Miracle-dz/UniFAR-FTUs huggingface dataset:
An outbreak of multidrug-resistant tuberculosis among hospitalized patients with the acquired immunodeficiency syndrome.

BACKGROUND Since 1990 several clusters of multidrug-resistant tuberculosis have been identified among hospitalized patients with the acquired immunodeficiency syndrome (AIDS). We investigated one such cluster in a voluntary hospital in New York. METHODS We compared exposures among 18 patients with AIDS in whom tuberculosis resistant to isoniazid and streptomycin was diagnosed from January 1989 through April 1990 (the case patients) with exposures among 30 control patients who had AIDS and tuberculosis susceptible to isoniazid, streptomycin, or both. We also compared exposures among the 14 case patients hospitalized during the six months before the diagnosis of tuberculosis (the exposure period) with those among 44 control patients with AIDS matched for duration of hospitalization. Mycobacterium tuberculosis isolates were typed with analysis of restriction-fragment-length polymorphism (RFLP). RESULTS Case patients with drug-resistant tuberculosis were significantly more likely than controls with drug-susceptible tuberculosis to have been hospitalized during their exposure periods (14 of 18 vs. 10 of 30) (odds ratio, 7.0; 95 percent confidence interval, 1.6 to 36; P = 0.006). Case patients hospitalized during their exposure periods were significantly more likely to have been hospitalized on the same ward as a patient with infectious drug-resistant tuberculosis than were either controls with drug-susceptible tuberculosis hospitalized during their exposure periods or controls matched for duration of hospitalization (13 of 14 vs. 2 of 10 and 23 of 44) (odds ratio, 52; 95 percent confidence interval, 3.1 to 2474; P less than 0.001; and odds ratio, infinity; 95 percent confidence interval, 2.4 to infinity; P = 0.005, respectively). Among those hospitalized on the same ward, the rooms of case patients were closer to that of the nearest patient with infectious tuberculosis than were the rooms of controls matched for duration of hospitalization. M. tuberculosis isolates from 15 of 16 case patients had identical patterns on RFLP analysis. Of 16 patients' rooms tested with air-flow studies, only 1 had the recommended negative-pressure ventilation. CONCLUSIONS Multidrug-resistant tuberculosis is readily transmitted among hospitalized patients with AIDS. Physicians must be alert to this danger and must enforce adherence to the measures recommended to prevent nosocomial transmission of tuberculosis.
Smooth Resilient Service Provision in Large Heterogeneous Networks

Mobile crowd missions like multiplayer online games, disaster recovery, and mobile-assisted public gatherings gain ever more attention. They depend on highly distributed software which has to run smoothly and highly synchronous, while the underlying network – often a mix of mobile and stationary nodes – may expose Byzantine errors and malicious attacks. In our paper, we present a first solution to this challenge, emphasizing first response missions as an example. It combines support for Byzantine error correction, mobile code, smooth handover, and availability and performance improvements through replication and intelligent service placement. Finally, we point at further challenges that arise on the move towards a broader spectrum of mobile crowd missions.
Comparison of CT and MRI for the diagnosis recurrent esophageal carcinoma after operation.

SUMMARY. Despite an increase in radical surgery for esophageal carcinoma, many patients continue to develop recurrent disease. Some reports have suggested that recurrent tumors should be treated aggressively with a combination of chemotherapy and radiotherapy. The aim of this study was to assess the comparative utility of computed tomography (CT) and magnetic resonance imaging (MRI) for the evaluation of recurrence after curative resection of cancer of the esophagus and gastroesophageal junction. To maximize survival benefit, detection of tumor recurrence as early and accurately as possible is important. Twenty-three patients who developed recurrent tumors after curative transthoracic esophagogastrectomy for esophageal carcinoma were analyzed retrospectively. The CT and MRI findings were correlated with pathology or with endoscopic and clinical follow-up. Primary tumor recurrence was detected at the anastomosis side in 19 patients (intraluminal mass in 13 and as diffuse or focal wall thickening in six). Distant recurrence was seen in the liver (n = 5), lung (n = 4), bone (n = 3), abdominal lymph node (n = 4), pleural effusion (n = 2) and pericardial effusion (n = 1). CT and MRI were found equal in showing the intraluminal mass, liver metastasis, pleural and pericardial effusion. Thickening of esophageal wall was demonstrated in nine patients using CT, but only seven of these tumor recurrences were confirmed by MRI, the remaining two were related to secondary fibrosis. Both CT and MRI showed diffuse gastric wall thickening determined as false tumor recurrence due to severe gastritis in one case. There were two (50%) false negatives for lung metastasis in MRI and one bone metastasis (33%) false negative in CT. CT was found superior in the demonstration of lung metastasis and MRI was superior in the evaluation of wall thickening and bone metastasis.
Investigation of design options for overlaying 40Gb/s coherent PDM-QPSK channels over a 10Gb/s system infrastructure

To contain limitations from cross nonlinear effects caused by 10Gb/s NRZ channels onto 40Gb/s coherent polarisation division multiplexing quadrature phase shift keying (PDM-QPSK) channels, we investigate the benefits of optimizing the carrier phase estimation process and introducing band-gaps in the multiplex.
Unstable EEG-vigilance in patients with cancer-related fatigue (CRF) in comparison to healthy controls

Abstract Objectives. Cancer-related fatigue (CRF) is associated with tiredness and sleepiness. It remains unclear, whether such complaints are associated with neurophysiological signs of sleep proneness or a state of neurophysiological hyperarousal in which the patient finds it difficult to relax and to initiate sleep. Therefore the goal of this study is to compare the electroencephalographic (EEG)-vigilance regulation of patients with CRF and healthy controls. Methods. A 15-min resting EEG with eyes closed was recorded in 22 patients with CRF and 22 matched healthy controls. Consecutive 1-s segments were classified into seven different vigilance stages ranging from high alertness to relaxed wakefulness (stage 0, A1, A2, A3) and further on to drowsiness (B1, B2/3) and sleep onset (stage C). Results. Results showed that patients with CRF revealed a higher number of vigilance stages A3 (mean 15.26 vs. 6.67%, P = 0.004) dropped significantly earlier to vigilance levels A3 (drop after 130.8 vs. 533.3 s, P = 0.000) and B2/3&C (407.8 vs. 604.1 s, P = 0.035) and showed significantly more transitions between vigilance stages (46.0 vs. 31.1%, P = 0.003) in comparison to healthy controls. Conclusions. These findings suggest an unstable vigilance regulation in patients with CRF and provide a neurophysiological framework for the reported efficacy of psychostimulants in CRF.
Phytochemicals and Antimicrobial potential of Phyllantus amarus Schum and Thonn obtained in Ebonyi State, Nigeria

The antimicrobial efficiency of Phyllanthus amarus Schum. and Thonn, medicinal plants (leaf extracts), was examined using ethanol and chloroform as solvents and tested against human pathogens ; Staphylococcus aureus, Escherichia coli, and Candida albican, using the agar well-diffusion method and minimum inhibitory concentration. The result of the phytochemical analysis of the plant showed that the plant contain, alkaloid, tannins, steroid, saponins, phlobatannin, terpenoids and cardiac glycoside while anthraquinone was absent. The plant showed significant activity against all pathogens, but the alcoholic extract of P. amarus showed the maximum zone of inhibition and minimum inhibitory concentration against all the microorganisms. The alcoholic extracts of these plants could be a possible source of obtaining new and effective herbal medicines to treat infections; hence, it justified the ethnic use of P. amarus against various infectious diseases.
Characterization of Depression in Children With Autism Spectrum Disorders

Depressive syndromes represent a disabling comorbidity for many children with autism spectrum disorders (ASD); however, the ascertainment of depression can be complicated by phenotypic overlap between the 2 conditions, by ways in which autistic symptomatology can mask cardinal features of depression and by atypical manifestations of depression in children with ASD. These issues have contributed to wide variation in the estimation of prevalence rates of depression in individuals with ASD and invoke the need for new approaches to the specific detection of depression and other neuropsychiatric comorbidities that aggregate in children affected by ASD. The authors review the scientific literature relevant to the occurrence of depression in ASD and consider important parameters of risk, including psychosocial factors such as insight into affectation status, as well as biological factors such as the aggregation of depressive syndromes in certain families affected by autism, which has suggested possible overlap in genetic influences underlying the 2 conditions. Variability in the manifestations of depression across environmental contexts provides important clues to intervention and underscores the potential importance of involving multiple informants in ascertaining depression in children and adolescents with ASD. A practical strategy for evaluating the presence of depression in youth with ASD is synthesized from the available data and discussed.
Differential inducibility of the transcriptional repressor ICER and its role in modulation of Fas ligand expression in T and NK lymphocytes

The engagement of antigen receptor can initiate apoptosis of T lymphocytes through the induced expression of Fas ligand (FasL). Forskolin, an activator of the cAMP/PKA pathway, results in antagonism of Fas‐dependent, activation‐induced cell death (AICD) by suppressed expression of the FasL. We report that forskolin‐mediated induction of inducible cAMP early repressor (ICER) correlates with transcriptional attenuation of FasL expression in the AICD model 2B4 T cell hybridoma. ICER is inducible in human peripheral blood CD3+ T cells, but in CD19+ B cells, its induction is less responsive to forskolin treatment. Increased expression of ICER correlates with decreased FasL expression in both T and NK cells. ICER binds specifically to the proximal DNA binding siteof the nuclear factor of activated T cells (NFAT) in the FasL promoter and in the presence of the minimal NFAT DNA‐binding domain, the proximal NFAT motif allows ICER and NFAT to form an NFAT/ICER ternary complex in vitro. Moreover, in the activated 2B4 T cell hybridoma, the proximal NFAT motif participates in the down‐regulation of the FasL promoter mediated by ICER. These findings provide further insight into the mechanism involved in cAMP‐mediated transcriptional attenuation of FasL expression in T and NK lymphocytes.
Effect of oxygen breathing on distribution of pulmonary blood flow in chronic obstructive lung disease.

In chronic obstructive lung disease, a major functional disturbance lies in maldistribution of ventilation of the lungs. It has been postulated that, at least in some patients, compensatory regional pulmonary vasoconstriction may occur in the poorly ventilated portions of such lungs, thus reducing the range of ventilation-perfusion ratios and improving arterial oxygen tension. The evidence for this lies largely in the reduction of arterial oxygen tension or saturation that may follow the administration of pulmonary vasodilator drugs, such as tolazoline (1, 2) and aminophylline (3-5). It has been suggested that these drugs reverse pre-existing vasoconstriction in poorly ventilated regions of the lungs and that this leads to a worsening of ventilation-perfusion ratio distribution and a fall in arterial oxygen tension. Oxygen is a powerful, nonspecific, pulmonary vasodilator agent. Pain, Read, and Read (6) showed that in a group of patients with chronic lung disease oxygen breathing was sometimes associated with an increase of arterial carbon dioxide tension (Pac02 ) greater than that to be expected from any hypoventilation produced by the oxygen. It was suggested that these increases of Pa002, not due to diminished ventilation of the lungs, were also due to worsening of ventilationperfusion ratio distribution in the lungs. Analysis of the factors involved indicated that this, in turn, must reflect an increased blood flow through poorly ventilated regions of the lungs associated with oxygen breathing; that is, there was reversal of pre-existing regional compensatory vasoconstriction in some of these patients. These conclusions were based on comparisons of ventilation and Pa002 that were made when the subject was breathing air and after breathing oxygen for ten minutes. Some of the conclusions
Facility location and distribution planning with multiple transport alternatives

In this paper, we present a modeling and optimization of facility location and distribution planning problems with multiple transport alternatives. The problem is to determine an optimal facility location with respect to management strategy by using huge physical distribution data. We consider two types of problems. The first one is the facility location problem with transportation from depot to customer and a direct transportation from factory to customer simultaneously. Lagrangian relaxation is applied to solve the large size problem efficiently. The second one is the competitive facility location problem with multiple competing companies. We show the effectiveness of distribution profit by collaborative decision making.
Time required to set up for and clean up after a case should be attributed to the actual case in measuring turnover time.

I read with interest the article Abouleish et al. (1). As have most institutions, we have struggled with the measurement of “turnover time” and whether or not to include it in block time utilization. Our solution is quite different from that described in this article and, I believe, warrants inclusion of turnover time in the calculation of operating room utilization. Our premise has been that it is entirely possible to measure turnover time and that the time required to set up for and clean up after a case should be attributed to the actual case. We, therefore, use our intraoperative nursing documentation software to measure the following events: Set-up start, Set-up complete, Patient in Room, Prep Start, Prep End, Procedure Start, Procedure End, Patient Out of Room, Room Clean. We have identified an additional interval that we call “Delay Time,” which is the time from Set-up complete until the patient enters the room. Analysis of our data reveals that the vast majority of “Delay Time” is attributable to surgeon delay (surgeon not available for whatever reason). When the delay time exceeds 10 min, the nurse must enter a reason for the delay from a predefined list of reasons. We believe that delay time that is attributable to the surgeon should be included in the time for the procedure and should be part of the block time utilization calculation. Measuring turnover time in the above manner allows us to determine the “turnover time,” which we define as the sum of Set-up time and Room Clean time ( Delay Time as appropriate) for the case in question. This method keeps the turnover time as part of a single case and, therefore, is not dependent on the scheduled following or preceding case. As important as this is to determine block time utilization, a greater benefit of this method is that it also allows more accurate prediction of how much OR time should be allotted to a given procedure so scheduling can be more realistic. I believe that the authors have made a potentially problematic decision by taking one month’s turnover data and extrapolating it to the entire 13-mo period. Data should be available for all cases in the study period in order to draw any conclusions about including or excluding turnover time in determining block time utilization. Measuring turnover time as we do allows for a complete data set and does not require manual measurement methods that may actually influence turnover times (Hawthorne Effect). In addition, arbitrarily excluding turnover times of 75 min may mask a problem with slow turnover times—a potential topic for quality improvement. Finally, attributing the turnover time following a case to the succeeding case may inadvertently allocate too much (or too little) time to the service not responsible for the long turnover time, as the authors correctly point out. This could be solved by measuring the actual times required for set up and clean up and attributing these times to the case in question. Doing so gives a better picture of actual operating room utilization.
Neurocardiological anamnesis : development from complementarities with syndrome differentiation of Traditional Chinese Medicine

Cardiologists that are examining patients with ECG monitoring devices for years may get clinical experience from which they are sometimes able to closely evaluate type of autonomic nervous system (ANS) in patients, not just through overview of ECG parameters, but even before: during introduction conversation with patients, from their symptoms, will, mood, voice gesticulations. All of them can be differentiated in two types: hyperactive versus phlegmatic behavioral manners. These energetic types are often matching with sympathetic and parasympathetic ANS predomination, respectively. This is very similar to diagnostic methods of observation 望 诊 (wàngzhěn) and auscultation 闻诊 (wénzhěn) in Traditional Chinese Medicine (TCM). From specific patterns in the voice, tong, mimics of the face, eyes, gesticulation and history of patient, TCM physicians are obtaining syndrome 证 (zhèng), a generalized clinical result of health status; briefly, it is characterization of the state of 气 (qì) in patient. Very sophisticated and complex zhèng is basis for successful administration of therapy. After drawing complementary analogies of yang and yin excess/deficit with sANS and pANS predomination/failure, and extracting main principles of TCM diagnostic procedures we can use it for development of algorithm for neurocardiological anamnesis in the form of simple expert system. Its purpose would be the software support to cardiologist in order to get synoptic health report of patient useful in further ANS analysis and recommendation of therapy. In other words, it would do mimetic of expert knowledge of experienced neurocardiologist. That could be a basis in neurocardiology for greater and fruitful personalized medical approach, that is otherwise practiced for centuries in TCM
Contribution of peripheral chemoreception to the depression of the hypoxic ventilatory response during halothane anesthesia in cats.

BACKGROUND The effects of inhalational anesthetics on the hypoxic ventilatory response are complex. This study was designed to determine the contribution of peripheral chemoreception to the depression of hypoxic ventilatory response seen with halothane anesthesia. METHODS Cats were anesthetized with pentobarbital sodium and alpha-chloralose and artificially ventilated. Respiratory output was evaluated by phasic inspiratory activity of the phrenic nerve. In 12 cats, this activity was measured during inhalation of an hypoxic gas mixture with halothane, 0, 0.1, and 0.8%, with intact or denervated carotid bodies. In 10 cats, a carotid body was isolated from the systemic circulation and perfused with hypoxic Krebs-Ringer solution equilibrated with halothane, 0, 0.1, and 0.8%. RESULTS The hypoxic ventilatory response was depressed in a dose-dependent manner during halothane anesthesia. In carotid body perfusion studies, the response was significantly depressed only with halothane, 0.80%. CONCLUSION The hypoxic ventilatory response is depressed by a high dose of halothane through a peripheral effect at the carotid body.
Increased blood oxygen level‐dependent (BOLD) sensitivity in the mouse somatosensory cortex during electrical forepaw stimulation using a cryogenic radiofrequency probe

Functional MRI (fMRI) based on the blood oxygen level‐dependent (BOLD) contrast is widely used in preclinical neuroscience. The small dimensions of rodent brain place high demands on spatial resolution, and hence on the sensitivity of the fMRI experiment. This work investigates the performance of a 400‐MHz cryogenic quadrature transceive radiofrequency probe (CryoProbe) with respect to the enhancement of the BOLD sensitivity. For this purpose, BOLD fMRI experiments were performed in mice during electrical forepaw stimulation using the CryoProbe and a conventional room temperature surface coil of comparable dimensions. Image signal‐to‐noise ratio (SNR) and temporal SNR were evaluated as quality measures for individual images and for fMRI time series of images, resulting in gains (mean ± standard deviation) with factors of 3.1 ± 0.7 and 1.8 ± 1.0 when comparing the CryoProbe and room temperature coil. The CryoProbe thermal shield temperature did not affect the noise characteristics, with temporal noise levels being 63 ± 16% of the corresponding room temperature value. However, a significant effect on BOLD amplitudes was found, which was attributed to temperature‐dependent baseline cerebral blood volumes. Defined local thermal conditions were found to be a critical parameter for achieving an optimal and reproducible fMRI signal. In summary, the CryoProbe represents an attractive alternative for the enhancement of image SNR, temporal SNR and BOLD sensitivity in mouse fMRI experiments. Copyright © 2010 John Wiley & Sons, Ltd.
Differential induction of 5-HT1A-mediated responses in vivo by three chemically dissimilar 5-HT1A agonists.

In the rat, activation of 5-hydroxytryptamine1A (5-HT1A) receptors causes hypothermia and the 5-HT syndrome. The effects of three chemically dissimilar 5-HT1A agonists administered s.c. [8-hydroxy-2-(di-n-propylamino)tetralin (8-OH-DPAT), gepirone, and (+)4-[n-5-(methoxychroman-3-yl)n-propylamino]butyl-8-azaspiro++ +[4,5] decane-7,adione ((+) S-20499)] on both of these responses were studied. The same maximal drop in body temperature (approximately 2.5 degrees C) was elicited by all three agonists, 8-OH-DPAT being the most potent (EC50 = 0.05 mg/kg), followed by gepirone (1.8 mg/kg) and (+) S-20499 (8 mg/kg). Both pindolol, a nonselective 5-HT1A receptor/beta adrenoceptor antagonist and n-t-butyl,-3-[1-[4-(2-methoxy)phenyl]piperazinyl]-1-phenylpropionamid e [(+) WAY 100135], a more selective 5-HT1A receptor antagonist, dose dependently attenuated the hypothermia induced by all three agonists. From these data, we inferred that all three agonists caused hypothermia via activation of 5-HT1A receptors. The syndrome was observed reliably in rats at doses of 2 to 4 mg/kg 8-OH-DPAT; doses up to 100 mg/kg of gepirone or (+) S-20499 did not produce the syndrome. In reserpine-pretreated animals, 8-OH-DPAT (maximal effect at 2-4 mg/kg) and 5-methoxy-N,N-dimethyltryptamine (5-MeODMT) (5 mg/kg) induced forepaw treading, whereas gepirone (10 mg/kg) and (+) S-20499 (75 mg/kg) did not. (+) WAY 100135 competitively antagonized the forepaw treading caused by 8-OH-DPAT in reserpine-pretreated rats. This indicates that forepaw treading, like hypothermia, is mediated by activation of 5-HT1A receptors. Gepirone (5-10 mg/kg) attenuated the forepaw treading induced by either 8-OH-DPAT (4 mg/kg) or 5-MeODMT (5 mg/kg); by contrast, (+) S-20499, at doses up to 75 mg/kg, did not attenuate the forepaw treading induced by either 8-OH-DPAT or 5-MeODMT. The inability of (+) S-20499 either to induce the 5-HT syndrome or forepaw treading or to attenuate the forepaw treading induced by other agonists could be due to several factors, one of which is that different subtypes of the 5-HT1A receptor mediate hypothermia and the 5-HT syndrome.