Miracle-dz/UniFAR-FTUs huggingface dataset:
Which is the Better Prognostic Factor for Resected Non-small Cell Lung Cancer: The Number of Metastatic Lymph Nodes or the Currently Used Nodal Stage Classification?

Introduction: This retrospective study was conducted to evaluate the prognostic significance of the number of metastatic lymph nodes (nN) in resected non-small cell lung cancer (NSCLC) in comparison with the currently used pathologic nodal (pN) category in the staging system. Methods: A total of 1659 patients who underwent potentially curative resection for NSCLC from 2000 to 2006 were included in this study. The association between the nN and survival was explored, and the results were compared with those using the location-based pN stage classification. Results: The patients were divided into four categories according to the number of metastatic nodes: nN0, absence of metastatic nodes; nN1, metastasis in one to two nodes; nN2, metastasis in three to six nodes; and nN3, metastasis in seven or more nodes. The 5-year overall survival for nN0, nN1, nN2, and nN3 was 89.2%, 65.1%, 42.1%, and 22.4%, respectively (p < 0.001). The nN category could be used to subdivide pN1 and pN2 patients into two (nN1 and nN2) and three (nN1, nN2, and nN3) prognostically distinct subgroups, respectively. Multivariate analysis showed the nN category was an independent prognostic factor for resected NSCLC. The difference in overall survival between pN1 and pN2 was not significant (55.4% versus 47.8%, p = 0.245). Patients in each nN category could not be subdivided into different prognostic subgroups according to the pN classification. Conclusions: The nN category in this study was shown to be a better prognostic determinant than the location-based pN stage classification.
Enzyme kinetics for the formation of 3-hydroxyquinine and three new metabolites of quinine in vitro; 3-hydroxylation by CYP3A4 is indeed the major metabolic pathway.

The formation kinetics of 3-hydroxyquinine, 2'-quininone, (10S)-11-dihydroxydihydroquinine, and (10R)-11-dihydroxydihydroquinine were investigated in human liver microsomes and in human recombinant-expressed CYP3A4. The inhibition profile was studied by the use of different concentrations of ketoconazole, troleandomycin, and fluvoxamine. In addition, formation rates of the metabolites were correlated to different enzyme probe activities of CYP1A2, CYP2C9, CYP2C19, CYP2D6, and CYP3A4 in microsomes from 20 human livers. Formation of 3-hydroxyquinine had the highest intrinsic clearance in human liver microsomes (mean +/- S.D.) of 11.0 +/- 4.6 micro l/min/mg. A markedly lower intrinsic clearance, 1.4 +/- 0.7, 0.5 +/- 0.1, and 1.1 +/- 0.2 micro l/min/mg was measured for 2'-quininone, (10R)-11-dihydroxydihydroquinine and (10S)-11-dihydroxydihydroquinine, respectively. Incubation with human recombinant CYP3A4 resulted in a 20-fold higher intrinsic clearance for 3-hydroxyquinine compared with 2'-quininone formation whereas no other metabolites were detected. The formation rate of 3-hydroxyquinine was completely inhibited by ketoconazole (1 micro M) and troleandomycin (80 micro M). Strong inhibition was observed on the formation of 2'-quininone whereas the formation of (10S)-11-dihydroxydihydroquinine was partly inhibited by these two inhibitors. No inhibition on the formation of (10R)-11-dihydroxydihydroquinine was observed. There was a significant correlation between the formation rates of quinine metabolites and activities of the CYP3A4 selected marker probes. This in vitro study demonstrates that 3-hydroxyquinine is the principal metabolite of quinine and CYP3A4 is the major enzyme involved in this metabolic pathway.
Curiosities in Periodic Precipitation Patterns

Observations have been made of several types of Liesegang patterns that are more complex than the usual concentric ring or parallel bands of precipitate. The structures observed show radial gaps, segmentation, irregular patterns within concentric rings, add the formation of spiral precipitation bands instead of sets of parallel Lisegang bands.
Spinal Cord Bioavailability of Methylprednisolone after Intravenous and Intrathecal Administration: The Role of P-Glycoprotein

Background High-dose intravenously administered methylprednisolone has been shown to improve outcome after spinal cord injury. The resultant glucocorticoid-induced immunosuppression, however, results in multiple complications including sepsis, pneumonia, and wound infection. These complications could be reduced by techniques that increase the spinal bioavailability of intravenously administered methylprednisolone while simultaneously decreasing plasma bioavailability. This study aimed to characterize the spinal and plasma bioavailability of methylprednisolone after intravenous and intrathecal administration and to identify barriers to the distribution of methylprednisolone from plasma into spinal cord. Methods The spinal and plasma pharmacokinetics of intravenous (30-mg/kg bolus dose plus 5.4 mg · kg−1 · h−1) and intrathecal (1-mg/kg bolus dose plus 1 mg · kg−1 · h−1) methylprednisolone infusions were compared in pigs. In addition, wild-type mice and P-glycoprotein knockout mice were used to determine the role of P-glycoprotein in limiting spinal bioavailability of methylprednisolone. Results Despite the greater intravenous dose, concentrations of methylprednisolone in pig spinal cord were far higher and plasma concentrations much lower after intrathecal administration. After intraperitoneal administration in the mouse, the concentrations of methylprednisolone in muscle were not different between mice expressing P-glycoprotein (2.39 ± 1.79 &mgr;g/g) and those lacking P-glycoprotein (2.83 ± 0.46 &mgr;g/g). In contrast, methylprednisolone was undetectable in spinal cords of wild-type mice, whereas concentrations in spinal cords of P-glycoprotein–deficient mice were similar to those in skeletal muscle (2.83 ± 0.27 &mgr;g/g). Conclusions These pig studies demonstrate that the spinal cord bioavailability of methylprednisolone is poor after intravenous administration. The studies in knockout mice suggest that this poor bioavailability results from P-glycoprotein–mediated exclusion of methylprednisolone from the spinal cord.
Precursor Lesions and Prognostic Factors in Primary Peritoneal Serous Carcinoma

Primary peritoneal serous carcinoma (PPSC) is uncommon and precursor lesions and prognostic factors are incompletely understood or described. Charts of 22 women with PPSC were reviewed for clinical and pathology data. Glass slides were reviewed for areas of PPSC, ovarian surface epithelium (OSE), ovarian cortical inclusion cysts (OCICs), tubal epithelial atypia (TEA), and serous tubal intraepithelial carcinoma (STIC). p53 and p16 immunohistochemical staining was scored and expression between the sites was compared. PPSC outcome was correlated with biomarker expression and clinicopathologic variables. p53 and p16 scores were significantly higher among PPSC and tubes than OSE and OCICs. Approximately 64% of PPSC, 46% of fallopian tubes, and none of the OSE overexpressed both biomarkers. OCICs were more frequently negative. Tubal pathologies of STIC, TEA and/or p53 signatures were present in approximately 46% of PPSC cases and the association with tubal p53 overexpression was significant. Statistically significant associations between tubal pathologies, OSE and OCICs biomarker expression profiles and their PPSC expression profiles did not occur. The median overall survival was 53 months and low-grade tumors had a better prognosis (P=0.02). A role for p53 and p16 overexpression in the formation of some PPSC, and p53 overexpression in the generation of precursor tubal pathology was identified. The high frequency of tubal pathology overexpressing p53 and low frequency of OSE and OCICs expressing either biomarker highlights a possible precursor role for the tube in some PPSC. Tumor grade was the only significant prognostic factor.
Nucleotide Sequence and Spatiotemporal Expression of the Vibrio cholerae vieSAB Genes during Infection

ABSTRACT The iviVII gene of Vibrio cholerae was previously identified by a screen for genes induced during intestinal infection. In the present study, nucleotide sequence analysis revealed that iviVII is a 1,659-bp open reading frame, herein designated vieB, that is predicted to be last in a tricistronic operon (vieSAB). The deduced amino acid sequence of VieS exhibited similarity to the sensor kinase component, and those of VieA and VieB were similar to the response regulator components, respectively, of the two-component signal transduction family. Analysis of transcriptional fusions to a site-specific DNA recombinase reporter, tnpR, revealed that vieSand vieA are transcribed during in vitro growth in avieAB-independent and vieA-dependent manner, respectively. In contrast, transcription of vieB occurred exclusively during infection and was not dependent upon VieB. We conclude that the vieSAB genes are differentially regulated, at least during laboratory growth. Use of a V. cholerae strain harboring avieB::tnpR transcriptional fusion allowed the kinetics and location of vieB expression within the intestine to be determined. We found that vieBtranscription is induced shortly after infection of the proximal and mid-small intestine.
Emergency medicine quality improvement and patient safety curriculum.

ACADEMIC EMERGENCY MEDICINE 2010; 17:e110–e129 © 2010 by the Society for Academic Emergency Medicine Preface All of us who have worked on this curriculum are career emergency physicians (EPs) who have become leaders with a focus on emergency medicine (EM) quality and safety. About 2 years ago, I approached my colleagues of the American College of Emergency Physicians Quality Improvement and Patient Safety (ACEP QIPS) Section and dreamed an idea of creating an EM quality and safety curriculum: an outline that would explain a topic few EPs understand. That outline would be used as a curriculum to teach our EM residents (and even our attendings, physician’s assistants, and nurse leaders) about EM quality and safety. My goal is for this curriculum to become an integral part of every EM residency program and department. We know that quality and safety in patient care does not happen by accident. We must teach these concepts to everyone on our emergency department (ED) team. The safety of our patients depends on this. I would like to thank each of the authors who spent many months on this project, along with the ACEP QIPS Section and ACEP Quality and Performance Committee. Also, I would like to thank ACEP staff Angela Franklin and Idania Lorenti for their help in getting this project to completion. I must also sincerely acknowledge the early work and ideas generated by Drs. Shari Welch and David John: their contributions clearly helped shape this article. —John J. Kelly, DO
One-year mortality in critically ill patients by severity of kidney dysfunction: a population-based assessment.

BACKGROUND Kidney dysfunction in the intensive care unit (ICU) results in increased morbidity, mortality, and health care costs; however, long-term mortality has not been described across strata of severity in kidney dysfunction. METHODS The primary objective is to describe and assess factors associated with 1-year mortality in critically ill patients stratified by severity of kidney dysfunction during admission to the ICU. Kidney dysfunction is defined by peak serum creatinine values and stratified by: (1) no dysfunction (creatinine < 1.7 mg/dL [<150 micromol/L]), (2) mild dysfunction (creatinine, 1.7 to 3.4 mg/dL [150 to 299 micromol/L]), (3) moderate dysfunction (creatinine >or= 3.4 mg/dL [>or= 300 micromol/L]), (4) severe acute dysfunction requiring renal replacement therapy (acute renal failure), or (5) preexisting end-stage kidney disease. Population-based surveillance was of adult residents of the Calgary Health Region (population, 1 million) admitted to any multidisciplinary ICU and a cardiovascular surgery ICU from May 1, 1999, to April 30, 2002. RESULTS Of 5,693 admissions, 62% were men, median age was 64.9 years (interquartile range, 50.6 to 74.5 years), and mean Acute Physiology and Chronic Health Evaluation (APACHE) II score was 24.9 +/- 8.7 (SD). Case fatality rates stratified by renal dysfunction were 17% (763 of 4,411), 47% (370 of 790), 48% (77 of 160), 64% (153 of 240), and 40% (37 of 92) for no, mild, and moderate dysfunction; severe acute renal failure; and end-stage kidney disease, respectively. By means of multivariate analysis, 1-year mortality was associated independently with advancing age, medical diagnosis, higher APACHE II score, and presence and severity of kidney dysfunction, although no difference was evident comparing those with mild to moderate dysfunction. End-stage kidney disease was not associated independently with 1-year mortality. CONCLUSION Severity of kidney dysfunction in patients in the ICU is associated with an incremental increase in long-term mortality. Although patients classified with either mild or moderate kidney dysfunction had an increased risk for death, use of serum creatinine level alone was poor at discriminating long-term outcome, suggesting this measure alone should not be used for defining long-term prognosis.
A Comprehensive and Harmonized Digital Forensic Investigation Process Model

Performing a digital forensic investigation (DFI) requires a standardized and formalized process. There is currently neither an international standard nor does a global, harmonized DFI process (DFIP) exist. The authors studied existing state‐of‐the‐art DFIP models and concluded that there are significant disparities pertaining to the number of processes, the scope, the hierarchical levels, and concepts applied. This paper proposes a comprehensive model that harmonizes existing models. An effort was made to incorporate all types of processes proposed by the existing models, including those aimed at achieving digital forensic readiness. The authors introduce a novel class of processes called concurrent processes. This is a novel contribution that should, together with the rest of the model, enable more efficient and effective DFI, while ensuring admissibility of digital evidence. Ultimately, the proposed model is intended to be used for different types of DFI and should lead to standardization.
Efficacy & safety evaluation of Ayurvedic treatment (Ashwagandha powder & Sidh Makardhwaj) in rheumatoid arthritis patients: a pilot prospective study

Background & objectives: In the traditional system of medicine in India Ashwagandha powder and Sidh Makardhwaj have been used for the treatment of rheumatoid arthritis. However, safety and efficacy of this treatment have not been evaluated. Therefore, the present study was carried out to evaluate the efficacy and safety of Ayurvedic treatment (Ashwagandha powder and Sidh Makardhwaj) in patients with rheumatoid arthritis. Methods: One hundred and twenty five patients with joint pain were screened at an Ayurvedic hospital in New Delhi, India. Eighty six patients satisfied inclusion criteria and were included in the study. Detailed medical history and physical examination were recorded. Patients took 5g of Ashwagandha powder twice a day for three weeks with lukewarm water or milk. Sidh Makardhwaj (100 mg) with honey was administered daily for the next four weeks. The follow up of patients was carried out every two weeks. The primary efficacy end point was based on American College of Rheumatology (ACR) 20 response. Secondary end points were ACR50, ACR70 responses, change from baseline in disease activity score (DAS) 28 score and ACR parameters. Safety assessments were hepatic function [alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), bilirubin and ß2 microglobulin], renal function (urea and creatinine and NGAL) tests and urine mercury level. Results: The study was completed by 90.7 per cent (78/86) patients. Patients with moderate and high disease activity were 57.7 per cent (45/78) and 42.3 per cent (33/78), respectively. All patients were tested positive for rheumatoid factor and increased ESR level. Ashwagandha and Sidh Makardhwaj treatment decreased RA factor. A significant change in post-treatment scores of tender joint counts, swollen joint counts, physician global assessment score, patient global assessment score, pain assessment score, patient self assessed disability index score and ESR level were observed as compared to baseline scores. ACR20 response was observed in 56.4 per cent (44/78) patients (American College of Rheumatology criteria) and moderate response in 39.74 per cent (31/78) patients [European League Against Rheumatism (EULAR) criteria]. Ayurvedic treatment for seven weeks in rheumatoid arthritis patients showed normal kidney and liver function tests. However, increased urinary mercury levels were was observed after treatment. Interpretation & conclusions: The findings of the present study suggest that this Ayurvedic treatment (Ashwagandha powder and Sidh Makardhwaj) has a potential to be used for the treatment of rheumatoid arthritis. However, due to small sample size, short duration, non randomization and lack of a control group as study limitations, further studies need to be done to confirm these findings.
Liver stem cells: when the going gets tough they get going

The ability of the liver to regenerate is widely acknowledged, and this is usually accomplished by the entry of normally proliferatively quiescent hepatocytes into the cell cycle. However, when hepatocyte regeneration is impaired, small bile ducts proliferate and invade into the adjacent hepatocyte parenchyma. In humans and experimental animals these ductal cells are referred to as oval cells, and their association with defective regeneration has led to the belief that they are the progeny of facultative stem cells. Oval cells are of great biological interest since they may represent a target population for hepatic carcinogens, and they may also be useful vehicles for ex vivo gene therapy for the correction of inborn errors of metabolism.
Corporate Governance and Firm Performance: A Case study of Karachi Stock Market

This paper seeks to study the relationship between corporate governance and firms performance of twenty five companies listed at Karachi Stock Market. The performance of corporate governance is analyzed through whereas the performance of the companies is measured by return on assets (ROA) and return on equity (ROE). The data set is obtained from the State Bank of Pakistan Annual Reports for the year 2011-2015. The multiple regression models are applied to check the significance of corporate governance and firm profit. The result shows that leverage and growth have a positive relationship between impacts in measure performance of the firm.
Bacteriological Analysis of Diabetic Foot infection

Bacteriological analysis and clinical grading of 113 patients with diabetic foot lesions revealed polymicrobial aetiology in 96 (85%) and single aetiology in 16 (14%) patients. A total of 290 organisms (223 aerobes and 67 anaerobes) were isolated and an average of 2.56 isolates per case was reported. In this study, Staphylococcus aureus among the gram-positive and Pseudomonas aeruginosa among the gram negative were the predominantly isolated organisms. Among anaerobes, gram positive cocci were the predominant (69%) with Peptostreptococcus species being the leading isolate. Antimicrobial sensitivity pattern of the isolates is discussed in detail.
Detecting Opioid-Related Aberrant Behavior using Natural Language Processing

The United States is in the midst of a prescription opioid epidemic, with the number of yearly opioid-related overdose deaths increasing almost fourfold since 20001. To more effectively prevent unintentional opioid overdoses, the medical profession requires robust surveillance tools that can effectively identify at-risk patients. Drug-related aberrant behaviors observed in the clinical context may be important indicators of patients at risk for or actively abusing opioids. In this paper, we describe a natural language processing (NLP) method for automatic surveillance of aberrant behavior in medical notes relying only on the text of the notes. This allows for a robust and generalizable system that can be used for high volume analysis of electronic medical records for potential predictors of opioid abuse.
Constitutive and In fl ammatory Immunopeptidome of Pancreatic b-Cells

Type 1 diabetes is characterized by the autoimmune destruction of pancreatic b-cells. Recognition of major histocompatibility complex (MHC)-bound peptides is critical for both the initiation and progression of disease. In this study, MHC peptide complexes were purified from NIT-1 b-cells, interferon-g (IFN-g)-treated NIT-1 cells, splenic and thymic tissue of 12-week-old NOD mice, and peptides identified by mass spectrometry. In addition to global LC-MS/MS analysis, the targeted approach of multiplereaction monitoring was used to quantitate the immunodominant K-restricted T-cell epitope islet-specific glucose-6-phosphatase catalytic subunit-related protein (IGRP)206–214. We identified . 2,000 MHC-bound peptides; 1,100 of these presented by b-cells grown under normal conditions or after exposure to IFN-g. These include sequences from a number of known autoantigens. Quantitation of IGRP206–214 revealed low-level presentation by K d (;25 complexes/cell) on NIT-1 cells after IFN-g treatment compared with the simultaneous presentation of the endogenously processed K-restricted peptide Janus kinase-1355–363 (;15,000 copies/cell). We have successfully sequenced peptides from NIT-1 b-cells under basal and inflammatory conditions. We have shown the feasibility of quantitating disease-associated peptides and provide the first direct demonstration of the disparity between presentation of a known autoantigenic epitope and a common endogenously presented peptide.
Towards QoS-Aware Fog Service Placement

Fog computing provides a decentralized approach to data processing and resource provisioning in the Internet of Things (IoT). Particular challenges of adopting fog-based computational resources are the adherence to geographical distribution of IoT data sources, the delay sensitivity of IoT services, and the potentially very large amounts of data emitted and consumed by IoT devices. Despite existing foundations, research on fog computing is still at its very beginning. A major research question is how to exploit the ubiquitous presence of small and cheap computing devices at the edge of the network in order to successfully execute IoT services. Therefore, in this paper, we study the placement of IoT services on fog resources, taking into account their QoS requirements. We show that our optimization model prevents QoS violations and leads to 35% less cost of execution if compared to a purely cloud-based approach.
A marginalized conditional linear model for longitudinal binary data when informative dropout occurs in continuous time

Within the pattern-mixture modeling framework for informative dropout, conditional linear models (CLMs) are a useful approach to deal with dropout that can occur at any point in continuous time (not just at observation times). However, in contrast with selection models, inferences about marginal covariate effects in CLMs are not readily available if nonidentity links are used in the mean structures. In this article, we propose a CLM for long series of longitudinal binary data with marginal covariate effects directly specified. The association between the binary responses and the dropout time is taken into account by modeling the conditional mean of the binary response as well as the dependence between the binary responses given the dropout time. Specifically, parameters in both the conditional mean and dependence models are assumed to be linear or quadratic functions of the dropout time; and the continuous dropout time distribution is left completely unspecified. Inference is fully Bayesian. We illustrate the proposed model using data from a longitudinal study of depression in HIV-infected women, where the strategy of sensitivity analysis based on the extrapolation method is also demonstrated.