Miracle-dz/UniFAR-FTUs huggingface dataset:
Emergent and Urgent Transfers to Neurosurgical Centers in Ontario

Abstract Critically ill neurosurgical patients require expedient access to neurosurgical centers (NC) to improve outcome. In regionalized health systems patients are often initially evaluated at a non-neurosurgical center (NNC) and are subsequently transferred to a NC using air or ground vehicles. We sought to identify barriers to accessing a NC for critically ill patients by analyzing interfacility transfer times and referral patterns in the province of Ontario. A retrospective observational analysis was undertaken. The cohort included patients in Ontario with emergent and urgent neurologic pathologies who underwent transfer from a NNC to NC between January 1, 2011 and December 31, 2013. Timing, clinical, and geographic data were collected for each transfer. We identified 1103 emergent/urgent transfers. The median transfer time to a NC was 3.4 h (IQR –2.2, 3.8) and varied by the geographic region of origin. A total of 17% of the patients bypassed a closer NC during transfer to their destination NC. Transfers that bypassed a closer NC travelled further (101 miles vs. 296 miles, p < 0.001), took longer (3.1 h vs. 3.9 h, p < 0.001), and in some regions were associated with a higher risk of in-transit clinical decline (3.0% vs. 8.3%, p < 0.05) when compared with transfers that ended at the closest NC. Regionalization of neurosurgical services in Ontario has led to heavy reliance upon patient transfers to maintain continuity of care. Access to a NC varied across the province, which may represent regional differences in neurosurgical bed availability, resource limitations at smaller NCs, or environmental factors. Our descriptions of referral patterns and transport times can guide health system planning in Ontario and similar jurisdictions in the United States and Canada.
Regular aquatic exercise for chronic kidney disease patients: a 10-year follow-up study

Chronic kidney disease (CKD) patients not yet in dialysis can benefit from increased physical activity; however, the safety and outcomes of aquatic exercise have not been investigated in observational studies. The aim of this study was to analyze association of 10 years of regularly performed aquatic exercise with the study endpoint – that is, all-cause death or start of dialysis. Consecutive CKD patients were included in the study in January 2002. The exercise group (n=7) exercised regularly under the supervision of physiotherapist for 10 years; the control group (n=9), matched in terms of age and clinical parameters, remained sedentary. Low-intensity aerobic aquatic exercise was performed regularly twice a week; 32 weeks or more of exercise therapy sessions were conducted annually. None of the members of the aquatic exercise group reached dialysis or died in 10 years. In the sedentary control group, 55% reached the study endpoint – renal replacement therapy (n=2) or all-cause death (n=3). Occurrence of the study endpoint, compared using the exact multinomial test with unconditional margins, was statistically significantly different (P-value: 0.037) between the study groups. Regular supervised aquatic exercise arrested CKD progression. There was a statistically significant difference between the sedentary group and the exercise group in reaching renal replacement therapy or all-cause death in a follow-up time of 10 years.
Leptin is required for fibrogenic responses induced by thioacetamide in the murine liver

In this study, we investigated hepatic fibrogenesis caused by long‐term thioacetamide (TAA) administration in ob/ob mice, a naturally occurring leptin deficient animal. In the lean littermates, prominent hepatic fibrosis, as well as positive staining for α smooth muscle actin (α‐SMA), was induced by treatment with TAA (200 μg/g, IP, 3 times per week) for 4 to 8 weeks as expected. In sharp contrast, almost no hepatic fibrosis developed in ob/ob mice given the equivalent doses of TAA, where specific staining for α‐SMA barely was detected. Induction of α1(I) procollagen mRNA caused by TAA also was prevented in ob/ob mice almost completely. Further, transforming growth factor β (TGF‐β) mRNA was increased in the liver after TAA treatment for 4 weeks in lean littermates, which also was prevented in ob/ob mice. Interestingly, fibrotic septa in the hepatic lobules, as well as increases in α1(I) procollagen mRNA, was observed in ob/ob mice, when they were injected with recombinant murine leptin (1 μg/g daily) in combination with TAA treatment. Leptin per se did not cause any fibrotic changes in the liver in ob/ob mice. These findings clearly indicated that leptin deficiency is responsible for the resistance to TAA‐induced profibrogenic responses in ob/ob mice. In conclusion, leptin appears to promote profibrogenic responses in the liver, in part, by up‐regulation of TGF‐β.
Relationship of Left-Right Reversals to Academic Achievement

The study was designed to investigate the relationship of reversal of letters and numbers to academic achievement to decide if the tendency to reversal might be used to predict achievement. Two groups of 45 predominantly white third-grade students whose chronological ages were 9.0 yr. or above were administered the California Achievement Tests and the Jordan Left-Right Reversal Test. A statistical comparison was made using scaled scores on the California Achievement Tests and raw errors on the Jordan Left-Right Reversal Test. Reversal was significantly correlated with academic achievement. Children who exhibit reversals at 9 yr. of age or older may be expected to perform less well academically than children who do not reverse letters.
Long-Term Results of Photodynamic Therapy for Choroidal Neovascularization in Pediatric Patients with Best Vitelliform Macular Dystrophy

Abstract Purpose: To report long-term results of photodynamic therapy (PDT) in young patients affected by Best vitelliform macular dystrophy (VMD) complicated by choroidal neovascularization (CNV). Methods: We evaluated a group of 30 VMD patients with confirmed mutations in the BEST1 gene. Five of these patients had been diagnosed with CNV when younger than 15 years of age and three of them were treated by PDT. After the treatment they were followed for an average period of 77 months (range 62–99). Results: In all the treated eyes visual acuity was stable during the first year of follow-up and then slowly improved even some years after the treatment. The improvement in visual acuity was associated with the development of fibrous tissue in the macula. Conclusions: PDT was a safe procedure in our series of pediatric patients with VMD complicated by CNV. It was followed by a CNV regression and a consequent improvement in visual acuity which continued to progress even several years after the treatment.
Letter: Changes in dermoscopic features in superficial basal cell carcinomas treated with imiquimod.

Imiquimod is a topical immunomodulator shown to be effective in the treatment of basal cell carcinoma (BCC). We recently demonstrated complete clinical response to imiquimod treatment in 93.3% of superficial BCCs (sBCCs) and in 52.6% of nodular BCCs. Treatment consisted of topical application of 5% imiquimod cream once daily three times a week, until the BCC lesion was clinically cleared or until 12 weeks of treatment were completed.
Levetiracetam versus placebo in childhood and adolescent autism: a double-blind placebo-controlled study

The purpose of this study was to determine the safety and efficacy of the anticonvulsant levetiracetam in the treatment of children with autism. A previous open-label study in autistic children treated with levetiracetam demonstrated effectiveness in hyperactivity, impulsivity/aggression, and mood lability. Twenty patients with autism ranging from 5 to 17 years of age were entered into a 10-week, placebo-controlled, double-blind trial of levetiracetam versus placebo. The mean maximum dosage for levetiracetam was 862.50±279.19 mg/day. We evaluated global improvement of autism with the Clinical Global Impression-Improvement (CGI-I) Scale and aggression and affective instability with the Aberrant Behavior Checklist (ABC) parent and teacher ratings. We measured repetitive behaviors using the Children's Yale–Brown Obsessive–Compulsive Scale (CY-BOCS) score and impulsivity and hyperactivity with the Conners' Rating Scale-Revised: Long Version for parent and teacher. No significant difference was found between levetiracetam and placebo groups comparing the change in CGI-I (t=0.350, d.f.=13.621, P=0.765), nor on change in ABC, CY-BOCS or Conners' scales. These findings suggest that levetiracetam does not improve behavioral disturbances of autism, but are limited by the small sample size and lack of stratification of the autistic sample at baseline.
Significant numbers of apheresis‐derived group O platelet units have “high‐titer” anti‐A/A,B: implications for transfusion policy

Transfusion of group O single‐donor apheresis PLTs (SDP) to group A recipients has resulted in intravascular hemolysis and mortality. Owing to low availability of type‐specific SDPs, transfusion services sometimes issue ABO‐mismatched PLTs. After observing two cases of acute hemolysis following infusion of O SDPs to group A patients, where both recipient eluates revealed anti‐A specificity, a prospective study to determine the prevalence of “high‐titer” anti‐A/A,B in group O SDPs was commenced.
Evidence for the Presence of Simkania negevensis in Drinking Water and in Reclaimed Wastewater in Israel

ABSTRACT Simkania negevensis is a recently discovered chlamydia-like intracellular microorganism which has been associated with bronchiolitis in infants and with community-acquired pneumonia in adults; a high seroprevalence of antibodies to the microorganism has been found in various population groups. S. negevensis can be grown in various cell lines as well as in free-living amoebae such as Acanthamoeba polyphaga. In this study, evidence for the existence of Simkania or Simkania-like microorganisms in drinking water and in reclaimed wastewater is presented for the first time. Detection of the microorganism was made possible by the development of a specific and sensitive filter membrane immunoassay and was confirmed by PCR detection of microbial DNA in the water samples. The common presence of S. negevensis in water sources together with the high seroprevalence of antibodies to it and early age of acquisition of infection may implicate water as a source of infection. The possible significance of this finding for public health and for municipal water testing and treatment needs to be further examined.
Central coercion or local autonomy? A comparative analysis of policy instrument choice in refugee settlement policies

ABSTRACT Although existing literature on central–local governance includes comprehensive studies on how constitutional and financial frameworks regulate local government autonomy, this study seeks explanations for the introduction or absence of central coercion within these frameworks. The analysis studies six processes of policy instrument choice with different outcomes in Norway, Denmark and Sweden in the field of refugee settlement. It finds that a uniform perception of crisis and political compromises make political parties abandon their political–ideological standpoints relating to central–local governance. Additionally, the success and failure of political strategies of obfuscation and of dividing the opposition help to explain the different outcomes. The study reveals differences in the political salience of central–local governance in three countries that have systematically been categorised in the same groups in central–local studies. Consequently, more studies on how and why local autonomy is regulated within national frameworks are necessary to understand the actual autonomy that local governments enjoy.
Religiosity and Bank Asset Securitization

The global financial turmoil of 2007–2008 underlines the importance of understanding asset securitization, a process that allows banks to shed credit risk, fund their credit growth, and arbitrage capital requirements. Examining this ethically questionable activity has become crucial given its perceived long-term social impact. This paper examines the factors that motivate banks’ decisions to enter into asset securitization. In particular, we examine the influence of both organizational and geographic religiosity as important ethical parameters of economic choices on banks’ decisions to securitize their assets. We employ propensity scores using a unique database on asset securitization of banks in 22 countries during the period of 2003–2012. We find that both types of religiosity indicators are significantly associated with banks’ decisions to securitize. Banks located in countries with high religious importance scores show a lower likelihood to securitize. We also find that religiously adhered banks are likely to embark on a constrained model of securitization, which involves a high level of monitoring. In addition, our analysis suggests that religiously adhered banks are less likely to engage in asset securitization to reduce credit risk by shifting it to new investors. This conclusion is supported by their lower credit risk in the years before securitization. Alternatively, our results suggest that these banks embark on asset securitization to improve their financial and regulatory performance. Our study emphasizes the importance of considering religiosity as an important institutional factor and a monitoring mechanism in future global banking studies. Findings in this study are of importance to researchers, to local and international regulators, and to different stakeholders in the international banking sector.
Primary malignant melanoma of the bladder

Abstract Primary malignant melanomma of bladder is extremely rare: 18 cases are reported to date. An 82 year‐old man underwent trans‐urethral resection of bladder for a bleeding tumor of the posterior wall. Histological diagnosis was melanoma of the bladder. There was no history of previous or regressed cutaneous malignant melanoma. Margins of the bladder lesion contained atypical melanocytes similar to those commonly seen in the periphery of primary mucous membrane lesions. Clinical studies and radiological examinations were negative for other primary site of melanoma. The patient had a bladder recurrence that was consistent with primary tumor and died of widespread disease 9 months after diagnosis.
Differences in xylem and leaf hydraulic traits explain differences in drought tolerance among mature Amazon rainforest trees

Considerable uncertainty surrounds the impacts of anthropogenic climate change on the composition and structure of Amazon forests. Building upon results from two large‐scale ecosystem drought experiments in the eastern Brazilian Amazon that observed increases in mortality rates among some tree species but not others, in this study we investigate the physiological traits underpinning these differential demographic responses. Xylem pressure at 50% conductivity (xylem‐P50), leaf turgor loss point (TLP), cellular osmotic potential (πo), and cellular bulk modulus of elasticity (ε), all traits mechanistically linked to drought tolerance, were measured on upper canopy branches and leaves of mature trees from selected species growing at the two drought experiment sites. Each species was placed a priori into one of four plant functional type (PFT) categories: drought‐tolerant versus drought‐intolerant based on observed mortality rates, and subdivided into early‐ versus late‐successional based on wood density. We tested the hypotheses that the measured traits would be significantly different between the four PFTs and that they would be spatially conserved across the two experimental sites. Xylem‐P50, TLP, and πo, but not ε, occurred at significantly higher water potentials for the drought‐intolerant PFT compared to the drought‐tolerant PFT; however, there were no significant differences between the early‐ and late‐successional PFTs. These results suggest that these three traits are important for determining drought tolerance, and are largely independent of wood density—a trait commonly associated with successional status. Differences in these physiological traits that occurred between the drought‐tolerant and drought‐intolerant PFTs were conserved between the two research sites, even though they had different soil types and dry‐season lengths. This more detailed understanding of how xylem and leaf hydraulic traits vary between co‐occuring drought‐tolerant and drought‐intolerant tropical tree species promises to facilitate a much‐needed improvement in the representation of plant hydraulics within terrestrial ecosystem and biosphere models, which will enhance our ability to make robust predictions of how future changes in climate will affect tropical forests.
Sustainable management methods: performance assessment in large companies

The general objective of this study is to contribute to the understanding of the performance evaluation methods used by large companies. As specific objectives, we have the following: to identify the methods used and the importance attributed to them; to analyse their implementation process and the level of success given to it. The data collection method used was a survey to the financial managers of the largest companies in Portugal, which resulted in 35 valid responses. The main contributions of this study were the associations found between the following variables: the method used and the level of importance assigned to it; the person in charge of implementing the method and training provided to employees; the method used and the degree of success attributed to its implementation; the degree of resistance to change and the degree of success in implementing the performance evaluation method.
Service Imports, Workforce Composition, and Firm Performance: Evidence from Finnish Microdata

“Informality” is a term used to describe the collection of firms, workers, and activities that operate outside the legal and regulatory systems. It is widespread in the majority of developing countries—in a typical developing economy, the informal sector produces about 35 percent of gross domestic product and employs 70 percent of the labor force. This paper studies informality in the context of economic development by presenting a model and projections that link informality, regulations, migration, and economic growth. This analytical framework highlights the trade-offs between formality and informality, the relationship between the different types of informality, and the connection between them and the forces of labor, capital, and productivity growth. The paper models the behavior of the informal sector based on the following fundamental asymmetry: formal firms confront higher labor costs while informal firms face higher capital costs and lower productivity. Using mandated minimum wages as the policy-induced distortion, the model first studies the static allocation of formal and informal capital and labor in a modern economy. Second, it opens the possibility of labor migration from a rudimentary economy with an ample supply of labor (rural areas or less advanced neighboring countries). Third, the model analyzes the dynamic behavior of the formal and informal sectors, considering how they affect and are affected by economic growth and labor migration. Then, the paper presents projections for the size of labor informality, in the modern and rudimentary economies, in the next two decades for a large group of countries representing all regions of the world. The projections are based on the calibration and simulation of the model and serve to discuss its usefulness and limitations.
Forearm Flexor Muscles in Children with Cerebral Palsy Are Weak, Thin and Stiff

Children with cerebral palsy (CP) often develop reduced passive range of motion with age. The determining factor underlying this process is believed to be progressive development of contracture in skeletal muscle that likely changes the biomechanics of the joints. Consequently, to identify the underlying mechanisms, we modeled the mechanical characteristics of the forearm flexors acting across the wrist joint. We investigated skeletal muscle strength (Grippit®) and passive stiffness and viscosity of the forearm flexors in 15 typically developing (TD) children (10 boys/5 girls, mean age 12 years, range 8–18 yrs) and nine children with CP Nine children (6 boys/3 girls, mean age 11 ± 3 years (yrs), range 7–15 yrs) using the NeuroFlexor® apparatus. The muscle stiffness we estimate and report is the instantaneous mechanical response of the tissue that is independent of reflex activity. Furthermore, we assessed cross-sectional area of the flexor carpi radialis (FCR) muscle using ultrasound. Age and body weight did not differ significantly between the two groups. Children with CP had a significantly weaker (−65%, p < 0.01) grip and had smaller cross-sectional area (−43%, p < 0.01) of the FCR muscle. Passive stiffness of the forearm muscles in children with CP was increased 2-fold (p < 0.05) whereas viscosity did not differ significantly between CP and TD children. FCR cross-sectional area correlated to age (R2 = 0.58, p < 0.01), body weight (R2 = 0.92, p < 0.0001) and grip strength (R2 = 0.82, p < 0.0001) in TD children but only to grip strength (R2 = 0.60, p < 0.05) in children with CP. We conclude that children with CP have weaker, thinner, and stiffer forearm flexors as compared to typically developing children.
Neptunomonas qingdaonensis sp. nov., isolated from intertidal sand.

A Gram-negative, motile, aerobic, oxidase- and catalase-positive rod, designated P10-2-4(T), was isolated from an intertidal sand sample collected from a coastal area of Qingdao (Yellow Sea), China. The isolate reduced nitrate to nitrite and grew at 4-33 °C and with 0.5-12 % (w/v) NaCl. The predominant cellular fatty acids were summed feature 3 (C16 : 1ω7c and/or iso-C15 : 0 2-OH), C18 : 1ω7c and C16 : 0. The major polar lipids were phosphatidylethanolamine and phosphatidylglycerol. The major respiratory quinone was Q-8. The genomic DNA G+C content was 45.1 %. Phylogenetic analysis of 16S rRNA gene sequences revealed that strain P10-2-4(T) belonged to the genus Neptunomonas. The isolate shared the highest 16S rRNA gene sequence similarity (98.1 %) with Neptunomonas japonica JAMM 0745(T) and 96.9, 96.5 and 95.9 % sequence similarities with N. antarctica S3-22(T), N. concharum LHW37(T) and N. naphthovorans NAG-2N-126(T), respectively, strains of the other three recognized species in the genus. DNA-DNA relatedness between strain P10-2-4(T) and N. japonica JCM 14595(T) was 35.6 %. Furthermore, strain P10-2-4(T) could be distinguished from the representatives of the genus Neptunomonas by a combination of phenotypic characteristics, such as temperature and NaCl concentration for growth, nitrate reduction, DNase activity and assimilation of substrates. The data from this study suggests that strain P10-2-4(T) represents a novel species in the genus Neptunomonas, for which the name Neptunomonas qingdaonensis sp. nov. is proposed. The type strain is P10-2-4(T) ( = CGMCC 1.10971(T) = KCTC 23686(T)).
Carcinosarcoma of the uterus with extensive neuroectodermal differentiation

A case of uterine carcinosarcoma with extensive neuroectodermal differentiation occurring in a 54‐year‐old woman is described. Microscopically, the endometrial tumour was predominantly composed of a sheet‐like proliferation of small‐ and medium‐sized cells. These cells were characterized by fibrillary cytoplasmic processes, rosette‐like formations, perivascular palisading patterns, and immunoreactivity for glial fibrillary acidic protein, synaptophysin, leu 7 and neuron‐specific enolase. In limited areas, features of conventional carcinosarcoma, including squamous cell carcinoma, leiomyosarcoma and islands of the above mentioned small‐to medium‐sized cells that were intermingled, were observed. The tumour was aneuploid by flow cytometry. The patient is alive with tumour for three months. It is suggested that at least some cases of uterine primitive neuroectodermal tumour may be explained by one‐sided neuroectodermal development within a carcinosarcoma.