Miracle-dz/UniFAR-FTUs huggingface dataset:
Occult serious bacterial infection in infants younger than 60 to 90 days with bronchiolitis: a systematic review.

OBJECTIVE To summarize the risk of occult serious bacterial infection in the youngest febrile infants presenting with either clinical bronchiolitis or respiratory syncytial virus infection. DATA SOURCES We performed a systematic search of the Medline database for studies reporting rates of serious bacterial infection in infants younger than 90 days with clinical bronchiolitis and/or respiratory syncytial virus infection. STUDY SELECTION Studies reporting on cultures performed at the time of presentation to care and providing a denominator, ie, total number of each type of culture obtained, were analyzed. MAIN EXPOSURE Admission for bronchiolitis. MAIN OUTCOME MEASURES Age-specific rates of urinary tract infection, bacteremia, and meningitis were extracted. RESULTS The weighted rate of urinary tract infections in the youngest infants in the 11 studies analyzed was 3.3% (95% confidence interval, 1.9%-5.7%). No case of bacteremia was reported in 8 of 11 studies. No case of meningitis was reported in any of the studies. Summary statistics for meningitis and bacteremia are not provided because of an excess of zero events in these samples. CONCLUSIONS A screening approach to culturing for serious bacterial infections in febrile infants presenting with bronchiolitis or respiratory syncytial virus infection is very low yield. The rate of urine cultures positive for bacteria remains significant, though asymptomatic bacteriuria may confound these results.
Anthropometric and Endocrine Features in Girls with Isolated Premature Pubarche or Non-Classical Congenital Adrenal Hyperplasia

UNLABELLED Clinical and hormonal changes in girls with precocious pubarche, a multifactorial entity, have not been thoroughly investigated. OBJECTIVES To describe anthropometric features and bone age in Brazilian girls with precocious pubarche, and to compare clinical and hormonal findings for patients with isolated precocious pubarche (IPP) or non-classical congenital adrenal hyperplasia (NC-CAH). PATIENTS AND METHODS Twenty-eight girls with precocious pubarche were consecutively seen at the Child and Pubertal Gynecologic Clinic and the Gynecological Endocrinology Unit of Hospital de Clinicas de Porto Alegre. Patients with central precocious puberty and pseudopuberty were excluded from the study. Diagnostic criteria: NC-CAH: 17-hydroxyprogesterone (17OHP) >12 ng/ml 60 min after 0.25 mg i.m. ACTH; IPP: hormonal levels compatible with adrenarche and normal adrenal function confirmed by ACTH testing. Anthropometric and hormonal features and bone age were assessed. RESULTS Six patients had NC-CAH, and 22 IPP. NC-CAH frequency was 21.42%. Weight and BMI were above 50th percentile except for patients <4 years; 46% of the girls were either overweight or obese. Clinical and hormonal features, except for response to ACTH testing, were similar in both groups; all patients were in or above the 50th percentile for height. Bone age was advanced in 43% of the patients. There was no statistical difference between the groups. CONCLUSION Slight acceleration of height and bone age, one of the clinical manifestations of precocious pubarche, is unlikely to be progressively severe.
Discriminación salarial por sexo: una análisis sel sector privado y sus diferencias regionales en España

El presente trabajo ofrece una medida tanto de las diferencias como de la discriminacion salarial por sexo en las comunidades autonomas. Utilizando los datos de la Encuesta de Estructura Salarial, referidos al sector privado en el ano 1995, las diferencias salariales se descomponen siguiendo el metodo de Oaxaca. Los resultados reflejan que, a nivel regional, unas mayores diferencias salariales no se corresponden necesariamente con una discriminacion mas elevada. Por otro lado, la incorporacion tardia de la mujer al mercado laboral, asi como su segregacion sectorial y ocupacional, constituyen el origen fundamental de las diferencias salariales por sexo.
Clinicopathologic Characteristics of Pregnancy-Associated Breast Cancer: Results of Analysis of a Nationwide Breast Cancer Registry Database

Purpose This study aimed to evaluate the clinicopathological characteristics of pregnancy-associated breast cancer (PABC) in comparison with non-pregnancy associated breast cancer (non-PABC). Methods A total of 344 eligible patients with PABC were identified in the Korean Breast Cancer Society Registry database. PABC was defined as ductal carcinoma in situ, invasive ductal carcinoma, or invasive lobular carcinoma diagnosed during pregnancy or within 1 year after the birth of a child. Patients with non-PABC were selected from the same database using a 1:2 matching method. The matching variables were operation, age, and initial stage. Results Patients with PABC had significantly lower survival rates than patient with non-PABC (10-year survival rate: PABC, 76.4%; non-PABC, 85.1%; p=0.011). PABC patients had higher histologic grade and were more frequently hormone receptor negative than non-PABC patients. Being overweight (body mass index [BMI], ≥23 kg/m2), early menarche (≤13 years), late age at first childbirth (≥30 years), and a family history of breast cancer were more common in the PABC group than in the non-PABC group. Multivariate analysis showed the following factors to be significantly associated with PABC (vs. non-PABC): early menarche (odds ratio [OR], 2.165; 95% confidence interval [CI], 1.566–2.994; p<0.001), late age at first childbirth (OR, 2.446; 95% CI, 1.722–3.473; p<0.001), and being overweight (OR, 1.389; 95% CI, 1.007–1.917; p=0.045). Conclusion Early menarche, late age at first childbirth, and BMI ≥23 kg/m2 were more associated with PABC than non-PABC.
Asymptotic capacity of Rician fading Channel for large scale antenna systems

This paper analyzes the asymptotic upper bound capacity of large scale antenna Array (Massive MIMO) system with the Rician fading Channel. We mathematically derived the channel matrix for Rician fading for Line of Sight (LOS) and Non Line of Sight (LOS) components by using fundamental wave equations. The channel characteristics of the LOS and NLOS (scattering) paths are shown. The asymptotic capacity results were verified by using analytical and Monte-Carlo simulations to analyze the Rician factor (K) characteristic with the transmit and receive antennas. The results show that the capacity gap is large for small number of receive antennas and higher K factor (K ≥10). And for large number of receive antennas the K factor (K ≤ 10) assuming the transmit antennas are large for both scenarios. The results also show that asymptotic capacity of the Rician channel converges to Rayleigh channel (K =0) for Large antenna Array. Mathematical expressions for Rician channel capacity have been provided. These results are great contribution to the Beamforming for the Massive MIMO Technology.
Autologous Chondrocyte Transplantation

We evaluated the durability of autologous chondrocyte transplantation grafts in 61 patients treated for isolated cartilage defects on the femoral condyle or the patella and followed up for a mean of 7.4 years (range, 5 to 11). Durability was determined by comparing the clinical status at the long-term follow-up with that found 2 years after the transplantation. After 2 years, 50 of the 61 patients had good or excellent clinical results, and 51 of 61 had good or excellent results at 5 to 11 years later. Grafted areas from 11 of the patients were evaluated with an electromechanical indentation probe during a second-look arthroscopy procedure (mean follow-up, 54.3 months; range, 33 to 84); stiffness measurements were 90% or more of those of normal cartilage in eight patients. Eight of twelve 2-mm biopsy samples taken from these patients showed hyaline characteristics with safranin O staining and a homogeneous appearance in polarized light. Three fibrous and eight hyaline biopsy specimens stained positive to aggrecan and to cartilage oligomeric matrix protein. Hyaline-like specimens stained positive for type II collagen, and fibrous, for type I collagen. Autologous chondrocyte transplantation for the treatment of articular cartilage injuries has a durable outcome for as long as 11 years.
Modeling Sexual Assault Risk Perception Among Heterosexual College Females

This investigation utilizes structural equation modeling (SEM) to build and test a comprehensive model of specific and global risk perception. A sample of 325 undergraduate females responded to measures of previous victimization, problematic alcohol use, and maladaptive coping. They also rated perceived risk in multiple hypothetical dating vignettes. The results revealed strong relationships between problematic alcohol use and both decreased specific and increased global risk perception. In addition, previous victimization and maladaptive coping were related to increased global risk perception and specific risk perception, respectively. These findings carry implications for theories of risk perception and point to new approaches for research.
The somatotopy of tic inhibition: Where and how much?

Tics are the hallmark feature of Tourette syndrome. The basic phenomenological and neurophysiological characteristics of tics have been widely investigated. Interestingly, the spatial distribution of tics across different body parts has received little attention. No previous study has investigated whether the capacity for voluntary tic inhibition also varies across body parts.
Disposition of chloroquine in man after single intravenous and oral doses.

1 Chloroquine was given in 300 mg single doses as an i.v. infusion, an oral solution and as tablets at intervals of at least 56 days to 11 healthy volunteers. Concentrations of chloroquine and its metabolite desethylchloroquine were measured in plasma, erythrocytes and urine using h.p.l.c. 2 Chloroquine was detectable in all plasma samples up to 23 days and occasionally up to 52 days after dosage. Urinary concentrations were monitored up to 119 days. The disposition pattern was multiexponential reflecting extensive tissue binding of the drug. 3 After i.v. dosing the volume of distribution ranged from 116 to 285 l/kg and the apparent terminal half-life from 146 to 333 h. Total plasma clearance +/- s.d. was 712 +/- 166 ml/min and renal clearance 412 +/- 139 ml/min. The mean estimated urinary recovery of chloroquine was 47%, 42% and 46% after i.v. , oral solution and tablets indicating nearly complete bioavailability. The corresponding figures for the metabolite were 7%, 10% and 12%. 4 The disposition of chloroquine in erythrocytes was parallel to that in plasma. The concentrations in erythrocytes were consistently 2 to 5 times higher than in plasma. 5 Subjective side effects like difficulties with swallowing and accommodation, diplopia and fatigue occurred during intravenous infusion and were closely related to plasma concentrations. No effect was seen on the electrocardiogram, mean arterial blood pressure and pulse rate. No adverse reactions were observed after the oral doses. High frequency audiometry did not reveal any significant hearing impairment for the group as a whole.
Increased placental expression of fibroblast growth factor 21 in gestational diabetes mellitus.

BACKGROUND Fibroblast growth factor 21 (FGF21) can regulate glucose and lipid metabolism. The placenta actively synthesizes and secretes many hormones, but it is unknown whether this includes FGF21. This study aimed to analyze the placental expression of FGF21 in women with or without gestational diabetes mellitus (GDM). METHODS FGF21 and peroxisome proliferator-activated receptor (PPAR)-α mRNA and protein expression were measured in the placentae of 20 women with and 18 without GDM. mRNA expression of PPARα, FGF receptors 1-4, the coreceptor β-klotho, and glucose transporter (GLUT)-1, -3, and -4 was investigated. Maternal and fetal circulating FGF21 levels were assessed in 10 mother-baby dyads per condition. RESULTS FGF21 was expressed in the placenta and its mRNA expression increased in women with GDM [10.75 (interquartile range 3.28-125.6 AU)] vs control [0.83 (0.22-4.78), P < . 001], as is its protein expression [GDM 2.89 (1.44-5.10)] vs control [0.42 (0.05-1.98), P < . 05]. PPARα mRNA but not protein expression was increased in GDM [2.94 (0.70-7.26)] vs control [0.99 (0.43-2.17), P < . 05] and was positively correlated to FGF21 mRNA expression (ρ = 0.43, P < .01). Placental mRNA expression of FGF receptors and GLUT1 was unchanged, and β-klotho, GLUT3, and GLUT4 showed increased expression in GDM. Maternal circulating FGF21 levels were similar [GDM 323 (75-921) vs control 269 (49-731) pg/mL, P = . 81]. FGF21 was undetected in fetal cord blood. CONCLUSIONS FGF21 is expressed in the placenta and its expression is increased in GDM. The absence of FGF21 in fetal cord blood suggests that neither placental FGF21 nor maternal circulating FGF21 is secreted into the fetal circulation. Placental FGF21 may be a regulator of placental metabolism.
Incremental value of global systolic dyssynchrony in determining the occurrence of functional mitral regurgitation in patients with left ventricular systolic dysfunction.

AIMS The aim of this study was to assess the contribution of left ventricular (LV) systolic dyssynchrony to functional mitral regurgitation (MR). METHODS AND RESULTS Patients (n = 136) with LV systolic dysfunction (ejection fraction <50%) and at least mild MR were prospectively recruited. The effective regurgitant orifice area (EROA) was assessed by the proximal isovelocity surface area method. Left ventricular global systolic dyssynchrony [the maximal difference in time to peak systolic velocity among the 12 LV segments (Ts-Dif)] and regional systolic dyssynchrony (the delay between the anterolateral and posteromedial papillary muscle attaching sites) were assessed by tissue Doppler imaging. Left ventricular global and regional remodelling, systolic function, indices of mitral valvular and annular deformation were also measured. The size of the EROA correlated with the degrees of mitral deformation, LV remodelling, systolic function, and systolic dyssynchrony. By multivariate logistic regression analysis, the mitral valve tenting area (OR = 1.020, P < 0.001) and the Ts-Dif (OR = 1.011, P = 0.034) were independent determinants of significant functional MR (defined by EROA ≥20 mm(2)). From the receiver-operating characteristic curve, the tenting area of 2.7 cm(2) (sensitivity 83%, specificity 82%, AUC 0.86, P < 0.001) and the Ts-Dif of 85 ms (sensitivity 66%, specificity 72%, AUC 0.74, P < 0.001) were associated with significant functional MR. The assessment of Ts-Dif showed an incremental value over the mitral valve tenting area for determining functional MR (χ(2) = 53.92 vs.49. 11, P = 0.028). CONCLUSION This cross-sectional study showed that LV global, but not regional systolic dyssynchrony, is a determinant of significant functional MR in patients with LV systolic dysfunction, and is incremental to the tenting area that is otherwise the strongest factor for mitral valve deformation.
Safety outcomes in the United States: trends and challenges in measurement.

OBJECTIVE To prepare Agency for Healthcare Research and Quality (AHRQ) for monitoring the impact of its own patient safety initiative, by exploring available outcomes data, assessing usability of measures, and estimating national trends in patient outcomes. DATA SOURCES Annual summary data on incidence of Joint Commission Sentinel Events, MEDMARX medication error events, and MDS measures of falls and pressure ulcers in nursing home residents. HCUP National Inpatient Sample (NIS) administrative claims data. METHODS Description and assessment of published summary data on selected safety measures. Analysis of selected Patient Safety Indicators (PSIs) and Utah–Missouri adverse event measures using HCUP NIS claims data (1994–2003). PRINCIPAL FINDINGS Interpretation of safety outcome trends requires close attention to the characteristics of underlying data sources and measures. Encounter-based measures have been affected by changes in definitions and ICD-9 coding, as well as by changes in the structure of administrative datasets like HCUP NIS. Historical trends are mixed for the safety outcome measures reviewed, with some measures showing improvement, others deterioration, and still others remaining fairly stable. CONCLUSIONS Constructing national trends of safety outcomes is difficult because of limitations in available data sources and measures. Tracking growth in the adoption of safe practices could offer an important strategy for complementing existing safety measurement capabilities.
Boston Keratoprosthesis Outcomes and Complications

Purpose: To evaluate the outcomes of the Boston Keratoprosthesis (KPro) at our institution. Methods: A computerized database retrospectively identified all patients who received a Boston KPro from August 2005 to October 2007. Results: There were 37 patients, 24 (65%) were male. Mean age was 66.3 years (median 69 years, range: 24-93 years; SD = 18.1 years). Mean follow-up was 16 months (range: 6-28 months; SD = 6.0 months). There were 36 type 1 (97%) and 1 type 2 (3%) KPros. The primary indication was failed penetrating keratoplasty in 29 patients (78%)-22 (59%) from multiple failures. Preoperative comorbidities included glaucoma [27 patients (73%)] and limbal stem cell deficiency [13 patients (35%)]. No intraoperative complications occurred. Postoperative complications included retroprosthetic membrane [24 patients (65%)], increased intraocular pressure [14 patients (38%)], glaucoma progression [5 patients (13.5%)], and endophthalmitis [4 patients (11%)-3 who discontinued prophylactic antibiotics secondary to compliance]. Thirty-six KPros (97%) were retained-1 type 2 KPro (3%) in a patient with ocular cicatricial pemphigoid extruded and was replaced. Mean best-corrected visual acuities were counting fingers preoperatively (range: light perception to 20/100) and 20/90 at last follow-up (range: light perception to 20/25). At last follow-up, 31 patients (84%) improved 2 lines or greater-3 patients (8%) had worse vision. Conclusions: Retention rates were excellent, and best-corrected visual acuities improved in the vast majority of patients. Complications can occur and require frequent follow-up to monitor and treat glaucoma progression, endophthalmitis, and inflammation. Patient compliance is of paramount importance. Despite the potential complications, the Boston KPro provides visual improvement in patients with an otherwise poor prognosis.
Comparison of Five Experimental Pain Tests to Measure Analgesic Effects of Alfentanil

BackgroundSeveral experimental pain models have been used to measure opioid effects in humans. The aim of the current study was to compare the qualities of five frequently used experimental pain tests to measure opioid effects. MethodsThe increase of electrical, heat, and pressure pain tolerance and the decrease of ice-water and ischemic pain perception was determined at baseline and at four different plasma concentrations of alfentanil (n = 7) administered as target controlled infusion or placebo (n = 7). A linear mixed-effects modeling (NONMEM) was performed to detect drug, placebo, and time effect as well as interindividual and intraindividual variation of effect. ResultsOnly the electrical, ice-water, and pressure pain tests are sensitive to assess a concentration–response curve of alfentanil. At a plasma alfentanil concentration of 100 ng/ml, the increase in pain tolerance compared with baseline was 42.0% for electrical pain, 22.2% for pressure pain, and 21.7% for ice-water pain. The slope of the linear concentration–response curve had an interindividual coefficient of variation of 58.3% in electrical pain, 35.6% in pressure pain, and 60.0% in ice-water pain. The residual error including intraindividual variation at an alfentanil concentration of 100 ng/ml was 19.4% for electrical pain, 6.1% for pressure pain, and 13.0% for ice-water pain. Electrical pain was affected by a significant placebo effect, and pressure pain was affected by a significant time effect. ConclusionElectrical, pressure, and ice-water pain, but not ischemic and heat pain, provide significant concentration–response curves in the clinically relevant range of 200 ng/ml alfentanil or lower. The power to detect a clinically relevant shift of the curve is similar in the three tests. The appropriate test(s) for pharmacodynamic studies should be chosen according to the investigated drug(s) and the study design.
+61A>G polymorphism in the EGF gene does not increase the risk of lung cancer

Background and objectives: Epidermal growth factor (EGF) plays an important role in tumourigenesis by binding with its receptor, EGFR. Variations in the DNA sequence in the EGF gene can lead to an alteration in EGF production and/or activity, which can affect an individual's susceptibility to lung cancer. To test this hypothesis, this study examined the association between the +61 A>G polymorphism in the 5′‐untranslated region of the EGF gene and the risk of lung cancer in a Korean population.
Solitons northeast of Tung-Sha Island during the ASIAEX pilot studies

In a recent study, satellite images have shown that internal solitons are active in the northern South China Sea (SCS). During the Asian Seas International Acoustic Experiment (ASIAEX) pilot studies, current profiler and thermistor chain moorings were deployed in the spring of 1999 and 2000 to investigate internal solitons northeast of Tung-Sha Island on the continental slope of the northern SCS. Most of the observed internal solitons were first baroclinic mode depression waves. The largest horizontal current velocity, vertical displacement, and temperature variation induced by the internal solitons were around 240 cm/s, 106 m, and 11/spl deg/C, respectively, while the estimated nonlinear phase speed was primarily westward at 152 /spl plusmn/ 4 cm/s. The observed internal solitons could be categorized as four types. The first type is the incoming wave from deep water and can be described reasonably well with the KdV equation. The second and third types are in the transition zone before and close to the turning point (where the upper and lower layer depths are equal), respectively. These two types of solitons were generally near the wave-breaking stage. The fourth type of soliton is a second baroclinic mode and probably was locally generated. The time evolutions are asymmetric, especially at the middle depths. A temperature kink following the main pulse of the soliton is often seen. Higher order nonlinear and shallow topographic effects could be the primary cause for these features. The appearance/disappearance of internal solitons coincides mostly with spring/neap tide. The internal soliton is irregularly seen during the neap tide period and its amplitude is generally small. The time interval between two leading solitons is generally around 12 h. The first baroclinic mode of the semidiurnal tide has a larger amplitude than the diurnal tide and could redistribute its energy into the soliton.
Bicycle-Related Injuries Among Children and Adolescents in the United States

The objective of this study is to describe the epidemiology of bicycle-related injuries among children and adolescents 18 years and younger on a national level. This is a retrospective analysis of data from the National Electronic Injury Surveillance System of the US Consumer Product Safety Commission for patients 18 years and younger who were seen in emergency departments (EDs) between January 1, 1990, and December 31, 2005, for injuries received while operating a bicycle. During the 16-year study period, there were an estimated 6 228 700 individuals 18 years and younger treated in US EDs for bicycle-related injuries. Children with head injuries were more than 3 (relative risk, 3.63) times as likely to require hospitalization and were almost 6 (relative risk, 5.77) times more likely to have their injuries result in death. The large number of annual bicycle related—injuries is evidence that prevention of these injuries should remain an important area of bicycle safety research and practice.