Miracle-dz/UniFAR-FTUs huggingface dataset:
Older Patients' Understanding of Emergency Department Discharge Information and Its Relationship With Adverse Outcomes

Objectives: To describe older patients' understanding of emergency department (ED) discharge information and to explore the relationship between understanding of ED discharge information and adverse outcomes. Methods: Telephone interviews were conducted with patients 65 years or older (or their proxies) within 72 hours of discharge from an academic medical center ED. We assessed 4 areas of discharge information: ED diagnosis, expected course of illness, self-care instructions, and return precautions. Adverse events were defined as repeat ED visits and hospitalizations or deaths within 90 days of ED discharge. Reverse Kaplan-Meier curves were constructed to illustrate cumulative event probabilities according to patient understanding of discharge information (differences examined with log-rank tests). Results: Of 92 respondents (mean patient age, 75.1; SD, 7.4; 59.8% female subjects), patients or proxies reported not understanding discharge information about diagnosis (20.7%), self-care instructions (16.3%), expected course of illness (63%), and return precautions (55.7%). Within 90 days of ED discharge, 42.3% of patients had returned to the ED, 30.4% were hospitalized, and 4.3% had died. There was little difference in cumulative event probabilities according to whether patients understood self-care instructions or return precautions. Adverse event probabilities were higher among patients who did not understand their ED diagnosis (P = 0.33) and those who did not understand expected course of illness (P = 0.12), although these did not achieve statistical significance. Conclusions: A substantial number of older patients, or proxies, may not understand ED discharge information, and this could have an effect on patient outcomes. Strategies are needed to improve communication of ED discharge information to older patients and their families.
Pharmacokinetics of penciclovir in healthy cats following oral administration of famciclovir or intravenous infusion of penciclovir.

OBJECTIVE To investigate the pharmacokinetics of penciclovir in healthy cats following oral administration of famciclovir or IV infusion of penciclovir. ANIMALS 6 cats. PROCEDURES Cats received famciclovir (40 [n = 3] or 90 [3] mg/kg, PO, once) in a balanced crossover-design study; the alternate dose was administered after a ≥ 2-week washout period. After another washout period (≥ 4 weeks), cats received an IV infusion of penciclovir (10 mg/kg delivered over 1 hour). Plasma penciclovir concentrations were analyzed via liquid chromatography-mass spectrometry at fixed time points after drug administration. RESULTS Mean ± SD maximum plasma concentration (C(max)) of penciclovir following oral administration of 40 and 90 mg of famciclovir/kg was 1.34 ± 0.33 μg/mL and 1.28 ± 0.42 μg/mL and occurred at 2.8 ± 1.8 hours and 3.0 ± 1.1 hours, respectively; penciclovir elimination half-life was 4.2 ± 0.6 hours and 4.8 ± 1.4 hours, respectively; and penciclovir bioavailability was 12.5 ± 3.0% and 7.0 ± 1.8%, respectively. Following IV infusion of penciclovir (10 mg/kg), mean ± SD penciclovir clearance, volume of distribution, and elimination half-life were 4.3 ± 0.8 mL/min/kg, 0.6 ± 0.1 L/kg, and 1.9 ± 0.4 hours, respectively. CONCLUSIONS AND CLINICAL RELEVANCE Penciclovir pharmacokinetics following oral administration of famciclovir were nonlinear within the dosage range studied, likely because of saturation of famciclovir metabolism. Oral administration of famciclovir at 40 or 90 mg/kg produced similar C(max) and time to C(max) values. Therefore, the lower dose may have similar antiviral efficacy to that proven for the higher dose.
Predictors of mortality in presenile and senile dementia

Forty‐seven hospitalized patients with a diagnosis of presenile or senile dementia and without focal neurological disease or major systemic illness were given complete neurological, neuroradiological, and neuropsychological examinations. Mortality at one year after hospitalization was determined, 12 patients being lost to follow‐up. Of the remaining 35 patients, 19 were alive and 16 had died. These two groups did not differ in age, education, length of dementia history, sex, race, or degree of cerebral atrophy (by computerized tomography). Significant differences were found in degree of electroencephalographic abnormality and in 8 of 14 cognitive measures, the largest single difference being on a test of expressive language. Discriminant function analysis made with the cognitive measures as dependent variables yielded a correct prediction (classification analysis) of mortality in all but 1 case (97% accuracy). These results suggest that (1) degree of functional brain impairment rather than degree of cerebral atrophy may be the more important influence on mortality in dementia patients without focal lesions, (2) short‐term survival may be accurately predicted in such patients by tests of cognitive functioning, and (3) expressive language deficit in such patients may indicate a particularly poor prognosis for survival.
Local Anesthetic Efficacy of Ropivacaine (LEA 103) in Ulnar Nerve Block

Ropivacaine (LEA 103) is a new long-acting local anesthetic that in animal experiments has proved to be equally potent but less toxic than bupivacaine. In this controlled double-blind study in man, the dose-response relation of ropivacaine was examined in peripheral nerve block and its potency was compared to that of bupivacaine. Nerve functions during bilateral ulnar nerve block were monitored in 70 normal subjects by a computer-controlled method. Results indicate that plain ropivacaine is optimally effective at concentrations between 0.5% and 0.75%, where it reliably blocks nerve functions for about 8 hours. Its profile of action is uniform for the different fiber groups and resembles that of bupivacaine. Addition of epinephrine does not improve latency or duration of ropivacaine nerve block. Adverse effects attributable to ropivacaine have not been observed.
The Experience of Living With Insulin-Dependent Diabetes: Lessons for the Diabetes Educator

The purpose of this grounded theory study was to investigate the experience of living with insulin-dependent diabetes mellitus. Data were collected from interviews with four participants, and from their diabetes papers and journals. This article summarizes the results of the data collection and presents implications for diabetes educators. The results challenge the traditional compliance/adherence paradigm within which current diabetes education programs operate and provide evidence of the need to move to a new integration paradigm. The new paradigm would replace adherence relationships with collaborative alliances between clients and educators and encourage educators to practice empathy as a way of knowing.
Daily cortisol production rate in man determined by stable isotope dilution/mass spectrometry.

Growth retardation as well as the development of Cushingoid features in adrenally insufficient patients treated with the currently accepted replacement dose of cortisol (33-41 mumol/day.m2; 12-15 mg/m2.day) prompted us to reevaluate the cortisol production rate (FPR) in normal subjects and patients with Cushing's syndrome, using a recently developed thermospray liquid chromatography-mass spectrometry method. The stable isotope [9,12,12-2H3]cortisol was infused continuously for 31 h at about 5% of the anticipated FPR. Blood samples were obtained at 20-min intervals for 24 h, spun, and pooled in 4-h groups. Tracer dilution in plasma was determined by liquid chromatography/mass spectrometry. The method was validated with controlled infusions in 6 patients with adrenal insufficiency. Results from 12 normal volunteers revealed a FPR of 27.3 +/- 7.5 mumol/day (9.9 +/- 2.7 mg/day) or 15.7 mumol/day.m2; 5.7 mg/m2. day). A previously unreported circadian variation in FPR was observed. Patients with Cushing's syndrome demonstrated unequivocal elevation of FPR and cortisol concentration correlated during each sample period in normal volunteers, indicating that cortisol secretion, rather than metabolism, is mainly responsible for changes in plasma cortisol. Our data suggest that the FPR in normal subjects may be lower than previously believed.
Market Orientation and Business Performance in the Veterinary Care Industry : An Empirical Analysis

This study conducted an empirical investigation into the link between market orientation and business performance in the professional veterinary service sector in Thailand. Market orientation was assessed using Narver and Slater’s (1990) construct, adapted to the industry and cultural context of this study. Customer orientation is a key sub-dimension of market orientation, but other components include competitor orientation, inter-functional coordination, long-term focus, and profit emphasis. Data from eighty owners of veterinary clinics and hospitals in Bangkok and suburban areas were used to empirically test the hypothesized relationship between these components and two components of business performance, customer response and financial performance. Regression analysis revealed that customer orientation was a significant determinant of customer response, and to complete the causal chain, customer response had a significant positive effect on financial performance. The customer orientation component is the key element driving the relationship. The implication for high level professional service businesses in general, and veterinary care businesses in particular, is that customer orientation can help them gain competitive advantage and improve business performance.
Degree of facial and body terminal hair growth in unselected black and white women: toward a populational definition of hirsutism.

CONTEXT Hirsutism (i.e. facial and body terminal hair growth in a male-like pattern in women) is the principal clinical sign of hyperandrogenism, although its definition remains unclear. OBJECTIVE The purposes of the present study were to define 1) the degree of facial and body terminal hair, as assessed by the modified Ferriman-Gallwey (mFG) score, in unselected women from the general population; 2) the effect of race (Black and White) on the same; and 3) the normative cutoff values. DESIGN AND SETTING We conducted a prospective observational study at a tertiary academic medical center. PATIENTS/PARTICIPANTS Participants included 633 unselected White (n = 283) and Black (n = 350) women presenting for a preemployment physical exam. INTERVENTIONS Interventions included history and physical examination. MAIN OUTCOME MEASURES Terminal body hair growth was assessed using the mFG scoring system; nine body areas were scored from 0-4 for terminal hair growth distribution. RESULTS The mFG scores were not normally distributed; although cluster analysis failed to identify a natural cutoff value or clustering of the population, principal component and univariate analyses denoted two nearly distinct clusters that occurred above and below an mFG value of 2, with the bulk of the scores below. Overall, an mFG score of at least 3 was observed in 22.1% of all subjects (i.e. the upper quartile); of these subjects, 69.3% complained of being hirsute, compared with 15.8% of women with an mFG score below this value, and similar to the proportion of women with an mFG score of at least 8 who considered themselves to be hirsute (70.0%). Overall, there were no significant differences between Black and White women. CONCLUSIONS Our data indicate that the prevalence and degree of facial and body terminal hair growth, as assessed by the mFG score, is similar in Black and White women and that an mFG of at least 3 signals the population of women whose hair growth falls out of the norm.
Automatic texture guided color transfer and colorization

This paper targets two related color manipulation problems: Color transfer for modifying an image's colors and colorization for adding colors to a grayscale image. Automatic methods for these two applications propose to modify the input image using a reference that contains the desired colors. Previous approaches usually do not target both applications and suffer from two main limitations: possible misleading associations between input and reference regions and poor spatial coherence around image structures. In this paper, we propose a unified framework that uses the textural content of the images to guide the color transfer and colorization. Our method introduces an edge-aware texture descriptor based on region covariance, allowing for local color transformations. We show that our approach is able to produce results comparable or better than state-of-the-art methods in both applications.
Is There a Place for Patellofemoral Arthroplasty?

Indications for patellofemoral arthroplasty were studied based on a 2− to 10-year followup review. Of 183 patellofemoral prostheses implanted between 1980 and 1990,104 were associated with unicompartmental arthroplasty, and 79 were implanted alone. Thirteen patients were lost to followup. The results of 66 patellofemoral arthroplasties are reported at an average followup of 66 months. The mean age of the patients at surgery was 57 years. Underlying causes of the osteoarthritis included patellar dislocation or dysplasia (22), patellar fracture (20), and primary osteoarthritis (24). A metallic femoral groove was associated with a polyethylene patella with no metal backing. Two (9%) prostheses were revised in the dysplasia group, 1 (5%) in the posttraumatic group, and 7 (29%) in the primary osteoarthritis group. In this latter group, the indications of patellofemoral arthroplasty must be restricted to lesions of the patellofemoral joint in a knee in neutral axis evaluated preoperatively on full standing and stress radiographs. The best results of patellofemoral arthroplasty were obtained in osteoarthritis after patellar dislocation or patellar fracture.
Assessment of myocardial deformation with cardiac magnetic resonance strain imaging improves risk stratification in patients with dilated cardiomyopathy.

AIMS To investigate the prognostic impact of left-ventricular (LV) cardiac magnetic resonance (CMR) deformation imaging in patients with non-ischaemic dilated cardiomyopathy (DCM) compared with late-gadolinium enhancement (LGE) quantification and LV ejection fraction (EF). METHODS AND RESULTS A total of 210 subjects with DCM were examined prospectively with standard CMR including measurement of LGE for quantification of myocardial fibrosis and feature tracking strain imaging for assessment of LV deformation. The predefined primary endpoint, a combination of cardiac death, heart transplantation, and aborted sudden cardiac death, occurred in 26 subjects during the median follow-up period of 5.3 years. LV radial, circumferential, and longitudinal strains were significantly associated with outcome. Using separate multivariate analysis models, global longitudinal strain (average of peak negative strain values) and mean longitudinal strain (negative peak of the mean curve of all segments) were independent prognostic parameters surpassing the value of global and mean LV radial and circumferential strain, as well as NT-proBNP, EF, and LGE mass. A global longitudinal strain greater than -12.5% predicted outcome even in patients with EF < 35% (P < 0.01) and in those with presence of LGE (P < 0.001). Mean longitudinal strain was further investigated using a clinical model with predefined cut-offs (EF < 35%, presence of LGE, NYHA class, mean longitudinal strain greater than -10%). Mean longitudinal strain exhibited an independent prognostic value surpassing that provided by NYHA, EF, and LGE (HR = 5.4, P < 0.01). CONCLUSION LV longitudinal strain assessed with CMR is an independent predictor of survival in DCM and offers incremental information for risk stratification beyond clinical parameters, biomarker, and standard CMR.
Regions outside of the Leucine-Rich Repeats of Flax Rust Resistance Proteins Play a Role in Specificity Determination

Multiple alleles controlling different gene-for-gene flax rust resistance specificities occur at the L locus of flax. At least three distinct regions can be recognized in the predicted protein products: the Toll/interleukin-1 receptor homology (TIR) region, a nucleotide binding site (NBS) region, and a leucine-rich repeat (LRR) region. Replacement of the TIR-encoding region of the L6 allele with the corresponding regions of L2 or LH by recombination changed the specificity of the allele from L6 to L7. Replacement of the TIR and most of the NBS-encoding region of L10 with the equivalent region of L2 or L9 generated recombinant alleles having a novel specificity. However, replacement of the L10 TIR-encoding region with the TIR-encoding region of L2 gave rise to an allele with no detectable specificity. These data indicate that non-LRR regions can determine specificity differences between allelic gene products and that functional specificity involves interactions between coadapted polymorphic regions in the protein products of the alleles. Evidence for the action of diversifying selection on the TIR region is observed.
Investigator‐masked comparison of tazarotene gel q.d. plus mometasone furoate cream q.d. vs. mometasone furoate cream b.i.d. in the treatment of plaque psoriasis

Seventy‐three patients with stable plaque psoriasis entered an investigator‐masked trial comparing once‐daily tazarotene 0.1% gel plus once‐daily mometasone furoate 0.1% cream with twice‐daily mometasone furoate 0.1% cream. The aim of the study was to determine whether tazarotene and mometasone furoate act synergistically –‐ a previous study showed that tazarotene plus mometasone furoate offered greater efficacy than tazarotene alone, and this study investigated whether tazarotene plus mometasone furoate also offered greater efficacy than mometasone furoate alone.
Integrating Mailed Personalized Feedback and Alcohol Screening Events: A Feasibility Study

This study characterized a sample of college students attending National Alcohol Screening Day (NASD), and tested the feasibility of using NASD as a platform for initiating the delivery of mailed personalized feedback forms. Participants (N = 153, 65% female) attended NASD and completed the Alcohol Use Disorders Identification Test (AUDIT [1]). A subset of at-risk drinkers completed additional questionnaires about their alcohol use and received personalized feedback through the mail. Thirty-four percent of the participants scored above the recommended clinical cutoff on the AUDIT. Men reported higher levels of alcohol consumption and alcohol-related negative consequences. The subset of at-risk drinkers reported frequent occasions of binge drinking and relatively high blood alcohol concentrations (BAC). NASD is an effective way of identifying college students with clinically significant levels of alcohol use, and provides an efficient mechanism for initiating the delivery of personalized feedback. More research on the combined effects of NASD and personalized feedback is warranted.
Genetic expression outside the skin: Clues to mechanisms of Genotype × Environment interaction

Abstract The rapidly moving study of Gene × Environment interaction (G × E) needs interim conceptual tools to track progress, integrate findings, and apply this knowledge to preventive intervention. We define two closely related concepts: the social mediation of the expression of genetic influences and the interaction between the entire genotype and the social environment (G × E). G × E, the primary focus of this report, assesses individual differences in the full genotype using twin, sibling, and adoption designs and, for the most part, employs fine-grained analyses of relational processes in the social environment. In comparison, studies of Allele × Environment interaction assess the influence on development of one or more measured polymorphisms as modified by environmental factors. G × E studies build on work showing how the social environment responds to genetic influences and how genetic influences shape the social environment. Recent G × E research has yielded new insight into variations in the sensitivity of the social environment to genotypic influences and provides clues to the specificity and timing of these environmental responses that can be leveraged to inform preventive interventions aimed at reducing genetic risk for problem behavior.
SPONTANEOUS CLOSURE OF MACULAR HOLE AFTER DRAINAGE OF SUBFOVEAL PERFLUOROCARBON LIQUID

Purpose: To report a rare case of macular hole formation after drainage of subretinal perfluorocarbon liquid (PFCL), which closed spontaneously. Methods: Retrospective case report. A 60-year-old was noted to have subfoveal PFCL after a macula-involving retinal detachment repair with silicone oil tamponade. Spectral domain optical coherence tomography (Spectralis; Heidelberg Engineering, Heidelberg, Germany) was used for postoperative imaging. Results: Two months postdetachment repair, the patient underwent removal of silicone oil and drainage of subfoveal PFCL using a 41-gauge cannula through a extrafoveal retinotomy. A full-thickness macular hole was noted 2 weeks postoperatively. This closed spontaneously 4 months later, with an improvement in vision, although there was evidence of subfoveal atrophy. Conclusion: Macular hole formation can occur after drainage of subfoveal PFCL, with a favorable prognosis if managed conservatively. The resultant foveal atrophy highlights the importance of early identification and removal of subretinal PFCL.
Perceived Success, Auditory Feedback, and Mental Imagery: What Best Predicts Improved Efficacy and Motor Performance?

Purpose: Performance enhancement techniques can improve self-efficacy (SE) and task performance. The focus of this study was to determine which techniques could best achieve this with three novel tasks. Method: Participants (n = 98) were counterbalanced across tasks and conditions (48 participants assigned to each condition in each task) and completed two trials of putting (imagery vs. no imagery), throwing (easy vs. difficult), and kicking (verbal feedback vs. no feedback) tasks, and SE and performance scores were recorded. Results: The results revealed that the auditory feedback condition had the greatest impact as it significantly explained both SE and performance scores, with a greater effect recorded for SE scores. Use of imagery or allocation to the easy-to-score condition did not improve performance or SE scores more than did the control conditions. Conclusions: These findings were unexpected as successful past performance is often cited as the main determinant of SE change. Further empirical investigation is required to determine if these findings are repeatable and if they generalize to sporting settings.
Exploring the Evolution of Star Formation and Dwarf Galaxy Properties with JWST/MIRI Serendipitous Spectroscopic Surveys

The James Webb Space Telescope’s Medium Resolution Spectrometer (MRS), will offer nearly two orders of magnitude improvement in sensitivity and >3× improvement in spectral resolution over our previous space-based mid-IR spectrometer, the Spitzer IRS. In this paper, we make predictions for spectroscopic pointed observations and serendipitous detections with the MRS. Specifically, pointed observations of Herschel sources require only a few minutes on source integration for detections of several star-forming and active galactic nucleus lines, out to z = 3 and beyond. But the same data will also include tens of serendipitous 0 ≲ z ≲ 4 galaxies per field with infrared luminosities ranging ∼106–1013 L☉. In particular, for the first time and for free we will be able to explore the LIR < 109 L☉ regime out to z ∼ 3. We estimate that with ∼ 100 such fields, statistics of these detections will be sufficient to constrain the evolution of the low-L end of the infrared luminosity function, and hence the star formation rate function. The above conclusions hold for a wide range in the potential low-L end of the IR luminosity function, and account for the PAH deficit in low-L, low-metallicity galaxies.