Miracle-dz/UniFAR-FTUs huggingface dataset:
Evaluation of the threshold value for the Early Warning Score on general wards.

Introduction The Early Warning Score (EWS) is used for early detection of deteriorating vital parameters and has been correlated with adverse outcomes. Unfortunately, neither its value on general wards nor the optimal cut-off value have been investigated. We aimed to find the optimal cut-off value for EWS on general wards, and investigated the possibility to raise this value from EWS ≥ 3 without compromising sensitivity too much. Methods From May 2010 until May 2011, EWS was calculated from vital parameters in all patients in medical and surgical wards in the Medical Centre Alkmaar. Cut-off value was defined as EWS ≥ 3, unless otherwise specified. Six responses were defined and categorised as interventions (infusion prescription, medication changes, ICU consultation) and other actions (no action, change EWS cut-off value, oxygen supplementation), and it was registered whenever the threshold was exceeded. Results 71,911 EWS values were obtained, 31,728 (44%) on medical wards and 40,183 (56%) on surgical wards. On medical wards, the cut-off value was exceeded 3734 times, and response was registered in 29% of the cases with 141 (12%) interventions. On surgical wards, the cut-off value was exceeded 3279 times, and response was registered in 19% of the cases with 633 (36%) interventions. Sensitivity and specificity for EWS ≥ 3 could not be calculated. For a calculated cut-off at EWS ≥ 4, sensitivity decreased to 74%. Conclusion Raising the EWS threshold to 4 on general wards in the hospital would lead to an unacceptable decrease in sensitivity. Therefore, we recommend that the pre-defined cut-off should remain 3, with the possibility to personalise the threshold.
Pitfalls in wrist and hand ultrasound.

OBJECTIVE The purpose of this article is to review a number of diagnostic pitfalls related to ultrasound evaluation of the hand and wrist. Such pitfalls relate to evaluation of ten-dons (extensor retinaculum, multiple tendon fascicles, tendon subluxation), inflammatory arthritis (incomplete evaluation, misinterpretation of erosions, failure to evaluate for enthesitis), carpal tunnel syndrome (inaccurate measurements, postoperative assessment), ulnar collateral ligament of the thumb (misinterpretation of the adductor aponeurosis and displaced tear), wrist ganglion cysts (incomplete evaluation and misdiagnosis), and muscle variants. CONCLUSION Although ultrasound has been shown to be an effective imaging method for assessment of many pathologic conditions of the wrist, knowledge of potential pitfalls is essential to avoid misdiagnosis and achieve high diagnostic accuracy.
Iodine, Thyroid Autoimmunity and Cancer

This review focuses on two different topics: (a) iodine and autoimmune thyroid disease (AITD) and (b) AITD and papillary thyroid carcinoma (PTC). Iodine intake modifies the expression of thyroid diseases and has been associated with induction of AITD. Thyroglobulin (Tg) is an important target in iodine-induced autoimmune response due to post-translational modifications of iodinated Tg, as suggested in animal models. We have shown that the unmasking of a cryptic epitope on Tg contributes to iodine-induced thyroid autoimmunity in humans. The relationship between AITD and PTC has been suggested in many studies. The presence of two different mechanisms has been hypothesized, one typical of AITD and the other of an immune reaction to PTC. We have shown that in AITD, the pattern of Tg recognition by anti-Tg antibodies (TgAb) is ‘restricted' to the immunodominant regions of Tg, while in patients with non-AITD, such as nodular goiter and PTC devoid of thyroid lymphocytic infiltration at histology, TgAb show a less restricted epitopic pattern and bind also to other regions of Tg. Thyroid function may also affect the frequency of PTC, the risk of cancer increasing with serum TSH levels. We have shown that this mechanism, rather than thyroiditis per se, plays a major role in the association of PTC with Hashimoto's thyroiditis, as a consequence of the autoimmune process leading to a progressive increase of serum TSH in these patients.
Strategies for inclusion in the face of social exclusion. Case study in Andalusia (Spain)

The aim of this study is to identify effective practices in education in order to address the issue of failure amongst pupils in secondary schools. It follows a descriptive research methodology, designed in the form of a case study. The results indicate the effectiveness of the learning strategies used and the satisfaction and commitment of the teaching staff, generating a list of factors which contribute to the development of good practice in education. It concludes by stating that learning and teaching strategies aimed at organising, teaching and planning for inclusive education are shown to be real weapons in the fight against early school leaving. The participation of all the relevant sectors is essential if the school is to see itself as a unit of exchange or a research space which incorporates differentiation into its processes of innovation.
Membrane Cholesterol Modulates the Outward Facing Conformation of the Dopamine Transporter and Alters Cocaine Binding*

Clearance of synaptically released dopamine is regulated by the plasmalemmal dopamine transporter (DAT), an integral membrane protein that resides within a complex lipid milieu. Here we demonstrate that cholesterol, a major component of the lipid bilayer, can modulate the conformation of DAT and alter cocaine binding to DAT. In striatal synaptosomes and transfected cells, DAT was in cholesterol-rich membrane fractions after mild detergent extraction. After increasing the membrane cholesterol content by treatment of water-soluble cholesterol (cholesterol mixed with methyl-β-cyclodextrin), we observed an increase in DAT binding Bmax values for cocaine analogs [3H]WIN35428 and [125I]RTI-55, but similar levels of DAT proteins on the cell surface were shown by surface biotinylation assays. Membrane cholesterol addition also markedly enhanced the accessibility of cysteine sulfhydryl moieties in DAT as probed by a membrane-impermeable maleimide-biotin conjugate. We identified cysteine 306, a juxtamembrane residue on transmembrane domain 6 (TM6) of DAT, as the intrinsic residue exhibiting enhanced reactivity. Similar effects on DAT cysteine accessibility and radioligand binding were observed with addition of zinc, a reagent known to promote the outward facing conformation of DAT. Using substituted cysteine mutants on various positions likely to be extracellular, we identified additional residues located on TM1, TM6, TM7, and TM12 of DAT that are sensitive to alterations in the membrane cholesterol content. Our findings in transfected cells and native tissues support the hypothesis that DAT adopts an outward facing conformation in a cholesterol-rich membrane environment, suggesting a novel modulatory role of the surrounding membrane lipid milieu on DAT function.
The d-Step Conjecture and Its Relatives

The d-step conjecture arose from an attempt to understand the computational complexity of edge-following algorithms for linear programming, such as the simplex algorithm. It can be stated in terms of diameters of graphs of convex polytopes, in terms of the existence of nonrevisiting paths in such graphs, in terms of an exchange process for simplicial bases of a vector space, and in terms of matrix pivot operations. First formulated by W. M. Hirsch in 1957, the conjecture remains unsettled, though it has been proved in many special cases and counterexamples have been found for slightly stronger conjectures. If the conjecture is false, as we believe to be the case, then finding a counterexample will be merely a small first step in the line of investigation related to the conjecture. This report summarizes what is known about the d-step conjecture and its relatives. A considerable amount of new material is included, but it does not seem to come close to settling the conjecture. Of special interest is the first example of a polytope that is not vertex-decomposable, showing that a certain natural approach to the conjecture will not work. Also significant are the quantitative relations among the lengths of paths associated with various forms of the conjecture.
Schooling and Social Capital in Diverse Cultures

Introduction: scaffolds for school achievement? The institutional foundations of social capital, B. Fuller, E. Hannum Social capital and immigrant children's achievement, C.L Bankston III, Min Zhou Family and non-family roots of social capital - Vietnamese and Mexican American children, K.A Goyette, G.Q. Conchas Commentary A - Use and misuses of social capital in studying school attainment, P. Fernandez Kelly Ethnic differences in parents' educational aspirations, G. Kao Schooling alternatives, inequality, and mobility in Israel, Y. Shavit et al Commentary B - Is social capital the self-esteem of the 1990s? , M. Schaub, D.P. Baker Getting ahead in Kenya: social capital, shadow education, and achievement, C. Buchman Commentary C - Cultural and social capital in educational research, R. Sin-Kwok Wong Conclusions - social capital, institutions, and stratification - contributions of the cross-cultural perspective, E. Hannum, Bruce Fuller.
Play as a predictor of coping and distress in children during invasive dental procedure

Investigated the relations among play, coping and distress in children undergoing an invasive dental procedure. A positive relation between play and coping and a negative relation between coping and distress and between play and distress were predicted. Subjects were 37 pedodontic patients (mean age = 8.1 years). Immediately prior to the dental procedure, children's play was assessed using the Affect in Play Scale (Russ, 1985,1993). Coping and distress were assessed during and after the dental procedure by observer report, dentist report, and child self-report. As predicted, children who were "good" players implemented a greater number and variety of cognitive coping strategies (rs ranged from .52 to .55, p < .05) and reported less distress, r(34) = -53, p < . 05, during the procedure than children who expressed less affect and fantasy in their play.
Molecules and structures involved in the adhesion of natural killer cells to vascular endothelium

The present study was designed to define molecules and structures involved in the interaction of natural killer (NK) cells with the vascular endothelium in vitro. Resting and interleukin 2 (IL-2)- activated NK cells were studied for their capacity to adhere to resting and IL-1-treated human umbilical vein endothelial cells (EC). In the absence of stimuli, NK cells showed appreciable adhesion to EC, with levels of binding intermediate between polymorphs and monocytes. The binding ability was increased by pretreatment of NK cells with IL-2. Using the appropriate monoclonal antibody, the beta 2 leukocyte integrin CD18/CD11a was identified as the major adhesion pathway of NK cells to unstimulated EC. Activation of EC with IL-1 increased the binding of NK cells. In addition to the CD18-CD11a/intercellular adhesion molecule pathway, the interaction of resting or IL-2-activated NK cells to IL-1-activated EC involved the VLA-4 (alpha 4 beta 1)- vascular cell adhesion molecule 1 receptor/counter-receptor pair. No evidence for appreciable involvement of endothelial-leukocyte adhesion molecule was obtained. Often, NK cells interacted either with the culture substrate or with the EC surface via dot-shaped adhesion structures (podosomes) protruding from the ventral surface and consisting of a core of F-actin surrounded by a ring of vinculin and talin. The identification of molecules and microanatomical structures involved in the interaction of NK cells with EC may provide a better understanding of the regulation of NK cell recruitment from blood, their extravasation, and their migration to tissues.
Reaching at risk groups

Latinos are at high risk for many health problems, but are often missed by traditional health communication campaigns aired through general audience channels. This article explores Latinos’ connections to communication channels for health goals - both mediated and interpersonal and media that is general audience and geo-ethnic (targeted toward a specific ethnicity and/or community). Data from a random digit dial telephone survey of Latinos in two Los Angeles communities are analyzed. The results indicate that Latinos have strong connections to media that target their ethnic group or community, to interpersonal networks of friends and family, and to health professionals. The implications of these findings are discussed and recommendations made for increased health storytelling about the dominant health risks facing Latino communities.
A Functional Slow Recycling Pathway of Transferrin is Required for Growth of Chlamydia

An inhibitor of host cell lysophospholipid acyltransferase, an enzyme involved in lipid metabolism blocked growth of the obligate intracellular pathogen Chlamydia through its action on the transport of transferrin (Tf) via the slow pathway of recycling. A detailed characterization of this inhibition revealed that Tf accumulated in vesicles positive for Rab11, with a concomitant reduction in the level of Tf found within the transport intermediate Rab4/11 hybrid vesicles. The net result was the failure to be recycled to the plasma membrane. In chlamydiae-infected cells, the Tf-containing Rab11-positive vesicles were typically found intimately associated with the inclusion, and treatment with the inhibitor caused their accumulation, suggesting that the timely progression and completion of Tf recycling was necessary for proper chlamydial growth. Growth inhibition by the compound could be negated by the simple removal of the Tf-containing fraction of the serum, a further indication that accumulation of Tf around the chlamydial inclusion was deleterious to the pathogen. Thus, it appears that manipulating the slow recycling pathway can have biological consequences for Chlamydia and implies the need to regulate carefully the interaction of the inclusion with this host trafficking pathway.
Identification of two HSP70-related Xenopus oocyte proteins that are capable of recycling across the nuclear envelope

Two 70-kD polypeptides, B3 and B4, are present in equivalent concentrations in the nucleus and cytoplasm of Xenopus oocytes. The objectives of this study were to determine if they (a) are members of the 70-kD family of heat shock proteins, and (b) recycle between the nuclear and cytoplasmic compartments. Evidence based on high-affinity binding to ATP, cross-reactivity of B3/B4-specific antibodies with rat hsc70, and a comparison of cyanogen bromide cleavage peptide maps with hsc70, verified that B3 and B4 are members of the 70-kD family of heat- shock proteins. Nuclear uptake studies were performed by microinjecting 125I-labeled B3/B4, rat hsc70, and BSA into the cytoplasm of oocytes, and examining their subsequent intracellular distributions. By 6 h postinjection, the nuclear concentration of B3/B4 and hsc70 were approximately 24-fold greater than BSA controls. It was also found that B3/B4-coated gold particles as large as 120A in diameter were able to enter the nucleus by passing through the pores. Nuclear efflux was analyzed by microinjecting the iodinated proteins directly into the oocyte nuclei. 2 h after nuclear injection, at least 46% of the B3/B4 and 60% of the hsc70 were found in the cytoplasmic fractions, compared with less than 10% for the BSA controls. Cell fusion experiments, in which labeled, anucleate oocyte vegetal hemispheres were fused, under oil, with nucleate unlabeled animal hemispheres, demonstrated that cytoplasmic B3 and B4 could enter the nucleus after equilibration was reached, arguing against the existence of separate nuclear and cytoplasmic populations. Collectively, these results show that B3, B4, and rat hsc70 are transported across the nuclear envelope and recycle between the nucleus and cytoplasm.
Stereoscopic images generation with directional Gaussian filter

The depth-based image rendering (DIBR) uses monoscopic image with its corresponding depth map to generate stereoscopic images for 3DTV. The main difficulty in the DIBR is that holes appear in the stereoscopic images because of the occlusion between objects. However, the previous depth smoothing methods to reduce holes usually destroy the perceived depth quality or the perceived naturalness. This paper proposed a new depth smoothing method to solve these problems by applying a new directional Gaussian filter guided by edge direction in the hole-flag area iteratively. The subjective evaluation results show that our proposed method can generate better stereoscopic images with good perceived depth quality as well as perceived naturalness.
From the Washington Consensus to the New International Financial Architecture

I feel somewhat relaxed and freer since I resigned from the position of Vice Minister of Finance for International Affairs about a month ago. At least now I don’t have to worry about what I say about the yen/US dollar rate for the wire people who used to follow me all over the world. I would like to remind you that what I say today does not necessarily reflect the official views of the Japanese Government, although I still retain the position of Special Adviser to the Minister of Finance.
Low complexity, efficient and embedded color image coding technique

In this paper, an efficient and embedded wavelet based color image coding technique having low complexity is proposed. The key idea is the use of block-tree hierarchical structure, due to which the proposed technique has the best features of both block and tree based wavelet image coding methods simultaneously. The proposed technique integrates the set partitioning strategies of hierarchical trees and blocks into a single algorithm, resulting in significant improvement in the coding efficiency, reduced computational complexity and reduced memory requirement. The block-tree structure of the luminance and the chrominance planes are linked in such a way that the insignificant sets of the three planes at correspondingly same locations are sorted together. The proposed coder is compared with similar existing techniques on number of test images. The simulation results show the performance improvement in coding efficiency, reduction in computational complexity and dynamic memory to store the lists over the existing techniques. Therefore, the proposed coding technique is quite attractive for image communication or image data browsing over wireless lines using modern day power-limited mobile/portable devices .
Interprofessional collaboration in family health teams: An Ontario-based study.

OBJECTIVE To examine family health team (FHT) members' perspectives and experiences of interprofessional collaboration and perceived benefits. DESIGN Qualitative case study using semistructured interviews. SETTING Fourteen FHTs in urban and rural Ontario. PARTICIPANTS Purposeful sample of the members of 14 FHTs, including family physicians, nurse practitioners, nurses, dietitians, social workers, pharmacists, and managers. METHODS A multiple case-study approach involving 14 FHTs was employed. Thirty-two semistructured interviews were conducted and data were analyzed by employing an inductive thematic approach. A member-checking technique was also undertaken to enhance the validity of the findings. MAIN FINDINGS Five main themes are reported: rethinking traditional roles and scopes of practice, management and leadership, time and space, interprofessional initiatives, and early perceptions of collaborative care. CONCLUSION This study shows the importance of issues such as roles and scopes of practice, leadership, and space to effective team-based primary care, and provides a framework for understanding different types of interprofessional interventions used to support interprofessional collaboration.
Community-acquired pneumonia due to gram-negative bacteria and pseudomonas aeruginosa: incidence, risk, and prognosis.

BACKGROUND Initial empirical antimicrobial treatment of patients with community-acquired pneumonia (CAP) is based on expected microbial patterns. We determined the incidence of, prognosis of, and risk factors for CAP due to gram-negative bacteria (GNB), including Pseudomonas aeruginosa. METHODS Consecutive patients with CAP hospitalized in our 1000-bed tertiary care university teaching hospital were studied prospectively. Independent risk factors for CAP due to GNB and for death were identified by means of stepwise logistic regression analysis. RESULTS From January 1, 1997, until December 31, 1998, 559 hospitalized patients with CAP were included. Sixty patients (11%) had CAP due to GNB, including P aeruginosa in 39 (65%). Probable aspiration (odds ratio [OR], 2.3; 95% confidence interval [CI], 1.02-5.2; P =.04), previous hospital admission (OR, 3.5; 95% CI, 1.7-7.1; P<.001), previous antimicrobial treatment (OR, 1.9; 95% CI, 1.01-3.7; P =.049), and the presence of pulmonary comorbidity (OR, 2.8; 95% CI, 1.5-5.5; P =.02) were independent predictors of GNB. In a subgroup analysis of P aeruginosa pneumonia, pulmonary comorbidity (OR, 5.8; 95% CI, 2.2-15.3; P<.001) and previous hospital admission (OR, 3.8; 95% CI, 1.8-8.3; P =.02) were predictive. Infection with GNB was independently associated with death (relative risk, 3.4; 95% CI, 1.6-7.4; P =.002). CONCLUSIONS In our setting, in every tenth patient with CAP, an etiology due to GNB has to be considered. Patients with probable aspiration, previous hospitalization or antimicrobial treatment, and pulmonary comorbidity are especially prone to GNB. These pathogens are also an independent risk factor for death in patients with CAP.
Benzodiazepine use among chronic pain patients prescribed opioids: associations with pain, physical and mental health, and health service utilization.

OBJECTIVE Benzodiazepines (BZDs) are commonly used by chronic pain patients, despite limited evidence of any long-term benefits and concerns regarding adverse events and drug interactions, particularly in older patients. This article aims to: describe patterns of BZDs use; the demographic, physical, and mental health correlates of BZD use; and examine if negative health outcomes are associated with BZD use after controlling for confounders. SUBJECTS A national sample of 1,220 chronic noncancer pain (CNCP) patients prescribed long-term opioids. METHODS We report on baseline data from a prospective cohort study comparing four groups based on their current BZD use patterns. General demographics, pain, mental and physical comorbidity, and health service utilization were examined. RESULTS One-third (N = 398, 33%) of participants reported BZD use in the past month, and 17% (N = 212) reported daily BZD use. BZD use was associated with: 1) greater pain severity, pain interference with life, and lower feelings of self-efficacy with respect to their pain; 2) being prescribed "higher-risk" (>200 mg oral morphine equivalent) doses of opioids; 3) using antidepressant and/or antipsychotic medications; 4) substance use (including more illicit and injection drug use, alcohol use disorder, and daily nicotine use); and 5) greater mental health comorbidity. After controlling for differences in demographic characteristics, physical and mental health, substance use, and opioid dose, BZD use was independently associated with greater past-month use of emergency health care such as ambulance or accident and emergency services. CONCLUSIONS CNCP patients using BZDs daily represent a high-risk group with multiple comorbid mental health conditions and higher rates of emergency health care use. The high prevalence of BZD use is inconsistent with guidelines for the management of CNCP or chronic mental health conditions.
A Prospective Population‐Based Study of Cutaneous Malignant Melanoma of the Head and Neck

Objectives/Hypothesis For cutaneous malignant melanoma (CMM) of the head and neck, neither prognostic factors in population‐based groups, nor outcome with respect to surgical resection margins is clear. Therefore, we analyzed data in a regional registry to align treatment results for CMM of the head and neck with prognosis and survival times.