Miracle-dz/UniFAR-FTUs huggingface dataset:
Antibiotic treatment strategies for community-acquired pneumonia in adults.

BACKGROUND The choice of empirical antibiotic treatment for patients with clinically suspected community-acquired pneumonia (CAP) who are admitted to non-intensive care unit (ICU) hospital wards is complicated by the limited availability of evidence. We compared strategies of empirical treatment (allowing deviations for medical reasons) with beta-lactam monotherapy, beta-lactam-macrolide combination therapy, or fluoroquinolone monotherapy. METHODS In a cluster-randomized, crossover trial with strategies rotated in 4-month periods, we tested the noninferiority of the beta-lactam strategy to the beta-lactam-macrolide and fluoroquinolone strategies with respect to 90-day mortality, in an intention-to-treat analysis, using a noninferiority margin of 3 percentage points and a two-sided 90% confidence interval. RESULTS A total of 656 patients were included during the beta-lactam strategy periods, 739 during the beta-lactam-macrolide strategy periods, and 888 during the fluoroquinolone strategy periods, with rates of adherence to the strategy of 93.0%, 88.0%, and 92.7%, respectively. The median age of the patients was 70 years. The crude 90-day mortality was 9.0% (59 patients), 11.1% (82 patients), and 8.8% (78 patients), respectively, during these strategy periods. In the intention-to-treat analysis, the risk of death was higher by 1.9 percentage points (90% confidence interval [CI], -0.6 to 4.4) with the beta-lactam-macrolide strategy than with the beta-lactam strategy and lower by 0.6 percentage points (90% CI, -2.8 to 1.9) with the fluoroquinolone strategy than with the beta-lactam strategy. These results indicated noninferiority of the beta-lactam strategy. The median length of hospital stay was 6 days for all strategies, and the median time to starting oral treatment was 3 days (interquartile range, 0 to 4) with the fluoroquinolone strategy and 4 days (interquartile range, 3 to 5) with the other strategies. CONCLUSIONS Among patients with clinically suspected CAP admitted to non-ICU wards, a strategy of preferred empirical treatment with beta-lactam monotherapy was noninferior to strategies with a beta-lactam-macrolide combination or fluoroquinolone monotherapy with regard to 90-day mortality. (Funded by the Netherlands Organization for Health Research and Development; CAP-START ClinicalTrials.gov number, NCT01660204.).
The vertical mechanical impedance of the locomotor system during human walking with applications in rehabilitation

We have developed a second order biomechanical model to estimate the vertical mechanical impedance of able-bodied walkers. Our ultimate purpose is to design prostheses for lower-limb amputees that provide the necessary impedance to match the vertical mechanical impedance of the able-bodied population. The objective is to increase walking comfort and walking speed for lower-limb amputees. The impedance values can also be used as a reference for shock absorption when designing walking machines.
Repulsion of phase-velocity dispersion curves and the nature of plate vibrations

The Lamb waves propagating in an elastic plate in vacuo generate compressional (L) and shear type (T) plate vibrations which are coupled due to the boundary conditions. Without such coupling, their phase-velocity dispersion curves would form two intersecting families which at high frequency tend towards the elastic-wave speeds C L and C T , respectively. It is shown that the coupling causes a repulsion of the dispersion curves similar to that encountered in atomic physics for the energy levels of atoms combining into molecules, which prevents their intersection and at the same time exchanges the nature (L↔T) of the underlying vibrations. However, in the repulsion regions a succession of dispersion curves combines to asymptotically approach the uncoupled L or T dispersion curves, respectively
Radiosensitivity at the subcellular level.

Studies were carried out at a subcellular level on 2 types of mouse mammary tumors, an epithelial slow-growing type, designated H, and a fast-growing spindle cell tumor, designated G. Both tumors are of the same genetic origin, having arisen from the mammary gland tissue of the inbred DBA/212 strain of mice. The tissues were irradiated in situ with various doses of x rays, up to 10000 r. A study of the distribution of catalase activity within the mitochondrial, microsomal, and cell sap fractions of both types of tumors showed that the highest activity of the enzyme resides in the mitochondrial fraction of the epithelial tumor, and in the cell sap fraction of the spindle cell tumor. A shift in catalase activity from mitochondrial to cell sap fraction occurred following irradiation of the tumors in situ. This is explained by a change in permeability or fragility of the mitochondrial membranous system. Electron microscopic studies of the tumors following irradiation revealed profound changes in the mitochondrial structures and ruptures in the limiting plasma membranes. Evidence is presented that the quantity and quality of the membranous system including mitochondria play a significant role in cellular radiosensitivity. It is conceivable that the variation inmore » radiosensitivity between different cell types is due to the difference in their cytoplasmic composition, specifically in the quality of the membranous system. It is suggested that interphase or acute cell death is caused by radiation damage to the plasma membrane. It is proposed that: the quality and quantity of the cytoplasmic constituents are determining factors in cellular radiosensitivity, and radiation damage to the membranous system (including mitochondria) such as change in permeability, dilatation of vesicles, and rupture of the limiting plasma membrane are the cause of interphase cell death. The cells that are rich in submicroscopic vesicles and poor in mitochondria seem to be the most radiosensitive. (TCO)« less
Metabolites from Sinularia species

This review covers about 40 species of the genus Sinularia, in which many compounds with novel chemical structures have been isolated, characterised and bioassayed for various activities since the beginning of marine chemistry until now. The bioactivities of the metabolites have been reported in the tables wherever found in the literature.
Droop controlled cognitive power electronics for DC microgrids

A dc-based low-voltage power supply offers many advantages over the historically grown ac voltage infrastructure. The paper shows the potentials for cost reduction, efficiency enhancement and equipment miniaturization through new cognitive power electronics, but also discusses the obstacles to a faster market penetration of dc microgrids. These include aspects of grid control, grid stability, security and safety. As a main challenge the arc phenomena in connectors will be discussed, which affects all mechanical connectors in a dc grid installation.
Arterial thrombus formation

Summary Platelet and coagulation factor-dependent thrombus formation is critical to limit post-traumatic blood loss at sites of vascular injury. However, under pathological conditions like rupture of an atherosclerotic plaque, it may also lead to vessel occlusion causing myocardial infarction or stroke. Therefore, antithrombotic treatment is the prime therapeutic option in the prophylaxis and treatment of ischaemic cardio- and cerebrovascular diseases. The use of existing antithrombotic agents is, however, limited by their inherent effect on primary haemostasis. In recent years, major advances have been made in understanding the mechanisms of thrombus formation in haemostasis and thrombosis and some studies raised the interesting possibility that occlusive thrombus formation and haemo stasis may involve partially different mechanisms. This review briefly summarizes these developments and highlights newly identified mechanisms involved in platelet adhesion and activation, intracellular calcium signaling, integrin activation and initiation of coagulation. The suitability of these pathways as novel targets for antithrombotic therapy is discussed.
Mathematics of Communications : Sequences , Codes and Designs ( 15 w 5139 )

Modern society depends crucially on the ability to store and transmit large amounts of digital information at high speed. Satellite communication, movies on demand, portable music players, flash drives, and cellphones all rely on the mathematical theory of coding to ensure that the original images, speech, music, or data can be recovered perfectly even if mistakes are introduced during storage or transmission [2], [27]. As coding theory has developed over the last 65 years, deep connections with the theory of combinatorial designs [1], [3], [7] and with sequences [18] [20], have been discovered. Emerging applications continually lead to new problems of codes, designs and sequences; conversely, new theoretical developments in these areas enable novel applications [8]. The workshop brought together representatives of the applied and theoretical communities that study the mathematics of communications, working in Mathematics, Computer Science, and Engineering departments, in order to promote new linkages and collaborations. Among the participants were four graduate students and two postdoctoral fellows. Five speakers gave extended expository lectures, accessible to all participants, with an emphasis on methods, approaches, and open questions. Nineteen speakers gave contributed talks on a range of theoretical and practical topics. A panel discussion gave participants an opportunity to reflect on the entire workshop and to assess future research directions. Throughout these events, as well as in numerous individual interactions, participants exchanged information and ideas about both theoretical and practical aspects, and identified new connections between the principal objects of study.
Enumeration of T cells reactive with Mycobacterium tuberculosis organisms and specific for the recombinant mycobacterial 64‐kDa protein

The major goal of the present study was to develop a limiting dilution system for the enumeration of T cells which respond to mycobacterial antigens. Purified T cells from M. tuburculosis‐immune mice were restimulated with mycobacterial antigens and accessory cells, and after 4 days expanded with antigen, accessory cells and T cell growth factor. After another 3 days, proliferative responses were determined. Similar cultures performed without antigen served as controls. Limiting dilution analysis revealed that approximately 1/2000 to 1/3000 T cells from M. tuberculosis‐immune mice responded to whole M. tuberculosis organisms while T cells from normal mice did not respond. Similar T cell numbers reacted with several mycobacterial strains indicating expression of shared T cell antigens. Using a semi‐purified recombinant 64‐kDa protein from M. bovis the frequency of T cells generated after immunization with M. tuberculosis which reacted with a single mycobacterial protein could be estimated. We found that approximately 1/5 of the M. tuberculosis‐reactive T cells recognized this particular antigen. Immunization with the recombinant 64‐kDa protein in an adjuvant containing trehalose dimycolate, monophosphoryl lipid A and mycobacterial cell wall skeleton stimulated an equally high number of M. tuberculosis‐reactive T cells (1/2000). These findings demonstrate (a) that a high proportion of tuberculosis‐responsive T cells are directed against the 64‐kDa protein and (b) that immunization with this antigen in an appropriate adjuvant system is capable of stimulating high numbers of M. tuberculosis‐reactive T cells. Limiting dilution analysis with a panel of mycobacterial proteins or peptides may allow their ranking from immunodominant to immunosilent and facilitate identification of antigens or epitopes relevant to protection.
Factors influencing sweat gland innervation in diabetes

Background: Using a stereologic approach, the density of nerve fibers innervating sweat gland (SG) fragments in patients with diabetes mellitus (DM) and healthy controls using protein gene product (PGP), tyrosine hydroxylase (TH), and vasoactive intestinal peptide (VIP) was measured to determine which marker best detected differences between the groups. Factors associated with SG nerve fiber (SGNF) innervation were assessed and the change in SG innervation over a 1-year time period was determined. Methods: Ninety-two control subjects and 2 groups of subjects with DM totaling 97 were assessed in this cross-sectional study. Intraepidermal nerve fiber density and SG innervation were determined from leg skin biopsies that were immunohistochemically stained for ubiquitin hydrolase, VIP, and TH. Factors associated with SG innervation were assessed and 15 subjects were longitudinally followed for 1 year. Results: SGNF innervation was reduced in subjects with DM compared with controls. Lower SG innervation values were associated with increasing glycated hemoglobin A1c, body mass index (BMI), men compared with women, and tobacco use, but not diabetes type or age. Sex, A1c, and BMI remained significant in multivariate modeling. SG innervation measured by VIP+ fibers is a more sensitive marker for neuropathy than either PGP or TH. Fifteen subjects with DM followed for 1 year showed a significant decrease in SGNF innervation but not intraepidermal nerve fiber density. Conclusions: Stereologic measurement of SG innervation is feasible to assess postganglionic autonomic nerve fiber densities. SG innervation was reduced in subjects with DM compared with control subjects and was associated with sex, A1c, and BMI in multivariate modeling. VIP+ SGNF is more severely reduced in DM than TH+ or PGP9.5+-based assessments. Progression of diabetic polyneuropathy was detected by SGNF over a 1-year time period.
Myelofibrosis with myeloid metaplasia and pancytopenia after thorotrast injection.

Twenty-two years after an injection of thorotrast, myelofibrosis with extramedullary metaplasia of the spleen and lymph nodes developed in a man aged 50 years. Pancytopenia with erythroblasts and poikilocytes in the blood was present. The clinical picture was characterized by anaemia, infections and haemorrhages, which ultimately led to death. The case is remarkable owing to the absence of splenomegaly. Both the spleen and the lymph nodes were the site of marked follicular atrophy, presumably evoked by radiation from the deposited thorium dioxide, which was also present in the liver and bone marrow. This radioactive material, which is assumed to have induced the myeloproliferative disorder, is also likely to have accentuated the pancytopenia. It is pointed out that some of the cases which are described in the literature as aplastic anaemia after thorotrast injection had morphological changes in the red blood picture of the same type as in myelofibrosis. This diagnosis may be overlooked if the thorium radiation induces splenic atrophy instead of the splenomegaly which is otherwise a characteristic feature.
Plant growth promotion and induction of resistance in Camellia sinensis by Bacillus megaterium

Bacillus megaterium de Bary TRS‐4 was isolated from tea rhizosphere and tested for its ability to promote growth and cause disease reduction in tea plants. In vivo studies revealed the ability of this bacterium to promote growth of tea plants very significantly. Brown root rot disease, caused by Fomes lamaoensis was markedly reduced by application of the bacterium to the soil. Population of F. lamaoensis in soil before and after application of B. megaterium, as determined by ELISA and dot‐blot using PAb raised against the pathogen, was shown to be greatly reduced in presence of the bacterium. Biochemical changes induced in tea plants were also examined. Root colonization by B. megaterium and subsequent inoculation with F. lamaoensis also led to an increase in polyphenolics, as well as in defense related enzymes‐peroxidase, chitinase, β ‐1,3‐glucanase and phenyl alanine ammonia lyase. Determination of mechanism of action of this bacterium revealed it to be able to solubilize phosphate, produce IAA, siderophore and antifungal metabolite. The plant growth promotion and reduction of disease intensity have been shown to be due to a combination of several mechanisms. (© 2006 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)
Women's perception of sexuality during pregnancy and after birth.

BACKGROUND Pregnancy and birth mark a distinct period in the life of a woman. Hormonal alterations and bodily and social changes impact on women's physical well-being, mood, relationship and sexuality. Most existing research on sexuality during pregnancy focuses on the quantitative analysis of sexual activities, but neglects subjective experiences of women. AIMS To examine women's sexual needs, sexual activities, subjective importance of sexuality and contentment with sex life, focusing on the changes over the course of pregnancy and post-partum. METHODS Twenty-six women completed a series of three extensive interviews in early and late pregnancy, as well as 6 months post-partum. A semiqualitative approach, combining visual analogue scales and a semistructured interview with self-developed questions, was used. RESULTS The statistical analysis revealed a significant decrease of perceived 'importance of sexuality', 'importance of sexual intercourse' and 'contentment with present sex life', from prepregnancy over early pregnancy to late pregnancy, which was followed by a slight increase in the post-partum period. Samples from the structured interviews provide a detailed insight into female experiences, perceptions and opinions, and demonstrate the high interindividual variability. CONCLUSION Doctors can provide invaluable advice to women regarding the psychosexual changes and help them to understand the normal fluctuations in sexual interest during pregnancy and the post-partum.
The incidence of optic neuritis and its prognosis for multiple sclerosis

ABSTRACT An incidence study of idiopathic optic neuritis (ON) was carried out in 2 geographic areas of Finland for the 9‐year period 1970 to 1978. The southern province of Uusimaa composes a medium‐risk and the western province of Vaasa a high‐risk area for multiple sclerosis (MS). The risk for subsequent MS was determined.
The Emerging Role of the COP9 Signalosome in Cancer

In the last several years, multiple lines of evidence have suggested that the COP9 signalosome (CSN) plays a significant role in the regulation of multiple cancers and could be an attractive target for therapeutic intervention. First, the CSN plays a key role in the regulation of Cullin-containing ubiquitin E3 ligases that are central mediators of a variety of cellular functions essential during cancer progression. Second, several studies suggest that the individual subunits of the CSN, particularly CSN5, might regulate oncogenic and tumor suppressive functions independently of, or coordinately with, the CSN holocomplex. Thus, deregulation of CSN subunit function can have a dramatic effect on diverse cellular functions, including the maintenance of DNA fidelity, cell cycle control, DNA repair, angiogenesis, and microenvironmental homeostasis that are critical for tumor development. Additionally, clinical studies have suggested that the expression or localization of some CSN subunits correlate to disease progression or clinical outcome in a variety of tumor types. Although the study of CSN function in relation to tumor progression is in its infancy, this review will address current studies in relation to cancer initiation, progression, and potential for therapeutic intervention. (Mol Cancer Res 2005;3(12):645–53)
A fast-freezing device with a retractable environmental chamber, suitable for kinetic cryo-electron microscopy studies.

The design and construction of a fast-freezing device are described. A polycarbonate chamber, in which the humidity and temperature are controlled by microprocessors, slides on a robust chassis guided by ball or Teflon bushings. In its freezing position, the chamber rests on top of the cryogen vessel. The specimen is therefore frozen directly from the experimental conditions within the chamber without exposure to the external environment. After freezing, the chamber, but not the specimen, rises automatically, vacating space for handling the specimen. The chamber, the shutter, and the specimen are all driven pneumatically at an adjustable speed of up to approximately 10 m s-1 and coordinated by either pneumatic or electronic logical gates. Provisions are made for automatic blotting, spraying, and flashing. The chamber is compatible with a liquid nitrogen-cooled copper block assembly for impact (slam) freezing for freeze-substitution and freeze-fracture.
Optimal Control of a Robot with Obstacles

The Maximum principle is used to design an optimal control for a robot based on minimizing the time for a specified motion. With the use of an optimization technique, the optimal control problem is solved numerically using the complete, highly non-linear dynamic model of the manipulator. Robot geometrical and actuator limitations, as well as obstacles inside the work space, are considered in the optimal control solution.
c‐Rel: A pioneer in directing regulatory T‐cell lineage commitment?

The transcription factor Foxp3 controls the differentiation and function of Treg, but the molecular mechanisms that regulate Foxp3 transcription remain elusive. In particular, signals and factors that open and remodel the Foxp3 locus and imprint developing Treg with a stable Foxp3 phenotype are largely unknown. Two reports in this issue of the European Journal of Immunology, together with recent reports published elsewhere, demonstrate that a member of the NF‐κB family transcription factors, c‐Rel, is required for thymic differentiation of Foxp3+ Treg. Moreover, c‐Rel is shown to regulate Foxp3 transcription directly by binding to cis‐regulatory elements at the Foxp3 locus upon TCR/CD28 stimulation, including the promoter and the newly identified conserved non‐coding DNA sequence harboring a “permissive” chromatin status in Treg precursors. These findings collectively suggest that c‐Rel may act as a pioneer transcription factor in initiating Foxp3 transcription in Treg precursors in the thymus.
The effects of dexmedetomidine on inflammatory mediators after cardiopulmonary bypass

Cardiac surgery with cardiopulmonary bypass is associated with the development of a systemic inflammatory response that can often lead to dysfunction of major organs. We hypothesised that the highly selective α2‐adrenergic agonist, dexmedetomidine, attenuates the systemic inflammatory response. Forty‐two patients were randomly assigned to receive dexmedetomidine or saline after aortic cross‐clamping). The mean (SD) levels of the nuclear protein plasma high‐mobility group box 1 increased significantly from 5.1 (2.2) ng.ml−1 during (16.6 (7.3) ng.ml−1) and after (14.3 (8.2) ng.ml−1) cardiopulmonary bypass in the saline group. In the dexmedetomidine group, the levels increased significantly only during cardiopulmonary bypass (4.0 (1.9) ng.ml−1 baseline vs 10.8 (2.7) ng.ml−1) but not after (7.4 (3.8) ng.ml−1). Dexmedetomidine infusion also suppressed the rise in mean (SD) interleukin‐6 levels after cardiopulmonary bypass (a rise of 124.5 (72.0) pg.ml−1 vs 65.3 (30.9) pg.ml−1). These suppressive effects of dexmedetomidine might be due to the inhibition of nuclear factor kappa B activation and suggest that intra‐operative dexmedetomidine may beneficially inhibit inflammatory responses associated with ischaemia‐reperfusion injury during cardiopulmonary bypass.
Myelodysplasia following paroxysmal nocturnal haemoglobinuria: evidence for the emergence of a separate clone

SUMMARY. A patient with paroxysmal nocturnal haemoglobinuria (PNH) who developed a myelodysplastic syndrome (MDS) is described. After the onset of myelodysplasia the neutrophils of the patient fully expressed GPI‐linked proteins. It is concluded that the myelodysplasia does not originate from transformed PNH stem cells, but represents the emergence of a separate clone arising from an injured marrow.