Miracle-dz/UniFAR-FTUs huggingface dataset:
Improved survival with hospitalists in a pediatric intensive care unit*

ObjectiveTo compare the survival of patients in a teaching hospital pediatric intensive care unit in which residents provided after-hours in-house coverage with survival in the same unit with hospitalists providing this coverage. DesignRetrospective cohort study. SettingPediatric intensive care units in two teaching hospitals that are managed by the same group of academic pediatric intensivists, one of which transitioned from the traditional resident-staffed model to a hospitalist-staffed model for after-hours in-house coverage. PatientsAll pediatric patients admitted to the study pediatric intensive care unit and to the control pediatric intensive care unit from April 1997 through March 1998, the resident era, and from October 1998 through September 1999, the hospitalist era. InterventionsMultivariate analysis, with survival as the dependent variable and era (hospitalist vs. resident) as an independent variable, was used to compare odds of survival during the hospitalist era with that of the resident era, adjusted for severity of illness. Multivariate linear regression was used to compare length of stay during the hospitalist era with that of the resident era, adjusted for severity of illness. Pediatric Risk of Mortality scores and those diagnostic categories typically associated with higher mortality rates also were included as independent variables in both analyses to adjust for severity of illness. Measurements and Main ResultsMultivariate analysis yielded an estimated odds ratio of survival of 2.8 for the hospitalist era compared with the resident era (p = .013), and our analysis supported an independent association between survival and hospitalist era. Multivariate linear regression showed that length of stay, also adjusted for severity of illness, during the hospitalist era was 21.1 hrs shorter than during the resident era (p = .013). Neither survival nor length of stay was significantly associated with era at the control hospital. ConclusionImproved survival with hospitalists, rather than residents, providing after-hours care when an intensivist is not in house suggests that the quality of care of critically ill patients is improved when more experienced physicians are providing bedside care. Shorter length of stay with the hospitalist model also may reflect improved quality of care.
Sentence-level control vectors for deep neural network speech synthesis

This paper describes the use of a low-dimensional vector representation of sentence acoustics to control the output of a feed-forward deep neural network text-to-speech system on a sentence-by-sentence basis. Vector representations for sentences in the training corpus are learned during network training along with other parameters of the model. Although the network is trained on a frame-by-frame basis, the standard framelevel inputs representing linguistic features are supplemented by features from a projection layer which outputs a learned representation of sentence-level acoustic characteristics. The projection layer contains dedicated parameters for each sentence in the training data which are optimised jointly with the standard network weights. Sentence-specific parameters are optimised on all frames of the relevant sentence – these parameters therefore allow the network to account for sentence-level variation in the data which is not predictable from the standard linguistic inputs. Results show that the global prosodic characteristics of synthetic speech can be controlled simply and robustly at run time by supplementing basic linguistic features with sentencelevel control vectors which are novel but designed to be consistent with those observed in the training corpus.
An Update to Hepatobiliary Stents

Endoscopic stent placement is a common primary management therapy for benign and malignant biliary strictures. However, continuous use of stents is limited by occlusion and migration. Stent technology has evolved significantly over the past two decades to reduce these problems. The purpose of this article is to review current guidelines in managing malignant and benign biliary obstructions, current endoscopic techniques for stent placement, and emerging stent technology. What began as a simple plastic stent technology has evolved significantly to include uncovered, partially covered, and fully covered self-expanding metal stents (SEMS) as well as magnetic, bioabsorbable, drug-eluting, and antireflux stents.1
Proliferation of Purple Sulphur Bacteria at the Sediment Surface Affects Intertidal Mat Diversity and Functionality

There is a relative absence of studies dealing with mats of purple sulphur bacteria in the intertidal zone. These bacteria display an array of metabolic pathways that allow them to disperse and develop under a wide variety of conditions, making these mats important in terms of ecosystem processes and functions. Mass blooms of purple sulphur bacteria develop during summer on sediments in the intertidal zone especially on macroalgal deposits. The microbial composition of different types of mats differentially affected by the development of purple sulphur bacteria was examined, at low tide, using a set of biochemical markers (fatty acids, pigments) and composition was assessed against their influence on ecosystem functions (sediment cohesiveness, CO2 fixation). We demonstrated that proliferation of purple sulphur bacteria has a major impact on intertidal mats diversity and functions. Indeed, assemblages dominated by purple sulphur bacteria (Chromatiaceae) were efficient exopolymer producers and their biostabilisation potential was significant. In addition, the massive growth of purple sulphur bacteria resulted in a net CO2 degassing whereas diatom dominated biofilms represented a net CO2 sink.
Fibromyalgia Patients' Communication of Cues and Concerns: Interaction Analysis of Pain Clinic Consultations

ObjectivesClinicians' recognition of patients' concerns is an important component of effective treatment and care. During a consultation, patients often do not express their concerns directly, but rather present them indirectly as hints or cues. The aim of this study was to explore the types of concerns and cues patients expressed in an initial consultation with a nurse at a pain clinic, how and who initiated these cues and concerns, and predictors of these expressions. MethodsInitial consultations between patients with fibromyalgia [n=58, 85% female, duration 30 minutes, mean age 47.8 y (SD 10.7)] and clinical nurse specialists (n=5) were videotaped. Patients' cues and concerns were coded using the Verona Coding Definitions of Emotional Sequences. Nurses' responses to patients' cues and concerns were evaluated using the Hierarchical Coding Scheme of Comforting Strategies. In addition, pain intensity and duration, overall evaluation of health, affect at the start of the consultation, and psychological distress were evaluated. ResultsPatients expressed more cues than concerns, mostly about pain, interpersonal relationships, and/or emotional reactions. Both the lack of empathic responding and unspecific empathic responding were associated with the expression of an increased number of cues in the consultation, whereas higher evaluation of health was associated with less cues. More concerns were expressed by patients when nurses exhibited a high level of empathic responding and when the patient entered the consultation with a higher level of negative effect. DiscussionFindings from this study highlight the importance of a patient centered communication style to facilitate the expression of cues and concerns.
Cloud Security Engineering: Avoiding Security Threats the Right Way

Information security is a key challenge in the Cloud because the data will be virtualized across different host machines, hosted on the Web. Cloud provides a channel to the service or platform in which it operates. However, the owners of data will be worried because their data and software are not under their control. In addition, the data owner may not recognize where data is geographically located at any particular time. So there is still a question mark over how data will be more secure if the owner does not control its data and software. Indeed, due to shortage of control over the Cloud infrastructure, use of ad-hoc security tools is not sufficient to protect the data in the Cloud; this paper discusses this security. Furthermore, a vision and strategy is proposed to mitigate or avoid the security threats in the Cloud. This broad vision is based on software engineering principles to secure the Cloud applications and services. In this vision, security is built into all phases of Service Development Life Cycle SDLC, Platform Development Life Cycle PDLC or Infrastructure Development Life Cycle IDLC.
On the phylogenetic position of the pre-Neandertal specimen from Reilingen, Germany.

This paper describes the morphology and phylogenetic significance of a well-preserved fossil human cranium found near Reilingen, Germany in 1978. The specimen consists of two complete parietals, most of the right temporal, and 70% of the occipital. The specimen displays several features characteristic of early "archaic" Homo sapiens: maximum breadth at the supramastoid crests, roughly pentagonal occipital view, an angular torus, superoinferiorly elongate/ anteroposterior shortened squamous temporal, strong mastoid, and separation of the tympanic and mastoid temporal portions. Other features align the Reilingen cranium with the "classic" Neandertals: developed suprainiac fossa, bilaterally protuberant occipital torus, strong juxtamastoid eminence, a highly convex occipital plane, and lambdoid flattening. This morphology and our cephalometric analysis support the assignment of this specimen to a Stage 2 "pre-Neandertal" group (e.g., Steinheim, Swanscombe, and Atapuerca [SH site]). Following an "Accretion Model" of European hominid evolution, Stage 2 succeeds Stage 1 European "early-pre-Neandertals" (e.g., Mauer and Petralona), and precedes both the Saale-Eem Stage 3 "early Neandertals" (e.g., Biache 1), which present greater platycephaly, a reduced mastoid process, an enlarged juxtamastoid eminence, and true "en-bombe" (parieto-occipital form), and Weichsel Stage 4 "Neandertals" (sensu stricto, i.e., "classic" Neandertals).
KIT as a therapeutic target in metastatic melanoma.

CONTEXT Some melanomas arising from acral, mucosal, and chronically sun-damaged sites harbor activating mutations and amplification of the type III transmembrane receptor tyrosine kinase KIT. We explored the effects of KIT inhibition using imatinib mesylate in this molecular subset of disease. OBJECTIVE To assess clinical effects of imatinib mesylate in patients with melanoma harboring KIT alterations. DESIGN, SETTING, AND PATIENTS A single-group, open-label, phase 2 trial at 1 community and 5 academic oncology centers in the United States of 295 patients with melanoma screened for the presence of KIT mutations and amplification between April 23, 2007, and April 16, 2010. A total of 51 cases with such alterations were identified and 28 of these patients were treated who had advanced unresectable melanoma arising from acral, mucosal, and chronically sun-damaged sites. INTERVENTION Imatinib mesylate, 400 mg orally twice daily. MAIN OUTCOME MEASURES Radiographic response, with secondary end points including time to progression, overall survival, and correlation of molecular alterations and clinical response. RESULTS Two complete responses lasting 94 (ongoing) and 95 weeks, 2 durable partial responses lasting 53 and 89 (ongoing) weeks, and 2 transient partial responses lasting 12 and 18 weeks among the 25 evaluable patients were observed. The overall durable response rate was 16% (95% confidence interval [CI], 2%-30%), with a median time to progression of 12 weeks (interquartile range [IQR], 6-18 weeks; 95% CI, 11-18 weeks), and a median overall survival of 46.3 weeks (IQR, 28 weeks-not achieved; 95% CI, 28 weeks-not achieved). Response rate was better in cases with mutations affecting recurrent hotspots or with a mutant to wild-type allelic ratio of more than 1 (40% vs 0%, P = .05), indicating positive selection for the mutated allele. CONCLUSIONS Among patients with advanced melanoma harboring KIT alterations, treatment with imatinib mesylate results in significant clinical responses in a subset of patients. Responses may be limited to tumors harboring KIT alterations of proven functional relevance. Trial Registration clinicaltrials.gov Identifier: NCT00470470.
Frequent Transmission of Immunodeficiency Viruses among Bobcats and Pumas

ABSTRACT With the exception of human immunodeficiency virus (HIV), which emerged in humans after cross-species transmissions of simian immunodeficiency viruses from nonhuman primates, immunodeficiency viruses of the family Lentiviridae represent species-specific viruses that rarely cross species barriers to infect new hosts. Among the Felidae, numerous immunodeficiency-like lentiviruses have been documented, but only a few cross-species transmissions have been recorded, and these have not been perpetuated in the recipient species. Lentivirus seroprevalence was determined for 79 bobcats (Lynx rufus) and 31 pumas (Puma concolor) from well-defined populations in Southern California. Partial genomic sequences were subsequently obtained from 18 and 12 seropositive bobcats and pumas, respectively. Genotypes were analyzed for phylogenic relatedness and genotypic composition among the study set and archived feline lentivirus sequences. This investigation of feline immunodeficiency virus infection in bobcats and pumas of Southern California provides evidence that cross-species infection has occurred frequently among these animals. The data suggest that transmission has occurred in multiple locations and are most consistent with the spread of the virus from bobcats to pumas. Although the ultimate causes remain unknown, these transmission events may occur as a result of puma predation on bobcats, a situation similar to that which fostered transmission of HIV to humans, and likely represent the emergence of a lentivirus with relaxed barriers to cross-species transmission. This unusual observation provides a valuable opportunity to evaluate the ecological, behavioral, and molecular conditions that favor repeated transmissions and persistence of lentivirus between species.
Identification of TRIM23 as a Cofactor Involved in the Regulation of NF-κB by Human Cytomegalovirus

ABSTRACT Human cytomegalovirus (HCMV) regulates NF-κB during infection by a variety of mechanisms. For example, the HCMV gene product, UL144, is known to activate NF-κB in a tumor necrosis factor receptor (TNFR)-associated factor 6 (TRAF6)-dependent manner, causing the upregulation of the chemokine CCL22 (MDC). Viral UL144 is expressed from the UL/b′ region of the HCMV genome at early times postinfection and is a TNFR1-like homologue. Despite this homology to the TNFR1 receptor superfamily, UL144 does not bind to members of the TNF ligand superfamily. We show here that the upregulation of NF-κB by UL144 is dependent upon cellular tripartite motif 23 (TRIM23) protein. We propose a mechanism by which UL144 activates NF-κB through a direct interaction with the cellular protein TRIM23 in a complex containing TRAF6. In contrast, TRIM23 is not involved in conventional double-stranded RNA signaling via NF-κB. Therefore, we present a novel role for TRIM23 that is specific to UL144-mediated activation of NF-κB during the course of virus infection.
Child Witnesses to Intimate Partner Violence: Their Descriptions of Talking to People About the Violence

Witnessing intimate partner violence (IPV) may have damaging effects on children’s well-being and development. How children understand IPV affects the risk of their developing negative outcomes. Talking with children about the violent episodes they have experienced can change their beliefs regarding their parents’ IPV, and therefore may also be a way to help them deal with these adverse experiences. The purpose of the current study was to use the children’s narratives to explore the relationship between how IPV was perceived by the children and their experience of talking about it. Interviews with 31 children between 9 and 13 years of age were analyzed using a thematic method. Two main groups of children were identified: children who described the violence as a horrifying experience and children who preferred not to think about the violence. The findings showed that children who described the violence as a horrifying experience perceived talking about the violence as a positive, yet sometimes distressing, experience that made a real difference in their lives; whereas, children who preferred not to think about the violence did not see much need to talk about it and benefit from talking about it. The study confirms previous research indicating that talking about IPV experiences sometimes leads to feelings of relief in children. Thereby, professionals play an important role by providing an appropriate setting to help children reduce their distressing feelings.
Reconstructing scene depth and appearance behind foreground occlusion using camera array

Foreground occlusion is a significant challenge in 3D reconstruction. In the paper, we first characterize the differences between multiview reconstruction with and without foreground occlusion. Considering both scene depth and appearance are unknown, we propose a generalized model for scene reconstruction. Then, we propose an iterative reconstruction approach in the global optimization framework, which is well performed on the camera array system. Even when all views are partially occluded, our approach can recover accurate depth map as well as scene appearance. Experimental results have indicated that our approach is more robust to foreground occlusions and outperforms state-of-the-art approaches.
Identification of miRNAs that are associated with tumor metastasis in Neuroblastoma

The discovery of microRNAs (miRNAs) has opened a new avenue for both diagnosis and treatment of cancers. Accumulating experimental evidences indicate that miRNAs are aberrantly expressed in different tumor types and have a critical role in tumorigenesis. However, the miRNA expression profile in neuroblastoma (NB), one of the most common cancer forms in children, has not been well characterized. In the present study, we established a heterotopic transplant mice model of NB and employed miRNA microarray analysis to identify miRNAs that are differentially expressed in metastatic NB compared to primary NB. A list of 54 miRNAs was found to be significantly altered in metastatic tumors compared to primary tumors. These differentially-expressed miRNAs were selectively validated by a stem-loop qRT-PCR assay. Furthermore, we predicted a list of potential miRNA–target pairs that may be involved in the metastasis of neuroblastoma by three different computer–aided algorithms. Taken together, our results indicate that a unique panel of miRNAs are associated with metastatic NB and these differentially-expressed miRNAs may play an important role in the NB metastatic process. This finding may also shed light in our understanding of the nature of metastatic NB and provide a potential novel target for therapeutic treatment of this tumor.
Cutting Planes Algorithm for the Connected k-Factor Problem Using the Facet Inequalities

The relevance of the search facet inequalities for polytopes of combinatorial problems caused to the effect of their use in the algorithms for solving problems of high dimensionality. At the stage of incorporation facet inequalities in the algorithm, the fundamental role played the separation problem. The separation problem is a question existence in class of inequalities such inequality, which strictly separates the noninteger optimum and polytope. In this paper, for even k, the polynomial solvability of the separation problem for the clique inequalities on the polyhedron of connected k-factors is shown. In addition, sufficient conditions (polynomial complexity) for the existence of a separating inequality for odd k are found.
Pharmacokinetics of butorphanol in cats after intramuscular and buccal transmucosal administration.

OBJECTIVE To determine the pharmacokinetics of butorphanol in cats following IM and buccal transmucosal (BTM) administration, to determine the relative bioavailability of butorphanol following BTM administration, and to extrapolate a plasma concentration associated with antinociception on the basis of existing data from pharmacologic studies of butorphanol in cats. ANIMALS 6 healthy adult cats. PROCEDURES Following IM or BTM butorphanol tartrate (0.4 mg/kg) administration to cats in a 2-way crossover trial, plasma samples were obtained from blood collected via a central venous catheter during a 9-hour period. Plasma butorphanol concentrations were determined by high-performance liquid chromatography. RESULTS Data from 1 cat contained outliers and were excluded from pharmacokinetic analysis. Mean+/-SD terminal half-life of butorphanol for the remaining 5 cats was 6.3+/-2.8 hours and 5.2+/-1.7 hours for IM and BTM administration, respectively. Peak plasma butorphanol concentrations were 132.0 and 34.4 ng/mL for IM and BTM administration, respectively. Time to maximal plasma concentration was 0.35 and 1.1 hours for IM and BTM administration, respectively. Extent of butorphanol absorption was 37.16% following BTM application. On the basis of data from extant pharmacologic studies of butorphanol in cats, mean+/-SD duration of antinociception was 155+/-130 minutes. The estimated plasma concentration corresponding to this time point was 45 ng/mL. CONCLUSIONS AND CLINICAL RELEVANCE In cats, IM butorphanol administration at 0.4 mg/kg maintained a plasma concentration of >45 ng/mL for 2.7+/-2.2 hours, whereas BTM administration at the same dose was not effective at maintaining plasma concentrations at >45 ng/mL.
Revenue Premium as an Outcome Measure of Brand Equity

The authors propose that the revenue premium a brand generates compared with that of a private label product is a simple, objective, and managerially useful product-market measure of brand equity. The authors provide the conceptual basis for the measure, compute it for brands in several packaged goods categories, and test its validity. The empirical analysis shows that the measure is reliable and reflects real changes in brand health over time. It correlates well with other equity measures, and the measure's association with a brand's advertising and promotion activity, price sensitivity, and perceived category risk is consistent with theory.
The role of robotics for adrenal pathology

Purpose of review This review assesses the role of robotic surgery in management of benign and malignant adrenal disease. Recent findings Laparoscopic adrenalectomy is considered the standard of care for benign adrenal neoplasms and has been increasingly considered for malignant disease. Robotic techniques have been considered for theoretical advantages in visualizing and dissecting the adrenal and its vasculature. Series of robotic adrenalectomy and limited comparisons with laparoscopic adrenalectomy have shown that robotic adrenalectomy is well tolerated and effective with subjective advantages compared with laparoscopic adrenalectomy. There has been growing interest in adrenal sparing-surgery using minimally invasive techniques and encouraging outcomes for selected benign lesions. Summary Robotic techniques for adrenalectomy have subjective advantages compared with laparoscopic adrenalectomy, but no objective superiority has been demonstrated. Surgical outcomes have been comparable with laparoscopic adrenalectomy though there have been no randomized controlled studies. Robotic adrenalectomy will be increasingly considered in lieu of laparoscopic adrenalectomy as robotic systems further disseminate and the cost disadvantages become less prohibitive. Although laparoscopic adrenalectomy remains the standard of care, robotic adrenalectomy is an acceptable option in high volume robotic centers from standpoints of outcomes, feasibility, and cost.