Miracle-dz/UniFAR-FTUs huggingface dataset:
The role of rotation thromboelastometry in early prediction of massive transfusion.

INTRODUCTION Early prediction of massive transfusion (MT) is critical in the management of severely injured trauma patients. Variables available early after injury including physiologic, laboratory, and rotation thromboelastometric (ROTEM) parameters were evaluated as predictors for the need of MT. METHODS After Institutional Review Board approval, we retrospectively reviewed a cohort of severely injured trauma patients (Injury Severity Score ≥ 16) admitted to a Level I trauma center with available ROTEM measurements on hospital admission during a 1-year study period. Patients with isolated head injury (Abbreviated Injury Scale head ≥ 3 and Abbreviated Injury Scale chest, abdomen, and extremity < 3) and patients with a penetrating mechanism of injury were excluded. Patients who received a MT (≥ 10 units packed red blood cell within 24 hours of admission) were compared with patients who did not. Variables independently associated with MT were identified using stepwise logistic regression. RESULTS A total of 53 patients met inclusion criteria. Of these, 18 patients (34.0%) received a MT and 35 patients (66.0%) did not. Massively transfused patients had significantly lower baseline hemoglobin values (7.9 g/dL ± 0.4 g/dL vs. 11.4 g/dL ± 0.4 g/dL; p < 0.001) and a trend toward higher lactate (4.8 mmol/L ± 0.8 mmol/L vs. 3.0 mmol/L ± 0.3 mmol/L; p = 0.056) and base deficit values (5.9 mmol/L ± 1.1 mmol/L vs. 3.6 mmol/L ± 0.6 mmol/L; p = 0.052). Mean international normalized ratio (1.46 ± 0.07 vs. 1.22 ± 0.05; p = 0.001) and partial thromboplastin times (42.4 seconds ± 5.0 seconds vs. 29.7 seconds ± 1.8 seconds; p < 0.001) were significantly higher in MT patients. Patients receiving a MT had significantly altered ROTEM values on admission compared with non-MT patients. An increase in the clot formation time (471.3 seconds ± 169.9 seconds vs. 178.1 seconds ± 19.9 seconds; p = 0.001), a shortening of the maximum clot firmness (37.5 mm ± 2.9 mm vs. 50.7 mm ± 1.4 mm; p < 0.001), and a shortening of the clot amplitude at all time points (10/20/30 minutes) were observed in massively transfused trauma patients. Variables independently associated with MT included a hemoglobin level ≤ 10 g/dL and an abnormal maximum clot firmness value (area under the receiver operator characteristic curve: 0.831 [95% confidence interval: 0.719-0.942; p < 0.001]). CONCLUSION Hemoglobin ≤ 10 g/dL and an abnormal maximum cloth firmness measured by rotation thromboelastometry on admission reliably predict the need for MT. Prospective validation of the effectiveness of thromboelastometry to guide the transfusion practice after trauma is warranted.
Resource–consumer diversity: testing the effects of leaf litter species diversity on stream macroinvertebrate communities

SUMMARY 1. Understanding relationships between resource and consumer diversity is essential to predicting how changes in resource diversity might affect several trophic levels and overall ecosystem functioning. 2. We tested for the effects of leaf litter species diversity (i.e. litter mixing) on litter mass remaining and macroinvertebrate communities (taxon diversity, abundance and biomass) during breakdown in a detritus-based headwater stream (North Carolina, U.S.A.). We used full-factorial analyses of single- and mixed-species litter from dominant riparian tree species with distinct leaf chemistries [red maple (Acer rubrum), tulip poplar (Liriodendron tulipifera), chestnut oak (Quercus prinus) and rhododendron (Rhododendron maximum)] to test for additivity (single-species litter presence ⁄ absence effects) and non-additivity (emergent effects of litter species interactions). 3. Significant non-additive effects of litter mixing on litter mass remaining were explained by species composition, but not richness, and litter-mixing effects were variable throughout breakdown. Specifically, small differences in observed versus expected litter mass remaining were measured on day 14; whereas observed litter mass remaining in mixed-species leaf packs was significantly higher on day 70 and lower on day 118 than expected from data for single-species leaf packs. 4. Litter mixing had non-additive effects on macroinvertebrate community structure. The number of species in litter mixtures (two to four), but not litter species composition, was a significant predictor of the dominance of particular macroinvertebrates (i.e. indicator taxa) within mixed-species packs. 5. In addition, the presence ⁄ absence of high- (L. tulipifera) and low-quality (R. maximum) litter had additive effects on macroinvertebrate taxon richness, abundance and biomass. The presence of L. tulipifera litter had both positive (synergistic) and negative (antagonistic) effects on invertebrate taxon richness, that varied during breakdown but were not related to litter chemistry. In contrast, the presence ⁄ absence of L. tulipifera had a negative relationship with total macroinvertebrate biomass (due to low leaf mass remaining when L. tulipifera was present and higher condensed and hydrolysable tannins associated with leaf packs lacking L. tulipifera). Macroinvertebrate abundance was consistently lower when R. maximum was present, which was partially explained by litter chemistry [e.g., high concentrations of lignin, condensed tannins, hydrolysable tannins and total phenolics and high carbon to nutrient (N and P) ratios].
Completely Unacceptable Levels in Conjoint Analysis: A Cautionary Note

An experiment is reported on the extent to which respondents adhere to the implications of choosing the “completely unacceptable” level in hybrid conjoint (and related) applications. The findings indicate that the form of the instructions matters, but that respondents often ignore the implications of previous responses when responding to full-profile options containing unacceptable attribute levels. The authors discuss the impact of this inconsistency on internal predictive validity in both empirical and theoretical terms.
Strong measure zero sets without Cohen reals

Abstract If ZFC is consistent, then each of the following is consistent with : (1) X ⊆ ℝ is of strong measure zero iff ∣X∣ ≤ ℵ1 + there is a generalized Sierpinski set. (2) The union of ℵ many strong measure zero sets is a strong measure zero set + there is a strong measure zero set of size ℵ2 + there is no Cohen real over L.
Does leg ulcer treatment improve patients' quality of life?

OBJECTIVE To investigate the impact of 'disease' and treatment on quality of life in patients with venous leg ulceration. METHOD Sixty-five patients with venous leg ulcers were recruited and treated. At study entry and exit or following complete wound closure, whichever occurred first, each patient was assessed using the SF-36 quality-of-life questionnaire. Data analysis included an investigation of the study population as whole, differences between patients whose ulcers did and did not heal and between gender and age. Health domain means for all patients were compared with age equivalent norms (AENs) at both entry and exit. RESULTS There was a significant improvement in the SF-36 domains of bodily pain, health transition, mental health and social functioning for all 65 patients. Patients whose ulcers healed also showed a statistically significant improvement in the vitality domain. Patients whose ulcers did not heal had statistically significant improved scores for bodily pain and health transition. At entry all SF-36 values, except for general health, were lower than the AENs. On exit, scores for bodily pain, general health and mental health were comparable with the AEN; values for the remaining five domains increased at exit. CONCLUSION The results highlight that good wound management and effective compression therapy can improve quality of life in patients with venous leg ulceration, whether or not the patient's leg ulcer healed following treatment.
Predictors of sedentary status in overweight and obese patients with multiple chronic conditions: a cohort study

Purpose Walking may improve health in obese patients with multimorbidity. We aimed to identify predictors associated with achieving <5000 steps per day after 4 months. Patients and methods We conducted a cohort study of 125 adult patients with a body mass index >25 kg/m2 and ≥7 comorbidities. We evaluated potential predictors for <5000 steps per day using logistic regression and adjusting for age >65 years and sex. Results The mean (range) age was 63.6 (20.3–89.8) years. Daily step counts <5000 at baseline showed the highest risk of <5000 daily steps at 4 months (odds ratio [OR] 31.82, 95% confidence interval [CI]: 12.14–95.50). Other significant characteristics were physical quality of life (OR 6.21, 95% CI: 2.32–18.54), gait speed <1 m/s (OR 2.57, 95% CI: 1.18–5.71), age ≥65 years (OR 2.21, 95% CI: 1.05–4.77), waist circumference ≥102 cm (OR 2.48, 95% CI: 1.05–6.06), and body mass index ≥30 kg/m2 (OR 2.69, 95% CI: 1.20–6.26). Conclusion New models to increase walking may be required for higher-risk patients.
Structural correlates of subjective and objective memory performance in multiple sclerosis

Subjective and objective memory deficits represent a frequent and ill‐understood aspect of multiple sclerosis (MS), and a significant cause of disability and quality of life reduction. The aim of the study is to verify the role of hippocampal and temporal associative fibers' damage in MS‐related memory complaints. To reach this aim, 25 patients with low disability relapsing‐remitting MS and 19 healthy controls were included in the study. All subjects underwent 3D T1 structural imaging and Diffusion Tensor Imaging. Additionally, MS patients underwent neuropsychological evaluation of objective (Selective Reminding Test and Spatial Recall Test) and of subjective (Perceived Deficit Questionnaire, Retrospective and Prospective Memory Subscales) memory deficits. Normalized hippocampal volume (NHV) and mean Fractional Anisotropy (FA) for the uncinate fasciculus (UF) and for the ventral division of the cingulum bundle (VCB) were calculated for all subjects. We showed that, compared to controls, MS subjects presented with reduced right NHV and with reduced mean FA bilaterally in the UF and the VCB. In the MS group, verbal memory scores correlated with left NHV, spatial memory scores correlated with right NHV, while perceived retrospective and prospective memory deficits correlated with left VCB and left UF mean FA respectively. Our data confirm an early involvement of memory‐related brain structures in MS patients. Our data suggest that verbal and nonverbal memory as well as perceived retrospective and prospective memory deficits are related to alterations of discrete anatomical structures in the low‐disability phase of MS. © 2013 Wiley Periodicals, Inc.
Factors determining the heterogeneity of malaria incidence in children in Kampala, Uganda.

BACKGROUND Malaria risk may be heterogeneous in urban areas of Africa. Identifying those at highest risk for malaria may lead to more targeted approaches to malaria control. METHODS A representative sample of 558 children aged 1-10 years were recruited from a census population in a single parish of Kampala and followed up for 2 years. Malaria was diagnosed when a child presented with a new episode of fever and a thick blood smear positive for parasites. Multivariate analysis was used to identify independent predictors of malaria incidence. RESULTS A total of 695 episodes of uncomplicated malaria were diagnosed after 901 person years of follow-up. Sickle cell trait (relative risk [RR], 0.68 [95% confidence interval {CI}, 0.52-0.90]), glucose-6-phosphate dehydrogenase deficiency in female children (RR, 0.48 [95% CI, 0.31-0.75]), and use of an insecticide-treated bed net (RR, 0.52 [95% CI, 0.32-0.83]) were associated with a lower risk of malaria. The distance of the subject's residence from a swamp bordering the parish showed a strong "dose-response" relationship; living in the swamp was the strongest predictor of malaria risk (RR, 3.94 [95% CI, 2.61-5.97]). CONCLUSION Malaria incidence was highly heterogeneous in this urban cohort of children. Malaria control interventions in urban areas should target populations living in pockets of high malaria risk.
Genes encoding proteoglycans are associated with the risk of anterior cruciate ligament ruptures

Background Genetic variants within genes involved in fibrillogenesis have previously been implicated in anterior cruciate ligament (ACL) injury susceptibility. Proteoglycans also have important functions in fibrillogenesis and maintaining the structural integrity of ligaments. Genes encoding proteoglycans are plausible candidates to be investigated for associations with ACL injury susceptibility; polymorphisms within genes encoding the proteoglycans aggrecan (ACAN), biglycan (BGN), decorin (DCN), fibromodulin (FMOD) and lumican (LUM) were examined. Methods A case–control genetic association study was conducted. 227 participants with surgically diagnosed ACL ruptures (ACL group) and 234 controls without any history of ACL injury were genotyped for 10 polymorphisms in 5 proteoglycan genes. Inferred haplotypes were constructed for specific regions. Results The G allele of ACAN rs1516797 was significantly under-represented in the controls (p=0.024; OR=0.72; 95% CI 0.55 to 0.96) compared with the ACL group. For DCN rs516115, the GG genotype was significantly over-represented in female controls (p=0.015; OR=9.231; 95%CI 1.16 to 73.01) compared with the ACL group and the AA genotype was significantly under-represented in controls (p=0.013; OR=0.33; 95% CI 0.14 to 0.78) compared with the female non-contact ACL injury subgroup. Haplotype analyses implicated regions overlapping ACAN (rs2351491 C>T-rs1042631 T>C-rs1516797 T>G), BGN (rs1126499 C>T-rs1042103 G>A) and LUM-DCN (rs2268578 T>C-rs13312816 A>T-rs516115 A>G) in ACL injury susceptibility. Conclusions These independent associations and haplotype analyses suggest that regions within ACAN, BGN, DCN and a region spanning LUM–DCN are associated with ACL injury susceptibility. Taking into account the functions of these genes, it is reasonable to propose that genetic sequence variability within the genes encoding proteoglycans may potentially modulate the ligament fibril properties.
Zika Virus on YouTube: An Analysis of English-language Video Content by Source

Objectives The purpose of this study was to describe the source, length, number of views, and content of the most widely viewed Zika virus (ZIKV)-related YouTube videos. We hypothesized that ZIKV-related videos uploaded by different sources contained different content. Methods The 100 most viewed English ZIKV-related videos were manually coded and analyzed statistically. Results Among the 100 videos, there were 43 consumer-generated videos, 38 Internet-based news videos, 15 TV-based news videos, and 4 professional videos. Internet news sources captured over two-thirds of the total of 8 894 505 views. Compared with consumer-generated videos, Internet-based news videos were more likely to mention the impact of ZIKV on babies (odds ratio [OR], 6.25; 95% confidence interval [CI], 1.64 to 23.76), the number of cases in Latin America (OR, 5.63; 95% CI, 1.47 to 21.52); and ZIKV in Africa (OR, 2.56; 95% CI, 1.04 to 6.31). Compared with consumer-generated videos, TV-based news videos were more likely to express anxiety or fear of catching ZIKV (OR, 6.67; 95% CI, 1.36 to 32.70); to highlight fear of ZIKV among members of the public (OR, 7.45; 95% CI, 1.20 to 46.16); and to discuss avoiding pregnancy (OR, 3.88; 95% CI, 1.13 to 13.25). Conclusions Public health agencies should establish a larger presence on YouTube to reach more people with evidence-based information about ZIKV.
Ecological Approaches to Organizations

Our goal is to assess and consolidate the current state-of-the-art in organizational ecology. To accomplish this we review major theoretical statements, empirical studies, and arguments that are now being made. Although we attempt to survey ecological approaches to organizations comprehensively, because ecological research now constitutes a very large body of work, and because other extensive reviews are available (Aldrich & Wiedenmayer, 1993; Barnett & Carroll, 1995; Baum, 1996; Baum & Amburgey, 2002; Baum & Rao, 2004; Carroll, Dobrev & Swaminathan, 2002; Galunic & Weeks 2002; Rao, 2002; Singh & Lumsden, 1990), we emphasize recent work that challenges and extends established theory and highlight new and emerging directions for future research that appear promising. Our appraisal focuses on two main themes - demographic processes and ecological processes.
An Ecological Approach to Breastfeeding

Purpose Current numbers of breast-feeding mothers are well below Healthy People 2010 goals of 75% in the early postpartum period, 50% at 6 months, and 25% at 1 year. A promising line of research is the use of an ecological model for breastfeeding that includes factors traditionally examined in breastfeeding (mother/infant and family) as well as mesosystem and exosystem sources of influence on families (healthcare delivery system, community, and societal/cultural). Study Design and Methods A telephone survey was conducted with 95 primiparous, postpartum women using closed and open-ended items. Content analysis was used with the transcribed comments from these telephone interviews, to test the fit of a preexisting ecological model for breastfeeding. Results The comments of postpartum women provided a rich source of information about the many mother-infant, family, healthcare delivery system, community, and societal/cultural factors that influence breastfeeding. These all fit the ecological breast-feeding model proposed. Clinical Implications Efforts to improve rates of breastfeeding in this country to meet year 2010 goals must consider the many contextual factors that influence feeding. Interventions to promote breastfeeding should exceed the individual level, and occur at many layers simultaneously. The ecological model provides direction for the multiple interventions needed to increase rates and duration of breastfeeding.
Influence of Protein Malnutrition on Teratogenicity of Acetylsalicylic Acid in Rats

The effect of protein malnutrition (PM) on the embryotoxicity and teratogenicity of aspirin in rats has been studied. Protein malnourishment was produced from Days 7 to 21 of gestation by limiting the casein content of the diet to 5% in comparison to 20% for the normal animals. Six dose levels of aspirin (50-175 mg kg-1) were administered p.o. from Days 8 to 11 of pregnancy. Aspirin from 75 mg kg-1 d-1 induced growth retardation, embryolethality and teratogenicity, as shown by external, skeletal and visceral malformations. All these effects were potentiated by protein malnutrition.
Dispositional Mindfulness Attenuates the Link Between Daily Stress and Depressed Mood

Mindfulness is theorized to attenuate negative responses to stress, but the majority of prior research supporting this hypothesis has relied on cross-sectional correlations or reactions to laboratory-induced stressors. In two independent samples, we tested whether dispositional mindfulness promoted less negative reactions to naturally-occurring day-to-day stressors. Participants first completed measures of dispositional mindfulness and individual differences in negative reactivity and emotion regulation. Participants then reported their level of stress and depressed mood, at the end of each day, for 10 days. Greater daily stress was associated with increases in daily depressed mood, but the negative impact of daily stress was attenuated for people higher in dispositional mindfulness. The stress buffering effect of mindfulness was also independent of participants’ neuroticism, existing depressive symptoms, and emotion regulation tendencies. These results reveal the unique and important role dispositional m.
Review of the Archaeology of Foveaux Strait, New Zealand

A recent archaeological survey of the south coast of the South Island of New Zealand highlighted some unusual features of the occupation of this part of the country. Although there was clear evidence for widespread settlement early in the prehistoric sequence and again early in the period of sustained European contact, there was a marked absence of evidence for settlement during much of the intervening period. Furthermore, there was a bias towards relatively small sites except where stone procurement or working were the major focus of activity. To investigate these features a radiocarbon dating programme was carried out alongside a study of specific aspects of material culture and site distribution. The results confirmed the initial impression of an all but invisible archaeological presence in the Foveaux Strait area for a period of up to two centuries until about the contact period. Three models to explain this pattern of settlement are evaluated and the one that is selected as the best fit is a resource network model in which Foveaux Strait may never have been permanently settled in prehistory but was always peripheral to wider economic imperatives.
A modulatory role of endogenous opioids on prolactin secretion at the end of pregnancy in the rat.

It is well known that the fall in serum progesterone concentrations during late pregnancy induces prolactin secretion in rats. On day 19 of pregnancy, administration of 10 mg of the antiprogesterone RU-486/kg induced a small but significant increase in serum prolactin. A lower dose (2 mg/kg) was not effective. Administration of naloxone (2 mg/kg) to pregnant rats on day 19 of pregnancy did not modify circulating prolactin but, after RU-486 treatment, a notable increase in serum prolactin was obtained 30 min after naloxone was given. The lack of effect of naloxone-methobromide in pregnant rats pretreated with RU-486 may indicate that the opioid-induced prolactin suppression acts centrally, most probably at the hypothalamic level. During day 21 of pregnancy, the time-course of prolactin secretion, measured at 0900, 1400, 1900 and 2200 h, was inversely correlated with circulating progesterone levels. At 0900 h, serum prolactin was very low with high serum progesterone concentrations but a significant increase in serum prolactin occurred at 2200 h; this was coincident with a significant decrease in the steroid. The stimulatory effect of naloxone on prolactin secretion was clearly dependent on the circulating progesterone level. Thus, at 1900 h of day 21, naloxone induced a significant increase in serum prolactin but, at 2200 h, the opioid antagonist dramatically enhanced the circulating level of prolactin. The serum prolactin increase induced by naloxone at 1900 h was prevented by the s.c. administration of 5 mg progesterone given 7 h earlier. (ABSTRACT TRUNCATED AT 250 WORDS)