Miracle-dz/UniFAR-FTUs huggingface dataset:
Do drug interaction alerts between a chemotherapy order-entry system and an electronic medical record affect clinician behavior?

Introduction We developed an enhancement to a chemotherapy order-entry system that alerted prescribers to potential drug interactions between patients’ usual outpatient medications and those prescribed for onsite cancer treatment. This report summarizes the interactions and analyzes the impact of alerts on clinician behavior. Methods We studied electronic orders created from November 2010 to December 2011 by oncology clinicians at two comprehensive cancer centers who shared a chemotherapy order-entry system and an ambulatory electronic medical record. The enhancement generated an alert if a new chemotherapy system order for an antineoplastic agent or supportive care medication interacted with an existing medication in the ambulatory record, and tracked prescribers’ responses. Results New chemotherapy system orders triggered 29,592 drug interaction alerts. New orders for antineoplastic agents accounted for 495 (32.6%) of 1518 high- and medium-severity alerts. Interactions with antibiotics accounted for the majority of these alerts. New chemotherapy system orders for antiemetics triggered 352 (23.2%) alerts and more than two-thirds were attributed to interactions with analgesic opioids. High- and medium-severity alerts changed prescriber behavior in 224 (14.8%) occurrences, including potentially fatal interactions between meperidine and monoamine oxidase inhibitors. Clinicians who overrode alerts indicated that they would monitor the patient (54.6%), the patient already tolerated the combination (24.5%), and they would adjust the dose (15.1%). Conclusion Cancer patients are at risk of serious interactions between medications ordered for cancer care and those provided for general medical care. Organizations and order-entry applications should develop countermeasures to identify and prevent potentially serious drug interactions.
Influence of inflammation on total energy expenditure in hemodialysis patients.

BACKGROUND AND OBJECTIVES Studies show that inflammation can contribute to an increase in resting energy expenditure in patients with chronic kidney disease; however, findings about total energy expenditure (TEE) have not been reported. The aim of this study was to evaluate the effects of inflammation on TEE and physical activity energy expenditure in hemodialysis (HD) patients. DESIGN This was a cross-sectional study. SETTING This study was conducted from Hôpital Edouard Herriot, Lyon, France. PATIENTS This study included 24 HD patients and 18 healthy subjects. MAIN OUTCOME MEASURE TEE and step counts were measured over a 7-day period by the SenseWear Pro2 Armband in 24 HD patients (15 patients with C-reactive protein <5 mg/L, aged 67.0 ± 14.7 years, and 9 with C-reactive protein >5 mg/L, aged 69.0 ± 18.0 years) and compared with 18 healthy subjects (62.3 ± 15.3 years). RESULTS Mean estimated TEE measured with SenseWear Pro2 Armband was significantly lower (25.5 ± 4.1 kcal/kg/day) in patients with inflammation when compared with those without inflammation (32.0 ± 6.7 kcal/kg/day) and with healthy subjects (31.8 ± 7.0 kcal/kg/day) (P = .012). There was a difference in the physical activity (step counts) between patient groups (P < .05). Healthy subjects and patients without inflammation walked more (8,107 ± 5,419 and 6,016 ± 3,752 steps/day, respectively) as compared with patients with inflammation (2,801 ± 2,754 steps/day, P = .001). CONCLUSION Our findings suggest that patients with inflammation have a lower TEE when compared with healthy subjects and patients without inflammation. TEE is influenced by physical activity because patients with inflammation appear to be less active.
Synaptic reorganisation in the rat striatum after dopaminergic deafferentation: An ultrastructural study using glutamate decarboxylase immunocytochemistry

The ultrastructure of GABAergic and non‐GABAergic synapses in the adult rat neostriatum was examined 6‐8 months after unilateral removal of the nigrostriatal dopaminergic pathway by 6‐hydroxydopamine injection into the medial forebrain bundle. GABAergic profiles were identified by preembedding glutamate decarboxylase (GAD) immunocytochemistry performed on parasagittal vibratome sections. In three representative fields of the striatum, the nature and number of boutons and their postsynaptic partners were determined and the differences between the striata ipsi‐ and contralateral to the lesion analyzed. The percentage of GAD‐immunoreactive boutons was increased from 23% on the intact side to 28% on the lesioned side. In addition, the GABAergic boutons underwent significantly more multiple contacts with several independent postsynaptic profiles, preferentially with dendritic spines. This could reflect a lesion‐induced sprouting of local GABAergic axon terminals. On the other hand, although the vast majority of GABAergic boutons underwent synaptic contacts with dendrites (77% vs. 80%), the number of boutons per dendrite or per dendritic circumference remained unchanged. Thus, the higher frequency of GABAergic boutons may simply reflect the loss of the dopaminergic nerve endings, without a heterosynaptic replacement by GABAergic boutons. The deafferentation also induced structural changes of the postsynaptic profiles. Some dendritic spines had a shortened neck; others were completely integrated in the dendrite which now contained a spine apparatus and was contacted by boutons with the features of axospinous synapses. The spine retraction resulted in a quantitative decrease in the number of spines. Analysis of the synaptic curvature revealed that only spines with a flat contact zone were lost. Concurrently, the number of dendrites was increased, of the GAD‐containing in particular, suggesting that the denrites of GABAergic interzeurons tend to elongate and/or arborize. Taken together, the results of the present study show that the dopaminergic denervation caused a remodeling of the postsynaptic neurons. The relative increase of the number of GABAergic boutons and their synaptic contacts suggests that an altered wiring of the intrinsic GABAergic system contributes to the changes in the striatal output activity. © 1995 Wiley‐Liss, Inc.
Effect of Graduated Intravenous and Standard Rectal Doses of Indomethacin on Cerebral Blood Flow in Healthy Volunteers

Administration of indomethacin may aid treatment of intracranial hypertension, and the present study was conducted to determine the optimal dose. In healthy volunteers, cerebral blood flow (CBF) has been shown to decrease considerably after a bolus dose of indomethacin, 0.4 mg/kg, followed by continuous infusion, 0.4 mg/kg/h. This decrease was sustained for 6 h without any evidence of adaptation. In a randomized study in healthy volunteers, indomethacin, 0.1, 0.2, and 0.3 mg/kg, was given as bolus, followed by continuous infusion of 0.1, 0.2, and 0.3 mg/kg/h. CBF decreased from normal levels (52–74 ml/100 mg/min) to 38–51 ml/100 g/min. There were no differences among the three groups in CBF reduction, and the reduction was sustained during the 6-h infusion period. Rectal application of 100 mg indomethacin was found to reduce CBF from normal levels (54–74 ml/100 mg/min) to 33–18 ml/100 mg/min. These low levels were only sustained for 2 h, and values returned to normal over the next 6 h. We observed no rebound phenomenon 2 h after stopping the infusion and no rebound after 100 mg of rectally applied indomethacin. Since a dose as low as 0.1 mg/kg/h is effective, it is possible to treat most patients in a 24-h schedule without going over maximum recommended doses.
Ubiquitous Text Interaction

Computer-based interactions increasingly pervade our everyday environments. Be it on a mobile device, a wearable device, a wall-sized display, or an augmented reality device, interactive systems often rely on the consumption, composition, and manipulation of text. The focus of this workshop is on exploring the problems and opportunities of text interactions that are embedded in our environments, available all the time, and used by people who may be constrained by device, situation, or disability. This workshop welcomes all researchers interested in interactive systems that rely on text input or output. Participants should submit a short position statement outlining their background, past work, future plans, and suggesting a use-case they would like to explore in-depth during the workshop. During the workshop, small teams will form around common or compelling use-cases. Teams will spend time brainstorming, creating low-fidelity prototypes, and discussing their use-case with the group. Participants may optionally submit a technical paper for presentation as part of the workshop program. The workshop serves to sustain and build the community of text entry researchers who attend CHI. It provides an opportunity for new members to join this community, soliciting feedback from experts in a small and supportive environment.
A randomised controlled study comparing the effects of laryngeal mask airway and endotracheal tube on early postoperative pulmonary functions.

INTRODUCTION Classic laryngeal mask airway (LMA) has long been used for airway management. General anaesthesia has been associated with a significant decrease in pulmonary functions during the postoperative period. The decrease in pulmonary functions has been found to be greater with the use of a tracheal tube (TT). In this study, we compared the effects on pulmonary functions during the early postoperative period when the airway was managed using an LMA versus a TT. METHODS A total of 20 patients in each group received either LMA or TT for airway management. Postoperative pulmonary functions were recorded at 30 and 60 minutes after removal of the airway device in patients undergoing peripheral limb surgeries. Forced vital capacity (FVC) , forced expiratory volume during the first second (FEV1), vital capacity, FEV1/FVC, peak expiratory flow rate and percentage saturation of oxygenated haemoglobin were compared. Postoperative coughing and hoarseness were also recorded. RESULTS Pulmonary functions were significantly decreased in both groups at 30 and 60 minutes postoperatively. The decrease in the TT group was significantly greater than that in the LMA group at both 30 and 60 minutes. The FEV1/ FVC was not significantly changed, indicating a restrictive pattern. Patients in the TT group had a significantly higher incidence of coughing at both 30 and 60 minutes. CONCLUSION The use of LMA instead of TT for airway management during peripheral limb surgeries causes less depression of pulmonary functions during the early postoperative period. The incidence of coughing is also significantly lower.
Genomic Analysis Distinguishes Mycobacterium africanum

ABSTRACT Mycobacterium africanum is thought to comprise a unique species within the Mycobacterium tuberculosis complex. M. africanum has traditionally been identified by phenotypic criteria, occupying an intermediate position between M. tuberculosis and M. bovis according to biochemical characteristics. Although M. africanum isolates present near-identical sequence homology to other species of the M. tuberculosis complex, several studies have uncovered large genomic regions variably deleted from certain M. africanum isolates. To further investigate the genomic characteristics of organisms characterized as M. africanum, the DNA content of 12 isolates was interrogated by using Affymetrix GeneChip. Analysis revealed genomic regions of M. tuberculosis deleted from all isolates of putative diagnostic and biological consequence. The distribution of deleted sequences suggests that M. africanum subtype II isolates are situated among strains of “modern” M. tuberculosis. In contrast, other M. africanum isolates (subtype I) constitute two distinct evolutionary branches within the M. tuberculosis complex. To test for an association between deleted sequences and biochemical attributes used for speciation, a phenotypically diverse panel of “M. africanum-like” isolates from Guinea-Bissau was tested for these deletions. These isolates clustered together within one of the M. africanum subtype I branches, irrespective of phenotype. These results indicate that convergent biochemical profiles can be independently obtained for M. tuberculosis complex members, challenging the traditional approach to M. tuberculosis complex speciation. Furthermore, the genomic results suggest a rational framework for defining M. africanum and provide tools to accurately assess its prevalence in clinical specimens.
Population-based, multi-generational family clustering study of social anxiety disorder and avoidant personality disorder

Background We aimed to provide unbiased estimates of familial risk and heritability of social anxiety disorder (SAD) and avoidant personality disorder (AVPD). Method We identified 18 399 individuals diagnosed with SAD and 2673 with AVPD in the Swedish National Patient Register between 1997 and 2009. Risks (odds ratios; OR) for SAD in all biological and non-biological relatives of probands, compared to relatives of unaffected individuals were calculated. We also estimated the risks for AVPD in relatives of probands with SAD. Results The risk for SAD among relatives of SAD probands increased proportionally to the degree of genetic relatedness. The risks for first-degree relatives [OR 4.74, 95% confidence interval (CI) 4.28–5.25] were significantly higher than for second-degree and third-degree relatives. Second-degree relatives (OR 2.30, 95% CI 2.01–2.63) had significantly higher risk than third-degree relatives (OR 1.72, 95% CI 1.52–1.94). Relatives at similar genetic distances had similar risks for SAD, despite different degrees of shared environment. Heritability was estimated to be approximately 56%. There were no significant sex differences in the familial patterns. The risk of AVPD in relatives of SAD probands was significantly elevated, even after excluding individuals with both diagnoses (first-degree OR 3.54, second-degree OR 2.20, third-degree OR 1.62). Non-biological relatives (spouses/partners) also had elevated risks for both SAD (OR 4.01) and AVPD (OR 3.85). Conclusions SAD clusters in families primarily due to genetic factors. SAD and AVPD are aetiologically related and may represent different expressions of the same vulnerability. The strong marital concordance observed in SAD/AVPD may indicate assortative mating but the exact mechanisms and implications require further investigation.
Tunable Near-Field Focused Circular Phase-Array Antenna for 5.8-GHz RFID Applications

An RFID-compatible focused circular phase-array antenna working at 5.8 GHz is proposed, which is theoretically analyzed and experimentally demonstrated. It consists of 24 half-wavelength dipole antennas placed on three circles. Using only two phase-shifters, a tunable focal spot in the range of 0.4-1 m (10λ) is obtained. The antenna system is analyzed using the Huygens-Fresnel theory, which is compared to the experimental results. At a focal distance of 0.9 m, the measured beam width and focal depth are given by 0. 75λ and 5λ, respectively, which are in agreement with the calculated results.
Tertiary work-up of apparent treatment-resistant hypertension

Abstract Objective: Treatment-resistant hypertension (TRH) has regained attention with development of new methods for treatment. However, the prevalence of TRH varies considerably from primary to secondary and tertiary care. We aimed to assess the prevalence of true TRH in a population of patients with apparent TRH in a university hospital setting of tertiary work-up and also investigate reasons for poor BP control and evaluate how work-up can be performed in general practice and secondary care. Methods: In this cohort study, we characterize a study population from Oslo Renal Denervation (RDN) Study. Patients (n = 83) were referred for RDN from secondary care. All patients underwent thorough medical investigation and 24-h ambulatory blood pressure measurements (24ABPM) after directly observed therapy (DOT). We then assessed reasons for lack of BP control. Results: Fifty-three of 83 patients did not have true TRH. Main reasons for non-TRH were poor drug adherence (32%), secondary hypertension (30%) and white coat hypertension (15%). Forty-seven percent achieved blood pressure control after DOT with subsequent 24ABPM. There were otherwise no statistically significant differences in patient characteristics between the true TRH and the non-TRH group. Conclusion: Despite being a highly selected cohort referred for tertiary work-up of apparent TRH, BP control was achieved or secondary causes were identified in almost two thirds of the patients. Thorough investigation according to guidelines and DOT with subsequent 24ABPM is needed in work-up of apparent TRH.
Outcome of endotherapy for pancreas divisum in patients with acute recurrent pancreatitis.

AIM To assess the rate of relapses of acute pancreatitis (AP), recurrent AP (RAP) and the evolution of endosonographic signs of chronic pancreatitis (CP) in patients with pancreas divisum (PDiv) and RAP. METHODS Over a five-year period, patients with PDiv and RAP prospectively enrolled were divided into two groups: (1) those with relapses of AP in the year before enrollment were assigned to have endoscopic therapy (recent RAP group); and (2) those free of recurrences were conservatively managed, unless they relapsed during follow-up (previous RAP group). All patients in both groups entered a follow-up protocol that included clinical and biochemical evaluation, pancreatic endoscopic ultrasonography (EUS) every year and after every recurrence of AP, at the same time as endoscopic retrograde cholangiopancreatography (ERCP). RESULTS Twenty-two were treated by ERCP and 14 were conservatively managed during a mean follow-up of 4.5 ± 1.2 years. In the recent RAP group in whom dorsal duct drainage was achieved, AP still recurred in 11 (57.9%) after the first ERCP, in 6 after the second ERCP (31.6%) and in 5 after the third ERCP (26.3%). Overall, endotherapy was successful 73.7%. There were no cases of recurrences in the previous RAP group. EUS signs of CP developed in 57.9% of treated and 64.3% of untreated patients. EUS signs of CP occurred in 42.8% of patients whose ERCPs were successful and in all those in whom it was unsuccessful (P = 0.04). There were no significant differences in the rate of AP recurrences after endotherapy and in the prevalence of EUS signs suggesting CP when comparing patients with dilated and non-dilated dorsal pancreatic ducts within each group. CONCLUSION Patients with PDiv and recent episodes of AP can benefit from endoscopic therapy. Effective endotherapy may reduce the risk of developing EUS signs of CP at a rate similar to that seen in patients of previous RAP group, managed conservatively. However, in a subset of patients, endotherapy, although successful, did not prevent the evolution of endosonographic signs of CP.
SPERM ASCENT THROUGH THE OVIDUCT OF THE HAMSTER AND RABBIT IN RELATION TO THE TIME OF OVULATION.

Female golden hamsters were mated either about 5 to 8 hr before ovulation or about 2 hr after ovulation. At various intervals after mating, a ligature was placed slightly above the intramural portion of the oviduct, thus preventing further sperm ascent. In the females mated before ovulation, the percentages of eggs fertilized, as examined 10 to 12 hr after the estimated time of ovulation, were 16\m=. \8,39\m=. \6,58\m=. \3 and 81\m=. \4when oviducts were ligated 1, 2, 4 and 6 hr after mating, respectively. In the females mated after ovulation, on the other hand, 37\m=. \5and 92\m=. \0%of eggs were fertilized following ligation of oviduct at 0\m=. \5and 1 hr after mating, respectively. Examination of complete serial sections of oviducts fixed 1 hr after mating showed that the oviducts of females mated after ovulation contained a relatively larger number of spermatozoa in their upper reaches than those of females mated before ovulation. It is concluded that in the hamster the ascent of spermatozoa through the oviduct takes place more rapidly when females are mated after ovulation than before ovulation. When rabbits were mated 8 and 4 hr before or 2 hr after ovulation, and their utero-tubal junctions were ligated 2 hr later, the fast sperm ascent after ovulation was not demonstrated.
Incidence and prevalence of uveitis: results from the Pacific Ocular Inflammation Study.

IMPORTANCE Uveitis is responsible for a significant proportion of legal blindness in the United States. Currently, there are few population-based reports characterizing the epidemiology of uveitis. OBJECTIVE To ascertain the incidence and prevalence of uveitis in a Hawaiian population and compare these estimates with those from prior population-based studies. DESIGN Retrospective, population-based cohort study conducted from January 1, 2006, to December 31, 2007. SETTING Kaiser Permanente Hawaii, a multispecialty managed care organization serving approximately 15% of the general Hawaiian population with locations throughout the Hawaiian islands. PARTICIPANTS All patients enrolled in the Kaiser Permanente Hawaii health plan during the study (N = 217,061). MAIN OUTCOMES AND MEASURES Clinical diagnosis of uveitis, either incident or prevalent, during the study determined by an initial search of the electronic medical record database of Kaiser Permanente Hawaii for uveitis-associated International Classification of Diseases, Ninth Revision diagnosis codes and subsequently confirmed through individual record review by a uveitis specialist. RESULTS Of 217,061 eligible patients, 872 were identified using International Classification of Diseases, Ninth Revision codes and 224 cases of uveitis were confirmed. The overall uveitis incidence rate was 24.9 cases per 100,000 person-years. The annual prevalence rates for 2006 and 2007 were 57.5 and 58.0 per 100,000 persons, respectively. No difference in incidence rate was found by sex (P = .63), but female patients had a higher prevalence (P = .008). Incidence and prevalence increased with older age (P < .001 for incidence and prevalence). Pacific Islanders had a lower prevalence rate than non-Pacific Islanders (2006: P = .09, 2007: P = .04), while white individuals had a higher prevalence rate than nonwhite individuals (2006: P = .07, 2007: P = .01). CONCLUSIONS AND RELEVANCE The incidence and prevalence of uveitis in this population were much lower than in the Northern California Epidemiology of Uveitis Study, but similar to the Northwest Veterans Affairs Study. The results of this study highlight incidence and prevalence estimates in a new population and provide novel comparisons by race. These differences by race raise questions regarding the effects of genetic and environmental influences on the pathophysiology of uveitis.