Miracle-dz/UniFAR-FTUs huggingface dataset:
Tumour induced hypophosphataemia associated with small cell carcinoma of the bronchus.

A 37 year old man gave a two month history of mild dysphagia, weight loss, haemoptyses, and pain affecting the lumbar spine, buttocks, and thighs. He had been previously well with no relevant past medical history. There were no abnormal physical findings. A barium meal showed nothing abnormal but the chest radiograph showed a left hilar mass and bronchoscopy revealed neoplastic occlusion of the left upper lobe bronchus. Bronchial biopsy specimens confirmed small cell carcinoma. Investigations showed that the serum phosphate concentration was 0 5 (normal 0 8-1 5) mamoll (15(25-46) mg/100 ml), serum calcium 2-6 mmol/l(104,mg/100 ml) (corrected for the low serum albumin), and alkaline phosphatase 170 U/l (figure). His full blood count and urea, creatinine, and electrolyte concentrations were normal. He had persistent 2% glycosuria despite normal blood-sugar concentrations. Aspartate transaminase activity was 90 (normal 0-35) U/I and y glutamyl transaminase activity 217 (normal 0-50) U/1. Alkaline phosphatase isoenzymes showed an increase in the bone fraction. Radiographs of the spine and pelvis were normal. He was initially treated with vincristine, adriamycin, cyclophosphamide, and etoposide and the same drug regimen was repeated three weeks later (figure). There was no radiographic improvement and he developed increasingly severe back pain, which now prevented him from standing. Examination showed considerable paraspinal muscle spasm and generalised skin and palmar crease hyperpigmentation. Serum cortisol concentrations at 09.00 and 24.00 hours were 583 (normal 138-690) nmol/l (21 (5-25) pg/100 ml) and 607 (normal 96-330) nmol/l (22 (3 5-12) pg/100 ml) respectively, urinary free cortisol 1330 (normal 96-330) nmol 24 h (48 (3-5-12) Mg/24 h); but the serum adrenocorticotrophic hormone (ACTH) concentration was 58 (normal < 10-80)
Altered Host-Microbe Interaction in HIV: A Target for Intervention with Pro- and Prebiotics

The intestinal immune system is severely affected by HIV and circulating microbial products from the intestinal tract that provide an ongoing source of systemic inflammation and concomitant viral replication. In addition, HIV-infected individuals can have a deregulated immune response that may hamper the anti-viral capacity of the host. Various probiotic organisms and prebiotic agents have been shown to enhance intestinal epithelial barrier functions, reduce inflammation, and support effective Th-1 responses. As these characteristics may benefit HIV patients, this review aims to provide a theoretical framework for the development of probiotic and prebiotic interventions specifically for this population.
Topology formation for tactical networks with directional RF and free-space optical links

This work addresses the graph theoretical under-pinning of forming a topology during the deployment of directional RF or free space optical (FSO) based tactical networks. The objective is to construct a topology that not only has a good reliability, but also supports the maximal delivery of traffic. Given the fact that each node has a limited number of transceivers, the design problem falls into the category of (node) degree-constrained topology optimization problem, for which an exhaustive search or integer programming approach becomes prohibitive for larger networks. As such, we focus on first developing a design guideline based on theoretic analysis and then proposing algorithms. The algorithms consist of two components. The first component involves forming a minimum spanning tree (MST) or traveling salesman path (TSP) to guarantee a networkpsilas connectivity. The second component involves iteratively connecting node pairs based on an updated criterion, which takes into considerations of traffic, hop distance, link bandwidth, and network load. Extensive tests demonstrate that the proposed algorithms produce optimal or close-to-optimal solutions. Compared with existing approaches, the proposed algorithms outperform in traffic delivery; while they have similar performance in network reliability.
Outcomes and risk factors for mortality in community-onset bacteremia caused by extended-spectrum beta-lactamase-producing Escherichia coli, with a special emphasis on antimicrobial therapy

Abstract Background: Although extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli has emerged as a significant pathogen, there is little information regarding treatment outcomes in community-onset bacteremia due to ESBL E. coli. The purpose of this study was to evaluate treatment outcomes of community-onset bacteremia caused by ESBL-producing E. coli and the factors associated with mortality. Methods: A retrospective cohort study was performed, including 92 adult patients with community-onset bacteremia caused by ESBL-producing E. coli. Results: The 30-day mortality rate was 10.9% (10/92). Independent risk factors for mortality were underlying liver disease and severity of illness (e.g., high Pitt bacteremia score, the presence of severe sepsis or septic shock; p < 0.05). Mortality in patients receiving inappropriate initial antimicrobial therapy was not significantly higher than mortality in those receiving appropriate empirical antimicrobial therapy (10.9 vs 10.7%; p = 0.975), if antimicrobial therapy was adjusted appropriately according to susceptibility results. Carbapenems, piperacillin/tazobactam, fluoroquinolones, and amikacin were the most effective antibiotics for community-onset bacteremia caused by ESBL-producing E. coli, although susceptibility profiles confirmed that alternatives to carbapenems are limited. Of 68 isolates in which the ESBLs and their molecular relationships were studied, all isolates produced ESBLs from the CTX-M family (CTX-M-14, 30 isolates; CTX-M-15, 22; and other CTX-M, 16). Conclusions: In patients with community-onset bacteremia caused by ESBL-producing E. coli, severe sepsis and underlying liver disease were significantly associated with mortality, and a delay in appropriate antimicrobial therapy was not associated with a higher mortality if therapy was adjusted appropriately according to the susceptibility results.
Assessment of the Tourism’s Potential as a Sustainable Development Instrument in Terms of Annual Stability: Application to Spanish Rural Destinations in Process of Consolidation

Tourism has established itself as an instrument that supports the sustainable development of rural destinations and has both, negative and positive effects. The annual instability of the flow of visitors, known as tourist seasonality, contributes to the intensification of some of these negative effects. In this work, we perform an analysis on the evolution of the seasonality intensity during the process of consolidation of the Spanish rural destinations, designed to improve the knowledge about the tourist activity’s capacity to generate a sustainable development alternative steady throughout the year. To guarantee an accurate measurement, we propose the use of a synthetic indicator as a methodological innovation, such as the Method of Distance Pena DP2, that brings together the supply and demand variables. We can observe that tourist seasonality is restrained in smaller destinations that experience a growth in terms of tourists’ arrivals, so it is associated with the early stages of the consolidation process. However, the destinations with a lower seasonality level do not match with those that welcome a larger number of visitors. Those destinations with the potential to obtain more benefits because of their level of consolidation do not have the necessary annual stability to provide employment and income in a steady way throughout the year.
Malignant lymphoma and granulocytic sarcoma of the uterus and vagina a clinicopathologic analysis of 27 cases

Twenty‐five cases of malignant lymphoma of the uterine corpus or cervix and the vagina, and one case of granulocytic sarcoma of the cervix were analyzed. The patients typically presented with vaginal bleeding and a subepithelial mass without obvious ulceration or other epithelial abnormality. Twenty‐one of the 27 tumors appeared to originate in the cervix, 4 in the vagina, and 2 in the endometrium. Seven of them were nodular lymphomas, 17 diffuse large cell, or “histiocytic” lymphomas, 1 was a Burkitt's tumor, and 2 were granulocytic sarcomas. Sclerosis was a prominent histologic feature in lymphomas of the cervix and vagina. Twenty‐one patients had disease confined to a single extranodal site (Ann Arbor Stage IE), and six had lymph node or ovarian involvement (Stages IIE + IV). The overall actuarial 5‐year survival was 73%. The survival of patients with Stage IE tumors was 89%, compared with 20% for patients with lymph node or ovarian involvement. None of the 12 patients with Stage IE lymphoma of the cervix or vagina who received definitive initial local treatment (surgical and/or radiation therapy) relapsed. Nodular lymphomas and diffuse lymphomas with a preponderance of large cleaved cells were more often localized and had a better prognosis than large or small noncleaved and immunoblastic types. Lymphoma of the lower female genital tract is a rare, but treatable malignancy, which must be distinguished microscopically from inflammatory lesions and nonlymphoid tumors arising in this site.
Skeletal Muscle Injury Biomarkers: Assay Qualification Efforts and Translation to the Clinic

Skeletal muscle (SKM) injury or myopathy results in structural or functional defects in SKMs that can be caused by variety of factors such as (1) genetic, (2) drug-induced, (3) disease progression (cachexia), or (4) aging (sarcopenia). Creatine kinase (CK) and aspartate transaminase (AST) activity assays have been routinely used as SKM injury biomarkers, but they lack sensitivity and tissue specificity. In collaboration with the Predictive Safety Testing Consortium, we evaluated the diagnostic performance of a muscle injury biomarker panel (MIP) compared to CK and AST and their correlation with the histology scores across 34 different rat studies. The MIP panel included the analytes skeletal troponin I, myosin light chain 3, fatty acid binding protein 3, and a CK mass (versus activity) assay. The area under the receiver operator characteristic curve for MIP panel ranged from 0.82 to 0.91 as compared to 0.71 and 0.82 for CK and AST activity assays, respectively. Because the MIP biomarkers outperformed the routine biomarkers, the European Medicines Agency and U.S. Food and Drug Administration posted Letters of Support encouraging further study of these analytes and acknowledged the utility of the MIP panel. Ongoing efforts are directed toward the application of the MIP panel biomarkers in clinical studies and regulatory qualification.
Frequency of virulence factors in Escherichia coli isolated from pigs with postweaning diarrhea and edema disease in North Carolina

Polymerase chain reaction for five fimbriae (K88, K99, 987P, F41, F18), two heatstable enterotoxins (STa, STb), one heatlabile enterotoxin (LT), and Shiga-like toxin type II (SLT) was performed on Escherichia coli isolates to determine their genotype among isolates from weaned pigs with diarrhea and/or edema disease in North Carolina. A total of 175 isolates were tested. All but two isolates possessed genes for at least one of the enterotoxins or fimbrial adhesins. Nearly all (94.86%) of the isolates that carried enterotoxin genes also carried genes for one of the fimbrial adhesins. The two predominant genotypes were K88 LT STb and F18 STa STb SLT, respectively.
Instructional design best practices for Second Life: a case study from a college-level English course

Interest in the instructional application of virtual worlds, such as Second Life (SL), has grown substantially. However, little information is available about effective instructional activities using virtual worlds. This case study illustrates lessons learned from a pilot integrating SL into a two-semester English course at a large southwestern US university. A building activity was implemented in the first semester, and based on qualitative and quantitative formative evaluation results and additional planning, the instructional activity for the second semester was modified. These changes substantially enhanced students' learning experiences. Eight general and five discussion/debate-specific best practices discussed for implementing SL in college-level courses include capitalising on social interactions and establishing a clear connection of activities with learning objectives. This study demonstrates the importance of combining careful instructional design with ongoing assessment when implementing emerging technologies. It also indicates that course learning goals and students' needs should be considered first and foremost when adopting new technologies for instruction.
Care co-ordination and key worker schemes for disabled children: results of a UK-wide survey.

AIM To investigate the prevalence and nature of care co-ordination and key worker services for disabled children and their families. METHODS Postal survey of 225 Children with Disabilities Teams across the UK. RESULTS Out of 159 questionnaires returned (70%), 35 (22%) reported having a care co-ordination scheme, with 30 (19%) of these providing key workers for families. The majority had multiagency and parent involvement in setting up and overseeing the schemes. However, multiagency funding was less common and funding for many schemes was short term. Different models of key working were apparent. Five schemes employed full-time key workers. In 21 schemes, professionals key worked with a few families as part of a larger case load, and in three schemes, both types of key workers were employed. Most schemes provided initial or ongoing training for key workers, but a few provided neither of these. DISCUSSION The proportion of areas having care co-ordination or key worker services is consistent with findings on research with parents of disabled children, which reports that less than one-third of families have a key worker. The extent of multiagency involvement in planning and overseeing the operation of the service was positive but joint funding was more problematic. There was considerable variation in service models and as yet, little is known about whether or how such variations relate to outcomes for children and families. Further research will investigate these issues.
Xylan-mediated aggregation of Lactobacillus brevis and its relationship with the surface properties and mucin-mediated aggregation of the bacteria

Some Lactobacillus brevis strains were found to aggregate upon the addition of xylan after screening for lactic acid bacteria that interact with plant materials. The S-layer proteins of cell surface varied among the strains. The strains that displayed xylan-mediated aggregation retained its ability even after the removal of S-layer proteins. L. brevis had negative zeta potentials. A correlation between the strength of aggregation and zeta potential was not observed. However, partial removal of S-layer proteins resulted in decreases in the electric potential and aggregation ability of some strains. Therefore, xylan-mediated aggregation of L. brevis was considered to be caused by an electrostatic effect between the cells and xylan. L. brevis also aggregated in the presence of mucin, and the strengths of aggregation among the strains were similar to that induced by xylan. Thus, xylan- and mucin-mediated L. brevis aggregation was supposed to be caused by a similar mechanism. Graphical Abstract Some Lactobacillus brevis strains were found to aggregate upon the addition of xylan, and these strains also aggregated in the presence of mucin.
Price haggling between a single buyer and a single seller

In this paper, we develop a model for price haggling between a single buyer and a single seller. We consider haggling to be an ordered pair of sequences of countero ers of the buyer and seller. These sequences are given a particular form in the linear haggling model in which the next countero er is made at a xed proportion of the two previous countero ers. The buyer's and seller's countero ers tend toward an equilibrium price when carried on ad in nitum. The notion of a fair haggle is introduced and conditions for a fair haggle are found. Results regarding countero ers carried on for nitely many periods are given. Examples are given to compare several nite period haggles with di erent parameters.
Modeling and analysis of power processing systems

Effort of a NASA-sponsored, computer-based pro­ gram on "Modeling and analysis of Power Processing Systems" is reported. The overall program objec­ tive is to provide an engineering tool to reduce the design, analysis,and development time, and thus the cost, in achieving the required perform­ ance for power processing equipment and systems. Program philosophy, structures, and design and analysis examples are given to illustrate the program's utility in power and control circuit design, analysis, and optimization.
Co-transplantation of endothelial progenitor cells and mesenchymal stem cells promote neovascularization and bone regeneration.

BACKGROUND Bone formation relies on sufficient blood supply and osteoprogenitor cells. PURPOSE The study aims to evaluate the influence of endothelial progenitor cells (EPCs) in combination with mesenchymal stem cells (MSCs) on early vascularization and intramembranous bone regeneration. MATERIALS AND METHODS Vertical bone regeneration was tested in rat calvarium guided bone regeneration model. Gold domes were filled with a mixture of 5 × 10(5) osteogenic transformed MSC and 5 × 10(5) EPC (EPC/MSC) that were mixed with β-tricalcium phosphate (βTCP) scaffold. Domes filled with βTCP alone served as control. Rats were sacrificed after 4 or 12 weeks. Histomorphometry was used to determine blood vessel (Bv) density, vertical bone height, and bone area in the regenerated tissue. RESULTS At both time points, new augmented hard tissue filled the space under the dome, and Bv density was higher in the EPC/MSC transplanted group vs control. However, bone height and bone area were similar among the groups 4 weeks posttransplantation, but were doubled in the EPC/MSC transplanted group 12 weeks posttransplantation. CONCLUSIONS EPC/MSC transplantation increases Bv formation in the early stages of healing that precedes enhancement of extracortical bone regeneration in later stages.
Screening breast MR imaging: comparison of interpretation of baseline and annual follow-up studies.

PURPOSE To determine whether baseline screening breast magnetic resonance (MR) imaging studies have a higher rate of follow-up or biopsy recommendation than do studies with prior MR images available for comparison. MATERIALS AND METHODS This was an institutional review board-approved, HIPAA-compliant, retrospective study. Informed consent was waived. Reports from 650 consecutive screening breast MR imaging examinations performed in women between September 2007 and December 2008 were reviewed. All examinations were performed by using the same protocol, and images were interpreted by the same radiologists. Presence of comparison studies, Breast Imaging Reporting and Data System (BI-RADS) category, and biopsy results were recorded. Data were analyzed by using the χ(2) test, the two-sample test of proportions, and the Fisher exact test. RESULTS Mean patient age was 51 years (range, 25-81 years). Of the baseline studies, findings in 31 of 307 (10.1%) were interpreted as BI-RADS category 3 and findings in 18 of 307 (5.9%) were interpreted as BI-RADS category 4 or 5. Of the examinations with findings classified as BI-RADS category 4 or 5, the results in two of 18 (11.1%) were positive for malignancy at biopsy. Of the examinations with prior MR images for comparison, findings in nine of 343 (2.6%) were interpreted as BI-RADS category 3 and findings in 16 of 343 (4.7%) were interpreted as BI-RADS category 4 or 5. Of the examinations with findings classified as BI-RADS category 4 or 5, the results in three of 16 (18.8%) were positive for malignancy at biopsy. The difference in the number of BI-RADS category 3 interpretations between the two groups was significant (P < .001), but there was no significant difference in BI-RADS category 4 or 5 interpretations or positive predictive values. CONCLUSION Baseline screening MR imaging was associated with a higher likelihood of recommendation for short-interval follow-up than was MR imaging with prior images for comparison.
Failure of plasma brain natriuretic peptide to identify left ventricular systolic dysfunction in the community

Heart failure is a major public health problem. The clinical diagnosis is imprecise and a simple test of left ventricular function would greatly improve diagnostic accuracy. Measurement of brain natriuretic peptide (BNP) has been shown in some studies to be a potential marker of left ventricular dysfunction.1 Heart failure is more common in the elderly and is often treated in the community where a simple test would be of considerable benefit. We have therefore measured plasma BNP values and compared them with echocardiographic measures of left ventricular function in a large, community based population. Eight general practices of a total list size of 65 820 were surveyed. All patients currently prescribed loop diuretics were invited to take part in the study as it was thought the majority of patients with the clinical syndrome of heart failure would be treated with them. Of the 1425 patients asked to participate, informed consent, echocardiograms, and measurement of plasma BNP were obtained in 653. The median age of the group was 76 years with an interquartile range (IQR) of 70–82 years. The group was composed of 254 males and …
EVOLUTION OF THE ANTI-GM SUBSTANCES AND OF THE REACTIVITY OF RHEUMATOID SERA FOR HUMAN RED CELLS SENSITIZED WITH 3 DIFFERENT ANTI-RH SERA OR IMMUNE RABBIT SERA AND FOR F. II LATEX.

In rheumatoid arthritis (R.A.) in addition to the rheumatoid factors detected by the Waaler-Rose and latex F. II tests,1 anti-Gm substances and agglutinins for human red cells sensitized with 3 different anti-Rh sera appear, mainly in cases of severe disease of long duration. Usually, during the evolution of the disease, their titer does not parallel that of the rheumatoid factors; this fact is in favor of the individuality of the anti-Gm substances. In arthritis rheumatoidee, a parte le factores rheumatoidee que es detegite per le tests Waaler-Rose e de latex a F.II, le presentia de substantias anti-Gm e de agglutininas pro human erythrocytos sensibilisate con tres differente seros anti-Rh es notate, principalmente in casos sever o in casos de longe duration. Usualmente, in le curso del evolution del morbo, lor titro non curre in parallela con illo del factores rheumatoid-. Iste facto representa un argumento in favor del individualitate del substantias anti-Gm.