Miracle-dz/UniFAR-FTUs huggingface dataset:
Management of ventilator-associated pneumonia: epidemiology, diagnosis and antimicrobial therapy

Ventilator-associated pneumonia (VAP) is the most frequent infection among patients hospitalized in intensive care units, maintaining a high morbidity and mortality. The global incidence of VAP ranges from 8 to 28%. Early-onset VAP is mainly caused by community pathogens with a favorable pattern of antibiotic sensitivity, whereas late-onset VAP is often caused by multidrug-resistant pathogens, mainly methicillin-resistant Staphylococcus aureus, Pseudomonas aeruginosa and Acinetobacter spp. and enteric Gram-negative bacilli. The diagnosis of VAP remains difficult to confirm, lacking both microbiological analysis and radiological signs of high specificity. The Clinical Infection Pulmonary Score has been proposed to overcome the difficulties related to the diagnosis, but is not applicable to all patient categories. A continuous evaluation of the antimicrobial therapeutic options, along with their pharmacodynamic and pharmacokinetic profiles, is mandatory to create therapeutic protocols and reduce VAP-related mortality.
Proactive palliative care in the medical intensive care unit: Effects on length of stay for selected high-risk patients

Objective:The purpose of this study was to examine the effect of proactive palliative care consultation on length of stay for high-risk patients in the medical intensive care unit (MICU). Design:A prospective pre/post nonequivalent control group design was used for this performance improvement study. Setting:Seventeen-bed adult MICU. Patients:Of admissions to the MICU, 191 patients were identified as having a serious illness and at high risk of dying: 65 patients in the usual care phase and 126 patients in the proactive palliative care phase. To be included in the sample, a patient had to meet one of the following criteria: a) intensive care admission following a current hospital stay of ≥10 days; b) age >80 yrs in the presence of two or more life-threatening comorbidities (e.g., end-stage renal disease, severe congestive heart failure); c) diagnosis of an active stage IV malignancy; d) status post cardiac arrest; or e) diagnosis of an intracerebral hemorrhage requiring mechanical ventilation. Interventions:Palliative care consultations. Measurements and Main Results:Primary measures were patient lengths of stay a) for the entire hospitalization; b) in the MICU; and c) from MICU admission to hospital discharge. Secondary measures included mortality rates and discharge disposition. There were no significant differences between the usual care and proactive palliative care intervention groups in respect to age, gender, race, screening criteria, discharge disposition, or mortality. Patients in the proactive palliative care group had significantly shorter lengths of stay in the MICU (8.96 vs. 16.28 days, p = .0001). There were no differences between the two groups on total length of stay in the hospital or length of stay from MICU admission to hospital discharge. Conclusions:Proactive palliative care consultation was associated with a significantly shorter MICU length of stay in this high-risk group without any significant differences in mortality rates or discharge disposition.
Sensitivity, specificity and predictive values of health service based indicators for the surveillance of influenza A epidemics.

BACKGROUND The Regional Influenza Surveillance Group (GROG) is a French surveillance network set up in 1984. It collects virological specimens and health service based indicators on a weekly basis. Our aim was to assess the predictive value of the health service based indicators for the detection of influenza A epidemics. METHODS Virological data were used as a gold standard for defining the epidemics. For each health service based indicator, a statistical threshold was used as a test for the identification of epidemic weeks. Finally, an epidemiological criterion was defined in order to improve the specificity and the speed of detection of outbreaks. RESULTS Health service based indicators have a positive predictive value of around 0.80. They also advance the detection of outbreaks by between 1 and 4 weeks. CONCLUSIONS These indicators are easy to collect and are useful for the surveillance of influenza epidemics. Such a system is the prerequisite for the rational use of preventive tools.
Evidence for neutrino oscillations from muon decay at rest.

A search for {bar {nu}}{sub {mu}}{r_arrow}{bar {nu}}{sub {ital e}} oscillations has been conducted at the Los Alamos Meson Physics Facility using {bar {nu}}{sub {mu}} from {mu}{sup +} decay at rest. The {bar {nu}}{sub {ital e}} are detected via the reaction {bar {nu}}{sub {ital ep}}{r_arrow}{ital e}{sup +}{ital n}, correlated with the 2.2 MeV {gamma} from {ital np}{r_arrow}{ital d}{gamma}. The use of tight cuts to identify {ital e}{sup +} events with correlated {gamma} rays yields 22 events with {ital e}{sup +} energy between 36 and 60MeV and only 4.6{plus_minus}0.6 background events. The probability that this excess is due entirely to a statistical fluctuation is 4.1{times}10{sup {minus}8}. A {chi}{sup 2} fit to the entire {ital e}{sup +} sample results in a total excess of 51.0{sub {minus}19.5}{sup +20.2}{plus_minus}8.0 events with {ital e}{sup +} energy between 20 and 60MeV. If attributed to {bar {nu}}{sub {mu}}{r_arrow}{bar {nu}}{sub {ital e}} oscillations, this corresponds to an oscillation probability (averaged over the experimental energy and spatial acceptance) of (0.31{plus_minus}0.12{plus_minus}0.05){percent}. {copyright} {ital 1996 The American Physical Society. }
2016 Patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester. Part 2: recommended physical interventions (exercise, taping, bracing, foot orthoses and combined interventions)

Patellofemoral pain affects physically active and sedentary individuals, accounting for 11–17% of knee pain presentations to general practice1 ,2 and 25–40% of all knee problems seen in a sports injury clinic.3 ,4 Patellofemoral pain is characterised by anterior knee pain associated with activities such as squatting, rising from sitting and stair ambulation. While traditionally viewed as self-limiting, increasing research data suggest that patellofemoral pain is often recalcitrant and can persist for many years,5–8 and may cause a decline in sports participation.8 ,9 Despite its high prevalence among active individuals9–12 and frequent presentations for treatment, there are few published guidelines to help clinicians choose the appropriate evidence-based treatment for patellofemoral pain. The most recent and relevant paper from Barton and colleagues13 combined systematic review findings with qualitative interviews from expert clinicians to provide a clinically relevant synthesis, covering the literature up to September 2013. At the International Patellofemoral Pain Research Retreat in Manchester 2015, we held a consensus meeting to update the current evidence base and produce consensus-based recommendations regarding treatment for patellofemoral pain. All retreat registrants were active researchers in patellofemoral pain and presented their research findings. Many of the world leading researchers (eg, 8 out of the top 10 researchers with the highest number of publications, when the term ‘patellofemoral pain’ was searched in Scopus, February 2016) were in attendance and contributed to the consensus meeting. The consensus meeting during the retreat resulted in recommendations, based on evidence published between January 2010 and June 2015. These recommendations should be combined with information gathered from individual patients, regarding their preferences, experiences, presentation and values, along with the values, expertise and skills of individual practitioners to create a patient-centred treatment approach. ### Literature review CJB searched EMBASE, MEDLINE, CINAHL and Current Contents for systematic reviews …
Positron Emission Tomography in the Diagnosis of Giant Cell Arteritis

This case describes how positron emission tomography (PET) led to the diagnosis of giant cell arteritis in a 50-year-old woman with fever of unknown origin. The patient presented with fever, weight loss, anemia, and headaches. She underwent multiple serologic, biopsy, and imaging tests that were inconclusive. Her sedimentation rate was 83. Giant cell arteritis was suspected clinically. PET revealed diffuse abnormal F-18 fluorodeoxyglucose (FDG) arterial uptake consistent with giant cell arteritis. After treatment with steroids, the patient showed prompt resolution of symptoms. A repeat PET scan showed near-complete resolution of the abnormal FDG uptake.
The rate of diffusion of gases through animal tissues, with some remarks on the coefficient of invasion

THE rate at which gases and especially oxygen will diffuse through tissues has, so far as I am aware, never been systematically investigated and practicallv never been investigated at all, though a knowledge of the gas diffusion is obviously essential for the solution of one of the problems of the physiology of to-day: the supply of oxygen to the cells. The brilliant work of B a rcroft and his collaborators has made it comparatively easy to obtain a quantitative idea of the average oxygen tension in the capillaries and has furnished many of the necessary data concerning the call for oxygen of the tissues, but in order to make out how this call can be met it is necessary (1) to measure and calculate the average distances which the oxygen molecules have to travel from the capillaries until they enter into chemical combination, and (2) to know the rates at which they travel, that is the diffusion coefficients for oxygen in the different tissues. The present paper is intended to supply the second of these desiderata for certain tissues. The diffusion of gases through animal tissues must take place in essentiallv the same way as their diffusion through fluids or colloidal membranes. The gases are dissolved in the tissue fluids and diffuse in a liquid state. The laws governing the diffusion of gases through water and watery solutions have been worked out by Exner(i), who found that the rates of diffusion for different gases in the same fluid are proportional to the absorption coefficients of the gases in the fluid and inversely proportional to the square roots of their molecular weights. Exner could onlv measure relative diffusion rates for different gases. Stefan(2) measured directly the rate of diffusion of carbon dioxide. Hufn er (3) devised a method for measuring directly the diffusion rates
A novel approach to growing mangroves on the coastal mud flats of Eritrea with the potential for relieving regional poverty and hunger

About 700,000 mangroves, chiefly Avicennia marina, were grown in the tree-less mud flats of Eritrea by a newly developed technology that provides required nitrogen, phosphorus, and iron. A method of fertilization was devised that eliminates the possibility of fertilizer runoff. Novel methods have been developed for planting seeds at the final site and protecting seedlings from uprooting by wave action and encircling wrasse. Methods were developed for preserving mangrove seeds by sun-drying, which results in a stable grain-like product. However, dried mangrove seeds and foliage are insufficient for supporting good growth of sheep, which was a desired outcome. Supplementation of mangrove material with small quantities of a stress food for sheep, consisting of fat-soluble vitamins and minerals renders the mangroves an adequate food. Together, these findings are capable of forming a profitable sea water agriculture and relieving hunger and poverty in many regions of the world.
A system design framework for scalability analysis of geographic routing algorithms in large-scale mesh networks

It is important to evaluate the performance of large communication networks prior to their deployment, in particular if economic interests are involved. In wireless multi-hop mesh networks, a communication message is transferred from a source to a destination via multiple nodes. Typically the message can be transferred via multiple routes in a mesh network, because several nodes are in communication range. During the design phase of such a communication network, specific characteristics need to be considered in order to avoid boundaries like bottlenecks and dead-end problems of the deployed system. Hence these kinds of problems must be avoided prior to the network deployment. In this paper, we present a system design framework for the OMNeT++ simulation environment, which is able to identify potential bottlenecks and maximum loads of multi-hop networks. The process is presented via a realistic use case scenario for an Energy Management Application, in which geographic routing algorithms are used to identify the shortest route to a destination. The results of the performance evaluation enabled us to support the communication design process with information about reliability, data rate and routing schemes.
Robust Phase Unwraping Using Grid-fit Method

In MRI, field map estimation techniques using 3 point multi-echo acquisitions have been developed for reliable water fat separation. Among the various techniques, Iterative Decomposition of water and fat with Echo Asymmetry and Leastsquares estimation (IDEAL) has gained considerable popularity as a iterative method for acquiring high quality water and fat images. A core of IDEAL is to have an initial estimate of field map, to ensure that algorithm will converge to correct solution which is close to the true value. However, due to the worsened B0 inhomogeneity at high field, IDEAL could not adjust for the meaningful field map estimation, particularly for a large field of view. Previously, to improve the robustness of this estimation, a region-growing (RG) technique was developed to take advantage of the 2D linear extrapolation procedure through the seed point set by median value in target object. There are some limitations with this approach, such as the dependence on the initial seed point, like a number, intensity and position of seed point. In this work, we introduce the simplest and robust method called Gridfit that does not need to considering some parameters relate with accuracy. Keywords-component; MRI, Grid-fit, Least square fit, Phase unwrapping, K-sapce
Exploitation of wild relatives of pigeonpea and chickpea for resistance to Helicoverpa armigera

This article focuses on the utilization of wild relatives of pigeonpea and chickpea as sources of resistance to Helicoverpa armigera, with emphasis on interspecific hybridization to transfer genes conferring resistance from wild relatives belonging to compatible gene pool as well as interspecific hybridization using incompatible wild species.
Hemangiomas of the pons.

TUMORS of the pons are not common. McLean 1 stated: "The slowly growing, relatively infrequent tumors of this region produce a kaleidoscopic wealth of signs which are myriad combinations of nuclear paralyses and projection-tract disturbances, a neurologic delight for diagnosis and neurosurgical despair for therapeusis. " The vascular tumors constitute only a very small portion of these tumors and are thus extremely rare. A certain confusion still prevails with regard to the nomenclature of the vascular tumors of the central nervous system. Virchow 2 classified the angiomatous anomalies as follows: Cavernous angiomas, i. e. , vascular tumors made up of dilated "cavernous" spaces with fused walls, so that neither glia nor specific nerve tissue, but only a sparse stroma resembling connective tissue, is found between the spaces Vascular changes in which glia or nerve tissue is present between the individual lumina Telangiectases (or simple angiomas), consisting of vessels of capillary structure Racemose
Inulin and probiotics in newly weaned piglets: effects on intestinal morphology, mRNA expression levels of inflammatory marker genes and haematology

The study aimed at determining the effect of inulin and/or a multispecies probiotic formulation on gastrointestinal tract (GIT) morphology, immunological and haematological parameters. Forty-eight newly weaned piglets were assigned to four feeding groups, receiving a standard basal diet (control), supplemented with 0.4% inulin, probiotics (1 · 109 CFU/kg as fed, enterococci, lactobacilli, bifidobacteria) or a combination of both (synbiotic). After four weeks of ad libitum feeding piglets were slaughtered and intestinal tissue samples were obtained for histometry. Additional tissue samples of the GIT, mesenteric lymph nodes, blood, liver and spleen were taken for mRNA expression analysis of cell turnover (CDK4, caspase3, IGF I), transcription factor NFκB and inflammatory marker genes (TNFα, TGFβ). Changes in histometry occurred predominantly in the small intestine, showing higher jejunal villi when probiotics were administered alone (p < 0.10). Inulin decreased the number of acidic goblet cells in jejunal villi (p < 0.05), whereas probiotics increased neutral goblet cells in ileal villi (p < 0.05). Though inflammatory marker genes were uninfluenced by treatment in the proximal GIT, the colon showed downregulations induced by inulin (TNFα: p < 0.10, TGFβ: p < 0.05). Gene expression of CDK4 was upregulated in the jejunum and of TGFβ in the mesenteric lymph nodes in the probiotic groups. Interestingly, the probiotic group alone exhibited upregulations in cell turnover marker genes in the colon and blood. Furthermore, for numerous parameters, inulin and probiotics led to no synergistic but antagonistic interactions.
Drug safety profile of integrase strand transfer inhibitors

Introduction: HIV-1 integrase strand transfer inhibitors (INSTIs) are a novel class of antiretroviral drugs with a good safety profile. Several INSTIs have been developed clinically. Areas covered: The purpose of this review is to examine the safety data of the three FDA-approved INSTIs: Raltegravir (RAL), Elvitegravir (EVG) and Dolutegravir (DTG). The most relevant papers related to the safety profile of integrase inhibitors were selected and summarized. Expert opinion: INSTIs have demonstrated a favorable safety profile in Phase II and III trials. The most common clinical adverse events reported were diarrhea, nausea and headache. DTG and cobicistat, a component of Stribild™, increase serum creatinine and decrease estimated creatinine clearance due to inhibition of active tubular secretion of creatinine without affecting renal glomerular function. INSTIs intrinsic potency, together with an outstanding safety profile, preludes an important role for these drugs to build up highly active antiretroviral treatment (HAART) in the near future.
Modality-Specific Segregation of Input to Ant Mushroom Bodies

The mushroom bodies are central brain neuropils involved in the control of complex behavior. In ants, the mushroom bodies are relatively large compared to those of honey bees, whereas the optic lobes of ants are considerably smaller. The general morphology of ant mushroom bodies is similar to that of honey bees. As in other Hymenoptera, the main input region of the mushroom bodies, the calyx, is subdivided into three compartments: the lip, the collar, and the basal ring. In many ant species this compartmentalization is not obvious and can only be visualized using neuronal tracers. The lip region receives antennal input and is large in all ant species. It appears to be composed of at least two different regions that have not yet been characterized in detail. The collar is large in other Hymenoptera, yet in ant workers it varies in size and is always much smaller than the lip region. The collar receives visual input and is relatively larger in males, which generally are more dependant on vision than are workers. The basal ring receives input from both the optic and antennal lobes. In one ant tribe, the Ponerini, the collar region appears to have changed its position, but based on afferent input it appears to be homologous to the hymenopteran collar. Generally, the composition of the mushroom body calyx correlates with the living conditions of ants, reflecting the great importance of olfaction and the lesser and more variable significance of vision for workers of the observed ant species.
lustered structural and functional plasticity of dendritic spines u Lu

The configuration of synaptic circuits underlies their ability to process and store information. Research on dendritic spines has revealed that their structural and functional alterations are clustered along the parent dendrite. Here we review the evidence supporting such notion of clustered synaptic plasticity, discuss its functional implications and possible contributing factors, and suggest potential strategies to deal with open challenges.
Interobserver and intraobserver reliability of the modified Waldenström classification system for staging of Legg-Calvé-Perthes disease.

BACKGROUND The absence of a reliable classification system for Legg-Calvé-Perthes disease has contributed to difficulty in establishing consistent management strategies and in interpreting outcome studies. The purpose of this study was to assess interobserver and intraobserver reliability of the modified Waldenström classification system among a large and diverse group of pediatric orthopaedic surgeons. METHODS Twenty surgeons independently completed the first two rounds of staging: two assessments of forty deidentified radiographs of patients with Legg-Calvé-Perthes disease in various stages. Ten of the twenty surgeons completed another two rounds of staging after the addition of a second pair of radiographs in sequence. Kappa values were calculated within and between each of the rounds. RESULTS Interobserver kappa values for the classification for surveys 1, 2, 3, and 4 were 0.81, 0.82, 0.76, and 0.80, respectively (with 0.61 to 0.80 considered substantial agreement and 0.81 to 1.0, nearly perfect agreement). Intraobserver agreement for the classification was an average of 0.88 (range, 0.77 to 0.96) between surveys 1 and 2 and an average of 0.87 (range, 0.81 to 0.94) between surveys 3 and 4. CONCLUSIONS The modified Waldenström classification system for staging of Legg-Calvé-Perthes disease demonstrated substantial to almost perfect agreement between and within observers across multiple rounds of study. In doing so, the results of this study provide a foundation for future validation studies, in which the classification stage will be associated with clinical outcomes.