Miracle-dz/UniFAR-FTUs huggingface dataset:
A novel approach to improving coagulation sample ordering in an emergency department

Abstract Driven by emergency department targets, there is a need for rapid initial assessment and investigations of attendees to the department, and blood tests are often performed before full patient assessment. It has been shown that many investigations ordered in the emergency department are inappropriate. Coagulation samples are acknowledged as one the commonest blood samples requested on admission. We predicted that the majority of the routine coagulation samples performed in our ED department were unnecessary. We aimed to determine if coagulation tests sent from our department were appropriate, develop guidance for appropriate testing and to increase the percentage of appropriate tests to 90%. Criterion based audit was used. All coagulation samples sent from the ED over a one week period were reviewed and the indications for testing compared to guidance developed by consensus with ED consultants. On the first data collection, 66 of 369 (17%) samples were deemed appropriate. Feedback to clinical staff was given at educational meetings and appropriate indications discussed. In collaboration with both senior nursing and medical staff, coagulation screen request bottles were removed from the main clinical area and were only available in the resuscitation area. Following these interventions, 69 of 97 (71%) samples were deemed appropriate and a further intervention is planned to reach our standard. This improvement could lead to a £100,000 saving annually and a cross-site collaborative study is planned to spread these improvements.
Significance of vascular endothelial growth factor (VEGF)/soluble VEGF receptor‐1 relationship in breast cancer

Angiogenesis, the formation of new blood vessels, is controlled by a balance between positive and negative endothelial regulatory factors. Soluble vascular endothelial growth factor receptor‐1 (sVEGFR1), a naturally occurring soluble form of VEGFR1, is a negative counterpart of the vascular endothelial growth factor (VEGF) signaling pathway, which has been characterized as one of the most important endothelial regulators in human tumor angiogenesis. In our study, we examined the expression of sVEGFR1 in 110 primary breast carcinomas, and assessed its clinical significance. Ninety‐four of 110 tumors showed ≥0.1 ng/mg protein of sVEGFR1 (range:0. 1–6.9 ng/mg protein; median: 1.03 ng/mg protein) as determined by a specific enzyme‐linked immunosorbent assay (ELISA). Immunoblot analysis confirmed the presence of sVEGFR1 in breast tumor tissues. The levels of sVEGFR1 were correlated significantly with the levels of VEGF. There was no significant correlation between the levels of sVEGFR1 and any clinico‐pathological factors including age, menopause, nodal involvement and hormone receptor status. A univariate prognosis analysis showed that the intratumoral VEGF status, as determined by ELISA, was a significant prognostic indicator, but sVEGFR1 status was not. In the combined analysis, however, the ratio of sVEGFR1 and VEGF levels provided more statistically significant prognostic value than VEGF status alone. Tumors in which the sVEGFR1 levels exceeded VEGF levels 10‐fold had a markedly favorable prognosis. Multivariate analysis also demonstrated that the ratio of sVEGFR1 and VEGF was an independent prognostic indicator after nodal status. In conclusion, sVEGFR1, an intrinsic inhibitor of VEGF, frequently co‐expressed with VEGF in primary breast cancer tissues. The intratumoral balance between sVEGFR1 and VEGF levels might be crucial for the progression of breast cancer. © 2001 Wiley‐Liss, Inc.
Pharmacokinetics and biodistribution of 111In- and 177Lu-labeled J591 antibody specific for prostate-specific membrane antigen: prediction of 90Y-J591 radiation dosimetry based on 111In or 177Lu?

UNLABELLED 111In-Labeled antibodies and peptides have been routinely used as chemical and biologic surrogates for 90Y-labeled therapeutic agents. However, recent studies have shown that there are significant differences in biodistribution between 111In- and 90Y-labeled agents. Yttrium and lutetium metals favor the +3 oxidation state, similar to indium, but there are minor differences in the solution and coordination chemistries among these metals. These 3 metals, however, form strong complexes with the macrocyclic chelator, 1,4,7,10-tetraazacyclododecane-N,N',N'',N'''-tetraacetic acid (DOTA). We, therefore, compared the pharmacokinetics and biodistribution of 111In- and 177Lu-labeled J591 antibody. The radiation dosimetry of 90Y-J591 was estimated based on both 111In and 177Lu data to validate the usage of 111In as a chemical and biologic surrogate for 90Y. METHODS J591 is a deimmunized monoclonal antibody with specificity for the extracellular domain of prostate-specific membrane antigen. In patients with prostate cancer, phase I dose-escalation studies were conducted with 90Y-J591 (n = 29) and 177Lu-J591 (n = 25). Each patient had pharmacokinetics and imaging studies with 111In-J591 (185 MBq/20 mg) over a period of 1 wk and before treatment with 90Y-J591 antibody. In the 177Lu trial, the pharmacokinetics and imaging studies were performed after treatment with the 177Lu-J591 dose (370-2,590 MBq/m2/10 mg/m2) over a 2-wk period after treatment. RESULTS Blood and urinary pharmacokinetics were similar for both tracers. Based on biexponential decay, the terminal half-life was 44 +/- 15 h for both tracers. In addition, the total-body retention of radioactivity over a 7-d period was also similar between the 2 isotopes. The percentage uptake in liver was about 20% greater with 111In than with 177Lu. Radiation dosimetry estimates for 90Y-J591 calculated on the basis of 111In or 177Lu data were mostly similar and showed that liver is the critical organ, followed by spleen and kidney. Based on blood radioactivity, the radiation dose (mGy/MBq) to the bone marrow was 3 times higher with 90Y (0.91 +/- 0.43) compared with that with 177Lu (0.32 +/- 0.10). CONCLUSION 111In- and 177Lu-labeled J591 antibodies have similar plasma and whole-body clearance kinetics. The net retention of 111In activity by lung, liver, and spleen is slightly higher compared with that with 177Lu. These results justify using 111In as a chemical and biologic surrogate for 90Y. However, the radiation dose to the liver may be overestimated by about 25% based on 111In data. In addition, the data also suggest that 177Lu may be a potential alternative for estimating the pharmacokinetics and biodistribution of 90Y-labeled radiopharmaceuticals.
Autologous transplant of follicular lymphoma in the era of rituximab

In advanced follicular lymphoma (FL), autologous stem cell transplant (ASCT) has been studied extensively in an attempt to prolong remission duration and, possibly, achieve ultimate cure. However, increasing evidence of the benefit of rituximab and various other new drugs has questioned the appropriate place of ASCT in the treatment algorithm of FL in recent years. The purpose of this overview is to propose a definition of the potential role of ASCT in the treatment armamentarium of FL in the light of these new treatment options. Taken together, the absence of an overall survival benefit, the risk of secondary malignancies, and the remarkably good prognosis of patients who receive rituximab and ASCT as salvage therapy in the relapse situation make the use of ASCT as initial therapy difficult to justify. In contrast, evidence is accumulating that, in eligible patients with relapsed FL, rituximab-based chemotherapy followed by ASCT might provide superior disease control in comparison to either modality alone, and has curative potential in a subset of patients. However, these considerations are largely based on retrospective analyses and should be confirmed in prospective randomized trials.
Presurgical caudal block attenuates stress response in children.

BACKGROUND Our aim was to determine if the anesthesia technique for pain relief in children affects the stress response after minor surgery. A rise in blood glucose reflects stress-related effects in children who do not receive glucose perioperatively. METHODS Twenty-eight children, ages 17-81 mos, undergoing elective urologic procedures, were enrolled. For pain relief, patients received presurgical caudal block (group 1), intravenous narcotics (group 2), or postsurgical caudal block (group 3). Blood samples were analyzed for glucose concentrations immediately after induction of anesthesia at baseline, 15 min after surgical incision (second sample), and 30 min after end of surgery (third sample). RESULTS In group 1 there was no change in glucose concentration in the second or third samples compared to baseline, while in group 3 there were significant increases in those samples, and in group 2 there was a significant increase in the second sample compared to baseline. Children in group 1 required significantly fewer narcotics in the postanesthesia care unit (PACU), and those in group 2 had significantly longer PACU and hospital durations. CONCLUSIONS Presurgical caudal analgesia attenuates the stress response of anesthesia and surgery and decreases postoperative narcotic use while narcotics prolong PACU and discharge times.
Advances in individual prediction of methotrexate toxicity: a review

As the cure rates for haematological malignancies have improved, the exploration of the balance between efficacy and side effects has become a major research target. The antifolate methotrexate is widely used in the treatment of acute lymphoblastic leukaemia, non‐Hodgkin lymphoma, and osteosarcoma. Even when given identical methotrexate doses, patients vary significantly in their response and pattern of toxicities. This diversity can, to some extent, be linked to sequence variations in genes involved in drug absorption, metabolism, excretion, cellular transport, and effector targets or target pathways. In the coming years pharmacogenomics is expected to change our approaches to individualised therapy with methotrexate. However, genetic polymorphisms affect the pharmacokinetics and dynamics of all the drugs a patient receive as well as the normal tissues tolerance to a given drug exposure. Thus, although high‐throughput techniques will allow mapping of tens of thousands of genetic polymorphisms in one run, it will be a major challenge to dissect out which of these have the strongest impact on efficacy and toxicity and hence should be the targets for intervention. This paper discusses the pharmacology of methotrexate and reviews studies on haematological malignancies that have attempted to predict the risk of toxicity by specific clinical or genetic features.
A Unified Description of Linear and Nonlinear Polarization in Organic Polymethine Dyes

An internal or external electric field F can drive the chemical structure, bond order alternation, and electronic structure of linear polymethine dyes from a neutral, bond-alternated, polyene-like structure, through a cyanine-like structure, and ultimately to a zwitterionic (charge-separated) bond-alternated structure. As the structure evolves under the influence of F, the linear polarizability α, the first hyperpolarizability β, and the second hyperpolarizability γ are seen to be derivatives, with respect to F, of their next lower order polarization (for α) or polarizability (for β and γ). These derivative relations provide a unified picture of the dependence of the polarizability and hyperpolarizabilities on the structure in linear polymethine dyes. In addition, they allow for predictions of structure-property relations of higher order hyperpolarizabilities.
Development and validation of a simple model based on anthropometry: estimating fat mass for white postmenopausal women

ObjectiveThe aim of this study was to develop and validate a simple anthropometric model that estimates the fat mass of white postmenopausal women and compare it to other models available in the literature. MethodsAnthropometric data such as height, weight, waist and gluteal circumferences, biceps, triceps, suprailiac, and subscapular skinfolds, which were incorporated for the development and validation of this model, were derived from 276 white postmenopausal women. Dual-energy x-ray absorptiometry was used as the reference method. Furthermore, a comparison with other models was made using Bland-Altman analysis and intraclass correlation coefficient. ResultsThe model developed in the current study was: fat mass = 0.069 × biceps + 0.553 × weight − 14.655 × height + 0.218 × gluteal circumference − 9.830 (r2 = 0.934, P < 0.001). The Bland-Altman reliability analysis on the validation cohort showed a non-statistically significant bias of 0.158 kg and limits of agreement of ±4.21 kg; the intraclass correlation coefficient was 0.983. Furthermore, the validity of the current model also remained significant in different levels of BMI, ranging from 20.5-42 kg/m2. When other models available in the literature were tested in the current cohort, bias ranged from −1.239 to −6.996 kg, while the limits of agreement from ±5.25 to ±8.05 kg. ConclusionsThe model developed in the current work was found to be valid for the assessment of postmenopausal women’s fat mass at normal, overweight and obese BMI ranges, and can be easily applied in clinical practice and research.
L'imparfait narratif : point de vue (et images du monde)

Selon la theorie de la pertinence, l'imparfait, comme les autres temps verbaux, est une expression procedurale. Interpreter un imparfait comme « narratif » resulterait donc du parcours, par le destinataire, d'un chemin particulier dans la procedure de l'imparfait. Cet article defend l'idee que pour construire l'interpretation narrative de l'imparfait, le destinataire est amene a inferer un sujet de conscience, et donc a construire une representation en foncction d'un point de vue distinct du locuteur au « moi-ici-maintenant ».
Warming-up in USRPT 1 SWIMMING SCIENCE BULLETIN

Some activities for in-pool warm-ups have been evaluated. An historically important study was conducted by Carlile (1956). It was shown that the passive activity of tolerating a hot shower for as long as possible prior to performing a maximal 55-yard swim produced improved performances in all subjects significantly more than in a control group (no hot showers). A passive warm-up is possible if swimmers have the time and opportunity to fully engage the activity.
Neovascular potential of adipose‐derived stromal cells (ASCs) from diabetic patients

We explored the vascular biology of adipose‐derived stromal cells (ASCs) from diabetic patients and applied these cells to a murine ischemic flap model to assess the comparative angiogenic potentials between normal and diabetic human ASCs. ASCs were obtained from diabetic patients (n = 5) and controls (n = 5). Secretion and expression of angiogenic cytokines were measured under normoxic and hypoxic condition in vitro. Conditioned media harvested from ASC cultures were assessed for their ability to stimulate human umbilical vein endothelial cell proliferation and tubulization. The control and diabetic ASCs were injected into the murine ischemic flaps, and the surviving area was measured. Diabetic adipose‐derived stromal cells showed a lower level of vascular endothelial growth factor expression and cell proliferation rates than the control cells (p < 0.05). However, vascular endothelial growth factor, hepatocyte growth factor secretion, tubulogenesis, and cell proliferation in diabetic conditioned media were increased in response to hypoxic stimuli (p < 0.05), and it was similar to those of control cells. In an animal study, diabetic and normal ASCs significantly increased flap survival (p < 0.05); however, the functional difference was not found between the two groups. Diabetic ASCs were impaired in their ability to produce vascular endothelial growth factors and to induce cellular proliferation under hypoxic conditions. However, diabetic ASCs showed similar flap salvaging effect compared with controls. These findings may be important in the context of future study of autologous cell‐based therapy in diabetic patients.
Numerical Simulation of the Period 1971–2100 over the Mediterranean Area with a Regional Model, Scenario SRES-A1B

In this work, we discuss the results of numerical simulations performed with the regional model COSMO-CLM over the Mediterranean area at a spatial resolution of 14 km, employing an optimized model configuration. An assessment of model capabilities to reproduce the main features of the recent and past climate has been performed, using two different simulations: The first simulation is driven by the ERA40 Reanalysis and the second, by the CMCC-MED global model. Validation is performed through a comparison with the E-OBS dataset. Climate projections, according to the SRES A1B emission scenario, have been further analyzed in terms of change of 2-m temperature and precipitation, and have shown a significant warming expected at the end of the 21st Century, along with a general reduction in precipitation, particularly evident in spring and summer.
Analytics-Aware Graph Database Modeling

Graphs are a fundamental structure for modeling many real world domains and applications. They have emerged in various fields such as social, informational and transportation networks. The heterogeneity and dynamicity of these networks pose challenges to traditional techniques for data modeling, storage and analysis of data. Managing graph-structured data using native graph structures and algorithms is the key for its efficient analysis. Therefore, the graph should be modeled using nodes and edges, and explored using graph algorithms, such as pattern matching and k-neighborhood. In this paper, we introduce a novel model for management of graph data. The aim of our model is to provide analysts with a set of simple, welldefined, and adaptable components to perform complex graph modeling and analysis tasks.
Two novel direct SPIO labels and in vivo MRI detection of labeled cells after acute myocardial infarct

Background Acute myocardial infarction (AMI) is a leading cause of morbidity and mortality worldwide. Cellular decay due hypoxia requires rapid and validated methods for possible therapeutic cell transplantation. Purpose To develop direct and rapid superparamagnetic iron oxide (SPIO) cell label for a large-animal model and to assess in vivo cell targeting by magnetic resonance imaging (MRI) in an experimental AMI model. Material and Methods Bone marrow mononuclear cells (BMMNCs) were labeled with SPIO particles using two novel direct labeling methods (rotating incubation method and electroporation). Labeling, iron incorporation in cells and label distribution, cellular viability, and proliferation were validated in vitro. An AMI porcine model was used to evaluate the direct labeling method (rotating incubation method) by examining targeting of labeled BMMNCs using MRI and histology. Results Labeling (1 h) did not alter either cellular differentiation potential or viability of cells in vitro. Cellular relaxation values at 9.4 T correlated with label concentration and MRI at 1.5 T showing 89 ± 4% signal reduction compared with non-labeled cells in vitro. In vivo, a high spatial correlation between MRI and histology was observed. The extent of macroscopic pathological myocardial changes (hemorrhage) correlated with altered function detected on MRI. Conclusion We demonstrated two novel direct SPIO labeling methods and demonstrated the feasibility of clinical MRI for monitoring targeting of the labeled cells in animal models of AMI.
Predicting ADR from PDR and individual adenoma-to-polyp-detection-rate ratio for screening and surveillance colonoscopies: A new approach to quality assessment

Background and aims Adenoma detection rate (ADR) has been established as a quality indicator for screening colonoscopy. Because ADR is cumbersome to obtain in routine practice, polyp detection rate (PDR), polypectomy rate (PR) and adenoma-to-polyp-detection-rate-ratio (APDRR) have been proposed to estimate ADR. This study aimed to evaluate APDRR in order to estimate ADR (ADRest) in different settings. Methods Average risk screening and surveillance colonoscopies from a community-based private practice and a tertiary academic hospital setting were retrospectively evaluated. APDRR was calculated as averaged group APDRR for all study procedures (APDRR) and for the first half of study procedures of each gastroenterologist (APDRRag) or individually for each gastroenterologist on the basis of his or her first 25, 50 and 100 colonoscopies (APDRRind). ADRest was determined from PDR by using APDRR, APDRRag, and APDRRind, respectively. Results A total of 2717 individuals were analyzed. Using APDRR, significant correlations between ADR and ADRest were observed for the entire (0.944, p < 0.001), proximal (0.854, p < 0.001), and distal (0.977, p < 0.001) colon. These correlations were lost when APDRRag was used to estimate each gastroenterologist’s ADR for the second half of his or her included colonoscopies. However, ADR and ADRest correlated significantly with a root-mean-square-error of 6.8% and 5.8% when APDRRind on the basis of each gastroenterologist’s first 50 and 100 colonoscopies was used for subsequent colonoscopies. Conclusions ADR for subsequent colonoscopies of an individual endoscopist can be reliably estimated from PDR by using an individually calculated APDRR. Prospective studies are needed to verify this promising approach in different practice settings.
Intermittent Therapy with Terbinafine for Dermatophyte Toe‐Onychomycosis: A New Approach

Terbinafine, an orally active antifungal agent of the allylamine class, is effective in the treatment of dermatophyte onycomycosis. Its pharmacologic and pharmacokinetic properties give strong support to the possibility that intermittent treatment courses may be equally effective in onychomycosis in general.
Lo que vendrá. Una crítica a Braverman a propósito de Marx y la investigación empírica.

En el curso de nuestra investigacion sobre la transformaciones de los procesos de trabajo en la Argentina tuvimos que sortear una serie de problemas teoricos. Muchos de ellos estaban vinculados con las categorias utilizadas inicialmente; pronto resulto evidente que estas ocultaban mas de lo que mostraban, a partir de alli buscamos otro marco teorico que nos permitiera dar cuenta de la realidad que estudiabamos. Hallamos este marco en el marxismo: los conceptos de cooperacion simple, manufactura y gran industria nos permitieron redefinir el problema. En vez de interrogarnos sobre el momento en que surgen en la Argentina el taylorismo y el fordismo, ahora nos preguntamos cuando aparecen en el pais la manufactura y la gran industria. Tiene sentido esta diferenciacion, o se trata de una mera discrepancia nominal? En este articulo nos proponemos demostrar no solo la utilidad de plantear la cuestion desde la teoria marxista, sino tambien que unicamente desde ella se pueden comprender los fenomenos que categorias como taylorismo y fordismo intentan describir.