Miracle-dz/UniFAR-FTUs huggingface dataset:
Improving the TRISS methodology by restructuring age categories and adding comorbidities.

BACKGROUND The Trauma and Injury Severity Score (TRISS) methodology was developed to predict the probability of survival after trauma. Despite many criticisms, this methodology remains in common use. The purpose of this study was to show that improving the stratification for age and adding an adjustment for comorbidity significantly increases the predictive accuracy of the TRISS model. METHODS The trauma registry and the hospital administrative database of a regional trauma center were used to identify all blunt trauma patients older than 14 years of age admitted with International Classification of Diseases, Ninth Revision codes 800 to 959 from April 1993 to March 2001. Each individual medical record was then reviewed to ascertain the Revised Trauma Score, the Injury Severity Score, the age of the patients, and the presence of eight comorbidities. The outcome variable was the status at discharge: alive or dead. The study population was divided into two subsamples of equal size using a random sampling method. Logistic regression was used to develop models on the first subsample; a second subsample was used for cross-validation of the models. The original TRISS and three TRISS-derived models were created using different categorizations of Revised Trauma Score, Injury Severity Score, and age. A new model labeled TRISSCOM was created that included an additional term for the presence of comorbidity. RESULTS There were 5,672 blunt trauma patients, 2,836 in each group. For original TRISS, the Hosmer-Lemeshow statistic (HL) was 179.1 and the area under the receiver operating characteristic (AUROC) curve was 0.873. Sensitivity and specificity were 99.0% and 27.8%, respectively. For the best modified TRISS model, the HL statistic was 20.35, the AUROC curve was 0.902, the sensitivity was 99.0%, and the specificity was 27.8%. For TRISSCOM, the HL statistic was 14.95 and the AUROC curve was 0.918. Sensitivity and specificity were 99.0% and 29.7%, respectively. The difference between the two models almost reached statistical significance (p = 0.086). When TRISSCOM was applied to the cross-validation group, the HL statistic was 10.48 and the AUROC curve was 0.914. The sensitivity was 98.6% and the specificity was 34.9%. CONCLUSION TRISSCOM can predict survival more accurately than models that do not include comorbidity. A better categorization of age and the inclusion of comorbid conditions in the logistic model significantly improves the predictive performance of TRISS.
Variable expression of the Opc outer membrane protein in Neisseria meningitidis is caused by size variation of a promoter containing poly‐cytidine

Opa proteins of Neisseria meningitidis exhibit translational phase variation via addition or deletion of repetitive coding repeat units within the DNA encoding the protein leader sequence. In contrast, Opc phase variation is the result of transcriptional regulation. Transcription starts 13 nucleotides after the ‐10 region of an unusual promoter sequence containing a variable number of contiguous cytidine residues and lacking a ‐ 35 region. Efficient expression of Opc occurred in strains with 12 to 13 cytidine residues, intermediate expression in strains with 11 or 14 residues and no expression with ≤ 10 or ≥ 15 residues. This unusual regulation may have evolved because the Opc protein enables meningococcal invasion and is immunogenic.
Neostigmine-Induced Postprandial Phasic Contractility in the Proximal Stomach and Dyspepsia-Like Symptoms in Healthy Volunteers

BACKGROUND AND AIMS:In a subset of functional dyspepsia patients, we have recently described the association between unsuppressed postprandial phasic contractions of the proximal stomach and a specific symptom pattern. To better elucidate the role of phasic contractility of the proximal stomach in symptom generation, we aimed at inducing this motility pattern in healthy volunteers and we carefully monitored symptom onset.PATIENTS AND METHODS:Eleven healthy volunteers underwent gastric barostat on two separate days. Gastric tone and phasic contractility were evaluated for a 90-minte period. In particular, after 30 min of basal recording, a caloric liquid meal and neostigmine 0.5 mg IV or saline in a double-blind, randomized, crossover protocol were administered. During the measurement, severity of 9 dyspeptic symptoms was evaluated on a visual analog scale. Computer-aided baseline reconstruction allowed us to quantify phasic contractions as a motility index (MI), reflecting the area between signal and baseline normalized over time. Perception of contractions after placebo or neostigmine was evaluated. Moreover, we tested for influence of gastric tone and phasic contractility on symptoms.RESULTS:After neostigmine, gastric accommodation was not different than after placebo (225 ± 36 vs 206 ± 76 mL, P = NS). During the first 30-min postprandial period, the MI was significantly higher after neostigmine than after placebo (26.4 ± 3 vs 21.4 ± 3, P < 0.001), confirming the induction of unsuppressed postprandial phasic contractions. The postprandial total symptom score was significantly higher after neostigmine compared to saline; several individual postprandial symptom scores were also significantly higher after neostigmine-compared placebo. After neostigmine, a higher percentage of postprandial contractions was perceived compared to placebo.CONCLUSIONS:Unsuppressed postprandial phasic contractility of the proximal stomach is a mechanism potentially involved in the pathogenesis of dyspeptic symptoms.
A Self-Wetting Paper Electrode for Ubiquitous Bio-Potential Monitoring

This paper aims to develop a flexible and cost-effective dry electrode with low and stable contact impedance. With these benefits, the electrode can be practically used in ubiquitous bio-potential monitoring with similar signal-to-noise ratio as commercial wet electrode. A self-wetting electrode is developed by the aid of moisture naturally created by skin under the electrode. It consists of a layer of ethylcellulose fiber paper coated with PEDOT/PSS (PCwPEDOT) and a thin layer of parylene. PCwPEOT, which has a large contact area composed of micro-scale fibers, is a 30-<inline-formula> <tex-math notation="LaTeX">$\mu \text{m}$ </tex-math></inline-formula> flexible membrane that acts as the electrode material. A 3-<inline-formula> <tex-math notation="LaTeX">$\mu \text{m}$ </tex-math></inline-formula> parylene bonding at the backside of PCwPEOT, as a high-performance vacuum membrane, can collect moisture or sweat naturally evaporating from the skin and store it in the PCwPEDOT layer. This design increases the humidity of skin, especially the water content in the corneum, acting as electrolyte containing ions, increases effective contact area between electrode and skin, and decreases the impedance of the electrode. With an environmentally friendly and cost-effective fabrication process, the 33-<inline-formula> <tex-math notation="LaTeX">$\mu \text{m}$ </tex-math></inline-formula> thickness of electrode is light and flexible. It can be tailored to proper size according to the application. It achieves lower contact impedance compared with dry electrodes with a similar structure. Its recording performance is comparable to commercial patch electrode. The proposed electrode provides high-quality signals, and comfortable user experience in bio-potential recording. It is feasible for developing a long-term wearable system for bio-potential monitoring.
Early Nutrition and Weight Gain in Preterm Newborns and the Risk of Retinopathy of Prematurity

Objective To identify nutritional and weight gain limitations associated with retinopathy of prematurity (ROP) severity among very preterm newborns. Patients and Methods 1180 infants <28 weeks GA at birth with ROP examination results were grouped and analyzed by quartile of weekly total calorie, carbohydrate, protein, and lipid intake, as well as growth velocity between postnatal days 7 and 28 (adjusted for GA and birth weight Z-score). ROP was categorized by development of no, mild (<prethreshold), type 2, or type 1 ROP, as well as markers of ROP severity including stage 3 ROP, zone 1 disease, and plus disease. Associations between nutritional intake and ROP severity were compared. Results Greater risk for Type 1 ROP (risk/95% confidence intervals) was found for infants with lowest quartile receipt of lipids (2.1/1.1, 3.8), total calories (2.2/1.4, 3.6), and carbohydrates (1.7/1.1, 2.9). Development of zone 1 ROP was associated with lipid or total calorie intake in the lowest quartile, and development of stage 3 ROP was associated with lowest quartile of total calorie intake. Growth velocity in the lowest quartile was associated with increased risk of any ROP, including type 1 ROP. Conclusion The risk of developing severe ROP in extremely premature infants might be reduced by improving nutritional support, specifically targeting lipids and total calories, and perhaps by improving weight gain.
Care by parents in hospital.

admitted to the paediatric ward, representing 3-8% (17/439) of the infants under 1 year but 12% of the bed occupancy. Infants who had previously been in the neonatal intensive care unit accounted for a large proportion of the bed occupancy partly because they stayed in the ward longer for general problems (such as upper respiratory infections and social and feeding difficulties) than the other infants (table) and partly because a small number needed prolonged admissions for intensive treatment of chronic conditions-for example, one infant with chronic lung disease needed ventilation for five months and another required many months of intravenous feeding after extensive bowel resection in the neonatal period. Comment Although only a small number of infants who had previously received intensive care required admission to the paediatric ward, they represented about half the bed occupancy of infants under 1 year. Interestingly, although the paediatric ward served only the Cambridge Area Health Authority, babies admitted to the neonatal intensive care unit from the region accounted for about one third of the bed occupancy of those aged under 1 year. This study highlights the need for continued intensive nursing care for a few infants under 1 year after their discharge from a neonatal intensive care unit. This represents a considerable workload for a general ward, and as the survival rates of such infants continue to improve4 it is vital that these wards should be appropriately staffed and equipped. Spontaneous urinoma due to retroperitoneal fibrosis and aortic aneurysm Rupture of the ureter or renal pelvis leading to a mass of encapsulated extravasated urine usually occurs after surgery or trauma. When it occurs spontaneously it is usually a result of ureteric obstruction due to calculus. We report a case of urinoma caused by retroperitoneal fibrosis in association with an aortic aneurysm. Case report A 72 year old man with a history of right ureterolithotomy was admitted for investigation of uraemia. He was found to have a large, firm, ballotable abdominal mass on the left side. Blood urea concentration was 20-2 mmol/l (121 mg/100 ml) and creatinine concentration 428 ,mol/l (4-8 mg/100 ml). Intravenous urography showed a small right kidney and a hydronephrotic left kidney displaced upwards by a mass. The left ureter was not identified. Ultrasonography showed an abdominal aortic aneurysm with a large cystic mass adjacent. After needle aspiration had confirmed that this mass contained urine, contrast was injected (figure) and 600 …
Roles of Extracellular Polysaccharides and Biofilm Formation in Heavy Metal Resistance of Rhizobia

Bacterial surface components and extracellular compounds, particularly flagella, lipopolysaccharides (LPSs), and exopolysaccharides (EPSs), in combination with environmental signals and quorum-sensing signals, play crucial roles in bacterial autoaggregation, biofilm development, survival, and host colonization. The nitrogen-fixing species Sinorhizobium meliloti (S. meliloti) produces two symbiosis-promoting EPSs: succinoglycan (or EPS I) and galactoglucan (or EPS II). Studies of the S. meliloti/alfalfa symbiosis model system have revealed numerous biological functions of EPSs, including host specificity, participation in early stages of host plant infection, signaling molecule during plant development, and (most importantly) protection from environmental stresses. We evaluated functions of EPSs in bacterial resistance to heavy metals and metalloids, which are known to affect various biological processes. Heavy metal resistance, biofilm production, and co-culture were tested in the context of previous studies by our group. A range of mercury (Hg II) and arsenic (As III) concentrations were applied to S. meliloti wild type strain and to mutant strains defective in EPS I and EPS II. The EPS production mutants were generally most sensitive to the metals. Our findings suggest that EPSs are necessary for the protection of bacteria from either Hg (II) or As (III) stress. Previous studies have described a pump in S. meliloti that causes efflux of arsenic from cells to surrounding culture medium, thereby protecting them from this type of chemical stress. The presence of heavy metals or metalloids in culture medium had no apparent effect on formation of biofilm, in contrast to previous reports that biofilm formation helps protect various microorganism species from adverse environmental conditions. In co-culture experiments, EPS-producing heavy metal resistant strains exerted a protective effect on AEPS-non-producing, heavy metal-sensitive strains; a phenomenon termed “rescuing” of the non-resistant strain.
Word Sense Discrimination by Clustering Contexts in Vector and Similarity Spaces

This paper systematically compares unsupervised word sense discrimination techniques that cluster instances of a target word that occur in raw text using both vector and similarity spaces. The context of each instance is represented as a vector in a high dimensional feature space. Discrimination is achieved by clustering these context vectors directly in vector space and also by finding pairwise similarities among the vectors and then clustering in similarity space. We employ two different representations of the context in which a target word occurs. First order context vectors represent the context of each instance of a target word as a vector of features that occur in that context. Second order context vectors are an indirect representation of the context based on the average of vectors that represent the words that occur in the context. We evaluate the discriminated clusters by carrying out experiments using sense–tagged instances of 24 SENSEVAL2 words and the well known Line, Hard and Serve sense–tagged corpora.
Changes in Ultrasound-Assessed Carotid Intima-Media Thickness and Plaque With a Mediterranean Diet: A Substudy of the PREDIMED Trial

Objective—The Prevención con Dieta Mediterránea (PREDIMED) trial showed that a Mediterranean diet (MedDiet) supplemented with either extra virgin olive oil or 30 g/d of mixed nuts reduced incident cardiovascular events compared with a control (low fat) diet. The mechanisms of cardiovascular protection afforded by MedDiets remain to be uncovered. We assessed the effect of both supplemented MedDiets on internal carotid intima-media thickness (ICA-IMT) and plaque height, the ultrasound features that best predict future cardiovascular events, in subjects at high cardiovascular risk. Approach and Results—In a PREDIMED subcohort (n=175), plaque height and carotid IMT of 3 prespecified segments (ICA, bifurcation, and common) were sonographically assessed at baseline and after intervention for a mean of 2.4 years. We evaluated 164 subjects with complete data. In a multivariate model, mean ICA-IMT progressed in the control diet group (mean [95% confidence interval], 0.052 mm [−0.014 to 0.118 mm]), whereas it regressed in the MedDiet+nuts group (−0.084 mm [−0.158 to −0.010 mm]; P=0.024 versus control). Similar results were observed for maximum ICA-IMT (control, 0.188 mm [0.077 to 0.299 mm]; MedDiet+nuts, −0.030 mm [−0.153 to 0.093 mm]; P=0.034) and maximum plaque height (control, 0.106 mm [0.001 to 0.210 mm]; MedDiet+nuts, −0.091 mm [−0.206 to 0.023 mm]; P=0.047). There were no changes in ICA-IMT or plaque after the MedDiet+extra virgin olive oil. Conclusions—Compared with a control diet, consumption of a MedDiet supplemented with nuts is associated with delayed progression of ICA-IMT and plaque. The results contribute mechanistic evidence for the reduction of cardiovascular events observed in the PREDIMED trial. Clinical Trial Registration—URL: http://www.controlled-trials.com. Unique identifier: ISRCTN35739639.
Contemporary Access Structures under Mixed Workloads

Modern high-performance computing systems and databases are implemented under the assumption that a very large proportion of the data used can now be maintained in volatile memory. In this paper, we compare experimentally two recently proposed self-adjusting access structures that can be used to organize data in such settings, namely, the Skip-List (SL) and the Binary B-Tree (BB-Tree). We examine the scalability of these two methods against both mixed and pure-query workloads. Our experiments reveal the behaviour of SLs and BB-Trees under diverse environments and varying data requirements.
The Smartphone in Medicine: A Review of Current and Potential Use Among Physicians and Students

Background Advancements in technology have always had major impacts in medicine. The smartphone is one of the most ubiquitous and dynamic trends in communication, in which one’s mobile phone can also be used for communicating via email, performing Internet searches, and using specific applications. The smartphone is one of the fastest growing sectors in the technology industry, and its impact in medicine has already been significant. Objective To provide a comprehensive and up-to-date summary of the role of the smartphone in medicine by highlighting the ways in which it can enhance continuing medical education, patient care, and communication. We also examine the evidence base for this technology. Methods We conducted a review of all published uses of the smartphone that could be applicable to the field of medicine and medical education with the exclusion of only surgical-related uses. Results In the 60 studies that were identified, we found many uses for the smartphone in medicine; however, we also found that very few high-quality studies exist to help us understand how best to use this technology. Conclusions While the smartphone’s role in medicine and education appears promising and exciting, more high-quality studies are needed to better understand the role it will have in this field. We recommend popular smartphone applications for physicians that are lacking in evidence and discuss future studies to support their use.
Exposing therapists to trauma-focused treatment in psychosis: effects on credibility, expected burden, and harm expectancies

Background Despite robust empirical support for the efficacy of trauma-focused treatments, the dissemination proves difficult, especially in relation to patients with comorbid psychosis. Many therapists endorse negative beliefs about the credibility, burden, and harm of such treatment. Objective This feasibility study explores the impact of specialized training on therapists’ beliefs about trauma-focused treatment within a randomized controlled trial. Method Therapist-rated (n=16) credibility, expected burden, and harm expectancies of trauma-focused treatment were assessed at baseline, post-theoretical training, post-technical training, post-supervised practical training, and at 2-year follow-up. Credibility and burden beliefs of therapists concerning the treatment of every specific patient in the trial were also assessed. Results Over time, therapist-rated credibility of trauma-focused treatment showed a significant increase, whereas therapists’ expected burden and harm expectancies decreased significantly. In treating posttraumatic stress disorder (PTSD) in patients with psychotic disorders (n=79), pre-treatment symptom severity was not associated with therapist-rated credibility or expected burden of that specific treatment. Treatment outcome had no influence on patient-specific credibility or burden expectancies of therapists. Conclusions These findings support the notion that specialized training, including practical training with supervision, has long-term positive effects on therapists’ credibility, burden, and harm beliefs concerning trauma-focused treatment. Highlights of the article Specialized training improved therapists’ credibility, burden, and harm beliefs. Patients’ symptom severity and treatment outcome did not affect these beliefs. Replication of our findings in larger cohorts with a control group is warranted.
Fine-needle Aspiration

Fine-needle aspiration involves using a thin, hollow needle to remove samples of tissue or fluid from an organ of the body or a lump found under the skin. Once the samples of cells have been removed, they are sent to the laboratory for further testing. Fine-needle aspiration is usually done to identify the type of cells inside a lump or to see how well treatment of an existing lump is working. It is commonly used to investigate lumps found in the breast or a gland found in your neck (the thyroid). However, it can also be used in other parts of the body. It is a very useful way of detecting cancer.
Reelin signaling directly affects radial glia morphology and biochemical maturation

Radial glial cells are characterized, besides their astroglial properties, by long radial processes extending from the ventricular zone to the pial surface, a crucial feature for the radial migration of neurons. The molecular signals that regulate this characteristic morphology, however, are largely unknown. We show an important role of the secreted molecule reelin for the establishment of radial glia processes. We describe a significant reduction in ventricular zone cells with long radial processes in the absence of reelin in the cortex of reeler mutant mice. These defects were correlated to a decrease in the content of brain lipid-binding protein (Blbp) and were detected exclusively in the cerebral cortex, but not in the basal ganglia of reeler mice. Conversely, reelin addition in vitro increased the Blbp content and process extension of radial glia from the cortex, but not the basal ganglia. Isolation of radial glia by fluorescent-activated cell sorting showed that these effects are due to direct signaling of reelin to radial glial cells. We could further demonstrate that this signaling requires Dab1, as the increase in Blbp upon reelin addition failed to occur in Dab1-/- mice. Taken together, these results unravel a novel role of reelin signaling to radial glial cells that is crucial for the regulation of their Blbp content and characteristic morphology in a region-specific manner.
Hepatic cholesterol transporter ABCG8 polymorphisms in gallstone disease in an Indian population

Background and Aim: Gallstone formation is characterized by the abnormal regulation of cholesterol trafficking and solubilization. The prevalence of gallstone disease (GSD) differs between ethnic groups sharing the common environment. These differences can be explained by a genetic predisposition to gallstone formation. Studies have identified single nucleotide polymorphisms (SNP) D19H and T400K in the cholesterol transporter gene ATP‐binding cassette, subfamily G, member 8 (ABCG8) in patients with cholesterol gallstones. The aim of this study was to analyze the relationship between D19H and T400K polymorphisms in the ABCG8 gene and GSD in an Indian population, and the effects of these polymorphisms on cholesterol levels in sera and bile.