colony-stimulating factor in established febrile neutropenia: a randomized study of pediatric patients.

PURPOSE Infection in neutropenic patients is potentially life-threatening and carries important implications for hospital resource use. Prophylactic administration of cytokines may reduce the severity of neutropenia, but involves the treatment of all patients for the possible benefit of a minority. This study evaluates whether treatment with cytokines in the setting of established febrile neutropenia will influence outcome and be potentially more cost-effective. PATIENTS AND METHODS In a double-blind study, pediatric patients with fever and severe neutropenia were randomized to receive granulocyte colony-stimulating factor ([G-CSF] filgrastim; 5 microg/kg/d) or placebo, in addition to antibiotics. The study protocol required a resolution of fever and a neutrophil count > or = 0.2 x 10(9)/L for hospital discharge. Patients could be randomized for up to four independent febrile episodes. A total of 186 episodes of febrile neutropenia were investigated. RESULTS Patients randomized to G-CSF had a shorter hospital stay (median, 5 v 7 days; P = .04) and fewer days of antibiotic use (median, 5 v 6 days; P = .02). G-CSF-treated patients also had more rapid neutrophil recovery and higher neutrophil levels at discharge. The 2-day reduction in hospital stay reduced the median bed cost by 29% per patient admission (P = .04). CONCLUSION Under the clinical guidelines of our institution, the use of G-CSF in the treatment of established febrile neutropenia produced a small but significant reduction in the time that children required antibiotics and hospital admission, with possible cost savings.
Interleukin‐10 does not affect phagocytosis of particulate antigen by bonemarrow‐derived dendritic cells but does impair antigen presentation

Dendritic cells (DC) are important initiators of an immune response so understanding the factors controlling antigen acquisition and presentation has important consequences for the use of these cells in vaccines and other forms of immunotherapy. We investigated the factors that influence phagocytosis by immature bone marrow‐derived DC (BMDC) and the effect of interleukin‐10 (IL‐10) on this process. Two sizes of fluorescent particles and recombinant bacillus Calmette–Guèrin expressing the green fluorescent protein (rBCG) were used as particulate antigens. The percentage of cells taking up the antigen was found to be dependent on the size and dose of the particles, and the length of exposure to them. BMDC exposed to IL‐10 at various concentrations for different periods exhibited no distinguishable change in antigen uptake. However, if BMDC treated with IL‐10 and rBCG were then exposed to a second dose of particulate antigen, uptake was increased compared with those BMDC not treated with IL‐10. The expression of major histocompatibility complex class II, CD80, CD86 and CD11c by BMDC after phagocytosing rBCG or inert beads, was inhibited when the BMDC were pretreated with IL‐10. In contrast, the expression of CD25 was increased. BMDC that had taken up BCG or purified protein derivative (PPD) were able to stimulate primed T‐cell proliferation but this was severely inhibited if the BMDC were cultured with IL‐10 before exposure to the antigen. This work suggests that although IL‐10 does not affect the phagocytic capacity of BMDC, it does inhibit maturation of the cells and consequently, T‐cell activation.
Effects of the polycyclic aromatic hydrocarbon heterocycles, carbazole and dibenzothiophene, on in vivo and in vitro cypia activity and polycyclic aromatic hydrocarbon‐derived embryonic deformities

Herocyclic derivatives of polycyclic aromatic hydrocarbons (PAHs) are often significant components of environmental contaminant mixtures; however, their contribution to the toxicity of these mixtures is not well characterized. These heterocycles commonly co‐occur in PAH mixtures, which contain agonists for the aryl hydrocarbon receptor (AHR). Our goal for these studies was to explore the effects of two PAH heterocycles, carbazole (CB) and dibenzothiophene (DBT), alone and in combination with a PAH‐type agonist for the AHR (β‐naphthoflavone [BNF]) on AHR‐mediated cytochrome P4501A (CYP1A) activity and on fish embryotoxicity. Embryos of Fundulus heteroclitus were exposed to CB or DBT, with and without coexposure to BNF. Carbazole alone slightly induced, whereas DBT alone slightly reduced, in ovo CYP1A‐mediated ethoxyresorufin‐O‐deethylase (EROD) activity compared to control values. However, exposure to CB or DBT reduced in ovo EROD activity in embryos coexposed to BNF. Carbazole and DBT were characterized in vitro as noncompetitive CYP1A inhibitors. Carbazole and DBT enhanced the embryotoxicity of BNF, although neither compound was embryotoxic by itself. The co‐occurrence of CB and DBT with PAH‐type AHR inducers in contaminated ecosystems may increase the toxicity of PAH‐type AHR agonists in these settings and may need to be considered when estimating the embryotoxicity of PAH mixtures.
Should distribution systems engineering be taught at the undergraduate level?

Although there are some exceptions, a distribution systems course is not part of a typical undergraduate curriculum. The course is usually taught at the graduate level. Teaching a distribution systems course requires the student to have a background in balanced three-phase power system modeling such as that obtained from a first power systems analysis course. The requirement to add breadth to an undergraduate curriculum often precludes the notion of depth in any one area unless a student takes the depth courses as technical or free electives. An argument could be made that a distribution systems course does not contain much power engineering fundamentals beyond what is covered in a first power systems course. Conversely, much of the interesting concepts including load characteristics, transformer configurations, unbalanced system modeling, power quality modeling, radial system protection coordination, etc., occur at the distribution level. In addition, much of the smart grid innovations will occur at this level. This paper discusses some of the merits and demerits of developing and teaching a distribution systems course at the undergraduate level and also focuses on the difficulties of developing the contents of such a course.
Clarity of objectives and working principles enhances the success of biomimetic programs

Biomimetics, the transfer of functional principles from living systems into product designs, is increasingly being utilized by engineers. Nevertheless, recurring problems must be overcome if it is to avoid becoming a short-lived fad. Here we assess the efficiency and suitability of methods typically employed by examining three flagship examples of biomimetic design approaches from different disciplines: (1) the creation of gecko-inspired adhesives; (2) the synthesis of spider silk, and (3) the derivation of computer algorithms from natural self-organizing systems. We find that identification of the elemental working principles is the most crucial step in the biomimetic design process. It bears the highest risk of failure (e.g. losing the target function) due to false assumptions about the working principle. Common problems that hamper successful implementation are: (i) a discrepancy between biological functions and the desired properties of the product, (ii) uncertainty about objectives and applications, (iii) inherent limits in methodologies, and (iv) false assumptions about the biology of the models. Projects that aim for multi-functional products are particularly challenging to accomplish. We suggest a simplification, modularisation and specification of objectives, and a critical assessment of the suitability of the model. Comparative analyses, experimental manipulation, and numerical simulations followed by tests of artificial models have led to the successful extraction of working principles. A searchable database of biological systems would optimize the choice of a model system in top-down approaches that start at an engineering problem. Only when biomimetic projects become more predictable will there be wider acceptance of biomimetics as an innovative problem-solving tool among engineers and industry.