Miracle-dz/UniFAR-FTUs huggingface dataset:
Decreased length of stay after addition of healthcare provider in emergency department triage: a comparison between computer-simulated and real-world interventions

Objective (1) To determine the effects of adding a provider in triage on average length of stay (LOS) and proportion of patients with >6 h LOS. (2) To assess the accuracy of computer simulation in predicting the magnitude of such effects on these metrics. Methods A group-level quasi-experimental trial comparing the St. Louis Veterans Affairs Medical Center emergency department (1) before intervention, (2) after institution of provider in triage, and discrete event simulation (DES) models of similar (3) ‘before’ and (4) ‘after’ conditions. The outcome measures were daily mean LOS and percentage of patients with LOS >6 h. Results The DES-modelled intervention predicted a decrease in the %6-hour LOS from 19.0% to 13.1%, and a drop in the daily mean LOS from 249 to 200 min (p<0.0001). Following (actual) intervention, the number of patients with LOS >6 h decreased from 19.9% to 14.3% (p<0.0001), with the daily mean LOS decreasing from 247 to 210 min (p<0.0001). Conclusion Physician and mid-level provider coverage at triage significantly reduced emergency department LOS in this setting. DES accurately predicted the magnitude of this effect. These results suggest further work in the generalisability of triage providers and in the utility of DES for predicting quantitative effects of process changes.
Gender difference in oxidative stress: a new look at the mechanisms for cardiovascular diseases

Gender differences are present in many diseases and are especially prevalent in cardiovascular disease. Males tend to suffer from myocardial infarctions earlier than females, and a woman's risk of cardiovascular disease increases after menopause, suggesting a cardio‐protective role of estrogen. However, hormone replacement therapy did not decrease the risk of cardiovascular disease in post‐menopausal women; thus, other mechanisms may be involved besides estrogen. Oxidative stress plays an important role in the development of cardiovascular diseases such as coronary artery disease. Gender is also associated with differences in oxidative stress. Under physiological conditions, females appear to be less susceptible to oxidative stress. This may be due to the antioxidant properties of estrogen, gender differences in NADPH‐oxidase activity or other mechanism(s) yet to be defined. This review strives to discuss gender differences in general terms followed by a more detailed examination of gender differences with oxidative stress and various associated diseases and the possible mechanisms underlying these differences.
Direct evidence for presynaptic inhibitory mechanisms in crayfish sensory afferents.

1. The central control of sensory inputs from a proprioceptor [chordotonal organ (CO)] in the second joint [coxo-basipodite (CB)] of the fifth leg was studied in crayfish in vitro preparations (Fig. 1A). Simultaneous intracellular recordings from CBCO terminals (CBT) and postsynaptic motoneurons (MNs) were performed along with micropipette pressure ejection or bath application of gamma-aminobutyric acid (GABA), to study the presynaptic mechanisms at work in the CBT (Fig. 1B). 2. Two intracellular recordings were used to show that the spikes never overshoot, and that the more central the recording site within the neuropile, the smaller the spikes (Fig. 2). Only electrotonic conduction occurs, therefore, in the sensory afferents within the ganglion. 3. Pressure ejection of GABA close to the recording site of CBTs in the ganglion (Fig. 3A) gave rise to a membrane depolarization, the reversal potential of which was about -25 mV (Fig. 7), as well as to an increase in the membrane conductance (Fig. 3C) and a decrease in the orthodromic spike amplitude; moreover, it did not elicit either hyperpolarization, or any change in the membrane conductance of the postsynaptic MN (Fig. 3B), which indicates that pressure ejection of GABA affected only a restricted area around the CBT and not the postsynaptic MNs. 4. In CBT, spontaneous primary afferent depolarizations (PADs) occurred irregularly when the activity of the preparation was not rhythmic (Fig. 4A), and in bursts when the preparation displayed fictive locomotion (Fig. 4B). In the latter case, antidromic spikes were sometimes superimposed on PADs (Fig. 4D). The amplitude of the PADs was reduced when picrotoxin (PTX), a GABA antagonist, was applied (Fig. 5), which suggests that GABA may be involved in spontaneous PADs. The reversal potential of PADs was about -25 mV (Figs. 6 and 7). 5. During simultaneous recordings from a CBT and a monosynaptically related MN, GABA applied by pressure ejection close to the CBT (Fig. 8A) completely suppressed the excitatory postsynaptic potentials (EPSPs) elicited by CBT spikes in the MN (Fig. 8, B and D). This was due to a presynaptic mechanism because no change in the membrane potential or membrane conductance was observed in the MN (Fig. 8C) and most of the CBTs associated with a given MN were affected (Fig. 9). 6. Simultaneously recording from a CBT and a monosynaptically related MN demonstrated that, during bouts of PADs, the spike amplitude decreased in proportion to the PAD amplitude (Fig. 10A). (ABSTRACT TRUNCATED AT 400 WORDS)
Relationship Between Residual Renal Function and Serum Fibroblast Growth Factor 23 in Patients on Peritoneal Dialysis

Fibroblast growth factor 23 (FGF23) levels in dialysis patients are influenced by various factors, including phosphorus load. However, the clinical parameters that determine serum FGF23 levels in patients on peritoneal dialysis (PD) remain unclear. The aim of the present study was to examine the effects of clinical factors, on serum FGF23 levels, with an emphasis on residual renal function (RRF). This cross‐sectional study included 56 outpatients undergoing PD therapy. Urine volume ≥100 mL/day or renal creatinine (Cr) clearance was used as a surrogate marker for RRF. Clinical characteristics were compared between patients with and without RRF. Linear regression analysis was conducted with serum FGF23 level as the dependent variable and renal Cr clearance as the main independent variable. The median and interquartile range of serum FGF23 levels were 5970 (1451–11 688) pg/mL. Patients with RRF showed higher urinary and total phosphate eliminations, and lower serum FGF23 and phosphate levels than patients without RRF. Multivariate linear regression analysis showed that the renal Cr clearance and serum phosphate and dialysis history were negatively associated with serum FGF23 levels, even after adjusting for potential confounders including peritoneal Cr clearance. Further, the predictabilities of serum FGF23 were comparable among renal Cr clearance, Kt/V for urea, and renal phosphate clearance. RRF determined by renal Cr clearance or residual urine volume is an independent negative determinant of serum FGF23 levels in PD patients.
Human Sensitivity to Phase Perturbations in Natural Images: A Statistical Framework

Fourier-phase information is important in determining the appearance of natural scenes, but the structure of natural-image phase spectra is highly complex and difficult to relate directly to human perceptual processes. This problem is addressed by extending previous investigations of human visual sensitivity to the randomisation and quantisation of Fourier phase in natural images. The salience of the image changes induced by these physical processes is shown to depend critically on the nature of the original phase spectrum of each image, and the processes of randomisation and quantisation are shown to be perceptually equivalent provided that they shift image phase components by the same average amount. These results are explained by assuming that the visual system is sensitive to those phase-domain image changes which also alter certain global higher-order image statistics. This assumption may be used to place constraints on the likely nature of cortical processing: mechanisms which correlate the outputs of a bank of relative-phase-sensitive units are found to be consistent with the patterns of sensitivity reported here.
LIGHT Induces Distinct Signals to Clear an AAV-Expressed Persistent Antigen in the Mouse Liver and to Induce Liver Inflammation

Background Infection with adeno-associated virus (AAV) vector with liver tropism leads to persistent expression of foreign antigens in the mouse liver, with no significant liver inflammation or pathology. This provides a model to investigate antigen persistence in the liver and strategies to modulate host immunity to reduce or clear the foreign antigen expressed from AAV vector in the liver. Methods/Principal Findings We showed that expressing LIGHT with an adenovirus vector (Ad) in mice with established AAV in the liver led to clearance of the AAV. Ad-LIGHT enhanced CD8 effector T cells in the liver, correlated with liver inflammation. LTβR-Ig proteins blocked Ad-LIGHT in clearing AAV. Interestingly, in LTβR-null mice, Ad-LIGHT still cleared AAV but caused no significant liver inflammation. Conclusions/Significance Our data suggest that LIGHT interaction with the LTβR plays a critical role in liver inflammation but is not required for LIGHT-mediated AAV clearance. These findings will shed light on developing novel immuno-therapeutics in treating people chronically infected with hepato-tropic viruses.
Enhanced alcohol self-administration after intermittent versus continuous alcohol vapor exposure.

BACKGROUND Ethanol self-administering rats exhibit enhanced responding during withdrawal from continuous exposure to ethanol vapor. This study compared self-administration of ethanol during withdrawal from continuous versus intermittent ethanol vapor. METHODS Experiment 1 examined self-administration of ethanol in rats trained to self-administer ethanol after continuous, intermittent (14 hr on and 10 hr off), or no (i.e., controls) ethanol vapor exposure. Exposure time was equalized such that the intermittent group received 4 weeks of exposure and the continuous group received 2 weeks of exposure. Four self-administration tests were conducted 2 hr after removal from vapor, and each test was separated by 3 to 4 days of ethanol vapor. Experiment 2 examined self-administration of ethanol after 2 weeks of intermittent vapor either 2 or 8 hr after removal from vapor. Experiment 3 addressed the specificity of the increased responding for ethanol by examining saccharin self-administration after 2 weeks of intermittent vapor. RESULTS Four weeks of intermittent exposure produced an increase in ethanol self-administration during the first withdrawal relative to controls and relative to animals receiving 2 weeks of continuous exposure. The continuous group was indistinguishable from controls on the first test and gradually increased their responding across tests. Two weeks of intermittent exposure also increased ethanol self-administration, and there was no difference in this effect 2 or 8 hr after removal from vapor. There was no difference in saccharin self-administration in control rats and those given 2 weeks of intermittent exposure. CONCLUSIONS The finding that intermittent exposure produces more rapid increases in self-administration of ethanol relative to continuous exposure suggests that intermittent exposure may be associated with a more rapid escalation of the allostatic processes responsible for excessive ethanol self-administration. The mechanisms that drive the increases in drinking during withdrawal are similar after 2 and 8 hr of withdrawal and seem to be specific to ethanol.
Ratio dependence in small number discrimination is affected by the experimental procedure

Adults, infants and some non-human animals share an approximate number system (ANS) to estimate numerical quantities, and are supposed to share a second, ‘object-tracking,’ system (OTS) that supports the precise representation of a small number of items (up to 3 or 4). In relative numerosity judgments, accuracy depends on the ratio of the two numerosities (Weber’s Law) for numerosities >4 (the typical ANS range), while for numerosities ≤4 (OTS range) there is usually no ratio effect. However, recent studies have found evidence for ratio effects for small numerosities, challenging the idea that the OTS might be involved for small number discrimination. Here we tested the hypothesis that the lack of ratio effect in the numbers 1–4 is largely dependent on the type of stimulus presentation. We investigated relative numerosity judgments in college students using three different procedures: a simultaneous presentation of intermingled and separate groups of dots in separate experiments, and a further experiment with sequential presentation. As predicted, in the large number range, ratio dependence was observed in all tasks. By contrast, in the small number range, ratio insensitivity was found in one task (sequential presentation). In a fourth experiment, we showed that the presence of intermingled distractors elicited a ratio effect, while easily distinguishable distractors did not. As the different ratio sensitivity for small and large numbers has been often interpreted in terms of the activation of the OTS and ANS, our results suggest that numbers 1–4 may be represented by both numerical systems and that the experimental context, such as the presence/absence of task-irrelevant items in the visual field, would determine which system is activated.
Learning a Tree-Structured Ising Model in Order to Make Predictions

We study the problem of learning a tree Ising model from samples such that subsequent predictions made using the model are accurate. The prediction task considered in this paper is that of predicting the values of a subset of variables given values of some other subset of variables. Virtually all previous work on graphical model learning has focused on recovering the true underlying graph. We define a distance ("small set TV" or ssTV) between distributions $P$ and $Q$ by taking the maximum, over all subsets $\mathcal{S}$ of a given size, of the total variation between the marginals of $P$ and $Q$ on $\mathcal{S}$; this distance captures the accuracy of the prediction task of interest. We derive non-asymptotic bounds on the number of samples needed to get a distribution (from the same class) with small ssTV relative to the one generating the samples. One of the main messages of this paper is that far fewer samples are needed than for recovering the underlying tree, which means that accurate predictions are possible using the wrong tree.
Combined Use of Airborne Lidar and DBInSAR Data to Estimate LAI in Temperate Mixed Forests

The objective of this study was to determine whether leaf area index (LAI) in temperate mixed forests is best estimated using multiple-return airborne laser scanning (lidar) data or dual-band, single-pass interferometric synthetic aperture radar data (from GeoSAR) alone, or both in combination. In situ measurements of LAI were made using the LiCor LAI-2000 Plant Canopy Analyzer on 61 plots (21 hardwood, 36 pine, 4 mixed pine hardwood; stand age ranging from 12-164 years; mean height ranging from 0.4 to 41.2 m) in the Appomattox-Buckingham State Forest, Virginia, USA. Lidar distributional metrics were calculated for all returns and for ten one meter deep crown density slices (a new metric), five above and five below the mode of the vegetation returns for each plot. GeoSAR metrics were calculated from the X-band backscatter coefficients (four looks) as well as both X- and P-band interferometric heights and magnitudes for each plot. Lidar metrics alone explained 69% of the variability in LAI, while GeoSAR metrics alone explained 52%. However, combining the lidar and GeoSAR metrics increased the R2 to 0.77 with a CV-RMSE of 0.42. This study indicates the clear potential for X-band backscatter and interferometric height (both now available from spaceborne sensors), when combined with small-footprint lidar data, to improve LAI estimation in temperate mixed forests.
The role of surgery in the treatment of gastrointestinal lymphomas other than low-grade MALT lymphomas.

BACKGROUND AND OBJECTIVE A bias in clinical investigations on gastrointestinal lymphomas is the lack of testing the intention to treat as to resection, emergency conditions at presentation and selection brought about by the evaluation of feasibility of surgery. DESIGN AND METHODS A prospective study involved 154 patients with gastrointestinal nodular or high-grade MALT lymphomas, 111 with a gastric and 43 with an intestinal presentation. The decision to resect or treat conservatively was left to clinicians, on condition that it was previously defined for each patient. RESULTS Failure-free survival was significantly higher in the 106 resected patients than in the 48 unresected ones but did not differ according to either primary intention to treat or emergency surgery/elective treatment. Survival was similar in patients operated on by choice and in those because of an emergency. Intentionally unresected patients had a significantly better survival than those not undergoing surgery despite the initial intention, for a number of clinical reasons. Patients with gastric lymphoma survived longer than those with intestinal disease and prognostic factors were analyzed separately in the two groups. The best predictors of prognosis were performance status and serum lactic dehydrogenase level in gastric lymphomas, resection alone in intestinal ones. INTERPRETATION AND CONCLUSIONS The prognosis of gastric lymphomas depends on lymphoma-related factors and not on surgical treatment. The prognosis of intestinal ones is exclusively related to surgery. These data support the appropriateness of different clinical approaches to gastric and intestinal lymphomas.
Change management at Mobil Oil Australia

To remain competitive, many businesses in the 1990's have undertaken business process reengineering projects, reorganising one or more parts of their operations. The paper results from a case study of the enterprise-wide review of Mobil Oil Australia Limited to increase profitability and change the culture of the organisation. A radical (to the oil industry) business unit organisation structure was designed, populated and implemented. The project was an immediate financial success and reenergized the company. Income after tax was six times higher after the reorganisation than in the previous year, notwithstanding a continuing recession and the uncertainty caused by the restructuring. Return on capital employed increased from 2% to 7%. Lessons can be learnt from the way the project was initiated and developed, the deployment of the project management structure and improvement methodology, the approach to the implementation of the new structure, and the findings of the post implementation review.
Hypertension Suppression, Not a Cumulative Thrust of Quantitative Trait Loci, Predisposes Blood Pressure Homeostasis to Normotension

Background—Genetics of high blood pressure (BP) has revealed causes of hypertension. The cause of normotension, however, is poorly understood. Inbred Lewis rats sustain normotension despite a genetic push in altering BP. It was unknown whether this rigid resistance to BP changes is because of an insufficient hypertensive impact from limited alleles of quantitative trait loci (QTLs) or because of an existence of a master control superseding the combined strength of hypertensive QTL alleles. Methods and Results—Currently, BP-elevating QTL alleles from hypertensive Dahl salt-sensitive rats (DSS) replaced those of Lewis on chromosomes 7, 8, 10, and 17 on the Lewis background. These hypertensive QTL alleles were then merged to systematically achieve multiple combinations. Results showed that there was no quantitative correlation between BP variations and the number of hypertensive QTL alleles, and that BP was only slightly elevated from a combined force of normotensive alleles from 7 QTLs. Thus, a genetic factor aside from the known QTLs seemed to be at play in preserving normotension and act as a hypertension suppressor. A follow-up study using consecutive backcrosses from Dahl salt-sensitive rats and Lewis identified a chromosome segment where a hypertension suppressor might reside. Conclusions—Our results provide the first evidence that normotension is not enacted via a numeric advantage of BP-lowering QTL alleles, and instead can be achieved by a particular genetic component actively suppressing hypertensive QTL alleles. The identification of this hypertension suppressor could result in formulating unique diagnostic and therapeutic targets, and above all, preventive measures against essential hypertension.
Effect of Tannic Acid on the Protective Properties of the in situ Formed Pellicle

Objectives: In the present in situ/ex vivo study the impact of tannic acid on the erosion-protective properties of the enamel pellicle was tested. Additionally, the antiadherent and antibacterial effects of tannic acid were evaluated. Methods: The pellicle was formed in situ on bovine enamel samples fixed on individual splints worn by 6 subjects. Following 1 min of pellicle formation the volunteers rinsed for 10 min with tannic acid. After further oral exposure for 19 min, 109 min, and 8 h overnight, respectively, slabs were incubated in HCl ex vivo (pH 2.0, 2.3, 3.0) over 120 s. Subsequently, kinetics of calcium and phosphate release were measured photometrically. Samples after a 1-min fluoride mouth rinse as well as enamel samples with and without a 30-min in situ pellicle served as controls. Antiadherent effects were evaluated after a 1-min rinse with tannic acid and oral exposure of the slabs overnight. DAPI (4′,6-diamidino-2-phenylindole) combined with concanavalin A staining and live/dead staining was used for fluorescence microscopic visualization and quantification of adherent bacteria and glucans. Modification of the pellicle's ultrastructure by tannic acid was evaluated by transmission electron microscopy (TEM). Results: Tannic acid significantly improved the erosion-protective properties of the pellicle in a pH-dependent manner. Bacterial adherence and glucan formation on enamel were significantly reduced after rinses with tannic acid as investigated by fluorescence microscopy. TEM imaging indicated that rinsing with tannic acid yielded a sustainable modification of the pellicle; it was distinctly more electron dense. Conclusion: Tannic acid offers an effective and sustainable approach for the prevention of caries and erosion.