Miracle-dz/UniFAR-FTUs huggingface dataset:
Psychological Androgyny and Preference for Intubation in a Nypothetical Case of End-stage Lung Disease

Psychological androgyny theory (PAT) was employed as a model of the interpersonal (social) and task activities required of physicians for care of their patients. According to PAT, indi viduals with a large repertoire of task and social skills ("androgynous" individuals) should be optimally adaptable to contingencies reflecting varying combinations of task and social challenges. The authors examined the relationship between androgyny and preference for intubation on a patient management problem involving end-stage lung disease for 67 general internists and internal medicine housestaff from two hosptials. Results revealed a negative relationship between androgyny and preference for intubation, suggesting that androgynous and nonandrogynous physicians respond differently to complex and difficult decision-making tasks. Indirect evidence is offered to suggest that this response reflects a general tendency to utilize fewer health care resources. Discussion focuses on the need to improve the pre cision of measurement of these latent constructs. Key words: androgyny; critical care; health care; resource use. (Med Decis Making 1990;10:215-222)
High VEGFR-3–positive Circulating Lymphatic/Vascular Endothelial Progenitor Cell Level Is Associated with Poor Prognosis in Human Small Cell Lung Cancer

Purpose: The newly identified bone marrow–derived cell population, called lymphatic/vascular endothelial progenitor cells (LVEPC), has been shown to contribute to lymph capillary growth in experimental tumor systems. The clinical significance of these cells has not yet been investigated in a human malignancy. Our aim was to study whether peripheral blood circulating LVEPCs participate in the progression of human small cell lung cancer (SCLC). Experimental Design: A total of 88 patients with limited-stage SCLC and 32 tumor-free control subjects were included. Peripheral blood circulating LVEPC labeled with CD34 and vascular endothelial growth factor receptor-3 (VEGFR3) antibodies and the serum levels of the key lymphangiogenic molecule VEGF-C were measured by flow cytometry and ELISA, respectively. Results: CD34-positive/VEGFR3-positive LVEPC levels were significantly increased in patients (versus controls; P < 0.01), and there was also a significant relationship between LVEPC counts and lymph node metastasis (P < 0.01). High pretreatment circulating LVEPC numbers correlated with poor overall survival (P < 0.01). Although we observed significantly elevated VEGF-C concentrations in patients (versus controls; P < 0.01), there was no significant correlation between VEGF-C and LVEPC levels. Moreover, no significant differences in peripheral blood VEGF-C levels were seen between patients subgrouped by clinicopathologic variables including tumor and lymph node stages and survival. Conclusions: Peripheral blood levels of bone marrow–derived LVEPCs are significantly increased in patients with SCLC and correlate with lymphatic involvement and prognosis. This is the first study that shows evidence of increased numbers of circulating LVEPC in patients with a malignant tumor.
Prolonged diastolic dysfunction following exercise induced ischaemia: a gated myocardial perfusion SPECT study

Prolonged impairment of left ventricular (LV) systolic function following exercise induced ischaemia has been well demonstrated. The objective of this study was to examine the effect of exercise induced ischaemia on the post-stress LV diastolic function in patients with coronary artery disease (CAD). Seventy-four subjects with known or suspected CAD underwent gated myocardial single photon emission computed tomography (SPECT) 1 h after administration of 99mTc tetrofosmin according to a standard same day exercise rest protocol. LV volumes and ejection fractions (LVEFs) were determined by the Cedars-Sinai program. Fourier transformation of the gated SPECT volume curve was performed retaining the fourth order harmonics, and peak filling rate (PFR) and time-to-PFR (TPFR) were calculated from the derivative curve. In patients with exercise induced ischaemia (n = 26), 1 h post-stress PFR (2.66±0.75 s−1) and TPFR (119±12 ms) were significantly impaired in comparison to the resting PFR (3.06±0.74 s−1; P = 0.0002) and TPFR (114±10 ms; P = 0.03), respectively. In normal subjects (n = 26) and in patients with infarction (n = 22), the post-stress indices were similar to the resting values. When reduction of PFR or LVEF greater than the variability (2SD) of differences between the post-stress and resting values in the normal group was defined as significant impairment, six of the 26 ischaemic patients (23%) had such changes in PFR. All these patients exhibited severe ischaemia and five of them had simultaneous systolic impairment. Only one (4%) of the normal subjects and none of the patients in the infarction group showed such impairments. Stepwise logistic regression analysis of stress, scan and coronary variables revealed that the summed reversibility score, a scintigraphic index of ischaemic severity, was the only determinant of post-stress changes in LVEF and PFR. In conclusion, exercise induced LV diastolic impairment persists for a prolonged period after resolution of the ischaemic episode. The incidence and magnitude of the diastolic impairment are determined by the severity of the exercise provoked ischaemia.
Analisis Derajat Desentralisasi Fiskal Keuangan Daerah Sebelum dan Sesudah Pelaksanaan Kebijakan Otonomi Daerah di Kota Malang

Dengan berlakunya Undang-Undang No" 22 & 25 Tahun 1999 tentang Otonomi Daerah, pemerintah di daerah dituntut untuk menjalankan roda pemerintahan yang efektif, efesien dan mampu mendorong peran masyarakat dalam meningkatkan pemerataan dan keadilan dengan mengembangkan seluruh potensi yang dimiliki oleh masing-masing daerah" Keberhasilan otonomi daerah tidak terlepas dari kemampuan dalam bidang keuangan" Ciri utama daerah yang mampu untuk berotonomi adalah terletak pada kemampuan daerah untuk membiayai penyelenggaraan pemerintahan di daerahnya dengan tingkat ketergantungan kepada pemerintah pusat mempunyai proporsi yang semakin kecil" Artinya kemandirian keuangan daerah diharapkan mampu tercipta setelah adanya otonomi daerah dan diharapkan PAD ( Pendapatan Asli Daerah ) harus menjadi bagian terbesar dalam mobilisasi dana penyelenggaraan pemerintahan daerah dan sudah sewajarnya PAD dijadikan tolak ukur dalam pelaksanaan otonomi daerah"
Antarctic lakes suggest millennial reorganizations of Southern Hemisphere atmospheric and oceanic circulation

The phasing of millennial-scale oscillations in Antarctica relative to those elsewhere in the world is important for discriminating among models for abrupt climate change, particularly those involving the Southern Ocean. However, records of millennial-scale variability from Antarctica dating to the last glacial maximum are rare and rely heavily on data from widely spaced ice cores, some of which show little variability through that time. Here, we present new data from closed-basin lakes in the Dry Valleys region of East Antarctica that show high-magnitude, high-frequency oscillations in surface level during the late Pleistocene synchronous with climate fluctuations elsewhere in the Southern Hemisphere. These data suggest a coherent Southern Hemisphere pattern of climate change on millennial time scales, at least in the Pacific sector, and indicate that any hypothesis concerning the origin of these events must account for synchronous changes in both high and temperate latitudes.
The risk-of-malignancy index to evaluate potential ovarian cancers in local hospitals.

OBJECTIVE To assess the risk-of-malignancy index (a scoring system based on menopausal status, ultrasound features, and serum CA 125) at district hospitals for referral of women with suspected malignant pelvic masses for primary surgery at a central gynecologic oncology unit. METHODS All seven hospitals in Health Region IV, Norway, agreed to refer women with pelvic masses and risk-of-malignancy indices of 200 or more for centralized primary surgery. In total, 365 women 30 years of age or older, admitted consecutively at the local hospitals, were enrolled in the study from February 1, 1995, to January 31, 1997. RESULTS Compliance with the study was satisfactory; 84% (65 of 77) of women with risk-of-malignancy indices of at least 200 were referred for centralized primary surgery. Sensitivity and specificity to malignancy were 71% and 92%, respectively, which is in agreement with previous validation of the risk-of-malignancy index in teaching hospital settings. False negatives were due mainly to stage Ia (18 of 24) ovarian cancer, whereas 27 of 28 stage II-IV ovarian cancer cases were identified correctly. CONCLUSION The risk-of-malignancy index identified women with malignant pelvic masses efficiently. Our study showed the risk-of-malignancy index strategy in a practical setting to be able to centralize primary surgery for advanced ovarian cancer from local hospitals to a subspecialty unit. We recommend the risk-of-malignancy index for detection of patients with advanced ovarian cancer for centralized primary surgery.
The use of a nasogastric tube to facilitate nasotracheal intubation: a randomised controlled trial

During nasotracheal intubation, the tracheal tube passes through either the upper or lower pathway in the nasal cavity, and it has been reported to be safer that the tracheal tube passes though the lower pathway, just below the inferior turbinate. We evaluated the use of a nasogastric tube as a guide to facilitate tracheal tube passage through the lower pathway, compared with the ‘conventional’ technique (blind insertion of the tracheal tube into the nasal cavity). A total of 60 adult patients undergoing oral and maxillofacial surgery were included in the study. In 20 out of 30 patients (66.7%) with the nasogastric tube‐guided technique, the tracheal tube passed through the lower pathway, compared with 8 out of 30 patients (26.7%) with the ‘conventional’ technique (p = 0.004). Use of the nasogastric tube‐guided technique reduced the incidence and severity of epistaxis (p = 0.027), improved navigability (p = 0.034) and required fewer manipulations (p = 0.001) than the ‘conventional’ technique.
Radiation Dose Distribution in Polymer Gels by Raman Spectroscopy

The Raman spectroscopy of polymer gel dosimeters has been investigated with a view to developing a novel dosimetry technique that is capable of determining radiation dose within a micrometer of spatial resolution. The polymer gel dosimeter, known as the PAG dosimeter, is typically made up of acrylamide, N,N′-methylene-bis-acrylamide, gelatin, and water. A polyacrylamide network within the gelatin matrix forms in response to an absorbed dose. The loss of monomers may be monitored by corresponding changes to the Raman spectrum. Principal component analysis offers a simple method of quantifying the absorbed radiation dose from the Raman spectrum of the polymer gel. The background luminescence in the spectrum increased significantly with dose and is shown to originate in the glass of the sample vial. The competing effects of elastic scatter, which increases with dose due to the formation of polymer, and sample absorption were quantified and found to introduce errors of up to 5% under certain conditions. Raman spectra as a function of distance from the air–surface interface have been measured for samples that were subjected to doses delivered by a clinical linear accelerator. The depth dose profile thus obtained compared favorably with “gold standard” ion-chamber measurements.
Signal Detection in Underwater Sound by Dual-Tree Discrete Wavelet Transform

A use of a dual-tree discrete wavelet transform (DT DWT) to the problem of signal detection in underwater sound is proposed in this paper. By noted that there is no obvious distribution assumption can model underwater noise, an empirical model of noise constructed by the discrete wavelet transform (DWT) is applied to identify the signals. This DWT based model adapts with time and is treated as a baseline at any time to detect the signals. Though, the DWT has a high reputation as a tool for signal compression, due to lack of shift invariance, it has major variations in the distribution of energy between DWT coefficients in different subbands. For detection applications, the ill effects of translation need to be neutralized because the test statistic depends on the energy of signals. This paper proposes the use of a dual-tree discrete wavelet transform (DT DWT) to the problem of signal detection in underwater sound. This shift-invariant DT DWT can generate multi-resolution subspaces that keep more of their coefficient energy in each of these subspaces than discrete wavelet transform's (DWT). The detection performance comparison, using the receiver operating characteristics (ROC) curves, of this proposed DT DWT-based detector and DWT-based method is presented.
Individual decision making in relation to participation in cardiovascular screening: A study of revealed and stated preferences

Aims: The (cost-)effectiveness of a screening programme may be strongly influenced by the participation rate. The objective of this study was to compare participants’ and non-participants’ motives for the attendance decision as well as their overall preferences for participation in cardiovascular disease screening. Methods: This study sampled 1053 participants and 1006 non-participants from a screening trial and randomly allocated the participants to receive different levels of additional information about the screening programme. An ad hoc survey questionnaire about doubt and arguments in relation to the participation decision was given to participants and non-participants along with a contingent valuation task. Results: Among participants, 5% had doubt about participation and the most frequent argument was that they did not want the test result. Among non-participants, 40% would reconsider their non-participation decision after having received additional information while the remainder 60% stood by their decision and provided explicit arguments for it. After having received additional information the participants still valued the programme significantly higher than non-participants, but the difference was relatively small. Conclusions: Participants and non-participants in cardiovascular screening programmes seem to have different strengths of preferences, which signals that their behavioural choice is founded in rational thinking. Furthermore, it appears that additional information and a second reflection about the participation decision may affect a substantial proportion of non-participants to reverse their decision, a finding that should receive policy interest.
Genotoxicity and oxidative stress in chromium-exposed tannery workers in North India

Trivalent chromium (Cr) is an environmental contaminant, which is extensively used in tanning industries throughout the world and causes various forms of health hazards in tannery workers. Therefore, a cross-sectional study design was used to evaluate the DNA damage and oxidative stress condition in tannery workers exposed to Cr in North India. The study population comprised 100 male tanners in the exposed group and 100 healthy males (no history of Cr exposure) in the comparable control group. Baseline characteristics including age, smoking, alcohol consumption habits and duration of exposure were recorded via interviewing the subjects. Blood Cr level (measured by atomic absorption spectrophotometry), DNA damage (measured by comet assay) and oxidative stress parameters (malondialdehyde (MDA), glutathione (GSH) and superoxide dismutase (SOD)) were estimated in both the groups. As a result of statistical analysis, exposed group showed significantly higher level of Cr (p < 0.0001), DNA damage (p < 0.0001), MDA (p < 0.0001), SOD (p < 0.05) and lower level of GSH (p < 0.001) when compared with controls. Smoking, alcohol consumption habits and age had no significant effect (p > 0.05) on DNA damage and oxidative stress parameters in both the groups. In simple and multiple correlation analysis, DNA damage and oxidative stress parameters showed significant correlation with Cr level and duration of exposure in exposed group. The findings of the present study revealed that chronic occupational exposure to trivalent Cr may cause DNA damage and oxidative stress in tannery workers.
Phase I/II trial of 5-fluorouracil and a noncytotoxic dose level of suramin in patients with metastatic renal cell carcinoma.

BACKGROUND Renal cell carcinoma (RCC) is recognized as a neoplasm resistant to chemotherapy. In vitro experiments demonstrated that suramin, at noncytotoxic doses, enhanced the activity of chemotherapy including 5-fluorouracil (5-FU) in xenograft models. PATIENTS AND METHODS A phase I/II trial of noncytotoxic suramin in combination with weekly 5-FU in patients with metastatic RCC was conducted. The treatment consisted of intravenous (i.v.) suramin followed by a 500 mg/m2 i.v. bolus of 5-FU given 4.5 hours after starting suramin. In the phase I portion, a cohort of 6 patients received a suramin dose calculated to achieve a plasma level of 10-50 micromol/L. Therapy was administered once weekly for 6 doses, followed by 2 weeks off. This was followed by a phase II portion in which the primary goal was to determine the objective response rate. RESULTS Twenty-three patients were enrolled in the study: 6 in the phase I portion and 17 in phase II. Seventy-eight percent of patients were men, the mean age was 58.8 years, 96% had previous nephrectomy, and 70% had received previous systemic therapy. Histologic subtype was clear cell in 91%. Dose-limiting toxicity was observed in 1 of 6 patients (grade 3 hypersensitivity related to suramin infusion). The suramin dosing nomogram used in phase I and II portions of the trial yielded the desired plasma level of 10-50 micromol/L from 4.5 hours to 48 hours after infusion in 94 of 115 treatments. No objective responses were noted, and the median time to treatment failure was 2.5 months. The major toxicities (all grades) were fatigue (83%), nausea/vomiting (78%), diarrhea (61%), and chills (61%). CONCLUSION Suramin levels expected to reverse fibroblast growth factor-induced resistance can be achieved with the dosing regimen used in this study. The toxicity observed with suramin and 5-FU was acceptable. The combination does not have clinical activity in patients with metastatic RCC.
10-year incidence of diabetes and associated risk factors in Greece: the ATTICA study (2002-2012).

BACKGROUND The incidence of diabetes in the general population is increasing world-wide. The increase is attributed to the consumption of saturated fatty acids, obesity, lack of physical activity, genetic predisposition, and other factors, but knowledge about the reasons, biological mechanisms, and late complications is insufficient. It is therefore important to clarify the reasons more exactly through long-term clinical trials to stop the rise of diabetes and its complications. AIM To evaluate the 10-year incidence of type 2 diabetes in apparently healthy Greek adults. METHODS In 2001-2002, a random sample of 1514 men (18-87 years old) and 1528 women (18-89 years old) was selected to participate in the ATTICA study. During 2011-2012, the 10-year follow-up was performed. Patients diagnosed with diabetes at baseline (n = 210) and those lost at the 10-year follow-up (n = 1347) were excluded, yielding a final sample of 1485 participants. RESULTS During the period of investigation, diabetes was diagnosed in 191 cases corresponding to a 12.9% incidence (95%CI: 10.4-15.4), with 13.4% (95%CI: 10.8-16) in men and 12.4% (95%CI: 10.1-14.7) in women. A relative increase was observed in the second half of the 10-year follow-up when age became significant. Multiple logistic regression analysis revealed that age (OR = 1.14, 95%CI: 1.09-1.19), abnormal waist-to-height ratio (OR = 3.27, 95%CI: 1.07-10.0), fasting blood glucose (OR per 1 mg/dl = 0.05, 95%CI: 1.02-1.08), energy intake (OR per 500 kcal = 1.02, 95%CI: 1.01-1.35), and family history of diabetes (OR = 2.8, 95%CI: 1.30-6.03) were the most significant baseline predictors for diabetes, after adjusting for potential confounders. Waist-to-height ratio showed the best explanatory power of all anthropometric variables. Physical activity exerts an effect on risk factors. Being active was found to eliminate the aggravating effect of diabetes family history and fasting blood glucose. CONCLUSIONS The findings confirm the escalating increase of type 2 diabetes incidence in Greece, which is in line with global trends. A lifestyle change in individuals at risk of developing diabetes towards healthier eating and increased physical activity would be an effective and inexpensive means of reducing diabetes.
Antidepressant-Induced Hyponatremia in Older Adults.

OBJECTIVE To describe the prevalence of hyponatremia in older adults related to antidepressive agents and identify potential alternative options in older adults with a low-baseline serum sodium concentration and/or when a patient has experienced hyponatremia as a result of taking an antidepressant. DATA SOURCES A PubMed search was conducted on November 10, 2015. Search terms included: antidepressive agents, antidepressive agents second-generation, bupropion, citalopram, desvenlafaxine, duloxetine, escitalopram, fluoxetine, fluvoxamine, hyponatremia, milnacipran, mirtazapine, paroxetine, reboxetine, syndrome of inappropriate antidiuretic hormone, sertraline, trazodone, venlafaxine, and vilazodone. Filters included English language. A search of product labeling was also conducted. STUDY SELECTION Out of 363 results, 124 publications were identified and reviewed along with 11 additional references. Publications were chosen based on relevance to the review: case reports of patients 60 years of age or older or clinical investigations of the association between hyponatremia and antidepressants in older adults. DATA EXTRACTION Hyponatremia was counted as an adverse effect if an antidepressant was the likely cause of hyponatremia, and hyponatremia was resolved after withdrawal. DATA SYNTHESIS Antidepressant-induced hyponatremia in older adults is fairly common. Selective serotonin reuptake inhibitors, serotonin/norepinephrine reuptake inhibitors, and mirtazapine were implicated in the majority of the case reports and clinical studies evaluating older adults. Bupropion, trazodone, and tricyclic antidepressants were implicated less often in the same literature. CONCLUSION Given its unique mechanism of action, bupropion may be the most appropriate antidepressant for older adults at risk for antidepressant-induced hyponatremia.