jimnoneill/paper-to-field-training huggingface dataset:
66. Utilizing ceftazidime/avibactam therapeutic drug monitoring in the treatment of neurosurgical meningitis caused by Difficult-to-treat resistant (DTR)-Pseudomonas aeruginosa and KPC-producing Enterobacterales

Field: Medicine (Health Sciences)

Abstract Background Central nervous system (CNS) infections caused by carbapenem-resistant Enterobacterales (CRE) and Difficult-to-treat resistant (DTR)-Pseudomonas aeruginosa (PA) are a therapeutic challenge. Data demonstrating the pharmacokinetic/pharmacodynamic (PK/PD) properties of newer beta-lactamase inhibitors remains scarce. A clinical challenge lies in selecting an antimicrobial regimen that diffuses across the blood brain barrier and maintains concentrations to achieve PD targets associated with bacterial killing. These complexities compelled us to quantify the pharmacological properties of ceftazidime/avibactam (CZA). Utilizing therapeutic drug monitoring (TDM), we evaluated the adequacy of therapy and aimed to guide precise CNS dosing in the treatment of three patients with neurosurgical meningitis. Methods Bacterial identification and susceptibility testing were performed using MicroScan. TDM of CZA was implemented using a dose of 2.5 g infused intravenously over 2-hours, every 8 hours. The concentrations of ceftazidime and avibactam were determined by liquid chromatography/mass spectrometry. For patients 2 and 3, four unique CSF and plasma samples spanning the dosing interval were obtained; including trough values. (See table) Results Bacterial identification and CZA MICs for patients 1, 2, and 3 revealed blaKPCKp (0.25μg/mL), DTR PA (4 μg/mL), and blaKPCE. cloacae (0.25 μg/mL), respectively. Measured plasma and CSF concentrations of avibactam (AVI) and ceftazidime (CAZ) are shown in Table 1. Table 1a. Therapeutic Drug Monitoring of CAZ-AVI depicting dosing, time of samples, and measured concentrations in CSF and Human Plasma (HP) Table 1b. Therapeutic Drug Monitoring of CAZ-AVI concentrations in CSF and Human Plasma (HP) pertaining to patient 2 and 3 Conclusion Measuring CZA concentration levels in CSF was achieved in 3 patients with complicated CNS infections. Post-infusion concentrations indicated that adequate CAZ and AVI exposures were attained in the CSF. Notably, avibactam was shown to achieve concentrations ≥1 µg/ml in the CSF throughout the dosing interval. For avibactam and ceftazidime, the PK/PD target correlated with bacterial killing is ~50% fT &gt;MIC. In 2 out of 3 patients, concentrations were determined to be above the respective MICs throughout the entire dosing interval in the CSF. All patients attained clinical and microbiological cure. A novel CZA TDM method was successfully employed to establish that CZA maintains therapeutic CSF concentrations that exceed the MIC throughout the dosing interval. Disclosures Robert A. Bonomo, MD, entasis (Research Grant or Support)Merck (Grant/Research Support)NIH (Grant/Research Support)VA Merit Award (Grant/Research Support)VenatoRx (Grant/Research Support)
Data from Crizotinib, a c-Met Inhibitor, Prevents Metastasis in a Metastatic Uveal Melanoma Model

Field: Pharmacology, Toxicology and Pharmaceutics (Life Sciences)

<div>Abstract<p>Uveal melanoma is the most common primary intraocular malignant tumor in adults and half of the primary tumors will develop fatal metastatic disease to the liver and the lung. Crizotinib, an inhibitor of c-Met, anaplastic lymphoma kinase (ALK), and ROS1, inhibited the phosphorylation of the c-Met receptor but not of ALK or ROS1 in uveal melanoma cells and tumor tissue. Consequently, migration of uveal melanoma cells was suppressed <i>in vitro</i> at a concentration associated with the specific inhibition of c-Met phosphorylation. This effect on cell migration could be recapitulated with siRNA specific to c-Met but not to ALK or ROS1. Therefore, we developed a uveal melanoma metastatic mouse model with EGFP–luciferase-labeled uveal melanoma cells transplanted by retro-orbital injections to test the effect of crizotinib on metastasis. In this model, there was development of melanoma within the eye and also metastases to the liver and lung at 7 weeks after the initial transplantation. When mice were treated with crizotinib starting 1 week after the transplantation, we observed a significant reduction in the development of metastases as compared with untreated control sets. These results indicate that the inhibition of c-Met activity alone may be sufficient to strongly inhibit metastasis of uveal melanoma from forming, suggesting crizotinib as a potential adjuvant therapy for patients with primary uveal melanoma who are at high risk for the development of metastatic disease. <i>Mol Cancer Ther; 12(12); 2817–26. ©2013 AACR</i>.</p></div>
Using the Fluctuating Workweek Compensation Method to Reduce Overtime Expenses in Public Organizations

Field: Business, Management and Accounting (Social Sciences)

Modifications to the Fair Labor Standards Act promulgated by the Department of Labor as the FairPay Overtime Initiative in 2004 have produced an increasing number of workers subject to overtime payments and a concomitant increase in labor costs for public sector organizations. To adapt to this changing environment and to control employee overtime expenditures organizations may wish to examine the applicability of a relatively obscure provision of the Fair Labor Standards Act labelled the fluctuating workweek scheme. This approach becomes increasingly attractive to employers as worker overtime increases because a feature of this method is that the overtime rate due employees under this plan decreases as the number of overtime hours worked increases.
[A new approach to local ablation therapy for hepatocellular carcinoma--hand-assisted laparoscopic radio-frequency ablation].

Field: Medicine (Health Sciences)

We have developed a radio-frequency ablation using hand-assisted laparoscopic surgery (HALS-RFA) for hepatocellular carcinoma, and it applied for 10 patients who were difficult to be treated by common laparoscopic surgery (LS) from November 2001. The reasons for selection of HALS-RFA were severe adhesions in 3 patients, anatomical location at the hepatic dome in 3 patients, lesions adjacent to other organs or vasculatures in 3 patients, and co-operation for another organ in 1 patient. We compared efficacies of HALS to other ablation therapeutic techniques with LS and open surgery (OS). The average amount of bleeding was 85 ml in HALS, 14 ml in LS and 319 ml in OS. The amount of HALS was lesser than that of OS, but not significant. Post operative maximal CRP level was 3.2 mg/dl, 4.9 mg/dl and 10.5 mg/dl in HALS, LS, and OS, respectively, with a statistical significance between HALS and OS. Complications occurred in 2 out of 10 cases (20%) in HALS, 2 out of 62 cases (3.2%) in LS and 3 out of 9 cases (33%) in OS. Recurrence in the treated site was encountered in 1 out of 10 cases (10%) in HALS, 2 out of 62 cases (3.2%) in LS and none (0%) of OS. Based on these findings, we conclude that HALS-RFA seems to be a minimally invasive and highly effective treatment.
PROLONGED HYPOTHYROIDISM AS A RARE COMPLICATION AFTER ANTITHYROID TREATMENT FOR A PATIENT PRESENTING WITH THYROID STORM

Field: Medicine (Health Sciences)

INTRODUCTION/BACKGROUNDHypothyroidism rarely occurs following anti-thyroid therapy (ATT). We present a case of prolonged hypothyroidism following ATT for thyroid storm. CASEA 50-year-old female presented to the emergency department with a 3-week history of failure symptoms, 10 kg weight loss and diarrhoea. She was in respiratory distress, hypotensive with a high fever and had atrial fibrillation in rapid ventricular response (170 beats/min) with congestive heart failure. She had no goitre or ophthalmopathy. She was diagnosed with thyroid storm (Burch-Wartofsky Score 90) with free T4 79.9 pmol/L and TSH <0.005IU/L. Despite prompt initiation of carbimazole, IV hydrocortisone, Lugol’s iodine, non-invasive ventilation, IV amiodarone and electrical cardioversion, she suffered cardiorespiratory arrest. She was revived after cardiorespiratory resuscitation, intubation and triple inotropic support. Her 21-day ICU stay was eventful with multiorgan failure (ischaemic hepatitis, cardiogenic shock, oliguric kidney injury) complicated by nosocomial infection, critical illness myopathy and bedsore. She spent three months in the hospital, including one month of inpatient rehabilitation. Thyroid-wise, she responded to ATT with fT4 dropping to 36 pmol/L on day 3 of admission. All ATT was discontinued on day 11 when fT4 was reduced to 3.64 pmol/L and TSH <0.005 IU/L. On Day 28, her fT4 remained suppressed, reaching a nadir of 1.36 pmol/L (TSH 0.084IU/L, fT3 1.60 pmol/L [normal 3.1–6.8 pmol/L]). Her fT4 rebounded to 47.80 pmol/L (TSH <0.005 IU/L) after 6 weeks (or one month from the last dose of carbimazole). Carbimazole was reintroduced and continued up to her recent follow-up at 2 months post-discharge. CONCLUSIONHypothyroidism can occur with ATT for primary hyperthyroidism due to overdosage or increased individual sensitivity, but it is usually short-lived. Prolonged hypothyroidism shortly after presentation of thyroid storm is unusual. Possible explanations include the presence of TSH blocking or stimulating antibodies, sick euthyroid syndrome and the elusive “shock thyroid.” A thyroid storm due to a thyrotoxic phase of thyroiditis is unlikely here due to the subsequent relapse of thyrotoxicosis. Careful clinical assessment and monitoring are essential to guide treatment direction.
Delineation of terrain features in Demini’s Watershed – Setentrional Amazonia using regional geomorphometry

Field: Earth and Planetary Sciences (Physical Sciences)

The mapping of terrain features relies on the necessity of an object-based approach, which can be related to the constitution of terrain units. The regionalization of land surface parameters enables the assessment of characteristics inside terrain unities and enhances heterogeneity outside these patches. This study presents a classification methodology for hierarchical geomorphometric delineation, using visual and Random Forest (RF) classification in a regionalized dataset of terrain variables, applied in Demini’s watershed, north of Amazonia. These variables, calculated by segments derived from multiresolution segmentation, were evaluated in order to identify which had major contributions to RF’s classifications. The characterization of features had great correspondence with Environmental Informations Database (BDIA) data of geomorphological mapping, used as a reference in this work. The Overall Accuracy for RF taxon 1 was 96%, while Taxon 2 Highland and Lowland RF models reached 84% and 87%, respectively. Identification of subdomain classes was possible mostly using the digital elevation model (DEM) and variables directly derived from the DEM. The delineation of floodplain presented significant differences between visual and RF results, including BDIA’s data.
Cultivation of black soldier fly larvae on almond byproducts: impacts of aeration and moisture on larvae growth and composition

Field: Agricultural and Biological Sciences (Life Sciences)

Abstract BACKGROUND The increasing production of almonds worldwide has resulted in the significant generation of byproduct streams that require end uses. One potential use for byproducts is for cultivation of additional food sources including insects. Studies were performed to determine if black soldier fly larvae ( Hermetia illucens L.) could be cultivated on almond byproducts (hulls and shells) and to examine the effect of aeration and moisture on larvae growth and hull composition. RESULTS Increasing aeration from 0.04 to 0.36 mL min −1 g dry weight −1 tripled the harvest weight of larvae and increased larvae yield by a factor of five. Larvae calcium content increased by 18% with an increase in aeration from 0.04 to 0.95 mL min −1 g dry weight −1 . Moisture content also affected harvest dry weight and yield; increasing moisture content from 480 g kg −1 (wet basis) to 680 g kg −1 increased harvest weight by 56% and yield by a factor of 2. Variables did not affect larvae methionine and cysteine content. Low moisture content and aeration rate yielded an environment that supported microbial consumption of hulls over larvae consumption and growth. CONCLUSIONS The results demonstrate that almond hulls are a suitable feedstock for larvae production under controlled management of moisture content and aeration. © 2018 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.
Tunable structured illumination light sheet microscopy for background rejection and imaging depth in minimally processed tissues

Field: Computer Science (Physical Sciences)

We demonstrate improved optical sectioning in light sheet fluorescence microscopy using tunable structured illumination (SI) frequencies to optimize image quality in scattering specimens. The SI patterns are generated coherently using a one-dimensional spatial light modulator for maximum pattern contrast, and the pattern spatial frequency is adjustable up to half the incoherent cutoff frequency of our detection objective. At this frequency, we demonstrate background reductions of 2 orders of magnitude.
Low-Dose Bromocriptine Therapy in Parkinson's Disease

Field: Pharmacology, Toxicology and Pharmaceutics (Life Sciences)

The efficacy of low-dose bromocriptine mesylate administration (20 mg daily or less) was evaluated in a double-blind study. Nine of 16 individuals receiving bromocriptine completed the 40-week study. Modest, but significant, improvement was derived from bromocriptine therapy. Improvement was most evident in tremor. Maximum improvement was achieved with doses between 7.5 and 15.0 mg daily, with some decline in efficacy as doses approached 20 mg. Adverse effects were common, but were generally mild in severity. Our results suggest that bromocriptine in low doses may be an effective adjunct to carbidopa and levodopa (Sinemet) in the treatment of Parkinson's disease.
Sensitive Floral

Field: Computer Science (Physical Sciences)

"Sensitive Floral" is an interactive, generative artwork that ventures into the exploration of a unique generative system, biomimetically emulating the reactive behaviors of the Mimosa plant. By synthesizing the complexity of fractal tree data structures with the Cellular Automata mechanisms of grid computations, the artwork elegantly mirrors nature's adaptive and responsive traits. The interactive interface allows users to initiate a ripple of movement by simply touching the screen, triggering a cascade of changes across thousands of leaves, akin to the group leaf movements observed in Mimosa. The system, instantaneously detects which branch of the tree structure on the touch screen is being externally triggered. It then notifies the grid calculation system, based on the Cellular Automata mechanism, to generate parameters for angle gradients of closing behavior between branches. These parameters are applied in real time to the image generation system of the floral structure, altering the overall appearance of the flower.
MIGRAINE, TYRAMINE AND BLOOD SEROTONIN

Field: Medicine (Health Sciences)

SYNOPSIS Whole blood serotonin levels and headache symptoms were studied in 26 migrainous patients during a three day period with administration of tyramine the first day, reserpine the second day. No significant changes in serotonin occurred after tyramine; headache severity was not associated with change in blood serotonin, which dropped to low levels after a small dose of reserpine without precipitating migraine in most patients.
Efficient Implementation of Kernel Regularization based on ADMM

Field: Computer Science (Physical Sciences)

This work discusses about an efficient implementation of the kernel regularization method. In particular, this work focuses on Alternating Direction Method of Multipliers (ADMM) which is one of the convex optimization methods. This work employs two assumptions; (1) the identification input is periodic, and (2) the kernel matrix is tridiagonal. It is shown that ADMM updates can be implemented efficiently under these assumptions. A numerical example is shown to demonstrate the effectiveness of the proposed method.
Clinical features and outcomes of thoracic surgery patients during the COVID-19 pandemic

Field: Medicine (Health Sciences)

Abstract OBJECTIVES The goal of this study was to describe the clinical features and outcomes of thoracic surgery patients during the coronavirus disease 2019 (COVID-19) pandemic. METHODS Thirty-five patients were treated at the 12 de Octubre University Hospital in Madrid between 1 March 2020 and 24 April 2020 during the COVID-19 pandemic. Patient demographics, surgical procedures, complications, COVID-19 symptoms and outcomes were recorded. A protocol was introduced to reduce the risk of operating on patients with COVID-19, including symptom screening, a polymerase chain reaction test for severe acute respiratory syndrome coronavirus 2 and computed tomography scans of the chest. Surgical activity changed significantly during this time, from an initial period of near-normal activity, through an emergency-only period and finally a recovery period when some oncological surgical cases were restarted. Selection criteria for surgical patients are also described. RESULTS A total of 34 patients underwent surgery during the pandemic period. We performed 22 lung resections (11 lobectomies and 11 sublobar resections). No hospital deaths were recorded. An elective surgery patient and an emergency surgery patient were diagnosed with COVID-19 (5.88%). The former died within 30 days after surgery. CONCLUSIONS Severe acute respiratory syndrome coronavirus 2 represents a tremendous limitation for thoracic surgical practice. Preoperative practices to exclude asymptomatic cases infected with the virus allowed us to perform thoracic surgical procedures.
IN-VITRO STUDY OF ANTICONVULSANT ACTIVITY ON THE FRUITS EXTRACTS OF COCCINIA INDICA (WIGHT &ARN.) INDUCED MAXIMAL ELECTROSHOCK SEIZURE (MES) MODEL IN RATS

Field: Pharmacology, Toxicology and Pharmaceutics (Life Sciences)

Aim of the study: In-vitro study of Anticonvulsant activity on the fruits extracts of Coccinia indica (Wight &Arn.) induced maximal electroshock seizure (MES) model in rats. Materials & methods: For the assessment of anticonvulsant activity, the animals were divided into five groups of five animals each albino rats. Group I received Normal saline, Group II received Phenytoin, Group III received 200 mg/kg of CIEE suspended in Tween 80, Group IV received 400 mg/kg of CIEE suspended in Tween 80, and Group V received 600 mg/kg of CIEE suspended in Tween 80. The results are expressed in mean ± S.E.M. (n=5) Statistical analysis was done by one way ANOVA, followed Dunnett multiple comparison test vs. control. P<0.01 was considered as statistically significant. Results: In the present In vitro study, an anticonvulsant effect of ethanolic extracts of fruits Coccinia indica Wight & Arn. has been determined duration of HLTE 14.96, 3.49, 9.68, 8.20, 4.90 sec. The CIEE exhibited maximum anticonvulsant activity at 4.90 sec. at 600mg/kg (P<0.01) and it was significant when compared with control. In the present study, CIEE at the dose of 600mg/kg shows potent anticonvulsant activity as compared to 200mg/kg & 400mg/kg. The ethanolic extract of CI possesses potent anticonvulsant effect against MES induced and it is evidenced by its good anticonvulsant activity of 600 mg/kg against control and as positive control groups. Conclusions: In conclusion these observations suggest that 600 mg/kg doses of HLTE exhibit potent anticonvulsant activity.
Seroepidemiology of cytomegalovirus antibodies in Hiv-positive and Hiv-negative adults in Nigeria

Field: Medicine (Health Sciences)

Introduction: Cytomegalovirus (CMV) is the most common viral opportunistic infection in HIV/AIDS reported in the Western literature. There is a paucity of reports on the seroprevalence of CMV antibodies in Nigeria despite the high HIV burden. Few studies were carried out in pregnant women and healthy blood donors. This analytical cross-sectional study was conducted to describe the seroepidemiology of CMV antibodies in HIV-positive and healthy adults in Nigeria. Materials and Methods: Between August 2012 and March 2013, a structured questionnaire was administered to 250 HIV-positive patients attending the HIV clinic and 250 HIV-negative controls matched for age and gender. Participants were screened for quantitative CMV immunoglobulin G (IgG) and qualitative CMV immunoglobulin M (IgM) antibodies by enzyme-linked immunosorbent assay. Information was collected on sociodemographic characteristics, risk for HIV infection, and anthropometric measurements. Data were analyzed with SPSS Version 17. Results: A total of 500 participants were recruited. Females comprised 54%. Median age for males was 39 years (range 17-65 years), whereas for females, it was 35 years (range 16-62 years) (P = 0.002). In HIV-positive patients, CMV IgG and IgM antibodies were detected in 215 (86%) and 33 (13.2%), respectively, but in HIV-negative controls, it was 182 (72.8%) and 7 (2.8%), respectively (P = 0.001). In HIV-positive patients, CMV IgG age-specific seroprevalence was highest in the 16-25 years age group (93.5%), whereas CMV IgM, it was highest in the 26-35 years age group (16.1%). Mean quantitative CMV IgG antibody titer was higher in HIV-positive patients (P = 0.001). There was no gender difference between groups. Conclusion: Seroprevalence of CMV antibodies is high in Nigeria. HIV preventive strategies and routine screening of HIV patients and blood donors for CMV antibodies before blood transfusion are recommended to minimize the potential risk of transfusion transmitted CMV infection.
Mental Health of Postgraduate Orthodontic Students in India: A Multi‐Institution Survey

Field: Health Professions (Health Sciences)

The aim of this study was to evaluate the mental health of postgraduate orthodontic students in India by assessing the extent of three common negative affective states: depression, anxiety, and stress. Three hundred and thirty postgraduate students from thirty‐two dental colleges across India anonymously completed the short version of the Depression Anxiety Stress Scale (DASS21). The statistical analysis included summary statistics, nonparametric tests for intergroup comparisons, and logistic regressions to evaluate the influence of age, gender, year of study, and marital status on these mental states. In comparison to the general population, the students experienced mildly elevated levels of depression and anxiety (11±5.1 and 8.2±4.1, respectively) and a moderately elevated level of psychological stress (22±5.2). A moderate or higher level of coexisting symptoms of all three affective states was seen in 15.8 percent of the students. Female students reported a higher level of depression than males and were two and half times more likely to experience depression to a moderate or higher level. First‐year students exhibited lower levels in all three states than those in the second and third years and had lower odds than third‐year students of developing a moderate or higher level of any of the three affective states. Marriage had a significant buffering potential against all these states. The results clearly indicate a suboptimal level of mental health in these postgraduate students of the specialty and the need to improve their mental resilience and the academic climate.