Miracle-dz/UniFAR-FTUs huggingface dataset:
Prescription of opioids for opioid-naive medical inpatients.

BACKGROUND Harms associated with prescription opioids are a major and increasing public health concern. Prescribing of opioids for inpatients may contribute to the problem, especially if primary care practitioners continue opioid therapy that is initiated in hospital. OBJECTIVES To describe the extent and nature of opioid prescribing for opioid-naive patients (i.e., no use of opioids within 2 weeks before admission) on an internal medicine unit. METHODS This single-centre study involved chart review for opioid-naive patients admitted to the internal medicine unit of a large academic health sciences centre in Toronto, Ontario. Over 12 weeks, patients were prospectively identified for the study, and charts were later reviewed to characterize opioid use during the hospital stay and upon discharge. The primary outcomes were the proportions of opioid-naive patients for whom opioids were prescribed in hospital and upon discharge. Data on serious adverse events related to opioid use (e.g., need for naloxone or occurrence of falls) were also collected through chart review. RESULTS From July 4 to September 22, 2011, a total of 721 patients were admitted to the study unit, of whom 381 (53%) were classified as opioid-naive. Opioids were prescribed for 82 (22%) of these opioid-naive patients while they were in hospital. Among the opioid-naive patients, there were a total of 247 opioid prescriptions, with hydromorphone (110 prescriptions) and morphine (92 prescriptions) being the drugs most commonly prescribed. For 23 (28%) of the patients with a prescription for opioids in hospital (6% of all opioid-naive patients), an opioid was also prescribed upon discharge. The indication for opioids was documented in 16 (70%) of the 23 discharge prescriptions. No adverse events or deaths related to opioid use were identified during the hospital stays. CONCLUSIONS Among opioid-naive patients admitted to the internal medicine unit, opioids were prescribed for about 1 in 5 patients, and less than one-third of these patients were continued on opioids at the time of discharge. These results, if replicated elsewhere, suggest that efforts to improve opioid prescribing and reduce attendant harm should be focused primarily on the outpatient setting.
CARING FOR THE CRITICALLY ILL PATIENT Association of Corticosteroid Dose and Route of Administration With Risk of Treatment Failure in Acute Exacerbation of Chronic Obstructive Pulmonary Disease

CHRONIC OBSTRUCTIVE PULMOnary disease (COPD) affects more than 6% of adults in the United States, accounts for $32 billion in direct health care costs, and is the fourth leading cause of death. In 2006, there were approximately 600 000 hospital admissions for acute exacerbation COPD, making this 1 of the 10 leading causes of hospitalization nationwide. The mainstays of hospital care for patients with acute exacerbation of COPD include the provision of supplemental oxygen, short-acting bronchodilators, systemic corticosteroids, and usually antibiotics. Evidence supporting treatment with steroids is derived from a small number of randomized trials in which steroids were found to improve physiological measures of lung function, to reduce the risk of treatment failure, and to decrease length of stay in the hospital. Although the benefit of steroids appears clear, the optimal dose and route of administration of these agents remain uncertain. Based on
The Canine Papillomavirus E5 Protein Signals from the Endoplasmic Reticulum

ABSTRACT The recently discovered Canis familiaris papillomavirus (PV) type 2 (CfPV2) provides a unique opportunity to study PV gene functions in vitro and in vivo. Unlike the previously characterized canine oral PV, CfPV2 contains an E5 open reading frame and is associated with progression to squamous cell carcinoma. In the current study, we have expressed and characterized the CfPV2-encoded E5 protein, a small, hydrophobic, 41-amino-acid polypeptide. We demonstrate that, similar to the E5 protein from high-risk human PV type 16, the CfPV2 E5 protein is localized in the endoplasmic reticulum (ER) and that its expression decreases keratinocyte proliferation and cell life span. E5 expression also increases the percentage of cells in the G1 phase of the cell cycle, with a concomitant decrease in the percentage of cells in S phase. To identify a potential mechanism for E5-mediated growth inhibition from the ER, we developed a real-time PCR method to quantify the splicing of XBP1 mRNA as a measure of ER stress. We found that the CfPV2 E5 protein induced ER stress and that this, as well as the observed growth inhibition, is tempered significantly by coexpression of the CfPV2 E6 and E7 genes. It is possible that the spatial/temporal regulation of E6/E7 gene expression during keratinocyte differentiation might therefore modulate E5 activity and ER stress.
A Source-side Decoding Sequence Model for Statistical Machine Translation

We propose a source-side decoding sequence language model for phrase-based statistical machine translation. This model is a reordering model in the sense that it helps the decoder find the correct decoding sequence. The model uses word-aligned bilingual training data. We show improved translation quality of up to 1.34% BLEU and 0.54% TER using this model compared to three other widely used reordering models.
Beyond Medications and Diet: Alternative Approaches to Lowering Blood Pressure A Scientific Statement From the American Heart Association

Many antihypertensive medications and lifestyle changes are proven to reduce blood pressure. Over the past few decades, numerous additional modalities have been evaluated in regard to their potential blood pressure–lowering abilities. However, these nondietary, nondrug treatments, collectively called alternative approaches, have generally undergone fewer and less rigorous trials. This American Heart Association scientific statement aims to summarize the blood pressure–lowering efficacy of several alternative approaches and to provide a class of recommendation for their implementation in clinical practice based on the available level of evidence from the published literature. Among behavioral therapies, Transcendental Meditation (Class IIB, Level of Evidence B), other meditation techniques (Class III, Level of Evidence C), yoga (Class III, Level of Evidence C), other relaxation therapies (Class III, Level of Evidence B), and biofeedback approaches (Class IIB, Level of Evidence B) generally had modest, mixed, or no consistent evidence demonstrating their efficacy. Between the noninvasive procedures and devices evaluated, device-guided breathing (Class IIA, Level of Evidence B) had greater support than acupuncture (Class III, Level of Evidence B). Exercise-based regimens, including aerobic (Class I, Level of Evidence A), dynamic resistance (Class IIA, Level of Evidence B), and isometric handgrip (Class IIB, Level of Evidence C) modalities, had relatively stronger supporting evidence. It is the consensus of the writing group that it is reasonable for all individuals with blood pressure levels >120/80 mm Hg to consider trials of alternative approaches as adjuvant methods to help lower blood pressure when clinically appropriate. A suggested management algorithm is provided, along with recommendations for prioritizing the use of the individual approaches in clinical practice based on their level of evidence for blood pressure lowering, risk-to-benefit ratio, potential ancillary health benefits, and practicality in a real-world setting. Finally, recommendations for future research priorities are outlined.
The Role of Oil Price Shocks in Causing U.S. Recessions

Although oil price shocks have long been viewed as one of the leading candidates for explaining U.S. recessions, surprisingly little is known about the extent to which oil price shocks explain recessions. We provide the first formal analysis of this question with special attention to the possible role of net oil price increases in amplifying the transmission of oil price shocks. We quantify the conditional recessionary effect of oil price shocks in the net oil price increase model for all episodes of net oil price increases since the mid-1970s. Compared to the linear model, the cumulative effect of oil price shocks over course of the next two years is much larger in the net oil price increase model. For example, oil price shocks explain a 3% cumulative reduction in U.S. real GDP in the late 1970s and early 1980s and a 5% cumulative reduction during the financial crisis. An obvious concern is that some of these estimates are an artifact of net oil price increases being correlated with other variables that explain recessions. We show that the explanatory power of oil price shocks largely persists even after augmenting the nonlinear model with a measure of credit supply conditions, of the monetary policy stance and of consumer confidence. There is evidence, however, that the conditional fit of the net oil price increase model is worse on average than the fit of the corresponding linear model, suggesting much smaller cumulative effects of oil price shocks for these episodes of at most 1%.
Surface Strain and Stress Analysis of the Mid-Cervical Vertebrae Bony Compartments: A Biomechanical Pilot Study Orta Servikal Vertebra Kemik Bölümlerinin Gerilme ve fiekil Deifltirme Analizi: Biyomekanik Pilot Çal›flma

OBJECTIVE: This study provides preliminary information on stress distribution over the cervical spine in static physiologic loading conditions with the strain-gage technique. Limited numbers of in vitro studies have been conducted to investigate strain and stress patterns on the bony structure of the functional cervical spine unit by various techniques. METHODS: In this pilot biomechanical study, strain gages were applied to the vertebral bodies and bilateral laminar sides of the C4, C5 and C6 levels in an occiput-T1 human cadaver model. Three different loading tests (axial compression, flexion and extension compressions) were conducted under static physiologic loading conditions. RESULTS: The anterior vertebral body experienced compressive stress with axial compressive and flexion loadings and tensile stress with extension loading. Laminar stresses were tensile pattern during axial compressive loading while tensile and compressive stresses were equal during flexion and extension loadings. CONCLUSION: The vertebral bodies adapt to each of the loadings with an expected
The Promyelocytic Leukemia Protein Protects p53 from Mdm2-mediated Inhibition and Degradation*

The p53 protein is kept labile under normal conditions. This regulation is governed largely by its major negative regulator, Mdm2. In response to stress however, p53 accumulates and becomes activated. For this to occur, the inhibitory effects of Mdm2 have to be neutralized. Here we investigated the role of the promyelocytic leukemia protein (PML) in the activation of p53 in response to stress. We found that PML is critical for the accumulation of p53 in response to DNA damage under physiological conditions. PML protects p53 from Mdm2-mediated ubiquitination and degradation, and from inhibition of apoptosis. PML neutralizes the inhibitory effects of Mdm2 by prolonging the stress-induced phosphorylation of p53 on serine 20, a site of the checkpoint kinase 2 (Chk2). PML recruits Chk2 and p53 into the PML nuclear bodies and enhances p53/Chk2 interaction. Our results provide a novel mechanistic explanation for the cooperation between PML and p53 in response to DNA damage.
Distributed Robust Synchronization of Dynamical Networks With Stochastic Coupling

This paper deals with the problem of robust adaptive synchronization of dynamical networks with stochastic coupling by means of evolutionary algorithms. The complex networks under consideration are subject to: 1) the coupling term in a stochastic way is considered; 2) uncertainties exist in the node's dynamics; and 3) pinning distributed synchronization is also considered. By resorting to Lyapunov function methods and stochastic analysis techniques, the tasks to get the distributed robust synchronization and distributed robust pinning synchronization of dynamical networks are solved in terms of a set of inequalities, respectively. The impacts of degree information, stochastic coupling, and uncertainties on synchronization performance, i.e., mean control gain and convergence rate, are derived theoretically. The potential conservativeness for the distributed robust pinning synchronization problem is solved by means of an evolutionary algorithm-based optimization method, which includes a constraint optimization evolutionary algorithm and a convex optimization method and aims at improving the traditional optimization methods. Simulations are provided to illustrate the effectiveness and applicability of the obtained results.
Elemental and fatty acid composition of snow algae in Arctic habitats

Red, orange or green snow is the macroscopic phenomenon comprising different eukaryotic algae. Little is known about the ecology and nutrient regimes in these algal communities. Therefore, eight snow algal communities from five intensively tinted snow fields in western Spitsbergen were analysed for nutrient concentrations and fatty acid (FA) composition. To evaluate the importance of a shift from green to red forms on the FA-variability of the field samples, four snow algal strains were grown under nitrogen replete and moderate light (+N+ML) or N-limited and high light (−N+HL) conditions. All eight field algal communities were dominated by red and orange cysts. Dissolved nutrient concentration of the snow revealed a broad range of NH+4 (<0.005–1.2 mg N l−1) and only low PO3−4 (<18 μg P l−1) levels. The external nutrient concentration did not reflect cellular nutrient ratios as C:N and C:P ratios of the communities were highest at locations containing relatively high concentrations of NH+4 and PO3−4. Molar N:P ratios ranged from 11 to 21 and did not suggest clear limitation of a single nutrient. On a per carbon basis, we found a 6-fold difference in total FA content between the eight snow algal communities, ranging from 50 to 300 mg FA g C−1. In multivariate analyses total FA content opposed the cellular N:C quota and a large part of the FA variability among field locations originated from the abundant FAs C18:1n-9, C18:2n-6, and C18:3n-3. Both field samples and snow algal strains grown under −N+HL conditions had high concentrations of C18:1n-9. FAs possibly accumulated due to the cessation of growth. Differences in color and nutritional composition between patches of snow algal communities within one snow field were not directly related to nutrient conditions. We propose that the highly patchy distribution of snow algae within and between snow fields may also result from differences in topographical and geological parameters such as slope, melting water rivulets, and rock formation.
Data Integration via Constrained Clustering: An Application to Enzyme Clustering

When multiple data sources are available for clustering, an a priori data integration process is usually required. This process may be costly and may not lead to good clusterings, since important information is likely to be discarded. In this paper we propose constrained clustering as a strategy for integrating data sources without losing any information. It basically consists of adding the complementary data sources as constraints that the algorithm must satisfy. As a concrete application of our approach, we focus on the problem of enzyme function prediction, which is a hard task usually performed by intensive experimental work. We use constrained clustering as a means of integrating information from diverse sources as constraints, and analyze how this additional information impacts clustering quality in an enzyme clustering application scenario. Our results show that constraints generally improve the clustering quality when compared to an unconstrained clustering algorithm.
aiVIS - Artificial Immune Network Visualisation

The field of Artificial Immune Systems (AIS) is the use of the natural immune system as a metaphor for solving computational problems. A novel unsupervised machine-learning algorithm, inspired by the immune system, has been developed called AINE. Using various immunological metaphors, AINE evolves a network of objects, known as an Artificial Immune Network (AIN) that is a diverse representation of the data set being learnt. The results of AINE are visualised in a specially developed tool (aiVIS), which allows the user to interact with the network to perform exploratory analysis. aiVIS presents AINs in such as way as to build up an understanding of the make up of the data set, learning about subtle patterns and clusters within the data set and links between clusters. Unclassified items can then be introduced into the network so to further enhance the exploratory nature of the AIN. This paper provides an overview of the learning algorithm, but concentrates on the visualisation aspect of the work. The usefulness of using AIN for exploratory visualisation is investigated and an explanation of how aiVIS operates is presented.
Macular Ganglion Cell Inner Plexiform Layer Thickness in Glaucomatous Eyes with Localized Retinal Nerve Fiber Layer Defects

Purpose To investigate macular ganglion cell–inner plexiform layer (mGCIPL) thickness in glaucomatous eyes with visible localized retinal nerve fiber layer (RNFL) defects on stereophotographs. Methods 112 healthy and 149 glaucomatous eyes from the Diagnostic Innovations in Glaucoma Study (DIGS) and the African Descent and Glaucoma Evaluation Study (ADAGES) subjects had standard automated perimetry (SAP), optical coherence tomography (OCT) imaging of the macula and optic nerve head, and stereoscopic optic disc photography. Masked observers identified localized RNFL defects by grading of stereophotographs. Result 47 eyes had visible localized RNFL defects on stereophotographs. Eyes with visible localized RNFL defects had significantly thinner mGCIPL thickness compared to healthy eyes (68.3 ± 11.4 μm versus 79.2 ± 6.6 μm respectively, P<0.001) and similar mGCIPL thickness to glaucomatous eyes without localized RNFL defects (68.6 ± 11.2 μm, P = 1.000). The average mGCIPL thickness in eyes with RNFL defects was 14% less than similarly aged healthy controls. For 29 eyes with a visible RNFL defect in just one hemiretina (superior or inferior) mGCIPL was thinnest in the same hemiretina in 26 eyes (90%). Eyes with inferior-temporal RNFL defects also had significantly thinner inferior-temporal mGCIPL (P<0.001) and inferior mGCIPL (P = 0.030) compared to glaucomatous eyes without a visible RNFL defect. Conclusion The current study indicates that presence of a localized RNFL defect is likely to indicate significant macular damage, particularly in the region of the macular that topographically corresponds to the location of the RNFL defect.
MRI criteria for multiple sclerosis

This study assessed the validity of established MRI criteria for multiple sclerosis (MS) in a cohort of 20 children with clinically definite MS. The authors found that many pediatric MS patients did not meet the MRI criteria established for adult-onset MS, particularly the McDonald MRI criteria for dissemination in space. The authors thus suggest that MRI criteria for adult MS be applied cautiously to pediatric MS patients.
Cyclophilin C Participates in the US2-Mediated Degradation of Major Histocompatibility Complex Class I Molecules

Human cytomegalovirus uses a variety of mechanisms to evade immune recognition through major histocompatibility complex class I molecules. One mechanism mediated by the immunoevasin protein US2 causes rapid disposal of newly synthesized class I molecules by the endoplasmic reticulum-associated degradation pathway. Although several components of this degradation pathway have been identified, there are still questions concerning how US2 targets class I molecules for degradation. In this study we identify cyclophilin C, a peptidyl prolyl isomerase of the endoplasmic reticulum, as a component of US2-mediated immune evasion. Cyclophilin C could be co-isolated with US2 and with the class I molecule HLA-A2. Furthermore, it was required at a particular expression level since depletion or overexpression of cyclophilin C impaired the degradation of class I molecules. To better characterize the involvement of cyclophilin C in class I degradation, we used LC-MS/MS to detect US2-interacting proteins that were influenced by cyclophilin C expression levels. We identified malectin, PDIA6, and TMEM33 as proteins that increased in association with US2 upon cyclophilin C knockdown. In subsequent validation all were shown to play a functional role in US2 degradation of class I molecules. This was specific to US2 rather than general ER-associated degradation since depletion of these proteins did not impede the degradation of a misfolded substrate, the null Hong Kong variant of α1-antitrypsin.
A Controlled Experiment for Program Comprehension through Trace Visualization

Software maintenance activities require a sufficient level of understanding of the software at hand that unfortunately is not always readily available. Execution trace visualization is a common approach in gaining this understanding, and among our own efforts in this context is Extravis, a tool for the visualization of large traces. While many such tools have been evaluated through case studies, there have been no quantitative evaluations to the present day. This paper reports on the first controlled experiment to quantitatively measure the added value of trace visualization for program comprehension. We designed eight typical tasks aimed at gaining an understanding of a representative subject system, and measured how a control group (using the Eclipse IDE) and an experimental group (using both Eclipse and Extravis) performed these tasks in terms of time spent and solution correctness. The results are statistically significant in both regards, showing a 22 percent decrease in time requirements and a 43 percent increase in correctness for the group using trace visualization.
Promotion of Second Intention Wound Healing by Emu Oil Lotion: Comparative Results with Furasin, Polysporin, and Cortisone

&NA; Previous studies showed that twice‐daily application of emu oil lotion (mixture of emu oil/fat, vitamin E, and botanical oil) immediately after creation of full‐thickness skin defects delayed wound healing 6 days later, perhaps owing to its antiinflammatory actions. If administration was delayed for 48 hours, a two‐fold promotion of wound contraction, epithelialization, and infiltration of organized granulation tissue was observed. In the present study, emu oil lotion was applied to full‐thickness skin defects in rodents 24 hours after surgery. Six days postoperatively, wound contraction and infiltration of fronts of epithelialized and granulation tissue were assessed. Results indicated a two‐fold promotion of all of the above parameters with emu oil lotion. No such effects were exerted by pure emu oil, furasin, cortaid, or polysporin. Data obtained indicate promise for emu oil lotion as an aid in treating full‐thickness skin defects if applied after the major postinflammatory stages of wound healing have transpired. (Plast. Reconstr. Surg. 102: 2404, 1998.)