Miracle-dz/UniFAR-FTUs huggingface dataset:
Comparative evaluation of ERCP and endosonography in the diagnosis of extrahepatic biliary obstruction and a suggested algorithm.

BACKGROUND/AIMS Endosonography is an effective diagnostic tool for evaluating pancreatobiliary diseases. However, it is scarcely used in our healthcare system because of limited resources and scarcity of trained personnel. The aim of this study was to evaluate the role of endosonography in patients presenting with extrahepatic biliary obstruction in the Indian subcontinent. METHODS Fifty consecutive patients presenting with suspected obstructive jaundice of unknown cause were enrolled in the study. All the patients underwent abdominal ultrasound followed by endosonography and finally endoscopic retrograde cholangiopancreatography. Final diagnosis was obtained on endoscopic retrograde cholangiopancreatography or surgery, where indicated. RESULTS Twenty-six patients had malignant cause for extrahepatic biliary obstruction and 24 patients had non-malignant cause for extrahepatic biliary obstruction. The etiological diagnosis was established by endosonography in 23/26 patients with malignant cause for extrahepatic biliary obstruction compared to in 21/26 patients with endoscopic retrograde cholangiopancreatography. For non-malignant cases of extrahepatic biliary obstruction, endosonography and endoscopic retrograde cholangiopancreatography were equally accurate (23/24 patients) in providing the correct etiological diagnosis. CONCLUSIONS Endosonography and endoscopic retrograde cholangiopancreatography are equally efficient for diagnosing the cause of extrahepatic biliary obstruction. The evaluation of patients presenting with cholestasis should be based on careful clinical judgment supported by baseline investigations to suggest likely malignant or non-malignant etiology. Endosonography as first approach should be followed in patients with suspected malignant cause of extrahepatic biliary obstruction. Endoscopic retrograde cholangiopancreatography should be performed first in patients with suspected non-malignant cause of extrahepatic biliary obstruction.
Overdue invoice forecasting and data mining

The account receivable is one of the main challenges in the business operation. With poor management of invoice to cash collection process, the over due invoice may pile up, and the increasing amount of unpaid invoice may lead to cash flow problems. In this thesis, I addressed the proactive approach to improving account receivable management using predictive modeling. To complete the task, I built supervised learning models to identity the delayed invoices in advance and made recommendations on improving performance of order to cash collection process. The main procedures of the research work are data cleaning and processing, statistical analysis, building machine learning models and evaluating model performance. The analytical and modeling of the study are based on the real-world invoice data from a Fortune 500 company. The thesis also discussed approaches of dealing with imbalanced data, which includes sampling techniques, performance measurements and ensemble algorithms. The invoice data used in this thesis is imbalanced, because on-time invoice and delayed invoice classes are not approximately equally represented. The cost sensitivity learning techniques demonstrates favorable improvement on classification results. The results of the thesis reveal that the supervised machine learning models can predict the potential late payment of invoice with high accuracy. Thesis Supervisor: David Simchi-Levi Title: Professor of Civil and Environmental Engineering
Development and Validation of the Dissociative Symptoms Scale

The Dissociative Symptoms Scale (DSS) was developed to assess moderately severe levels of depersonalization, derealization, gaps in awareness or memory, and dissociative reexperiencing that would be relevant to a wide range of clinical populations. Structural analyses of data from four clinical and five nonclinical samples (N = 1,600) yielded four factors that reflected the domains of interest and showed good fit with the data. Sample scores were consistent with expectations and showed very good internal consistency and temporal stability. Analyses showed consistent evidence of convergent and divergent validity, and posttrauma elevations in scores and in patients with posttraumatic stress disorder provided additional evidence of construct validity. Item response theory analyses indicated that the items assessed moderately severe dissociative experiences. Overall, the results provide support for the reliability and validity of DSS total and subscale scores in the populations studied. Further work is needed to evaluate the performance of the DSS relative to structured interview measures and in samples of patients with other psychological disorders.
An Underlying Common Factor, Influenced by Genetics and Unique Environment, Explains the Covariation Between Major Depressive Disorder, Generalized Anxiety Disorder, and Burnout: A Swedish Twin Study

Depression and anxiety are highly comorbid due to shared genetic risk factors, but less is known about whether burnout shares these risk factors. We aimed to examine whether the covariation between major depressive disorder (MDD), generalized anxiety disorder (GAD), and burnout is explained by common genetic and/or environmental factors. This cross-sectional study included 25,378 Swedish twins responding to a survey in 2005–2006. Structural equation models were used to analyze whether the trait variances and covariances were due to additive genetics, non-additive genetics, shared environment, and unique environment. Univariate analyses tested sex limitation models and multivariate analysis tested Cholesky, independent pathway, and common pathway models. The phenotypic correlations were 0.71 (0.69–0.74) between MDD and GAD, 0.58 (0.56–0.60) between MDD and burnout, and 0.53 (0.50–0.56) between GAD and burnout. Heritabilities were 45% for MDD, 49% for GAD, and 38% for burnout; no statistically significant sex differences were found. A common pathway model was chosen as the final model. The common factor was influenced by genetics (58%) and unique environment (42%), and explained 77% of the variation in MDD, 69% in GAD, and 44% in burnout. GAD and burnout had additive genetic factors unique to the phenotypes (11% each), while MDD did not. Unique environment explained 23% of the variability in MDD, 20% in GAD, and 45% in burnout. In conclusion, the covariation was explained by an underlying common factor, largely influenced by genetics. Burnout was to a large degree influenced by unique environmental factors not shared with MDD and GAD.
Effects of Alkaline Combined with Ultrasonic Pretreatment and Enzymatic Hydrolysis of Agricultural Wastes for High Reducing Sugar Production

The effects of six pretreatments of five agricultural wastes (corn cob, pineapple waste, bagasse, rice straw and water hyacinth) on the chemical composition and total reducing sugar yield were investigated. Six pretreatments were: 1% NaOH with ultrasound for 60 min; 1% NaOH with ultrasound 100% duty; 2% NaOH with ultrasound for 60 min; 2% NaOH with ultrasound 100% duty cycle; 1% NaOH by standing in the oven at 60°C for 90 min; and 2% NaOH by standing in the oven at 60°C for 90 min. Among them, the highest cellulose content of 55.15% was obtained from bagasse by pretreating with 1% NaOH with ultrasound 100% duty cycle. It subsequently yielded the highest total reducing sugar of 36.21% (36.21 g reducing sugar/100 g substrate). The lignin content of all samples significantly decreased, but ultrasonic pretreatment increased the cellulose content. However, the best pretreatment method for each sample was different. Based on SEM analysis, the morphologies of all samples were changed after pretreatment. In addition, the increase of enzyme loading from 250 to 550 CMC U/g biomass led to more than 20% increase in the total reducing sugar. It was found that the higher enzyme loading (700 CMC U/g dried biomass) did not improve the total reducing sugar for all samples.
Evaluation of alternative methods for using LiDAR to predict aboveground biomass in mixed species and structurally complex forests in northeastern North America

Light detection and ranging (LiDAR) has become a common means for predicting key forest structural attributes, but comparisons of alternative statistical methods and the spatial extent of LiDAR metrics extraction on independent datasets have been minimal. The primary objective of this study was to assess the performance of local and non-local LiDAR aboveground biomass (AGB) prediction models at two locations in the Acadian Forest. Two common statistical techniques, nonlinear mixed effects (NLME) and random forest (RF), were used to fit the prediction models and compared. Finally, this study evaluated the influence of alternative plot radii for LiDAR metrics extraction on model fit and prediction accuracy. AGB models were independently developed at each forest and tested both locally (model applied to same forest used for development) and non-locally (model applied to different forest) using an extensive network of ground-based plots. In general, RF was found to outperform NLME when applied locally, but the differences between the approaches were negligible when applied to the non-local dataset. NLME was found to perform equally well locally and non-locally. LiDAR extraction radius had very little influence on model performance as well. Minimal differences between models developed using fixed- and variable-radius methods were found, while the optimal LiDAR extraction radius was not consistent among forests, statistical technique, or local vs. non-local. Overall, the results highlight the importance of a robust calibration dataset that covers the full range of observed variation for developing accurate prediction models based on remote sensing data.
Directed mutagenesis of the Rhodobacter capsulatus puhA gene and orf 214: pleiotropic effects on photosynthetic reaction center and light-harvesting 1 complexes

Rhodobacter capsulatus puhA mutant strains containing either a nonpolar, translationally in-frame deletion or a polar insertion of an antibiotic resistance cartridge were constructed and evaluated for their photosynthetic growth properties, absorption spectroscopy profiles, and chromatophore protein compositions. Both types of mutants were found to be incapable of photosynthetic growth and deficient in the reaction center (RC) and light-harvesting 1 (LH1) complexes. The translationally in-frame puhA deletion strains were restored to the parental strain phenotypes by complementation with a plasmid containing the puhA gene, whereas the polar puhA mutants were not. Analogous nonpolar and polar disruptions of orf 214 (located immediately 3' of the puhA gene) were made, and the resultant mutant strains were evaluated as described above. The strain containing the nonpolar deletion of orf 214 exhibited severely impaired photosynthetic growth properties and had greatly reduced levels of the RC and LH1 complexes. Complementation of this strain with a plasmid that expressed orf 214 from the nifHDK promoter restored photosynthetic growth capability, as well as the RC and LH1 complexes. The polar disruption of orf 214 yielded cells that were incapable of photosynthetic growth and had even lower levels of the RC and LH1 complexes, and complementation in trans with orf 214 only marginally improved these deficiencies. These results indicate that orf 214 and at least one additional gene located 3' of orf 214 are required to obtain the RC and LH1 complexes, and transcription read-through from the puhA superoperon is necessary for optimal expression of these new photosynthesis genes.
From Teacher Isolation to Teacher Collaboration: Theoretical Perspectives and Empirical Findings.

This study aims at: (1) reviewing the underlying causes of teacher isolation; (2) unreavelling the negative effects of isolation on teachers’ professional and personal life; (2) illustrating different modes of voluntary collaboration among teachers; (4) presenting substantive evidence is support of collaboration as an efficient mode of professional development, and (5) drawing implications for practice. Since collaboration leads to professional development and academic satisfaction, it is suggested that schools: (1) be structured in ways that maximize collaborative discussion among teachers; (2) create conditions taht are conducive to growth and development for both teachers and learners; (3) reinforce study groups which aim at making teachers reflect on their current beliefs and practices and chane them for the better; (4) move away from the once-popular teacher training courses towards teacher study groups, peer observation of teaching and mentoring, which are conducive to constructing knowledge rather than passively receiving knowledge. The review has many other clear implications for pracatitioners and other stakeholders.
Prognosis of patients with ventricular fibrillation in out-of-hospital cardiac arrest in Hong Kong: prospective study.

OBJECTIVE To determine the prognosis of patients with ventricular fibrillation in out-of-hospital cardiac arrest in Hong Kong and examine its relationship with the other links in the chain of survival. DESIGN Prospective descriptive study. SETTING Three accident and emergency departments, Hong Kong. PARTICIPANTS Patients older than 18 years with non-traumatic out-of-hospital cardiac arrest who were transported to the hospitals by ambulance between 15 March 1999 and 15 October 1999. MAIN OUTCOME MEASURES Demographic data, characteristics of the cardiac arrest and the response times of the emergency medical service according to the Utstein style, and survival to hospital discharge rate. RESULTS Three hundred and twenty patients were included. The incidence of ventricular fibrillation in this group of patients was 14.1%. The chance of survival to hospital discharge was significantly higher for patients with ventricular fibrillation than those with other rhythms of cardiac arrest (4.4% versus 0.7%). Approximately 40.0% of all cardiac arrests were witnessed. The bystander cardiopulmonary resuscitation rate was low at 15.6%. The median intervals for recognition to activation of the emergency medical service, time to cardiopulmonary resuscitation, time to defibrillation, and time to advanced life support were 1, 8, 9, and 27 minutes, respectively. CONCLUSION Patients with ventricular fibrillation in out-of-hospital cardiac arrest have a better chance of survival than those with other cardiac rhythms. Further improvement requires simultaneous strengthening of all four links in the chain of survival.
Culture and Implicit Self-Esteem

One explanation for the lower self-esteem of East Asians is that they have dialectical, or inconsistent, self-esteem in that they endorse both the positively and the negatively keyed items of the Rosenberg Self-Esteem Scale, relative to Euro-Americans. The following research extended this effect to implicit self-esteem. In two studies, Chinese, Euro-Americans (Studies 1 and 2), and Chinese Americans (Study 2) completed explicit and implicit measures of self-esteem. On both types of measures, Chinese scored most highly on various indices of dialectical self-esteem. In Study 2, the explicit self-esteem of Chinese Americans was similar to that of Chinese, but their implicit self-esteem was identical to that of Euro-Americans. In the discussion, we focus on how East Asians come to possess inconsistent self-esteem and pose questions for future research.
Gender‐associated differences in matriculating and graduating medical students

Data from the 1993 Matriculating Student Questionnaire (MSQ) and the 1994 Medical School Graduation Questionnaire (GQ) of the Association of American Medical Colleges were investigated for differences in responses between men and women. Notable differences were discovered, particularly with regard to career plans and experiences during medical school. Findings from the GQ include that a higher proportion of women rated curricular coverage of numerous subjects inadequate and that women students more frequently reported mistreatment during medical school. Women were also more likely than men to work in clinics serving the indigent and to complete a primary care clerkship. Over 30% of the 1994 women seniors, compared with 18% of the men, planned to pursue generalist careers. The authors discuss the gender-associated differences, with reference to previous studies, and conclude that medical educators should ensure that women have access to the same skill-development opportunities that men do and to a humane learning environment. Moreover, educators should examine what adaptations can encourage students of both genders to develop an ethic of “social responsibility. ”
Comparison of Sequential Protocol using Basiliximab versus Antithymocyte Globulin with High-Dose Mycophenolate Mofetil in Recipients of a Kidney Graft from an Expanded-Criteria Donor

This retrospective pilot study investigated use of high-dose mycophenolate mofetil with biological induction and sequential introduction of low-dose cyclosporine in recipients of expanded criteria donor (ECD) kidneys. Fifty-four patients received mycophenolate mofetil 3 g/day for 45 days, cyclosporine 4 mg/kg/day, prednisolone, and rabbit antithymocyte globulin (rATG, n=14) or basiliximab (n=40). Acute rejection incidence was 11.3% (7.1% with rATG, 12.6% with basiliximab). Delayed graft function was observed in 31 patients (54%). At one year, measured glomerular filtration rate was 54±4 ml/min, with no significant differences between induction therapies. Thirty patients (55%) required ≥1 MMF dose reduction within month 1 due to adverse events (gastrointestinal symptoms, 67%; leucopenia 33%). Leucopenia was more frequent with rATG, while gastrointestinal symptoms were more frequent with basiliximab. Cytomegalovirus replication occurred in three patients (23%) with rATG and 3 (8%) with basiliximab. In conclusion, high-dose MMF, corticosteroids, delayed low-dose cyclosporine and induction therapy offers an excellent risk-to-benefit ratio in patients receiving an ECD allograft.
Cystatin C as a Marker of Renal Function is Affected by HIV Replication Leading to an Underestimation of Kidney Function in HIV Patients

Background Broad use of tenofovir and an ageing HIV-infected population have created an interest in renal function in HIV patients. Serum cystatin C is a newer marker of renal function and might be more sensitive than creatinine. Methods Patients were enrolled consecutively in an observational study. HIV-seropositive patients naive to antiretroviral therapy (n=261) were compared with healthy volunteers undergoing check-up procedures (n=193). Estimated glomerular filtration rate (eGFR) was derived using creatinine-based Modification of Diet in Renal Disease (MDRD) and Cockcroft–Gault formulas or cystatin C-based calculations. HIV-seropositive patients starting antiretroviral therapy (n=92) were followed prospectively after enrolment. Results MDRD showed a higher median eGFR in antiretroviral- naive HIV-seropositive patients compared with controls (104 versus 93 ml/min; P<0.001). Cockcroft–Gault gave similar results (118 versus 106 ml/min; P<0.001). By contrast, cystatin C levels in HIV-seropositive individuals were higher, resulting in a lower median eGFR compared with controls (99 versus 120 ml/min; P<0.001). Cystatin C was positively correlated with HIV RNA (r=0.33, P<0.01) and inversely correlated with CD4+ T-cell count (r=-0.29, P<0.01). Initiating antiretroviral therapy (n=92) decreased cystatin C levels and led to an increased cystatin C-based eGFR from median 84 to 103 ml/min at week 24 (P<0.001). Serum creatinine was not substantially altered. Conclusions Correlation of cystatin C with HIV RNA and CD4+ T–cell count, plus decrease of cystatin C after suppression of HIV replication, suggest an increase of cystatin C levels by active HIV infection. This might result in overestimation of renal impairment, particularly in treatment-naive patients. Therefore, use of cystatin C to calculate GFR in HIV-seropositive individuals should not be recommended without further validation.
Random Walk Null Models for Time Series Data

Permutation entropy has become a standard tool for time series analysis that exploits the temporal and ordinal relationships within data. Motivated by a Kullback–Leibler divergence interpretation of permutation entropy as divergence from white noise, we extend pattern-based methods to the setting of random walk data. We analyze random walk null models for correlated time series and describe a method for determining the corresponding ordinal pattern distributions. These null models more accurately reflect the observed pattern distributions in some economic data. This leads us to define a measure of complexity using the deviation of a time series from an associated random walk null model. We demonstrate the applicability of our methods using empirical data drawn from a variety of fields, including to a variety of stock market closing prices.
Mono and Bi-ventricular Assistance: Their Effect on Ventricular Energetics

When mono- and bi-ventricular mechanical assistance is used for heart recovery, its control strategy and circulatory variables affect ventricular energetics (external work-EW, oxygen consumption-VO2, cardiac mechanical efficiency-CME). This study is based on the data obtained in vitro and presents an analysis of the effects of the mono- and bi-ventricular mechanical assistance on ventricular energetics. The assistance was conducted on the principle of counterpulsation with atrio-arterial connection. It includes the following stages: 1) the characterisation of the isolated ventricle model in terms of EW, VO2 and CME as a function of the filling pressure and peripheral resistance, 2) modelling of left ventricular and pulmonary dysfunction, followed by left ventricular and bi-ventricular assistance. Experimental data enable us to draw the following conclusions: • in general, the greatest hemodynamic improvement does not correspond to the highest energetic improvement, • LVAD assistance deteriorates left ventricular CME while its effect on right ventricular energetics depends on the value of right ventricular elastance (Emax). Right ventricular CME is deteriorated by BVAD assistance irrespective of right Emax, • the energetics optimisation in bi-ventricular assistance is closely related to the right Emax, which could probably be a deciding factor in the choice of the assistance mode.
Inhibition of Metastatic Spread by I.C.R.F. 159: Selective Deletion of a Malignant Characteristic

Treatment with I.C. R.F. 159 completely inhibited metastasis formation in mice implanted with Lewis lung carcinoma at doses having little influence on the rate of growth of the primary implant. This inhibition was due to the effect of I.C. R.F. 159 on the development of blood vessels of the invading margins of the primary tumour. So far as is known, this is the first time a drug has induced a specific loss of the malignant characteristic of blood-borne tumour cell dissemination.
Declines in Auditory Vigilance during Periods of High Multiple-Task Activity

Five, 5-man crews of AFROTC students performed an auditory-vigilance task 4 hr. /day on each of 4 days while concurrently performing two other passive tasks and various combinations of three active tasks. In spite of the high level of multiple-task activity required, auditory-vigilance performance declined in the typical way during each 4-hr. duty period. This is interpreted as a demonstration of the inapplicability of an “activation-hypothesis” explanation of vigilance behavior.