Miracle-dz/UniFAR-FTUs huggingface dataset:
An Evaluation of the Use of Aggressive Fluid Resuscitation in the Early Treatment of Sepsis Patients

Introduction Fluid resuscitation is a critical aspect of the sepsis protocol with the usual initial dose being 30 mL per kilogram. Although this dose is well accepted in patients with normal cardiac function, there is some significant variation in clinical practice concerning the optimal fluid resuscitation in septic patients with underlying congestive heart failure (CHF). Many different approaches have been tried to best treat these patients by using lesser volumes of fluid. The purpose of this retrospective study is to attempt to better define optimal fluid resuscitation in congestive heart failure patients and whether standard fluid resuscitation exacerbates CHF in these cases. Methods This was a retrospective study involving patients admitted to the Emergency Department (ED) during the time period of September of 2016 through March of 2019 with a primary diagnosis of sepsis and pre-existing CHF. Data collected from the data warehouse and patient charts included demographics, total amount of fluid received in the ED and outcome data. Evidence of fluid overload (chest X-ray [CXR] evidence, rising B-type natriuretic peptide [BNP], or use of diuretics), was evaluated with respect to in-hospital mortality, white blood cell (WBC) count and comorbidities (chronic obstructive pulmonary disease [COPD], hypertension and coronary artery disease). Results There were 422 patients included in the cohort. Of the 422, 113 (26.8%) patients showed evidence of fluid overload on CXR during hospital stay and received diuretics and therefore considered in the CHF exacerbation group. The patients that experienced CHF exacerbation were significantly older (mean ± SD, 70.9 ± 11.8 years versus 67.4 ± 15.1 years, p=0.014). Patients with exacerbation also received more fluid (median and interquartile range, 3.0, 2:5.5 L versus 2.0, 1:4.3 L, p=0.017). The receiver operating characteristic curve analysis for fluid to predict exacerbation resulted in an area under the curve of 0.59 with a 95% confidence interval (CI) of 0.52 to 0.65, p=0.012. The Youden Index was used to determine an optimal cutoff value of 2.6 L. The percentage of patients in the exacerbation group above the threshold was significantly higher (57.3%) than those without exacerbation (43.3%), p=0.019. Following multivariate analysis, age greater than 60 (odds ratio [OR]: 2.5; CI: 1.4-4.6, p=0.003) and fluid cutoff of 2.6 L (OR: 1.9; CI: 1.2-3.1, p=0.007) were both found to be independent predictors of CHF exacerbation. There was no significant difference in mortality based on the total fluid received in the ED. Conclusion The findings of this study showed that septic patients with pre-existing CHF who received more than 2.6 L of fluid in the ED were 90% more likely to develop symptoms of CHF exacerbation with no evidence of lowering mortality compared to the group that received less than 2.6 L. Our data supports the practice of limiting total fluid resuscitation in CHF to 2.6 L and reconfirms the idea that fluid resuscitation for patients with CHF needs to be individualized.
Early Detection of Freezing of Gait during Walking Using Inertial Measurement Unit and Plantar Pressure Distribution Data

Freezing of gait (FOG) is a sudden and highly disruptive gait dysfunction that appears in mid to late-stage Parkinson’s disease (PD) and can lead to falling and injury. A system that predicts freezing before it occurs or detects freezing immediately after onset would generate an opportunity for FOG prevention or mitigation and thus enhance safe mobility and quality of life. This research used accelerometer, gyroscope, and plantar pressure sensors to extract 861 features from walking data collected from 11 people with FOG. Minimum-redundancy maximum-relevance and Relief-F feature selection were performed prior to training boosted ensembles of decision trees. The binary classification models identified Total-FOG or No FOG states, wherein the Total-FOG class included data windows from 2 s before the FOG onset until the end of the FOG episode. Three feature sets were compared: plantar pressure, inertial measurement unit (IMU), and both plantar pressure and IMU features. The plantar-pressure-only model had the greatest sensitivity and the IMU-only model had the greatest specificity. The best overall model used the combination of plantar pressure and IMU features, achieving 76.4% sensitivity and 86.2% specificity. Next, the Total-FOG class components were evaluated individually (i.e., Pre-FOG windows, Freeze windows, transition windows between Pre-FOG and Freeze). The best model detected windows that contained both Pre-FOG and FOG data with 85.2% sensitivity, which is equivalent to detecting FOG less than 1 s after the freeze began. Windows of FOG data were detected with 93.4% sensitivity. The IMU and plantar pressure feature-based model slightly outperformed models that used data from a single sensor type. The model achieved early detection by identifying the transition from Pre-FOG to FOG while maintaining excellent FOG detection performance (93.4% sensitivity). Therefore, if used as part of an intelligent, real-time FOG identification and cueing system, even if the Pre-FOG state were missed, the model would perform well as a freeze detection and cueing system that could improve the mobility and independence of people with PD during their daily activities.
Rye Cover Crop and Nitrogen Fertilization Effects on Nitrate Leaching in Inbred Maize Fields

Nitrate leaching from maize (Zea mays L.) fields fertilized in excess of plant requirements continue to threaten water quality even though many agronomists have recommended reducing N fertilization rates to contain this environmental risk. Inbred maize has lower N uptake than conventional hybrid maize; therefore, inbred maize production exposes soils to even greater ground water pollution risks by nitrates. A 3-yr field experiment was conducted on sandy loam soils in southwestern Michigan to investigate the combined effects of N fertilization rates and rye (Secale cereale L.) cover crops on NO 3 leaching in inbred maize fields. Inbred maize was fertilized at 0, 101, and 202 kg N ha '. Annual NO 3 leaching losses were 7 kg N ha -1 higher in fields fertilized at 101 kg N ha 1 than in nonfertilized controls. Annual NO 3 leaching losses to ground water between May 1995 and April 1998 from lysimeters fertilized at 202 kg N ha 1 averaged 88 kg NO 3 -N ha '. Rye interseeded with inbred maize fertilized at 202 kg N ha 1 sequestered from 46 to 56 kg ha ' of excess fertilizer N. Rye scavenged little residual fertilizer N in plots fertilized at 101 kg N ha '. Well established rye cover crops in 1996 reduced NO 3 leaching by as much as 65 kg N ha ' when the previous crop was fertilized with 202 kg N ha '. Therefore, rye cover crops sequestered substantial amounts of soil NO 3 in heavily fertilized inbred maize fields.
Interpenetrating polymer networks based on poly(acrylic acid) and gelatin. I: Swelling and thermal behavior

This article describes the synthesis of full and semi-interpenetrating polymer networks (IPNs) based on poly(acrylic acid) and gelatin as polymers 1 and 2, which were crosslinked sequentially using N,N′-methylene bisacrylamide (BAm) and glutaraldehyde, respectively. Various samples were prepared by taking varying amounts of acrylic acid and gelatin in the initial feed. Sequential IPNs were prepared by first polymerizing and crosslinking acrylic acid in the presence of gelatin using redox initiators (ammonium persulphate and sodium metabisulphite) and BAm as a crosslinking agent. Gelatin present in the firm gels was then crosslinked using 4% glutaraldehyde. Characterization of these gels was done by measuring their swelling behavior as a function of pH, temperature, and time. Percent swelling increased with increasing amounts of acrylic acid. The swelling ratio was also determined in the pH range of 1 to 12. Acid/alkali or buffers were used for maintaining pH. A significant increase in the percent swelling was observed when pH of distilled water was above 10. On the other hand, in the case of buffer, the swelling ratio increased with increasing the pH, and a maxima was observed at pH 8.4. A further increase in pH resulted in a decrease in the swelling ratio. Thermal and morphological characterization was done using thermogravimetric analyzer and scanning electron microscopy, respectively. © 2001 John Wiley & Sons, Inc. J Appl Polym Sci 82: 217–227, 2001
An Ecological Momentary Intervention for people with social anxiety: A descriptive case study

ABSTRACT This study describes the development and pilot evaluation of a smartphone- delivered Ecological Momentary Intervention (EMI) for people with social anxiety symptoms. Using a software engineering framework (agile modeling, model-driven development, bottom-up development), mental health experts and software developers collaborated to develop a 4-module EMI app designed to reduce social anxiety in real-time. Fifty-five participants with social anxiety were randomly allocated to the EMI or a wait-list control arm. App downloads, usage and user satisfaction data were collected and mental health outcomes assessed at baseline and post-intervention. Software development practices allowed mental health experts to distil core elements of a psychological intervention into discrete software components but there were challenges in engaging mental health experts in the process. Relative to control there was no significant reduction in social anxiety among the EMI participants in the pilot trial. However, post-test data were available for only 4 intervention and 10 control participants and only 2 (4.0%) of the EMI participants downloaded the app. The two participants who both accessed the app and completed the post-test reported being satisfied with the intervention. Future research should address managing resources and providing additional training to support ongoing engagement with key stakeholders.
Endothelial transmigration of platelets depends on soluble factors released by activated endothelial cells and monocytes

Abstract Cardiovascular diseases (CVDs) remain leading causes of death worldwide. While platelet-mediated thrombus formation following the rupture of an atherosclerotic plaque is one of the key pathophysiologic events in CVDs, the role of platelets in previous or more advanced stages of atherosclerosis is less known. Interestingly, the presence of platelets has been observed at the core of the atherosclerotic plaque. In order to study the conditions necessary for platelets to migrate toward an atherosclerotic lesion, we designed an in vitro co-culture model. Platelets were co-cultured with monocytes in Transwell inserts covered with a confluent endothelium and the number of migrating platelets and/or monocytes was determined under different conditions. Platelets were also exposed to media conditioned obtained from co-cultures prior to migration assays. Here we show that coculturing platelets and monocytes increased platelet transmigration, with a considerable number of transmigrated platelets found not associated to monocytes. Interestingly, conditioned media from platelet-monocyte co-cultures also increased platelet transmigration and aggregation, suggesting the existence of soluble factors secreted by monocytes that enhance the migratory and pro-aggregating capabilities of platelets. We conclude that platelets have the machinery to migrate through an activated endothelium, a response that requires the interaction with secreted factors produce in the context of the interaction with monocytes under atherogenic conditions.
Crystal-Chemical Changes in an Oxidative Weathering Front in a Georgia Kaolin Deposit

The Eocene Huber Formation, exposed in the CFI Hall mine south of Irwinton, in Wilkinson County, Georgia, displays colored zones that are a consequence of an oxidative weathering front. These zones vary from very light gray (gray) to pinkish white (pink) to very pale yellow (cream) (Munsell N8, 5YR 8/2 and 2.5Y 8/2, respectively) with increasing degree of oxidation. A representative sample from each zone was collected and analyzed for its chemical, crystallographic and Raman spectroscopic properties. The comparison of these genetically related samples allowed for a quantitatively accurate assessment of anatase’s contribution to the total TiO2 content. All samples contain ∼1.5 wt. % TiO2. Progressing from gray to pink to cream, anatase contents range from half to nearly all the TiO2. The a lattice parameter for anatase is constant in all three kaolins (3.7916 Å), suggesting a constant 4.6 mol. % isomorphous substitution of Fe for Ti.Phase characterization and mass-balance considerations of the gray, pink and cream kaolins indicate that ilmenite and pyrite are precursor Ti- and Fe-bearing phases in the gray kaolin that undergo oxidation. Pseudorutile is a proposed intermediate phase resulting from the anodic corrosion of ilmenite. Hematite, goethite and anatase are the dominant end-products via dissolution-precipitation from the reactants pyrite and pseudorutile. The removal of Fe sulfides and organic matter and addition of hematite and goethite causes kaolin colors to change from gray to pink. Oxygen diffusing from groundwater in permeable overlying and underlying formations facilitates a process that probably involves aerobic and anaerobic bacteria that utilize Fe from pyrite, hematite and goethite. We postulate that the end result is the mobilization of Fe by siderophores and a kaolin color change from pink to cream.
The Impact of Classroom Chatter Noise on Comprehension: A Systematic Review

Communication through discussion and conversations is fundamental to human life; but when such discourse escapes the control of a teacher in the classroom, it becomes little more than chatter. This noise challenges teaching methods and the teaching stance with students. Yet, its impact on comprehension has rarely been studied. The aim of this literature review was to examine the research on the impact of classroom noise generated by chatter on students’ comprehension performance. We adopted the PRISMA (Preferred Reporting Items for Systematic Reviews and Metanalysis) guidelines to examine this literature. This review covered a 10-year period (papers written between 2009 and 2019), with nine experimental studies selected from the 2,954 papers screened. In 89% of these nine studies, there were significant comprehension differences on all tests, revealed when comprehension took place in a noisy environment due to chatter. This review indicated an essential need for a field survey to better understand the impact of chatter on comprehension. Other studies are recommended to highlight any correlation between measured chatter and student comprehension in a real classroom environment.
Bursitis, Bacteremia, and Disseminated Infection of Mycobacteroides (Mycobacterium) abscessus subsp. massiliense

We herein report a 59-year-old woman with a 2-year history of chronic bursitis of the hand who took 50 mg/day prednisolone for several autoimmune diseases. Mycobacteroides abscessus subsp. massiliense was isolated from the abscess and blood culture. Combination therapy (imipenem/cilastatin, amikacin, and clarithromycin) was administered for a month. Two months later, M. massiliense was detected from a blood culture again, and disseminated lesions were found. Clarithromycin and sitafloxacin were administered following eight weeks of the same regimen. Six months after the diagnosis, M. massiliense was isolated from a blood culture, and she expired due to multiple organ failure.
Costs and benefits of recycling PVC contaminated with the legacy hazardous plasticizer DEHP

Reusing materials is an attractive option for circular economy and can also reduce emissions of greenhouse gases and pollutants. However, recycling raises questions regarding the potential risks to human health or the environment when hazardous legacy chemical additives of materials are also recycled, instead of the recent and less hazardous additives of virgin materials. To address this trade-off, this study developed a model to calculate the total external cost of material supply, considering the health and environmental impacts of all industrial steps (e.g. virgin material production, incineration, and recycling), and the health effects of recycling chemicals present in the material. The model is coupling material flow analysis, life-cycle analysis, and environmental economics to compare different recycling policies. It is applied for all illustrative purposes to soft PVC and DEHP in France. Results show that recycling of materials is in the long-term positive despite the prolongation of the presence of hazardous additives in materials. The time when the recurring environmental benefits of recycling offset the negative impacts on human health of recycling the additives is very sensitive to the health impact of additives. This approach can improve the harmonization between recycling and circular economy policies, and as a framework to confirm the relevance and size treatments to remove additives from materials during recycling.
Protective efficacy of attenuated Salmonella Typhimurium strain expressing BLS, Omp19, PrpA, or SOD of Brucella abortus in goats

Background Attenuated Salmonella strain can be used as a vector to transport immunogens to the host antigen-binding sites. Objectives The study aimed to determine the protective efficacy of attenuated Salmonella strain expressing highly conserved Brucella immunogens in goats. Methods Goats were vaccinated with Salmonella vector expressing individually lipoprotein outer-membrane protein 19 (Omp19), Brucella lumazine synthase (BLS), proline racemase subunit A (PrpA), Cu/Zn superoxide dismutase (SOD) at 5 × 109 CFU/mL and challenge of all groups was done at 6 weeks after vaccination. Results Among these vaccines inoculated at 5 × 109 CFU/mL in 1 mL, Omp19 or SOD showed significantly higher serum immunoglobulin G titers at (2, 4, and 6) weeks post-vaccination, compared to the vector control. Interferon-γ production in response to individual antigens was significantly higher in SOD, Omp19, PrpA, and BLS individual groups, compared to that in the vector control (all p < 0.05). Brucella colonization rate at 8 weeks post-challenge showed that most vaccine-treated groups exhibited significantly increased protection by demonstrating reduced numbers of Brucella in tissues collected from vaccinated groups. Real-time polymerase chain reaction revealed that Brucella antigen expression levels were reduced in the spleen, kidney, and parotid lymph node of vaccinated goats, compared to the non-vaccinated goats. Besides, treatment with vaccine expressing individual antigens ameliorated brucellosis-related histopathological lesions. Conclusions These results delineated that BLS, Omp19, PrpA, and SOD proteins achieved a definite level of protection, indicating that Salmonella Typhimurium successfully delivered Brucella antigens, and that individual vaccines could differentially elicit an antigen-specific immune response.
Promoting cultural diversity and inclusion in undergraduate primary care education

ABSTRACT In this article, we review key factors in promoting a culturally diverse and inclusive learning environment for all undergraduate medical students, and the role of primary care educators in preparing students to work with diverse teams, patients and communities. These factors include approaches to curriculum and assessment, student community, faculty development and recruitment, and wider institutional factors. By highlighting these, including areas where further research, evaluation and consensus are needed, we hope to support further discourse on how primary care educators can promote culturally diverse and inclusive undergraduate medical education.
Setaria digitata was the main cause of equine neurological ataxia in Korea: 50 cases (2015–2016)

This study was performed to examine and clarify the cause of hindlimb ataxia and neuropathy seen in the South Korean horse population. Fifty horses diagnosed with hindlimb ataxia and neuropathy were referred for this study. Neurological examination was performed on 47 horses while necropsy was performed in all 50 animals. The occurrence of neurological diseases increased rapidly in the summer and 47 out of 50 horses were referred after the end of July. The incidence of neurological diseases started from the southern part of Korea in July and proceeded northward in August and September. Although there was no correlation with age, Thoroughbred and Warmblood horses showed a higher incidence rate than Halla and Jeju horses. The incidence rate was 5 times higher in geldings than in mares and stallions. Of the 20 cases, 16 were diagnosed with eosinophilic meningoencephalomyelitis in 2015. The most common lesions observed in 2016 were parasitic meningoencephalomyelitis (10 cases, 33%) and eosinophilic meningomyelitis (7 cases, 23%). Histopathological analysis of the brain and spinal cord revealed nematodes of approximately 100–200 µm in diameter, microcavitation and infiltrates of eosinophils, and brown pigmented macrophage infiltrates. The nematodes were identified as Setaria digitata via DNA sequencing, performed subsequent to polymerase chain reaction using DNA isolated from formalin-fixed paraffin-embedded tissue sections of the spinal cord. These results show that aberrant migration of Setaria digitata larva in the brain and spinal cord was a major cause for neurological signs in horses.
Incorporating Uncertainty in Data Labeling into Automatic Detection of Interictal Epileptiform Discharges from Concurrent Scalp-EEG via Multi-way Analysis

Interictal epileptiform discharges (IEDs) are elicited from an epileptic brain, whereas they can also be due to other neurological abnormalities. The diversity in their morphologies, their strengths, and their sources within the brain cause a great deal of uncertainty in their labeling by clinicians. The aim of this study is therefore to exploit and incorporate this uncertainty (the probability of the waveform being an IED) in the IED detection system which combines spatial component analysis (SCA) with the IED probabilities referred to as SCA-IEDP-based method. For comparison, we also propose and study SCA-based method in which probability of the waveform being an IED is ignored. The proposed models are employed to detect IEDs in two different classification approaches: (1) subject-dependent and (2) subject-independent classification approaches. The proposed methods are compared with two other state-of-the-art methods namely, time-frequency features and tensor factorization methods. The proposed SCA-IEDP model has achieved superior performance in comparison with the traditional SCA and other competing methods. It achieved 79.9% and 63.4% accuracy values in subject-dependent and subject-independent classification approaches, respectively. This shows that considering the IED probabilities in designing an IED detection system can boost its performance.
Small-Angle Neutron-Scattering and Viscosity Studies of CTAB/NaSal Viscoelastic Micellar Solutions

Micellar solutions of cationic surfactant cetyltrimethylammonium bromide (CTAB) in the presence of sodium salicylate (NaSal) show a viscoelastic behavior. Small-angle neutron-scattering (SANS) and viscosity studies from CTAB/NaSal micellar solutions are reported. Zero-shear viscosity of these solutions as a function of NaSal concentration (Cs), at all the four measured surfactant concentrations (Cd) of 12.5. 25, 50 and 100 mM, show a double-peak behavior. The effect of Cs/Cd on two viscosity maxima and a minimum has been examined, and the scaling relations are obtained. SANS experiments have been carried out at different NaSal concentrations, beyond the first viscosity maximum for two surfactant concentrations of 25 and 100 mM. It is found that micelles are rigid rods and their exponential length distribution shows that they behave as living polymers beyond the first viscosity maximum. The micellar structure does not change in the living polymer regime, whereas viscosity varies with increase in NaSal conc.