Miracle-dz/UniFAR-FTUs huggingface dataset:
Behind-the-Scenes of Patient-Centered Care: Content Analysis of Electronic Messaging Among Primary Care Clinic Providers and Staff

Background:Transitions to patient-centered health care, the increasing complexity of care, and growth in self-management have all increased the frequency and intensity of clinical services provided outside office settings and between visits. Understanding how electronic messaging, which is often used to coordinate care, affects care is crucial. A taxonomy for codifying clinical text messages into standardized categories could facilitate content analysis of work performed or enhanced via electronic messaging. Objective:To codify electronic messages exchanged among the primary care providers and the staff managing diabetes patients at an academic medical center. Research Design:Retrospective analysis of 27,061 electronic messages exchanged among 578 providers and staff caring for a cohort of 639 adult primary care patients with diabetes between April 1, 2003 and October 31, 2003. Subjects:Providers and staff using locally developed electronic messaging in an academic medical center's adult primary care clinic. Measures:Raw data included clinical text message content, message ID, thread ID, and user ID. Derived measures included user job classification, 35 flags codifying message content, and a taxonomy grouping the flags. Results:Messages contained diverse content: communications with patients, families, and other providers (47.2%), diagnoses (25.4%), documentation (33%), logistics and support functions (29.6%), medications (32.9%), and treatments (28.9%). All messages could be classified; 59.5% of messages addressed 2 or more content areas. Conclusions:Systematic content analysis of provider and staff electronic messages yields specific insight regarding clinical and administrative work carried out via electronic messaging.
On transverse exponential stability and its use in incremental stability, observer and synchronization

We study the relation between the exponential stability of an invariant manifold and the existence of a Riemannian metric for which the flow is “transversally” contracting. More precisely, we investigate how the following properties are related to each other: i). A manifold is “transversally” exponentially stable; ii). The “transverse” linearization along any solution in the manifold is exponentially stable; iii). There exists a Riemannian metric for which the flow is “transversally” contracting. We show the relevance of these results in the study of incremental stability, observer design and synchronization.
Detoxification and antioxidant responses in diverse organs of Jenynsia multidentata experimentally exposed to 1,2‐ and 1,4‐dichlorobenzene

We report changes in activities of detoxification and antioxidant enzymes as well as lipid peroxidation levels in liver, gills, and brain of Jenynsia multidentata exposed to 1,2‐ and 1,4‐dichlorobenzene (DCB). Fish were captured at an unpolluted area, transported to the laboratory, and acclimated previous to experiments. Exposures were carried out using 1,2‐DCB at 0.5, 1, 5, and 10 mg L−1 and 1,4‐DCB at 0.05, 0.1, 1, and 5 mg L−1. After 24‐h exposure, fish were sacrificed and dissected separating liver, gills, and brain of each fish. Organs were used for enzyme extractions, evaluating antioxidant system through the assay of glutathione reductase, guaiacol peroxidase, glutathione peroxidase, catalase as well as detoxification system by measuring glutathione‐S‐transferase (GST) activity. Additionally, thiobarbituric acid reactive substances (TBARS) method was used to evaluate the peroxidation of lipids. No changes in GST activity were found in liver of fish exposed to DCBs but in gills and brain of exposed fish. The detoxification system was activated at lower concentrations of 1,2‐DCB than 1,4‐DCB. Antioxidant response is activated in liver at low DCB concentrations, followed by a drop at highest levels. We also found activation of the antioxidant system in gills and brain of exposed fish. On the other hand, we did not observe changes in TBARS concentrations in liver or gills of exposed fish with respect to controls, but in brain of fish exposed to 1,2‐DCB (≥0.5 mg L−1) and 1,4‐DCB (5 mg L−1). Responses of both detoxification and antioxidant systems of J. multidentata suggest that 1,2‐DCB is more toxic than 1,4‐DCB to this specie. To the extent of our knowledge, this is the first report of oxidative stress induced by DCBs in fish. Our results evidence that the brain is the organ most severely affected by the oxidative stress caused by DCBs. © 2008 Wiley Periodicals, Inc. Environ Toxicol, 2008.
What Happened to the Quants in August 2007?

During the week of August 6, 2007, a number of quantitative long/short equity hedge funds experienced unprecedented losses. It has been hypothesized that a coordinated deleveraging of similarly constructed portfolios caused this temporary dislocation in the market. Using the simulated returns of long/short equity portfolios based on five specific valuation factors, we find evidence that the unwinding of these portfolios began in July 2007 and continued until the end of 2007. Using transactions data, we find that the simulated returns of a simple marketmaking strategy were significantly negative during the week of August 6, 2007, but positive before and after, suggesting that the Quant Meltdown of August 2007 was the combined effects of portfolio deleveraging throughout July and the first week of August, and a temporary withdrawal of marketmaking risk capital starting August 8th. Our simulations point to two unwinds---a mini-unwind on August 1st starting at 10:45am and ending at 11:30am, and a more sustained unwind starting at the open on August 6th and ending at 1:00pm---that began with stocks in the financial sector and long Book-to-Market and short Earnings Momentum. These conjectures have significant implications for the systemic risks posed by the hedge-fund industry.
4D FMS for Increasing Efficiency of TMA Operations

In order to meet the anticipated future demand for air travel, DLR's Institute of Flight Guidance is investigating distributed air-ground traffic management (DAG-TM) for arrivals in the extended TMA. Based on the exchange of information between aircraft and ATC via data link, a trajectory based traffic management can take into account user preferred trajectories as well as make use of highly accurate prediction of aircraft movements. This contribution focuses on the airborne part - in particular on the 4D FMS functions for planning and flying various types of CDA approaches. The planning functions to compute approach profiles ranging from 2 degree (clean configuration) up to steep slopes (more than 5 degree) with early configuration and glide path intersection from above are presented. Furthermore, functions to compensate deviations due to inaccurately forecasted wind are described. These functions ensure flying the predicted flight path. The new CDA functionalities have been implemented in DLR's 4D capable advanced flight management system (AFMS) and intensively tested during various flight trials in the A330 full flight simulator in Berlin and with DLR's test aircraft ATTAS, a VFW 614 twin engine jet transport aircraft modified for research purposes. The results of these trials are presented and discussed
Managing Patients on Endocrine Therapy: Focus on Quality-of-Life Issues

Purpose: To review the health-related quality of life (QOL) of women treated with adjuvant hormonal therapy. Experimental Design: To review the limited QOL data from randomized trials of tamoxifen versus placebo and ovarian ablation versus none. To discuss QOL results from randomized trials of aromatase inhibitors compared with tamoxifen or placebo for adjuvant therapy of postmenopausal women with estrogen receptor–positive and/or progesterone receptor–positive breast cancer. Results: QOL is generally good in up to 3 years of follow-up with either tamoxifen or aromatase inhibitors. Vasomotor and sexual complaints remain problematic, however, in only a small proportion of women. There are fewer data regarding the QOL effects of ovarian ablation, which may nonetheless be more substantial. Conclusion: Tamoxifen and aromatase inhibitors cause specific vasomotor or gynecologic symptoms, which may affect sexual function. However, clinical benefits of these agents are generally achieved without major detrimental effect on overall QOL.
High prevalence of decreased expression of KAI1 metastasis suppressor in human oral carcinogenesis.

PURPOSE KAI1 was originally identified in prostate cancer as a metastasis suppressor gene. Recent studies have shown a frequent down-regulation of KAI1 expression in many tumor types, whereas mutation or hypermethylation of the gene is infrequent. The aim of the present study was to examine whether loss of KAI1 expression that might be caused by genetic or epigenetic alterations could contribute to oral carcinogenesis. EXPERIMENTAL DESIGN We analyzed mutational and methylation status of the KAI1 gene and both the mRNA and protein level in a series of oral tumors [28 precancerous lesions, 101 primary oral squamous cell carcinomas (OSCCs), and 30 metastatic OSCCs] and OSCC-derived cell lines. We also examined p53 protein expression, which has been reported to be a candidate activator for the KAI1 gene. RESULTS With the exception of three microsatellite instabilities in the KAI1 gene, we found no mutations in the coding sequence of the KAI1 gene, no loss of heterozygosity, and no hypermethylation of the KAI1 promoter region in all samples investigated. By immunohistochemistry, however, high frequencies of KAI1 down-regulation were evident not only in the metastatic OSCCs [29 of 30 (97%)] but also in the primary OSCCs [83 of 101 (82%)] and in the precancerous lesions [13 of 28 (46%)]. There was a significant relationship between down-regulation of KAI1 protein expression and primary tumors associated with lymph node metastases (P = 0.0115), whereas there was no statistical correlation between p53 status and KAI1 expression. Taken together, reverse transcription-PCR data were consistent with the protein expression status in 16 patients from whom mRNA was available. CONCLUSIONS Our data suggest that whereas loss of KAI1 protein expression is associated with primary tumors with lymph node metastases, the down-regulation of KAI1 is an early event in the progression of human oral cancer. The down-regulation of KAI1 is not associated with either mutation, allelic loss, methylation of the promoter, or p53 regulation.
Prolactin secretion during sleep in obstructive sleep apnoea patients

SUMMARY Plasma prolactin (PRL) concentration exhibits a sleep‐dependent pattern, with highest levels during sleep and lowest levels during the waking period. The syndrome of obstructive sleep apnoea (OSA) is associated with severe hypoxaemia and chronic sleep fragmentation, both of which could affect the sleep‐entrained PRL rhythm. Treatment with nasal continuous positive airway pressure (CPAP) immediately restores a normal sleep structure by successful abolition of the apnoeas. In the present study, seven OSA patients underwent two night studies, once when no treatment was given and once during the first night of CPAP treatment. Sleep was recorded polygraphically in all experiments. Plasma PRL was measured at 10 min intervals and secretory rates were calculated by a deconvolution procedure. CPAP treatment greatly reduced hypoxaemia and improved sleep quality. The secretory pulse amplitude and the total amount of PRL secreted during the night remained constant regardless of whether patients were treated or not. The only difference found was a lower pulse frequency in untreated OSA patients as compared to treated patients, which may be attributed either to hypoxaemia or to sleep disturbance or to the combined action of both. Treatment may be considered to normalize PRL release by restoring pulse frequency to values similar to those observed for normal subjects.
Evolution in open source software: a case study

Most studies of software evolution have been performed on systems developed within a single company using traditional management techniques. With the widespread availability of several large software systems that have been developed using an "open source" development approach, we now have a chance to examine these systems in detail, and see if their evolutionary narratives are significantly different from commercially developed systems. The paper summarizes our preliminary investigations into the evolution of the best known open source system: the Linux operating system kernel. Because Linux is large (over two million lines of code in the most recent version) and because its development model is not as tightly planned and managed as most industrial software processes, we had expected to find that Linux was growing more slowly as it got bigger and more complex. Instead, we have found that Linux has been growing at a super-linear rate for several years. The authors explore the evolution of the Linux kernel both at the system level and within the major subsystems, and they discuss why they think Linux continues to exhibit such strong growth.
Parameter drift in LMS adaptive filters

We examine general conditions under which the LMS adaptive filter generates unbounded parameter estimates when driven by bounded sequences. This unexpected parameter divergence, or drift, is related to the inadequacy of excitation in the input sequence and is characterized by slow (i.e., nonexponential) escape of the parameter estimate vector to infinity in spite of all other signals (inputs, outputs, prediction errors) remaining bounded or even decaying to zero. The analysis proceeds by showing that, in a general adaptive filtering setting, the sequence of regressors (information vectors) provides a natural decomposition of the parameter estimate space into subspaces, each corresponding to a characteristic class of filter excitation. This subspace decomposition is applied to the LMS adaptive filter, yielding direct links between filter behavior and modes of excitation. In particular, stability and instability of the parameter estimates in the presence of bounded disturbances and prediction errors is obtained for various classes of excitation. This behavior is examined in detail for the first-and second-order cases, and is sufficient to characterize the behavior of higher order adaptive filters. The instability (drift) results are due to modes of "decaying" excitation, and bounds on the rates of drift are derived. This drift mechanism is inherent in the algorithm and is not due to numerical implementation problems or violation of small step-size conditions. Examples are presented where drift may occur in restricted complexity filtering and in the related stochastic gradient algorithm. An analysis of leakage in terms of input excitation reveals a tradeoff in performance between parameter and prediction errors. A modified form of leakage, using the subspace decomposition, is suggested to remove this difficulty.
Academic Achievement Varies With Gestational Age Among Children Born at Term

OBJECTIVE: The goal of this study was to examine the degree to which children born within the “normal term” range of 37 to 41 weeks’ gestation vary in terms of school achievement. METHODS: This study analyzed data from 128 050 singleton births born between 37 and 41 weeks’ gestation in a large US city. Data were extracted from city birth records to assess a number of obstetric, social, and economic variables, at both the individual and community levels. Birth data were then matched with public school records of standardized city-wide third-grade reading and math tests. Specifically, we assessed (1) whether children born within the normal term range of 37 to 41 weeks’ gestation show differences in reading and/or math ability 8 years later as a function of gestational age, and (2) the degree to which a wide range of individual- and community-level social and biological factors mediate this effect. RESULTS: Analyses revealed that gestational age within the normal term range was significantly and positively related to reading and math scores in third grade, with achievement scores for children born at 37 and 38 weeks significantly lower than those for children born at 39, 40, or 41 weeks. This effect was independent of birth weight, as well as a number of other obstetric, social, and economic factors. CONCLUSIONS: Earlier normal term birth may be a characteristic considered by researchers, clinicians, and parents to help identify children who may be at risk for poorer school performance.
Sparse LMS via online linearized Bregman iteration

We propose a version of least-mean-square (LMS) algorithm for sparse system identification. Our algorithm called online linearized Bregman iteration (OLBI) is derived from minimizing the cumulative prediction error squared along with an l1-l2 norm regularizer. By systematically treating the non-differentiable regularizer we arrive at a simple two-step iteration. We demonstrate that OLBI is bias free and compare its operation with existing sparse LMS algorithms by rederiving them in the online convex optimization framework. We perform convergence analysis of OLBI for white input signals and derive theoretical expressions for the steady state mean square deviations (MSD). We demonstrate numerically that OLBI improves the performance of LMS type algorithms for signals generated from sparse tap weights.
Adaptive Evolution of Escherichia coli to an α-Peptide/β-Peptoid Peptidomimetic Induces Stable Resistance

Antimicrobial peptides (AMPs) and synthetic analogues thereof target conserved structures of bacterial cell envelopes and hence, development of resistance has been considered an unlikely event. However, recently bacterial resistance to AMPs has been observed, and the aim of the present study was to determine whether bacterial resistance may also evolve against synthetic AMP analogues, e.g. α-peptide/β-peptoid peptidomimetics. E. coli ATCC 25922 was exposed to increasing concentrations of a peptidomimetic (10 lineages), polymyxin B (10 lineages), or MilliQ water (4 lineages) in a re-inoculation culturing setup covering approx. 500 generations. All 10 lineages exposed to the peptidomimetic adapted to 32×MIC while this occurred for 8 out of 10 of the polymyxin B-exposed lineages. All lineages exposed to 32×MIC of either the peptidomimetic or polymyxin B had a significantly increased MIC (16–32×) to the selection agent. Five transfers (∼35 generations) in unsupplemented media did not abolish resistance indicating that resistance was heritable. Single isolates from peptidomimetic-exposed lineage populations displayed MICs against the peptidomimetic from wild-type MIC to 32×MIC revealing heterogeneous populations. Resistant isolates showed no cross-resistance against a panel of membrane-active AMPs. These isolates were highly susceptible to blood plasma antibacterial activity and were killed when plasma concentrations exceeded ∼30%. Notably, MIC of the peptidomimetic against resistant isolates returned to wild-type level upon addition of 25% plasma. Whole-genome sequencing of twenty isolates from four resistant lineages revealed mutations, in murein transglycosylase D (mltD) and outer-membrane proteins, which were conserved within and between lineages. However, no common resistance-conferring mutation was identified. We hypothesise that alterations in cell envelope structure result in peptidomimetic resistance, and that this may occur via several distinct mechanisms. Interestingly, this type of resistance result in a concomitant high susceptibility towards plasma, and therefore the present study does not infer additional concern for peptidomimetics as future therapeutics.
The OPTIONS Model of Sexual Risk Assessment for Adolescents

Typically, clinical evaluations of adolescents’ sexual risk is based on inquiring about past sexual activity, which is limited by not including an adolescent’s cognitive decision making regarding their past sexual decisions. This study describes the novel OPTIONS framework for assessing adolescent sexual risk including three general categories of risk (e.g., primary, secondary, and tertiary risk), which is designed to overcome the limitation of action-based assessment of risk and improve practitioners’ ability to assess the levels of sexual risk. A convenience sample of 201 older adolescents (18-19 years of age) completed an online version of the Relationship Options Survey (ROS), designed to measure the OPTIONS sexual risk assessment. Bivariate correlation among the subscales functioned in the hypothesized manner, with all correlations being statistically significant. Using the OPTIONS model, 22.4% participants were classified as high risk primary, 7.0% participants were classified as high risk secondary, and 27.4% participants were classified as high risk tertiary. The study provided preliminary evidence for OPTIONS model of sexual assessment, which provides a more tailored evaluation by including cognitive decisions regarding an adolescent’s sexual actions.
Maternal Heart Rate Variability during the First Stage of Labor

Labor necessitates continuous adjustments of cardiac autonomic reflexes by alternate activation of the sympathetic and parasympathetic nervous systems. The division of the autonomic nervous system (ANS) that predominates during the first stage of labor is unclear and needs to be further investigated. The study aimed to compare heart rate variability (HRV) in pregnant women in the third trimester with those during the first stage of labor. We conducted a case–control study at Saad Abul Ela Maternity Hospital, Khartoum, Sudan. Forty-five women with singleton, live neonates in the first stage of labor and 45 women in the third trimester (but not in labor) were enrolled as case and control groups, respectively. Data on the medical history, obstetrics history, and clinical examinations that were performed in all of the studied women were obtained using prearranged questionnaires. Cardiac autonomic modulation (CAM) of the heart was examined in both groups based on time and frequency domain HRV indices. There were no significant differences in age, parity, body mass index, and hemoglobin levels between the two groups. Pregnant women in labor had significantly higher LnSDNN, LnRMSSD, LnTP, LnVLF, LnLF, LnHF, LF Norm, and LnLF/HF ratio, but lower HF Norm compared with controls (P < 0.001). These findings remained unchanged when possible confounders were controlled for using regression analysis. Our findings suggest a significant increase in indictors of sympathetic CAM, namely LF Norm and LnLF/HF, during labor. Sympathetic hypertonia associated with labor is unlikely to increase the risk of cardiac events because sympathetic CAM simultaneously increases with global HRV. Increased HRV during labor may be explained by parasympathetic activation as indicated by higher LnHF and LnRMSSD at the time of delivery.
Borderline Personality Disorder and Bipolar Disorder: What is the Difference and Why Does it Matter?

Abstract Borderline personality disorder (BPD) and bipolar disorder (types I and II) are frequently confused because of their symptomatic overlap. Although affective instability is a prominent feature of each, the pattern is entirely different. BPD is characterized by transient mood shifts that occur in response to interpersonal stressors, whereas bipolar disorder is associated with sustained mood changes. These disorders can be further distinguished by comparing their phenomenology, etiology, family history, biological studies, outcome, and response to medication. Their distinction is of great clinical importance because misdiagnosis can deprive the patient of potentially effective treatment, whether it is psychotherapy for BPD or medication for bipolar disorder. On the basis of a comprehensive literature review, guidelines for differential diagnosis are suggested, and priorities for further research are recommended.