Miracle-dz/UniFAR-FTUs huggingface dataset:
A new subarachnoid hemorrhage grading system based on the Glasgow Coma Scale: a comparison with the Hunt and Hess and World Federation of Neurological Surgeons Scales in a clinical series.

OBJECTIVE Although the Hunt and Hess Scale (HHS) and World Federation of Neurological Surgeons Scale (WFNSS) are the most widely used subarachnoid hemorrhage (SAH) grading systems, neither system has achieved universal acceptance. We propose a simplified grading system based entirely on the Glasgow Coma Scale (GCS), which compresses the 15-point GCS into five grades that are comparable with those of the HHS and WFNSS. We refer to this system as the GCS grading system and present a direct comparison with the HHS and WFNSS for predictive value regarding patient outcome and interrater reliability. METHODS We reviewed 291 consecutive patients with aneurysms treated at our institution between January 1992 and January 1996 and compared the admission grades from the GCS, WFNSS, and HHS with outcome measures at discharge from hospitalization. The Glasgow Outcome score was used as the major outcome measure to evaluate the predictive value of the three scales. Mortality and length of stay (LOS) were also evaluated as outcome measures. The predictive value of each scale was tested with an ordinal logistic regression model for Glasgow Outcome score, a logistic regression model for mortality data, and a linear regression model for LOS. RESULTS Using the logistic regression model, the GCS was the best predictor of discharge Glasgow Outcome score, with an odds ratio of 2.585 (P = 0.0001), compared with 2.311 (P = 0.0001) for the WFNSS and 2.262 (P = 0.0001) for the HHS. Using mortality data in the logistic model, the HHS was the best predictor, with an odds ratio of 3.391 (P = 0.0001), compared with 2.859 (P = 0.0001) for the GCS and 2.560 (P = 0.0001) for the WFNSS. Each of the three scales had a high predictive value for LOS, using a linear model. We discuss, however, the problematic nature of LOS as an outcome measure for SAH. Interrater reliability for each scale was evaluated using kappa statistics, based on 15 additional patients evaluated prospectively, and showed that the GCS grade also had the greatest interrater reliability, with a kappa of 0.46 (P = 0.0002), compared with 0.41 (P = 0.0005) for the HHS and 0.27 (P = 0.027) for the WFNSS. CONCLUSION We conclude that the GCS grade has equal or greater predictive value regarding outcome after SAH than do the currently used grading systems and that it has greater reproducibility across observers. Broader familiarity with the GCS among medical and paramedical personnel may further enhance the usefulness of the GCS grade over the HHS and WFNSS in providing a standardized, universally accepted grading system for SAH.
Online Perceptions of Mothers About Breastfeeding and Introducing Formula: Qualitative Study

Background Although the benefits of breastfeeding are well established for babies and their mothers, many women give formula to their infants. Whether to breastfeed or to give infant formula is a complex decision to make. Many parents use the Internet to find information and support that relate to infant feeding decisions. Objective The aim of this study was to analyze the perceptions of mothers, who are discussing the topic on Web forums, about introducing infant formula. Methods This is a qualitative, descriptive, and cross-sectional study on online data from parenting Web forums. The text was analyzed using qualitative content analysis. Results The analysis resulted in 1 main theme, “balancing between social expectations and confidence in your parental ability,” which is further divided into 3 themes: “striving to be a good mother,” “striving for your own well-being,” and “striving to discover your own path. ” Conclusions Breastfeeding is complex, and health care personnel can, with a more open approach toward formula, create better support for mothers by helping them to be more confident in their parental ability.
Indirect costs of rheumatoid arthritis

It is estimated that in Poland about 400,000 persons in general suffer from inflammatory joint diseases, including rheumatoid arthritis (RA). Epidemiological surveys documenting the frequency and disturbance of musculoskeletal disorders in the Polish population are few in number. Most of the estimations are based on epidemiological data from other countries (prevalence of 0.5–1%). According to the data of the National Health Fund in Poland 135,000–157,000 persons in total are treated because of rheumatoid arthritis per year [ICD10 (International Statistical Classification of Diseases and Related Health Problems): M05, M06]. In the case of this group of diseases indirect costs significantly outweigh the direct costs. Indirect costs increase together with activity level of the disease. The cost analysis of productivity loss of RA patients indicates that sickness absenteeism and informal care are the most burdensome. At the national level it amounts in total from 1.2 billion to 2.8 billion PLN per year, depending on the method of analysis. These costs could be significantly reduced through early diagnosis and introduction of effective treatment.
Influence of therapist competence and quantity of cognitive behavioural therapy on suicidal behaviour and inpatient hospitalisation in a randomised controlled trial in borderline personality disorder: Further analyses of treatment effects in the BOSCOT study

Objectives We investigated the treatment effects reported from a high-quality randomized controlled trial of cognitive behavioural therapy (CBT) for 106 people with borderline personality disorder attending community-based clinics in the UK National Health Service – the BOSCOT trial. Specifically, we examined whether the amount of therapy and therapist competence had an impact on our primary outcome, the number of suicidal acts†, using instrumental variables regression modelling. Design Randomized controlled trial. Participants from across three sites (London, Glasgow, and Ayrshire/Arran) were randomized equally to CBT for personality disorders (CBTpd) plus Treatment as Usual or to Treatment as Usual. Treatment as Usual varied between sites and individuals, but was consistent with routine treatment in the UK National Health Service at the time. CBTpd comprised an average 16 sessions (range 0–35) over 12 months. Method We used instrumental variable regression modelling to estimate the impact of quantity and quality of therapy received (recording activities and behaviours that took place after randomization) on number of suicidal acts and inpatient psychiatric hospitalization. Results A total of 101 participants provided full outcome data at 2 years post randomization. The previously reported intention-to-treat (ITT) results showed on average a reduction of 0.91 (95% confidence interval 0.15–1.67) suicidal acts over 2 years for those randomized to CBT. By incorporating the influence of quantity of therapy and therapist competence, we show that this estimate of the effect of CBTpd could be approximately two to three times greater for those receiving the right amount of therapy from a competent therapist. Conclusions Trials should routinely control for and collect data on both quantity of therapy and therapist competence, which can be used, via instrumental variable regression modelling, to estimate treatment effects for optimal delivery of therapy. Such estimates complement rather than replace the ITT results, which are properly the principal analysis results from such trials. Practitioner points Assessing the impact of the quantity and quality of therapy (competence of therapists) is complex. More competent therapists, trained in CBTpd, may significantly reduce the number of suicidal act in patients with borderline personality disorder.
Bounds on inference

Lower bounds for the average probability of error of estimating a hidden variable X given an observation of a correlated random variable Y, and Fano's inequality in particular, play a central role in information theory. In this paper, we present a lower bound for the average estimation error based on the marginal distribution of X and the principal inertias of the joint distribution matrix of X and Y. Furthermore, we discuss an information measure based on the sum of the largest principal inertias, called k-correlation, which generalizes maximal correlation. We show that k-correlation satisfies the Data Processing Inequality and is convex in the conditional distribution of Y given X. Finally, we investigate how to answer a fundamental question in inference and privacy: given an observation Y, can we estimate a function f(X) of the hidden random variable X with an average error below a certain threshold? We provide a general method for answering this question using an approach based on rate-distortion theory.
Optimal waveform design for UWB radios

With transmit power spectra strictly limited by regulatory spectral masks, the emerging ultra-wideband (UWB) communication systems call for judicious pulse shape design in order to achieve optimal spectrum utilization, spectral mask compatibility, and coexistence with other wireless services. Meanwhile, orthogonal pulse sets are often desired in order to apply high-rate multidimensional modulation and (carrier-free) orthogonal frequency-division multiple access. Motivated by these considerations, we suggest a digital finite impulse response (FIR) filter approach to synthesizing UWB pulses and propose filter design techniques by which optimal waveforms that satisfy the spectral mask can be efficiently obtained. For single pulse design, we develop a convex formulation for the design of the FIR filter coefficients that maximize the spectrum utilization efficiency in terms of both the bandwidth and power allowed by the spectral mask. For orthogonal pulse design, a sequential strategy is derived to formulate the overall pulse design problem as a set of convex subproblems, which are then solved in a sequential manner to yield a set of mutually orthogonal pulses. Our design techniques not only provide waveforms with high spectrum utilization and guaranteed spectral mask compliance but also permit simple modifications that can accommodate several other system objectives.
Perceptions of ergonomics importance at workplace and safety culture amongst safety & health (SH) practitioners in Malaysia

The article reports on a study to identify key components which can be used to relate ergonomics awareness and safety culture. These components can be used to facilitate the research which aimed at determining the elements that influence the ergonomics awareness and the relationship with safety culture in an organization. A survey was done using a sample of 108 Safety and Health (SH) practitioners in manufacturing companies in Malaysia. Exploratory Factor Analysis was used to examine the SH practitioners perceptions in determining the importance of ergonomics at their workplace and their beliefs on the importance of safety culture to be inculcated at their companies. Principle Components Analysis with the Varimax rotation method was used for this analysis. 20 items for ergonomics importance at workplace were identified after EFA. The variables were i) implication and improvement (10 items), ii) suitability of workplace to the workers (7 items) and iii) ergonomics basic consideration (3 items). Safety culture questions were developed focused on the SH practitioners perceptions on safety climate importance. Three construct models based on 17 items were designed: i) commitment and leadership (7 items), ii) motivation (6 items) and iii) safety management system practice (4 items). This finding is significant in order to further study the influence of the perceptions of SH practitioners on ergonomics importance at workplace to the safety culture
Activation of Microglial Poly(ADP-Ribose)-Polymerase-1 by Cholesterol Breakdown Products during Neuroinflammation

Multiple sclerosis (MS) is a chronic demyelinating disease in which it has only recently been suggested that damage to neuronal structures plays a key role. Here, we uncovered a link between the release of lipid breakdown products, found in the brain and cerebrospinal fluid (CSF) of MS patients as well as in experimental autoimmune encephalomyelitis, and neuronal damage mediated by microglial activation. The concentrations of the breakdown product 7-ketocholesterol detected in the CSF of MS patients were capable of inducing neuronal damage via the activation and migration of microglial cells in living brain tissue. 7-ketocholesterol rapidly entered the nucleus and activated poly(ADP-ribose)-polymerase (PARP)-1, followed by the expression of migration-regulating integrins CD11a and intercellular adhesion molecule 1. These findings reveal a novel mechanism linking demyelination and progressive neuronal damage, which might represent an underlying insidious process driving disease beyond a primary white matter phenomenon and rendering the microglial PARP-1 a possible antiinflammatory therapeutic target.
Building Genetic Scores to Predict Risk of Complex Diseases in Humans: Is It Possible?

Decades of research have identified numerous biomarkers for cardiovascular diseases (CVDs) and type 2 diabetes, providing molecular insights for improved treatment and prevention of the diseases (1–3). Of the biomarkers that could be objectively and systematically measured, genetic variants such as single nucleotide polymorphisms (SNPs) have some unique features in that they do not change over time, and the temporal sequence of genotype-phenotype can be clearly established for outcome prediction. Using high-density fixed SNP arrays, recent genome-wide association studies (GWAS) have successfully identified multiple risk alleles related to CVD and type 2 diabetes. These advances in genomics present many exciting opportunities in three scientific domains: 1 ) integrating novel genetic variants into risk prediction models of complex diseases in humans, 2 ) characterizing new biological pathways involved in pathogenesis and thus improved strategies for treatment and management, and 3 ) enhancing inference of traditional epidemiological work relevant to public health importance. To capitalize on these opportunities, several groups have attempted to develop genetic risk scores by summing up the number of risk alleles for disease prediction. However, almost all these studies have concluded that current genetic information contributes little information in distinguishing who will or will not develop a CVD or type 2 diabetes among apparently healthy adults (4–6). Given that most common risk variants identified so far confer relatively modest risk to these complex diseases (e.g., all risk alleles for type 2 diabetes identified by GWAS have very small relative risks [<1.50]) (7,8), the “common diseases-common variants” model has been formally challenged (9,10). In the field of complex disease genetics, it is now widely anticipated that some ongoing next-generation sequencing work covering the whole genome in diverse populations would identify rare variants of large effect sizes in the coming years (8). Yet, there …
The Accuracy of ADC Measurements in Liver Is Improved by a Tailored and Computationally Efficient Local-Rigid Registration Algorithm

This study describes post-processing methodologies to reduce the effects of physiological motion in measurements of apparent diffusion coefficient (ADC) in the liver. The aims of the study are to improve the accuracy of ADC measurements in liver disease to support quantitative clinical characterisation and reduce the number of patients required for sequential studies of disease progression and therapeutic effects. Two motion correction methods are compared, one based on non-rigid registration (NRA) using freely available open source algorithms and the other a local-rigid registration (LRA) specifically designed for use with diffusion weighted magnetic resonance (DW-MR) data. Performance of these methods is evaluated using metrics computed from regional ADC histograms on abdominal image slices from healthy volunteers. While the non-rigid registration method has the advantages of being applicable on the whole volume and in a fully automatic fashion, the local-rigid registration method is faster while maintaining the integrity of the biological structures essential for analysis of tissue heterogeneity. Our findings also indicate that the averaging commonly applied to DW-MR images as part of the acquisition protocol should be avoided if possible.
Diffusion model for ultrasound-modulated light

Abstract. Researchers use ultrasound (US) to modulate diffusive light in a highly scattering medium like tissue. This paper analyzes the US–optical interaction in the scattering medium and derives an expression for the US-modulated optical radiance. The diffusion approximation to the radiative transport equation is employed to develop a Green’s function for US-modulated light. The predicted modulated fluence and flux are verified using finite-difference time-domain simulations. The Green’s function is then utilized to illustrate the modulated reflectance as the US–optical interaction increases in depth. The intent of this paper is to focus on high US frequencies necessary for high-resolution imaging because they are of interest for applications such as phase conjugation.
Use of Rifamycin Drugs and Development of Infection by Rifamycin-Resistant Strains of Clostridium difficile

ABSTRACT The relationship between rifamycin drug use and the development of resistant strains of Clostridium difficile was studied at a large university hospital in Houston, TX, between May 2007 and September 2011. In 49 of 283 (17.3%) patients with C. difficile infection (CDI), a rifamycin-resistant strain of C. difficile was identified that compares to a rate of 8% using the same definitions in 2006-2007 (P = 0.59). The 49 patients infected by a resistant organism were matched by date of admission to 98 control patients with CDI from whom a rifamycin-susceptible C. difficile strain was isolated. Cases and controls did not differ according to demographic and clinical characteristics and showed similar but low rates of prior rifamycin use. Similar rates of rifamycin resistance were seen in cases of hospital-acquired CDI (38/112 [34%]) versus community-acquired CDI (7/20 [35%]). At a university hospital in which rifaximin was commonly used, infection by rifamycin-resistant strains of C. difficile was not shown to relate to prior use of a rifamycin drug or to acquiring the infection in the hospital, although the rate of overall resistance appeared to be rising.
A novel isotope pool dilution approach to quantify gross rates of key abiotic and biological processes in the soil phosphorus cycle

Abstract. Efforts to understand and model the current and future behavior of the global phosphorus (P) cycle are limited by the availability of global data on rates of soil P processes, as well as their environmental controls. Here, we present a novel isotope pool dilution approach using 33P labeling of live and sterile soils, which allows for high-quality data on gross fluxes of soil inorganic P (Pi) sorption and desorption, as well as of gross fluxes of organic P mineralization and microbial Pi uptake to be obtained. At the same time, net immobilization of 33Pi by soil microbes and abiotic sorption can be easily derived and partitioned. Compared with other approaches, we used short incubation times (up to 48 h), avoiding tracer remineralization, which was confirmed by the separation of organic P and Pi using isobutanol fractionation. This approach is also suitable for strongly weathered and P-impoverished soils, as the sensitivity is increased by the extraction of exchangeable bioavailable Pi (Olsen Pi; 0.5 M NaHCO3) followed by Pi measurement using the malachite green assay. Biotic processes were corrected for desorption/sorption processes using adequate sterile abiotic controls that exhibited negligible microbial and extracellular phosphatase activities. Gross rates were calculated using analytical solutions of tracer kinetics, which also allowed for the study of gross soil P dynamics under non-steady-state conditions. Finally, we present major environmental controls of gross P-cycle processes that were measured for three P-poor tropical forest and three P-rich temperate grassland soils.
Nanomechanical motion of Escherichia coli adhered to a surface.

Nanomechanical motion of bacteria adhered to a chemically functionalized silicon surface is studied by means of a microcantilever. A non-specific binding agent is used to attach Escherichia coli (E. coli) to the surface of a silicon microcantilever. The microcantilever is kept in a liquid medium, and its nanomechanical fluctuations are monitored using an optical displacement transducer. The motion of the bacteria couples efficiently to the microcantilever well below its resonance frequency, causing a measurable increase in the microcantilever fluctuations. In the time domain, the fluctuations exhibit large-amplitude low-frequency oscillations. In corresponding frequency-domain measurements, it is observed that the mechanical energy is focused at low frequencies with a 1/fα -type power law. A basic physical model is used for explaining the observed spectral distribution of the mechanical energy. These results lay the groundwork for understanding the motion of microorganisms adhered to surfaces and for developing micromechanical sensors for bacteria.
Midgut bacteria required for Bacillus thuringiensis insecticidal activity

Bacillus thuringiensis is the most widely applied biological insecticide and is used to manage insects that affect forestry and agriculture and transmit human and animal pathogens. This ubiquitous spore-forming bacterium kills insect larvae largely through the action of insecticidal crystal proteins and is commonly deployed as a direct bacterial spray. Moreover, plants engineered with the cry genes encoding the B. thuringiensis crystal proteins are the most widely cultivated transgenic crops. For decades, the mechanism of insect killing has been assumed to be toxin-mediated lysis of the gut epithelial cells, which leads to starvation, or B. thuringiensis septicemia. Here, we report that B. thuringiensis does not kill larvae of the gypsy moth in the absence of indigenous midgut bacteria. Elimination of the gut microbial community by oral administration of antibiotics abolished B. thuringiensis insecticidal activity, and reestablishment of an Enterobacter sp. that normally resides in the midgut microbial community restored B. thuringiensis-mediated killing. Escherichia coli engineered to produce the B. thuringiensis insecticidal toxin killed gypsy moth larvae irrespective of the presence of other bacteria in the midgut. However, when the engineered E. coli was heat-killed and then fed to the larvae, the larvae did not die in the absence of the indigenous midgut bacteria. E. coli and the Enterobacter sp. achieved high populations in hemolymph, in contrast to B. thuringiensis, which appeared to die in hemolymph. Our results demonstrate that B. thuringiensis-induced mortality depends on enteric bacteria.
SCIAMACHY Degradation Monitoring Results

The spectrometer SCIAMACHY (SCanning Imaging Absorption spectroMeter for Atmospheric CHartographY) on-board ENVISAT is measuring solar irradiances and Earthshine radiances from the UV to the NIR spectral region in nadir, limb and lunar/solar occultation geometry. From these measurements the amount and distribution of various atmospheric constituents are derived (O3, BrO, OClO, SO2, H2CO, NO2, CO, CO2, CH4, H2O, clouds, and aerosols). To assure the quality of these data products at any time during the whole mission a detailed knowledge of the instrument status and behaviour is mandatory. To achieve this a comprehensive monitoring concept has been developed and implemented, involving various dedicated calibration and monitoring measurements. We present selected results from the analysis of these monitoring data. Special emphasis is placed on the performance monitoring for the various light paths and the derivation of degradation correction factors for operational data products.