Miracle-dz/UniFAR-FTUs huggingface dataset:
Intercontinental differences in end-of-life attitudes in the pediatric intensive care unit: Results of a worldwide survey*

Objective: To examine intercontinental differences in end-of-life practices in pediatric intensive care units. Design: An international survey. The on-line questionnaire consisted of two case scenarios with five questions each. The scenarios described the management of children in pediatric intensive care units and the questions dealt with the decision-making process and the modalities of forgoing life support. Setting: The participants at the 5th World Congress on Pediatric Critical Care Medicine organized by the World Federation of Pediatric Intensive and Critical Care Societies (June 2007, Geneva, Switzerland) were invited to participate. Interventions: None. Measurements and Main Results: Six hundred sixty seven complete questionnaires were received from 71 countries, which were grouped into six continents: Europe (52.7%), North America (17.9%) and South America (9.5%), Asia (7.6%), Australia (6%), and Middle East (4.3%). In both scenarios, physicians played the major role in decision making in all of the continents. However, parents from North America, Australia, the Middle East, and Asia seem to be more involved in the decision-making process, compared with those from Europe and South America. In cases of septic shock, caregivers from Europe and South America are more prone to forego life support despite parents’ wishes. In North America and Australia, parents’ presence during cardiopulmonary resuscitation is usually accepted (89.7% and 92.3%, respectively), whereas their presence is less accepted in Asia (54%) and Europe (54.8%), or much less accepted in South America (25.8%) and the Middle East (7.1%). In both scenarios, the option to withhold rather than withdraw life supports was more commonly chosen among all continents, except South America, where the withdrawal of life support was more often proposed (51.6% vs. 45.2%). Conclusions: This study confirms that important intercontinental differences exist toward end-of-life issues in pediatric intensive care. Although the legal and ethical situation is rapidly evolving, a certain degree of paternalism seems to persist among European and South-American caregivers. This study suggests that ethical principles depend on the cultural roots of countries or continents, emphasizing the need to foster dialogue on end-of-life issues around the world to learn from each other and improve end-of-life care in pediatric intensive care units.
Global solutions for the two dimensional Euler-Poisson system with attractive forcing

The Euler-Poisson(EP) system describes the dynamic behavior of many important physical flows. In this work, a Riccati system that governs the flow's gradient is studied. The evolution of divergence is governed by the Riccati type equation with several nonlinear/nonlocal terms. Among these, the vorticity accelerates divergence while others suppress divergence and enhance the finite time blow-up of a flow. The growth of the latter terms are related to the Riesz transform of density and non-locality of these terms make it difficult to study global solutions of the multi-dimensional EP system. Despite of these, we show that the Riccati system can afford to have global solutions under a suitable condition, and admits global smooth solutions for a large set of initial configurations. To show this, we construct an auxiliary system in 3D space and find an invariant space of the system, then comparison with the original 2D system is performed. The present work generalizes several previous so-called restricted/modified EP models.
CD34, RAB20, PU.1 and GFI1 mRNA expression in myelodysplastic syndrome

Myelodysplastic syndrome (MDS) with hypocellular bone marrow (BM) is often difficult to distinguish from aplastic anemia (AA). Furthermore, the diagnosis of MDS with low blast counts and normal karyotype may be problematic. These issues highlight the need for a reliable marker for the diagnosis of MDS. This study was conducted to determine if changes of mRNA expression in any of the four selected genes would be useful markers for differentiation of hypoplastic MDS from AA, and MDS from benign disease, as well as to investigate whether mRNA expressions differ between MDS risk subgroups. Thirty‐five patients diagnosed with MDS, 27 patients with AA and 17 patients with benign diseases were included. The CD34, RAB20, PU.1 and GFI1 mRNA levels were measured by real‐time RT‐PCR. The CD34 mRNA expressions in hypoplastic MDS were higher than those found in AA. PU.1 and GFI1 mRNA expressions were significantly lower in MDS with low blast counts and normal karyotype than those of benign disease. High‐risk MDS showed higher CD34 expressions than those of low‐risk MDS. This study suggests that measurement of CD34 and GFI1 mRNA expressions could be useful as a diagnostic and prognostic marker for MDS.
HLA‐B*1511 is a risk factor for carbamazepine‐induced Stevens‐Johnson syndrome and toxic epidermal necrolysis in Japanese patients

Stevens‐Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare but life‐threatening severe cutaneous adverse reactions. Recently, strong associations of HLA‐B*1502 with carbamazepine‐induced SJS/TEN have been found in Han Chinese patients. These associations have been confirmed in several Asian populations, excluding Japanese. SJS patients carrying HLA‐B*1508, HLA‐B*1511, or HLA‐B*1521, which are members of the HLA‐B75 type along with HLA‐B*1502, were detected in studies in India and Thailand. In the current study, we genotyped the HLA‐B locus from 14 Japanese typical and atypical SJS/TEN patients in whom carbamazepine was considered to be involved in the onset of adverse reactions. Although there were no HLA‐B*1502 carriers, four patients had HLA‐B*1511. Our data suggest that HLA‐B*1511, a member of HLA‐B75, is a risk factor for carbamazepine‐induced SJS/TEN in Japanese.
Divergent effects of two sequence variants of GJB3 (G12D and R32W) on the function of connexin 31 in vitro

Abstract: Recently, we identified several missense mutations of the connexin gene GJB3 encoding connexin 31 (Cx31) in erythrokeratodermia variabilis (EKV), an autosomal dominant skin disorder. These mutations include G12D, which replaces a conserved glycine residue in the amino‐terminus of Cx31 and is associated with a severe EKV phenotype. In contrast, the biologic relevance of the GJB3 sequence variant R32W located in the first transmembrane domain of Cx31 is disputed. To examine the effects of these sequence variants on Cx31 biogenesis and gap junction activity we expressed wild type and mutant Cx31‐Flag constructs in HeLa cells. Using immunostaining, all expression variants were detected in the cytoplasm and in a punctate pattern at the cell surface, indicating that G12D and R32W did not interfere with either protein synthesis or transport to the cell membrane. Similarly, oligomerization into hemichannels appeared not impaired when expressing either Cx31 mutant as assessed by size exclusion chromatography, immunoblotting and immunostaining. However, dye transfer experiments and monitoring of intracellular calcium levels in response to serum stimulation revealed that G12D‐Cx31 did not form functional gap junction channels, probably due to incorrect assembly or altered properties of Cx31 channels. In contrast, intercellular coupling between cells expressing R32W‐Cx31 was comparable to that of wtCx31, suggesting that R32W is a functionally inconsequential polymorphism of Cx31.
DEM Extraction from LIDAR Data by Morphological Gradient

Digital Elevation Model (DEM) is essential for most geographic information system (GIS) applications and topographic analysis. The technology of airborne Light Detection And Ranging (LIDAR) provides a powerful support for generating high-resolution DEM. DEM extraction from LIDAR data includes filtering and DEM reconstruction. Recent years witnessed many kinds of filters designed and developed. However, filtering is still a practicably difficult, especially for scene complex area. In this paper, a new method of DEM extraction from LIDAR data based on morphological gradient is proposed. Firstly, point clouds are divided by an index mesh. Then, the morphological gradient of each point is calculated using the method suitable for filtering. And, objects are removed gradually by choosing some points based on gradients to carry on an improved opening operation iteratively. Finally, DEM is three-dimensional reconstructed through interpolating by inversing distance to a power. This method is tested with 15 sample data sets which are released by ISPRS and compared with other filtering methods qualitatively and quantitatively. The experimental results show that this method has high robustness in all kinds of complex scenes, which can reduce the nonessential computation as well as the possibility that all types of error happen. So the method has good adaptability and practicability.
The omohyoid muscle entrapment of the internal jugular vein. A still unclear pathogenetic mechanism

Objectives: To evaluate the role of the omohyoid muscle anatomic variants as a possible reversible cause of internal jugular vein extrinsic compression. Method: We describe a chronic cerebro-spinal venous insufficiency patient, who presented a omohyoid muscle entrapment of the internal jugular vein, confirmed by both magnetic resonance venography and ultrasound investigation. A omohyoid muscle surgical transection together with a patch angioplasty was performed. Results: The surgical procedure led to both IJV flow restoration and neurological improvement. Conclusions: The omohyoid muscle compression on the internal jugular vein seems to be a possible cause of venous obstruction, but several anatomical and patho-physiological aspects need further investigations. Such picture might cause balloon venous angioplasty inefficacy and needs to be preoperatively considered.
Cellular site of action of various adjuvants in antibody responses to hapten-carrier conjugates.

The adjuvant action of concanavalin A (Con A), Escherichia coli lipopolysaccharide (LPS), beryllium sulphate (Be salt) and Bordetella pertussis vaccine have been analyzed in a system measuring humoral immune responses to hapten-carrier conjugates in mice. For the definition of the cellular locus of their action, the effect of these adjuvants on adoptive secondary anti-hapten antibody responses was studied. Spleen cells from 2,4-dinitrophenyl (DNP)-keyhole limpet hemocyanin (KLH) primed donors, which normally fail to develop adoptive secondary anti-DNP responses to a heterologous conjugate such as DNP-bovine γ-globulin (BGG), can be stimulated to do so when an appropriate dose of adjuvant is administered with DNP-BGG. The capacity for the adjuvants employed to exert this effect requires the presence of thymus-derived (T) lymphocytes, since depletion of such cells by treatment of the donor cell inoculum with anti-θ serum and complement in vitro before adoptive transfer abrogates the response to DNP-BGG plus adjuvant. Moreover, evidence is presented which demonstrates that these substances exert their adjuvant action through the small number of unimmunized BGG-specific T lymphocytes in the donor cell inoculum. This conclusion derives from the failure of adjuvants to augment adoptive secondary anti-DNP responses to the DNP derivative of a non-immunogenic copolymer of d-glutamic acid and d-lysine for which there are few or no specific, functional T cells.
Partner Disclosure and Early CD4 Response among HIV-Infected Adults Initiating Antiretroviral Treatment in Nairobi Kenya

Background Disclosure of HIV serostatus can have significant benefits for people living with HIV/AIDS. However, there is limited data on whether partner disclosure influences ART treatment response. Methods We conducted a retrospective cohort study of newly diagnosed, ART-naïve HIV-infected adults (>18 years) who enrolled at the Coptic Hope Center in Nairobi, Kenya between January 1st 2009 and July 1st 2011 and initiated ART within 3 months. Analysis was restricted to adults who reported to have either disclosed or not disclosed their HIV status to their partner. Analysis of CD4 response at 6 and 12 months post-ART was stratified by age group. Results Among 615 adults newly initiating ART with partner disclosure data and 12 month follow-up, mean age was 38 years and 52% were male; 76% reported that they had disclosed their HIV-status to their partner. Those who disclosed were significantly younger and more likely to be married/cohabitating than non-disclosers. At baseline, median CD4 counts were similar between disclosure groups. Among younger adults (< 38 years) those who disclosed had higher CD4 recovery than those who did not at 6 months post- ART (mean difference = 31, 95% CI 3 to 58 p = 0.03) but not at 12 months (mean difference = 17, 95% CI -19 to 52, p = 0.4). Among older adults (≥ 38years) there was no observed difference in CD4 recovery at 6 or 12 months between disclosure groups. Conclusion Among younger adults, disclosure of HIV status to partners may be associated with CD4 recovery following ART.
Audio Tagging by Cross Filtering Noisy Labels

High quality labeled datasets have allowed deep learning to achieve impressive results on many sound analysis tasks. Yet, it is labor-intensive to accurately annotate large amount of audio data, and the dataset may contain noisy labels in the practical settings. Meanwhile, the deep neural networks are susceptive to those incorrect labeled data because of their outstanding memorization ability. In this article, we present a novel framework, named CrossFilter, to combat the noisy labels problem for audio tagging. Multiple representations (such as, Logmel and MFCC) are used as the input of our framework for providing more complementary information of the audio. Then, though the cooperation and interaction of two neural networks, we divide the dataset into curated and noisy subsets by incrementally pick out the possibly correctly labeled data from the noisy data. Moreover, our approach leverages the multi-task learning on curated and noisy subsets with different loss function to fully utilize the entire dataset. The noisy-robust loss function is employed to alleviate the adverse effects of incorrect labels. On both the audio tagging datasets FSDKaggle2018 and FSDKaggle2019, empirical results demonstrate the performance improvement compared with other competing approaches. On FSDKaggle2018 dataset, our method achieves state-of-the-art performance and even surpasses the ensemble models.
Effect of intratesticular administration of oxytocin on testicular steroidogenesis in immature rats

Summary The possible physiological role of testicular oxytocin in testicular steroidogenesis was studied in immature rats. In 5‐, 9‐, and 25‐day–old animals one of the testes was injected with 20, 50, and 200 ng of oxytocin, respectively, then the contralateral gonad was removed. Rats were killed 1 h, 1 day or 7 days post‐surgery. In each age group studied intratesticular injection of oxytocin resulted in a significant increase in basal testosterone secretion in vitro and/or serum testosterone concentration. Data indicate that in immature rats oxytocin of testicular origin might act as a local stimulator of steroidogenesis.
A modified quantitative subjective global assessment of nutrition for dialysis patients.

BACKGROUND Malnutrition, a predictor of increased mortality in dialysis patients, can be estimated using the subjective global assessment (SGA), a semiquantitative scale with three severity levels. This semiquantitative feature restricts the SGA's reliability and precision. METHODS Using the components of the conventional SGA, we developed a fully quantitative scoring system (the dialysis malnutrition score) consisting of seven variables: weight change, dietary intake, gastrointestinal symptoms, functional capacity, comorbidity, subcutaneous fat and signs of muscle wasting. Each component was assigned a score from 1 (normal) to 5 (very severe). The sum of all seven components in this malnutrition score lies between 7 (normal) and 35 (severely malnourished). To evaluate nutritional status in chronic dialysis patients, anthropometric measurements including mid-arm circumference (MAC), triceps skin-fold thickness, calculated mid-arm muscle circumference (MAMC), body mass index (BMI, ratio of weight to square of height) and laboratory parameters were used. Forty-one patients (20 men and 21 women) were randomly selected from a pool of 120 haemodialysis patients. Patients were aged between 26 and 81 years (mean SD, 57 +/- 12 years) and had undergone haemodialysis for between 7 months and 12 years (mean +/- SD, 3.0 +/- 2.1 years). RESULTS The malnutrition score of each patient was assessed by a dietitian within 5-20 min (12.0 +/- 3.5 min) with no knowledge of anthropometric findings. Pearson correlation coefficients between the malnutrition score and biceps skin-fold (r= -0.32) MAC (r= -0.55), MAMC (r= -0.66), BMI (r= -0.35), total iron-binding capacity (TIBC, r= -0.77), the serum albumin concentration (r= -0.36) and total protein (r= -0.33) were all significant, whereas the conventional SGA had significant correlation only with TIBC (r= -0.35) and MAMC (r= -0.37). Malnutrition score showed a significant correlation with age (r= +0.34) and years dialysed (r= +0.28). Multiple regression analysis showed a significant correlation between the malnutrition score and the combination of the MAMC, BMI, serum albumin concentration and TIBC (r= 0.81, P<0.001). There was no correlation between the malnutrition score and sex, urea reduction ratio, protein catabolic rate, and the absolute lymphocyte count. CONCLUSIONS We conclude that our invented malnutrition score, which can be performed in minutes, reliably assesses the nutritional status of haemodialysis patients. We suggest that our malnutrition score may be superior to the SGA. More comparative and longitudinal studies are needed to confirm the validity of this scoring system in nutritional evaluation of dialysis patients.
Beta-cell dysfunction, insulin sensitivity, and glycosuria precede diabetes in hepatocyte nuclear factor-1alpha mutation carriers.

OBJECTIVE Patients with diabetes due to hepatocyte nuclear factor (HNF)-1alpha mutations have beta-cell deficiency, insulin sensitivity, altered proinsulin levels, and a low renal threshold for glucose. It is uncertain how many of these features precede the development of diabetes. The aim of our study was to test for these characteristics in young nondiabetic HNF-1alpha mutation carriers. RESEARCH DESIGN AND METHODS A total of 47 offspring from 19 extended families underwent genetic testing, a standard oral glucose tolerance test, and urine testing. RESULTS HNF-1alpha mutations were found in 20 offspring, 7 with diabetes and 13 without diabetes. The 13 nondiabetic mutation carriers were compared with 27 family control subjects, who were matched for age, sex, and BMI. There was marked beta-cell deficiency with reduced insulinogenic index (53.5 [31.5-90.9] vs. 226.0 [126.0-407.1], SD [range], P < 0.001) and area under the curve for insulin (P < 0.001). Insulin sensitivity was increased in mutation carriers (homeostatic model assessment of insulin sensitivity 144.6 [82.7-252.7] vs. 100 [66.9-149.4], P = 0.025). A total of 38% of mutation carriers had glycosuria at 2 h compared with 0% of control subjects (P = 0.0034). Those with glycosuria had peak glucose values that were higher than the mutations carriers without glycosuria (range 8.1-11.8 vs. 6.2-8.4 mmol/l, P = 0.002). The seven subjects with diabetes all showed glycosuria. CONCLUSIONS We conclude that marked beta-cell deficiency, increased insulin sensitivity, and a low renal threshold are present in young nondiabetic HNF-1alpha mutation carriers. The presence of glycosuria post-glucose load could be used to screen children of mutation carriers as it occurs in all mutation carriers with a peak glucose in the oral glucose tolerance test >8.4 mmol/l.
One-year follow-up study of patients with enterochromaffin-like cell carcinoids after treatment with octreotide long-acting release

Objective. In a one-year study of 5 patients with chronic atrophic gastritis (CAG), pernicious anaemia (PA), hypergastrinaemia and enterochromaffin-like (ECL) cell tumours, the somatostatin analogue octreotide LAR (long-acting release) in a dose of 20 mg given intramuscularly at monthly intervals had an antiproliferative effect on the ECL cells. The aim of the present study was to follow neuroendocrine (NE) markers in the blood and macroscopic and histopathological changes in the stomach during a 12-month follow-up after discontinuation of octreotide LAR treatment. Material and methods. Five patients underwent upper gastrointestinal endoscopy at 6 and 12 months’ follow-up after octreotide LAR treatment. Biopsies from flat, oxyntic mucosa and from tumours were obtained. Sections were stained with haematoxylin-erythrosin and immunostained for the NE cell marker chromogranin A (CgA). Serum gastrin and CgA were measured every 3 months. Results. The number of visible tumours was unchanged (7) at 12 months’ follow-up. One lesion showed carcinoid tumour and the others various degrees of linear and micronodular NE hyperplasia. At the same time-point, biopsies from flat, oxyntic mucosa showed a slightly (non-significant) elevated number of CgA immunoreactive (IR) cells. Serum gastrin increased from 186±50 pM (mean±SEM) to 603±109 pM (normal < 40 pM); p<0.05, and serum CgA increased non-significantly from 25±2 ng/ml (normal < 30 ng/ml) to 61±11 ng/ml. Conclusions. During follow-up, slightly elevated levels of serum CgA and CgA IR cells in the oxyntic mucosa, without significant recurrence of ECL cell carcinoids, were observed.
Wie die "unsichtbare Hand" funktioniert: Gewinnmaximierung als Triebfeder der Effizienz. Ein "classroom-experiment"

Die empirische Prufung theoretischer Forschungsergebnisse wirft in der Okonomie - wie bei jeder Sozialwissenschaft - Probleme auf. Anders als in den Naturwissenschaften konnen kaum volkswirtschaftliche Labors errichtet werden. Seit einigen Jahren nutzen Okonomen die Erfahrungen der Psychologie mit stilisierten Experimenten, um zumindest ihre grundlegenden Verhaltenshypothesen testen zu konnen. Der Beitrag stellt ein einfaches Classroom-Experiment dar, das nicht nur eine zentrale Aussage der Mikrookonomie uberpruft, sondern auch hohen didaktischen Wert hat: Die Studenten erhalten Einblick in empirische Forschung und erleben hautnah das Funktionieren des Marktes.