Miracle-dz/UniFAR-FTUs huggingface dataset:
Airway, breathing, computed tomographic scanning: Duplicate computed tomographic imaging after transfer to trauma center

BACKGROUND Trauma patients imaged at community hospitals often receive duplicate computed tomographic (CT) imaging after transfer to regional trauma centers (RTCs). CT scanning is expensive, is resource intensive, and has acknowledged radiation risk to the patient. The objective of this study was to review and evaluate the frequency, indications, impact on patient management, as well as associated radiation and charges for duplicate CT imaging of trauma patients transferred to our RTC from outside hospitals (OSH). METHODS Patients transferred to our RTC between September 2009 and August 2010 were evaluated prospectively. The OSH patients’ charts and provider interviews were used to determine the reasons for repeated scans. The primary outcome was frequency of duplicate CT scan, defined as a repeated CT image of the same body part within 24 hours. The reason for duplicate imaging and impact on patient management was categorized. Radiation exposure and charges for duplicate scans were also determined. RESULTS Of the 185 patients transferred to our facility, 177 were eligible. CT examinations at the OSH were performed on 137 patients (77%). A duplicate CT examination occurred in 38 patients (28%). The most common reason for duplicate CT scanning was lack of thin-section multiplanar data, on images sent via CD-ROM (37%). There was a change in management in 16 patients (42%). The patients with duplicate scanning received a median of 10.2 mSv (interquartile range, 6.6–15.7 mSv) of additional radiation, with a median charge of $409 (interquartile range, $307–$734). CONCLUSION More than one third of duplicated scans performed on transferred trauma patients were potentially avoidable, primary owing to inadequate transfer of data from the OSH CT scan. The capacity of a single CD-ROM is insufficient to contain full imaging data from a trauma scan, and establishing direct links to imaging data from OSHs would decrease the number of repeated CT scans performed on transferred trauma patients. LEVEL OF EVIDENCE Care management study, level III.
Hierarchical problem solving with the linkage tree genetic algorithm

Hierarchical problems represent an important class of nearly decomposable problems. The concept of near decomposability is central to the study of complex systems. When little a priori information is available, a black box problem solver is needed to optimize these hierarchical problems. The solver should be able to learn linkage information, and to preserve and test partial solutions at different levels in the hierarchy. Two well known benchmark functions - shuffled Hierarchical If-And-Only-If (HIFF) and shuffled Hierarchical Trap (HTRAP) functions - exemplify the challenges posed by hierarchical problems. Standard genetic algorithms are unable to solve these problems, and specific methods, like SEAM and hBOA, have been designed to address them. In this paper, we investigate how the recently developed Linkage Tree Genetic Algorithm (LTGA) performs on these hierarchical problems. We compare LTGA with SEAM and hBOA on HIFF and HTRAP functions. Results show that, although LTGA is a simple algorithm compared to SEAM and hBOA, it nevertheless is a very efficient, reliable, and scalable algorithm for solving the randomly shuffled versions of HIFF and HTRAP, two hard, hierarchical problems.
Improved Color-Temperature Relations and Bolometric Corrections for Cool Stars

We present new grids of colors and bolometric corrections for F-K stars having 4000 K ≤ Teff ≤ 6500 K, 0.0 ≤ log g ≤ 4.5, and -3.0 ≤ [Fe/H] ≤ 0.0. A companion paper extends these calculations into the M giant regime (3000 K ≤ Teff ≤ 4000 K). Colors are tabulated for Johnson U-V and B-V, Cousins V-R and V-I, Johnson-Glass V-K, J-K, and H-K, and CIT/CTIO V-K, J-K, H-K, and CO. We have developed these color-temperature relations by convolving synthetic spectra with the best-determined, photometric filter transmission profiles. The synthetic spectra have been computed with the SSG spectral synthesis code using MARCS stellar atmosphere models as input. Both of these codes have been improved substantially, especially at low temperatures, through the incorporation of new opacity data. The resulting synthetic colors have been put onto the observational systems by applying color calibrations derived from models and photometry of field stars that have effective temperatures determined by the infrared flux method. These color calibrations have zero points that change most of the original synthetic colors by less than 0.02 mag, and the corresponding slopes generally alter the colors by less than 5%. The adopted temperature scale, that of Bell & Gustafsson, is confirmed by the extraordinary agreement between the predicted and observed angular diameters of these field stars, indicating that the differences between the synthetic colors and the photometry of the field stars are not due to errors in the effective temperatures adopted for these stars. Thus, we have derived empirical color-temperature relations from the field star photometry, which we use as one test of our calibrated, theoretical, solar-metallicity color-temperature relations. Except for the coolest dwarfs (Teff < 5000 K), our calibrated model colors are found to match these relations, as well as the empirical relations of others, quite well, and our calibrated, 4 Gyr, solar-metallicity isochrone also provides a good match to color-magnitude diagrams of M67. We regard this as evidence that our calibrated colors can be applied to many astrophysical problems, including modeling the integrated light of galaxies. Because there are indications that the dwarfs cooler than 5000 K may require different optical color calibrations than the other stars, we present additional colors for our coolest dwarf models that account for this possibility.
Influence of cohort effects on patterns of suicide in England and Wales, 1950–1999

Background Age- and gender-specific suicide rates in England and Wales have changed considerably since 1950. Aims To assess whether cohort effects underlie some of these changes. Method Graphical displays to assess age–period–cohort effects on suicide for the period 1950–1999. Results Successive male birth cohorts born after 1940 carried with them, as they aged, a greater risk of suicide than their predecessors although this effect diminished for the 1975 and 1980 birth cohorts. There was less clear evidence of any increased risk of suicide in post-war female birth cohorts. Conclusions Succeeding generations of males born in the post-war years have experienced increasing rates of suicide at all ages, an observation in keeping with patterns seen in other countries. If these trends continue into middle- and old-age they will lead to a great increase in overall male suicide rates.
A model of the sound generated by breaking waves

The sound produced from a single bubble, oscillating at its breathing mode frequency, and the bubble size distribution are used to model the sound produced by breaking waves. The data of Medwin and Daniel [J. Acoust. Soc. Am. 88, 408–412 (1990)] is used to evaluate the performance of the model. The model generates a damped sinusoidal pulse for every bubble formed, as calculated from the bubble size distribution. If the range from the receiver to the breaker is known then the only unknown parameters are e, the initial fractional amplitude of the bubble oscillation, and L, the dipole moment arm. It is found that if the product e×L is independent of the bubble radius the model reproduces the shape and magnitude of their measured sound spectrum accurately. The success of this simple model implies that the inverse problem (calculation of the bubble size distribution from the sound power spectrum) may be solved without the need to explicitly identify individual bubble pulses in the acoustic time series.
Virulence, Inflammatory Potential, and Adaptive Immunity Induced by Shigella flexneri msbB Mutants

ABSTRACT The ability of genetically detoxified lipopolysaccharide (LPS) to stimulate adaptive immune responses is an ongoing area of investigation with significant consequences for the development of safe and effective bacterial vaccines and adjuvants. One approach to genetic detoxification is the deletion of genes whose products modify LPS. The msbB1 and msbB2 genes, which encode late acyltransferases, were deleted in the Shigella flexneri 2a human challenge strain 2457T to evaluate the virulence, inflammatory potential, and acquired immunity induced by strains producing underacylated lipid A. Consistent with a reduced endotoxic potential, S. flexneri 2a msbB mutants were attenuated in an acute mouse pulmonary challenge model. Attenuation correlated with decreases in the production of proinflammatory cytokines and in chemokine release without significant changes in lung histopathology. The levels of specific proinflammatory cytokines (interleukin-1β [IL-1β], macrophage inflammatory protein 1α [MIP-1α], and tumor necrosis factor alpha [TNF-α]) were also significantly reduced after infection of mouse macrophages with either single or double msbB mutants. Surprisingly, the msbB double mutant displayed defects in the ability to invade, replicate, and spread within epithelial cells. Complementation restored these phenotypes, but the exact nature of the defects was not determined. Acquired immunity and protective efficacy were also assayed in the mouse lung model, using a vaccination-challenge study. Both humoral and cellular responses were generally robust in msbB-immunized mice and afforded significant protection from lethal challenge. These data suggest that the loss of either msbB gene reduces the endotoxicity of Shigella LPS but does not coincide with a reduction in protective immune responses.
Mechanism of the view-dependence of ultrasonic backscatter from normal myocardium

Anisotropy of ultrasonic scattering and attenuation in heart tissue depends on the specific orientation of myofibers with respect to angle of insonification. The present study was designed to delineate the effect of the angle of insonification with respect to the alignment of myofibers on measurements of integrated backscatter. A transmural cube of myocardium was cut from the anterior wall of the left ventricles from 5 normal canine hearts and their transmural scattering behavior was studied with the use of reflection acoustic microscopy at 50 MHz. A theoretical model for scattering based on the Born approximation (weak scattering) was employed to predict the relationship between backscatter and angle of insonification. Insonification of the basal face (basal view) demonstrated a wide transmural variation in integrated backscatter (/spl sim/15 dB), while insonification of the lateral face (lateral view) had much reduced variation (/spl sim/4 dB), despite an equivalent overall shift in transmural fiber angle of /spl sim/85/spl deg/ across the ventricular wall. Integrated backscatter was greatest in the midmyocardium when the basal face was viewed and least in the midmyocardium when the lateral face was viewed. The backscatter in the subepicardial and subendocardial regions was similar for both views. The maximum difference in backscatter from basal and lateral views at the midmyocardial level was approximately 18 dB, which represents a 64-fold change in the intensity of ultrasonic backscatter. The mathematical model developed for scattering based on the Born approximation (weak scattering) predicted the observed relationship between backscatter and angle of insonification. The rapid angular variation of integrated backscatter perpendicular to the fiber direction and the slow variation at parallel incidence observed experimentally were predicted by the model. This angular variation is due to the specific shape and elastic properties assumed for the predominant myocardial scatterer. There was a strong relationship between backscatter and fiber orientation, indicating that the view chosen for insonification of myocardium in clinical imaging may influence the estimation of scattering behavior. The mathematical model utilized here predicts the anisotropic behavior of scattering and suggests that the principal scattering structure in normal myocardium may be a stiff collagen shell surrounding a more compliant myocyte. This model might provide a valid approach for the study of material properties of the heart with the use of ultrasound. <<ETX>>
Arteriographic demonstration of slow antegrade opacification distal to a cerebrovascular thromboembolic occlusion site as a favorable indicator for intra-arterial thrombolysis.

PURPOSE This study sought to determine whether the angiographic demonstration of slow antegrade contrast opacification of an occluded cerebral artery distal to the thrombus (clot outline sign) on cerebral arteriograms performed immediately before thrombolytic treatment is associated with higher recanalization rates relative to patients without antegrade contrast opacification distal to the occlusion site. METHODS The angiographic images of 100 consecutive arteriograms performed before thrombolysis in patients eligible for intra-arterial thrombolysis from May 1995 to February 2005 were reviewed. A modified Thrombolysis in Myocardial Infarction flow grade (mTIMI) was adapted to grade recanalization after cerebral thrombolysis. Clot outline sign was defined as slow antegrade contrast opacification distal to the thrombus on the delayed images of the presenting arteriogram. Logistic regression analysis for mTIMI grade included the following potential predictors: presence of outline sign, age, time to treatment, sex, site of occlusion, presenting National Institutes of Health Stroke Scale (NIHSS) score, presenting platelets, presenting systolic blood pressure, presence of pial collaterals, and admitting glucose value. RESULTS Eighty-seven arteriograms were reviewed. Of these, 19 (22%) displayed the clot outline sign. Thirteen (69%) of 19 had clot outline sign, and 16 of 68 (29%) were not completely recanalized (mTIMI = 3); 95% with clot outline sign and 54% without were associated with either mTIMI 2 or 3 (P = .0055, Pearson correlation). Logistic regression analysis for recanalization relative to other predictors indicates that only the clot outline sign could act as a statistically significant predictor for recanalization (P = .0007). CONCLUSION Prethrombolysis cerebral arteriograms demonstrating delayed antegrade contrast opacification distal to the occlusion site are associated with higher recanalization rates.
An Exploration of Nursing Informatics Competency and Satisfaction Related to Network Education

&NA; The rapid development of computer technology has driven the growth of the Internet, which has made access to daily services more timely and convenient. Network education strategies for long-distance nursing education are increasingly being implemented to overcome distance barriers and allow nurses to obtain more knowledge. The purpose of this study was to investigate the relationship between the informatics competency of nurses and their satisfaction regarding network education as well as to explore related factors. A total of 218 nurses answered an online questionnaire after completing 4 hours of network education at their appropriate clinical level. Descriptive and inferential statistics were applied to analyze data. Study results found that nurses who took computer training less than 3 hours per week, were unable to connect to a network, or held an associate degree as their highest level of education achieved a lower nursing informatics competency than those who were older, were certified at an N4 clinical level, had previous online training experience or attended 4 or more course hours each week. Those who participated in the network education course more than 4 hours per week and owned their own computers were more satisfied with network education. Nurses who had higher nursing informatics competency were also more satisfied with network education. Network education not only enhances learners' computer competency but also improves learning satisfaction. By promoting network education and improving nurses' hardware/software skills and knowledge, nurses can use networks to access learning resources. Healthcare institutions should also enhance their computer infrastructures, and increase the interest of nurses to learn and apply network skills in clinical practice.
Psychosis alters association between IQ and future risk of attempted suicide: cohort study of 1 109 475 Swedish men

Objectives To explore associations between IQ measured in early adulthood and subsequent hospital admissions for attempted suicide and to explore the role of psychosis and examine associations of IQ with specific methods of attempted suicide. Design Cohort study. Setting Sweden. Participants 1 109 475 Swedish men with IQ measured in early adulthood followed up for an average 24 years. Main outcome measures Hospital admission for attempted suicide. Results 17 736 (1.6%) men had at least one hospital admission for attempted suicide by any means during follow-up. After adjustment for age and socioeconomic status, lower IQ scores were associated with an elevated risk of attempted suicide by any means (hazard ratio per standard deviation decrease in IQ=1.57, 95% confidence interval 1.54 to 1.60), with stepwise increases in risk across the full IQ range (P for trend<0.001). Similar associations were observed for all specific methods of attempted suicide. Separate analyses indicated that associations between IQ and attempted suicide were restricted to participants without psychosis and that IQ had no marked impact on risk of attempted suicide in those with psychosis. Conclusions Low IQ scores in early adulthood were associated with a subsequently increased risk of attempted suicide in men free from psychosis. A greater understanding of the mechanisms underlying these associations may provide opportunities and strategies for prevention.
Bisimilarity Enforcement for Discrete Event Systems Using Deterministic Control

For discrete event systems, the control to enforce bisimilarity with respect to a given specification has been studied in , , . In this note we consider the case when the control is required to be deterministic. While a deterministic control is restrictive compared to a nondeterministic one, the case of deterministic control has its own practical significance as it is easier to implement and computationally less expensive to verify. We provide a necessary and sufficient condition for the existence of a bisimilarity enforcing deterministic control, and discuss its computational complexity. We also study properties related to the synthesis of “subspecification” and “superspecification”.
Cell cycle kinetics in malignant lymphoma studied with in vivo iododeoxyuridine administration, nuclear Ki-67 staining, and flow cytometry.

Cell cycle kinetics of malignant lymphoma were investigated using in vivo labeling with iododeoxyuridine (IdUrd) and subsequent flow cytometry (FCM) of IdUrd/DNA and Ki-67/DNA. This approach provides an extensive cell kinetic profile from only one single tumor biopsy, including data upon the percentage of S-phase cells, the IdUrd labeling index (LI), Ki-67-derived growth fraction, duration of the S-phase, duration of the G1-phase, potential doubling time, cell production rate, and total cell cycle time. Tissue samples from 33 patients were studied: non-Hodgkin's lymphoma (NHL; n = 22), Hodgkin's disease (HD; n = 7), and reactive hyperplasia (n = 4). In NHL, the percentage of S-phase cells, LI, growth fraction, duration of the S-phase, and cell production rate were significantly correlated with the histologic malignancy grade according to the Working Formulation (P < or = .02). Data found in HD were not essentially different from those in low-grade NHL and reactive hyperplasia. Remarkably, the duration of the S-phase, the duration of the G1-phase, and the total cell cycle time appeared to be rather independent of histologic malignancy grade within the NHL category. A significant correlation was observed between the IdUrd LI and the percentage of S-phase cells, the growth fraction, the potential doubling time, and the cell production rate (P < .001), but not with the duration of the separate cell cycle phases (P > .05). Our data show (1) that it is feasible to obtain detailed information on the in vivo growth characteristics of malignant lymphoma; and (2) that the transition time through the different cell cycle phases widely varies, even within distinct histologic subgroups.
Mining and Validating Localized Frequent Itemsets with Dynamic Tolerance

We cast the frequent itemset mining problem as a criterion guided optimization problem instead of one based on exact counting. This opens several interesting possibilities, including modification of the criterion function to take into account (i) error tolerance, (ii) locality, (iii) unsupervised estimation of the error tolerance, and (iv) search strategy. We also propose a new validation procedure that takes into account the completeness and accuracy of the discovered patterns. Experiments with real Web transaction data are presented.
Surgical Treatment for Ossification of the Posterior Longitudinal Ligament in the Cervical Spine

Although classically associated with patients of East Asian origin, ossification of the posterior longitudinal ligament (OPLL) may cause myelopathy in patients of any ethnic origin. Degeneration of the PLL is followed by endochondral ossification, resulting in spinal cord compression. Specific genetic polymorphisms and medical comorbidities have been implicated in the development of OPLL. Patients should be evaluated with a full history and neurologic examination, along with cervical radiographs. Advanced imaging with CT and MRI allows three-dimensional evaluation of OPLL. Minimally symptomatic patients can be treated nonsurgically, but patients with myelopathy or severe stenosis are best treated with surgical decompression. OPLL can be treated via an anterior (ie, corpectomy and fusion) or posterior (ie, laminectomy and fusion or laminoplasty) approach, or both. The optimal approach is dictated by the classification and extent of OPLL, cervical spine sagittal alignment, severity of stenosis, and history of previous surgery. Anterior surgery is associated with superior outcomes when OPLL occupies >50% to 60% of the canal, despite increased technical difficulty and higher complication rates. Posterior surgery is technically easier and allows decompression of the entire cervical spine, but patients may experience late deterioration because of disease progression.
Distinct clinicopathological features in metanephric adenoma harboring BRAF mutation

BRAF mutation recently has been reported in metanephric adenoma. We sought to determine the clinical and morphologic features of BRAF-mutated metanephric adenoma and to correlate BRAF mutation with BRAF V600E immunohistochemical staining results. A series of 48 metanephric adenomas and 15 epithelial-predominant nephroblastomas were analyzed for the occurrence of BRAF mutation (BRAF V600E/V600E complex, BRAF V600D, BRAF V600K and BRAF V600R) using the BRAF RGQ PCR kit (Qiagen). Immunohistochemistry was performed using monoclonal mouse antibodies against p16INK4 and VE1 (Spring Bioscience), recognizing the BRAF V600E mutant protein. Forty-one of 48 cases (85%) showed BRAF V600E mutation; none of the other BRAF variants was detected. Of 41 BRAF-mutated metanephric adenomas, 33 showed positive VE1 immunostaining (sensitivity 80%, specificity 100%); in all cases we detected p16INK4 expression regardless of BRAF mutation status. All epithelial-predominant nephroblastomas were BRAF-wild-type and none expressed VE1. The following features were associated with BRAF V600E mutation: older patients (p=0.01), female predominance (p=0.005) and the presence of a predominantly acinar architecture (p=0.003). In summary, BRAF-mutated metanephric adenomas were associated with older age, female predominance, and the presence of a predominant acinar component. A subset (20%) of BRAF-mutated metanephric adenomas was not detected by VE1 immunostaining.