Miracle-dz/UniFAR-FTUs huggingface dataset:
Predictive and associative models to identify hospitalized medical patients at risk for VTE.

BACKGROUND Acutely ill hospitalized medical patients are at risk for VTE. We assessed the incidence of VTE in the observational International Medical Prevention Registry on Venous Thromboembolism (IMPROVE) study and derived VTE risk assessment scores at admission and associative VTE scores during hospitalization. METHODS Data from 15,156 medical patients were analyzed to determine the cumulative incidence of clinically observed VTE over 3 months after admission. Multiple regression analysis identified factors associated with VTE risk. RESULTS Of the 184 patients who developed symptomatic VTE, 76 had pulmonary embolism, and 67 had lower-extremity DVT. Cumulative VTE incidence was 1.0%; 45% of events occurred after discharge. Factors independently associated with VTE were previous VTE, known thrombophilia, cancer, age > 60 years, lower-limb paralysis, immobilization ≥ 7 days, and admission to an ICU or coronary care unit (first four were available at admission). Points were assigned to each factor identified to give a total risk score for each patient. At admission, 67% of patients had a score ≥ 1. During hospitalization, 31% had a score ≥ 2; for a score of 2 or 3, observed VTE risk was 1.5% vs 5.7% for a score ≥ 4. Observed and predicted rates were similar for both models (C statistic, 0.65 and 0.69, respectively). During hospitalization, a score ≥ 2 was associated with higher overall and VTE-related mortality. CONCLUSIONS Weighted VTE risk scores derived from four clinical risk factors at hospital admission can predict VTE risk in acutely ill hospitalized medical patients. Scores derived from seven clinical factors during hospitalization may help us to further understand symptomatic VTE risk. These scores require external validation.
Delirium: A Test of the Diagnostic and Statistical Manual III Criteria on Medical Inpatients

Although 10% to 15% of patients admitted to acute care hospitals are in a state of delirium, few patients are given this diagnosis by their clinician. We field‐tested the Diagnostic and Statistical Manual III (DSM‐III) criteria for diagnosing delirium on 133 consecutively admitted patients to an acute medical ward. Twenty patients were delirious using DSM‐III criteria, 19 more patients than were reported by the primary clinician. Seven delirious patients were less than 65 years of age (range, 32 to 64 years). Sixty‐five percent of patients with delirium died, whereas significantly fewer (3.3%) of patients without delirium died (P <.0001). We found that delirium could be readily and reliably detected (kappa coefficient of agreement = 0.62 for interrater reliability) using the DSM‐III criteria. Clinicians should routinely screen hospitalized patients of all ages using DSM‐III criteria to identify delirious patients for an immediate evaluation and treatment.
Interaction of pressure- and flow-induced responses in porcine coronary resistance vessels.

Pressure-induced myogenic responses and flow-induced vasodilatory responses have been documented in coronary resistance arterioles, but the interaction of these two mechanisms and the nature of the flow-mediated response are not well understood. Experiments were designed to quantitatively study the interaction of pressure- and flow-induced responses and to characterize the nature of the substance responsible for flow-mediated dilation in isolated coronary arterioles. Subepicardial arterioles (40-80 microns) were isolated from pigs and cannulated with two glass micropipettes and then pressurized via independent reservoir systems. Flow was initiated by simultaneously moving the reservoirs in equal and opposite directions thus generating a pressure gradient (delta P) without changing the mean intraluminal pressure (IP). IP was changed by moving both reservoirs in the same direction to alter myogenic tone in the absence of flow (delta P = 0). Flow-mediated dilation competed with myogenic constriction when flow and pressure were elevated. Also, flow potentiated myogenic dilation when IP was decreased. The magnitude of flow-induced dilation was greatest at an intermediate level of vascular tone (IP = 60 cmH2O) but was attenuated at higher and lower levels of tone. In the presence of flow (delta P = 4 cmH2O), pressure-diameter relationships were shifted upward, and the magnitude of myogenic responsiveness was attenuated. Double-vessel bioassay studies indicated that a transferable substance was released from intact endothelium in response to flow. Flow-induced dilation was not affected by indomethacin but was abolished by NG-monomethyl-L-arginine or by mechanical removal of endothelium. (ABSTRACT TRUNCATED AT 250 WORDS)
Automatic Statistical Analysis of Bivariate Nonstationary Time Series

We propose a new method for analyzing bivariate nonstationary time series. The proposed method is a statistical procedure that automatically segments the time series into approximately stationary blocks and selects the span to be used to obtain the smoothed estimates of the time-varying spectra and coherence. It is based on the smooth localized complex exponential (SLEX) transform, which forms a library of orthogonal complex-valued transforms that are simultaneously localized in time and frequency. We show that the smoothed SLEX periodograms are consistent estimators, report simulation results, and apply the method to a two-channel electroencephalogram dataset recorded during an epileptic seizure.
Emerging drugs for diabetic nephropathy

There is an increasing number of patients with diabetes mellitus in many countries. Diabetic kidney disease, one of its microvascular complications, is also increasing markedly and has become a major cause of end stage renal disease worldwide. Intervention for preventing and delaying the development and progression of diabetic kidney disease is not only a medical concern, but also a social issue. Despite extensive efforts, however, medical interventions thus far are not effective enough to prevent the progression of the disease and the development of end stage renal disease. This justifies attempts to develop novel therapeutic approaches for diabetic nephropathy. Recent insights on its pathogenesis and progression have suggested new targets for the specific treatment of this disease. They include aldosterone, aldose reductase, arachidonic acid metabolites, growth factors, advanced glycosylation end-products, peroxisome proliferator-activated receptors and endothelin. Several other biochemical mediators have been targeted in experimental animal models with the goal to prevent diabetic nephropathy progression, but translation to clinics of these experimental achievements are still limited or lacking.
Gamma Knife surgery for the management of intracranial dural arteriovenous fistulas.

OBJECT The purpose of this study was to assess the efficacy and safety of Gamma Knife surgery (GKS) for the treatment of cavernous sinus dural arteriovenous fistulas (CSDAVFs) and other intracranial dural arteriovenous fistulas (ODAVFs). METHODS Among the 238 GKS procedures performed for intracranial DAVFs in the authors' institute, 227 cases (146 CSDAVFs and 81 OIDAVFs) with clinical follow up formed the database from which the authors determined clinical outcome and the incidence of untoward events. One hundred ninety-five cases (118 CSDAVFs and 77 ODAVFs) with imaging follow up formed the database from which the authors determined the imaging results. Older age, female sex, higher incidence of diabetes, and shorter duration of symptoms were noted more in cases of CSDAVF than in ODAVFs. Most patients had symptomatic improvement after GKS. A symptomatic cure was observed in one patient with CSDAVFs as early as 6 weeks. The cumulative cure rate based on follow-up angiography of CSDAVFs approached 75% at 24 months, which was much better than that of ODAVFs (approximately 50% at 24 months). A neuroimaging-based cure lagged behind that of the clinical symptoms. Overall, there were only two nonfatal intracerebral hemorrhages during the follow-up period, both occurring less than 1 week after GKS and both being Cognard Type IIa+b with initial aggressive symptoms. Transient deterioration of neurological status without hemorrhage was noted in six patients with ODAVFs. Thrombosis of the superior ophthalmic vein occurred in 11 patients with CSDAVFs, in two of whom there were unilateral visual impairments. There were three cranial nerve neuropathies: transient in one CSDAVF and one ODAVF involving the jugular foramen, and another one was a CSDAVF previously treated by conventional radiotherapy. CONCLUSIONS Gamma Knife surgery provides a safe and effective option for treatment of intracranial DAVFs with a low risk of complications. In cases of DAVFs with benign clinical presentation, GKS can serve as a primary treatment. In some cases of aggressive DAVFs in which there is extensive retrograde cortical vein drainage, combined treatment with embolization or surgery is suggested.
High UBCH10 protein expression as a marker of poor prognosis in esophageal squamous cell carcinoma.

BACKGROUND/AIM Ubiquitin-conjugating enzyme H10 (UBCH10) is required in the cell-cycle transition from metaphase to anaphase. Therefore, we investigated whether its expression level in cancerous esophageal lesions affected prognosis of patients with esophageal squamous-cell carcinoma. MATERIALS AND METHODS Paraffin-embedded tissue samples from 121 patients with esophageal squamous cell carcinoma were stained with antibody to UBCH10 for immunohistochemical analysis. RESULTS UBCH10 was expressed in cancerous and dysplastic lesions, but not in normal tissue. Patients were grouped according to expression: High (N=33) or low (N=88), depending on the staining pattern. There were significant differences between the groups in terms of invasion into lymphatic vessels, number of metastatic lymph nodes, TNM classification, and stages, as well as in survival: the 50% survival rate in the high expression group was 2.3 years, whereas it was 9.9 years for the low-expression group (p<0.0001). Even with multivariate adjusting for stage 0 to stage IV using the Cox proportional hazard model, patients belonging to the high-expression group had a poor prognosis (Hazard ratio=2.5; 95% Confidence Interval=1.3-4.5; p=0.004). CONCLUSION High protein expression of UBCH10 is a marker of poor prognosis in esophageal squamous cell carcinoma.
A game theoretic method to model and analyze attack‐defense strategy of resource service in cloud application

Cloud computing has attracted much attention recently in both industry field and academic research area. More and more Internet applications are moving to the cloud environment. However, it is difficult to construct perfectly secure mechanisms facing up with complex and various attacks in cloud computing, the efficient attack‐defense strategy is highly demanded. In this paper, a stochastic game model is proposed based on combining stochastic Petri nets with game theory, which is used to describe the attack‐defense behaviors in cloud computing. The physical machine, attack‐defense behavior, and their attributes are also modeled by stochastic game model thus forming the attack‐defense game model of cloud computing. On this basis, the Nash equilibrium of attack‐defense process in physical machine is computed to get the optimal defense strategy. The related theories of Petri nets and the reachable states of attack‐defense game model are used to formally verify the correctness and effectiveness of the proposed method. The enforcement algorithm is proposed to make cloud computing dynamically evaluate and select the defense strategy to against attack behavior as quickly as possible. Both case study and simulation results show that the proposed method can adapt quickly to the changes in cloud application thus improving the security of cloud computing.
A critical examination of school-based occupational therapy collaborative consultation

Background Although collaborative consultation has been widely adopted in school-based occupational therapy practice, there is limited conceptual understanding of how collaboration contributes to educationally relevant outcomes for students with disabilities. Even without a clear understanding of the evidence related to school-based occupational therapy services, there continue to be decisions about funding and delivery of services. Purpose This paper synthesizes and critically appraises the research literature on collaborative consultation services in school-based occupational therapy in order to provide program administrators with direction for critically examining decision making for service deliveryin their districts. Key Issues Advancing occupational therapy practice in education settings requires a sound theoretical understanding of collaborative consultation. Distributed cognition offers a more robust understanding of the relationship between educator-therapist collaboration and outcomes of school-based occupational therapy services. Implications This review concludes with two fundamental conditions necessary for collaboration between educators and occupational therapists to flourish.
Selective Early Production of CCL20, or Macrophage Inflammatory Protein 3α, by Human Mast Cells in Response to Pseudomonas aeruginosa

ABSTRACT Mast cells are important as sentinel cells in host defense against bacterial infection. Much of their effectiveness depends upon recruiting other immune cells; however, little is known about the mechanisms of this response. CCL20, also known as macrophage inflammatory protein-3α (MIP-3α), Exodus, and LARC, is a chemokine known to be a potent chemoattractant for immature dendritic cells and T cells. In this study, we examined the human mast cell production of both CCL20 and granulocyte-macrophage colony-stimulating factor (GM-CSF), a critical cytokine for innate immune responses in the lung, in response to Pseudomonas aeruginosa. Reverse transcription-PCR and Western blot analysis demonstrated that the human mast cells (HMC-1) express CCL20 mRNA and are able to produce a significant amount (32.4 ng/ml) of CCL20 protein following stimulation by calcium ionophore and phorbol myristate acetate. Importantly, P. aeruginosa potently stimulated CCL20 production in human cord blood-derived mast cells (CBMC), with production peaking at 6 h after stimulation. This time course of expression was distinct from that of GM-CSF, which peaked after 24 to 48 h. Significant CCL20 production did not occur following immunoglobulin E-mediated activation of CBMC under conditions which induced a substantial GM-CSF response. Interestingly, the CCL20 response of mast cells to P. aeruginosa was relatively resistant to inhibition by the corticosteroid dexamethasone, interleukin-10, or cyclosporine, while GM-CSF production was potently inhibited. However, P. aeruginosa-induced CCL20 production was blocked by the protein kinase C (PKC) inhibitor Ro 31-8220 and a PKC pseudosubstrate. These results support a role for human mast cells in the initiation of immune responses to P. aeruginosa infection.
[LTB4-metabolism and histamine liberation by granulocytes in the disease pattern of cystic fibrosis (CF)].

We determined the generation and liberation of LTB4 in peripheral granulocytes and the histamine release from basophils in patients suffering from cystic fibrosis (CF, median 17.2 years of age, n = 12). We compared the data with an age matched group of healthy donors (n = 12). All patients suffered from an exacerbation of a chronic pulmonary infection caused by P. aeruginosa. Peripheral granulocytes were stimulated at different days before, during and after antiinfectious treatment with Ca-Ionophore, opsonized zymosan and arachidonic acid. The granulocytes from patients with CF as compared to the control group showed an increased omega-Oxidation of the synthesized LTB4 into 20-COOH- and 20-OH-LTB4 after stimulation with Ca-Ionophore and opsonized zymosan (Ca-Ionophore: ratio of LTB4 versus omega-oxidated products (CF): 0.77 +/- 0.007 mean +/- S.E. M. , n = 12, control group: 1.07 +/- 0.1, n = 12, p less than 0.01). Stimulation of the cells with Ca-Ionophore combined with arachidonic acid led to a significantly increased formation of lipoxygenase products in the patient group. No significant differences in the basophil counts were determined between both populations. However, the absolute histamine content per basophil was elevated in the CF group (2.4 +/- 0.3 versus 1.6 +/- 0.2 mean +/- S.E.M., n = 12/12, p less than 0.04). Stimulation of basophils with Ca-Ionophore and anti-IgE leads to a significant higher release of histamine per basophil in CF patients (Ca-Ionophore: 2.6 +/- 0.2 versus 1.3 +/- 0.8 pg/basophil, mean +/- S.E.M., p less than 0.05). These data indicate that basophils in CF may have a greater potential to release mediators. During the antiinfectious treatment a normalization of the altered pattern was observed. Within the CF-groups a strong correlation between the release of LTB4, its metabolites, the histamine release per basophil, the total histamine content and clinical (e.g. pO2 FEV1) and laboratory findings (e.g. IgE and IgG levels, CRP) was established. Our data suggest that the inflammatory process in patients with CF is associated with an alteration of the lipoxygenase pathway and histamine releasability of granulocyte subpopulations which correlates with the clinical signs of inflammation.
Sparse kernel logistic regression for β-turns prediction

A β-turn is a secondary protein structure type that plays a significant role in protein folding, stability, and molecular recognition. On average 25% of amino acids in protein structures are located in β-turns. Development of accurate and efficient method for β-turns prediction is very important. Most of the current successful β-turns prediction methods use support vector machines (SVMs) or Neural Networks (NNs), however a method that can yield probabilistic outcome, and has a well-defined extension to the multi-class case will be more valuable in β-turns prediction. Although kernel logistic regression (KLR) is a powerful classification technique that has been applied successfully in many classification problems, however it is often not found in β-turns classification, mainly because it is computationally expensive. In this paper we used KLR to obtain sparse β-turns prediction in short evolution time after speeding it using Nystrom approximation method. Secondary structure information and position specific scoring matrices (PSSMs) are utilized as input features. We achieved Qtotal of 80.4% and MCC of 50% on BT426 dataset. These results show that KLR method with the right algorithm can yield performance equivalent or even better than NNs and SVMs in β-turns prediction. In addition KLR yields probabilistic outcome and has a well-defined extension to multi-class case.
Long-term effects of cognitive training on everyday functional outcomes in older adults.

CONTEXT Cognitive training has been shown to improve cognitive abilities in older adults but the effects of cognitive training on everyday function have not been demonstrated. OBJECTIVE To determine the effects of cognitive training on daily function and durability of training on cognitive abilities. DESIGN, SETTING, AND PARTICIPANTS Five-year follow-up of a randomized controlled single-blind trial with 4 treatment groups. A volunteer sample of 2832 persons (mean age, 73.6 years; 26% black), living independently in 6 US cities, was recruited from senior housing, community centers, and hospitals and clinics. The study was conducted between April 1998 and December 2004. Five-year follow-up was completed in 67% of the sample. INTERVENTIONS Ten-session training for memory (verbal episodic memory), reasoning (inductive reasoning), or speed of processing (visual search and identification); 4-session booster training at 11 and 35 months after training in a random sample of those who completed training. MAIN OUTCOME MEASURES Self-reported and performance-based measures of daily function and cognitive abilities. RESULTS The reasoning group reported significantly less difficulty in the instrumental activities of daily living (IADL) than the control group (effect size, 0.29; 99% confidence interval [CI], 0.03-0.55). Neither speed of processing training (effect size, 0.26; 99% CI, -0.002 to 0.51) nor memory training (effect size, 0.20; 99% CI, -0.06 to 0.46) had a significant effect on IADL. The booster training for the speed of processing group, but not for the other 2 groups, showed a significant effect on the performance-based functional measure of everyday speed of processing (effect size, 0.30; 99% CI, 0.08-0.52). No booster effects were seen for any of the groups for everyday problem-solving or self-reported difficulty in IADL. Each intervention maintained effects on its specific targeted cognitive ability through 5 years (memory: effect size, 0.23 [99% CI, 0.11-0.35]; reasoning: effect size, 0.26 [99% CI, 0.17-0.35]; speed of processing: effect size, 0.76 [99% CI, 0.62-0.90]). Booster training produced additional improvement with the reasoning intervention for reasoning performance (effect size, 0.28; 99% CI, 0.12-0.43) and the speed of processing intervention for speed of processing performance (effect size, 0.85; 99% CI, 0.61-1.09). CONCLUSIONS Reasoning training resulted in less functional decline in self-reported IADL. Compared with the control group, cognitive training resulted in improved cognitive abilities specific to the abilities trained that continued 5 years after the initiation of the intervention. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00298558.
Aggressive periodontitis in children: a 14-19-year follow-up.

AIM The objective was to assess the recurrence of disease in subjects with a history of localized aggressive periodontitis (LAP). MATERIAL AND METHODS Initially, 11 children (7-13 years) with LAP were examined. Samples from the subgingival microbiota and soft tissue biopsies were obtained. Non-surgical periodontal therapy was performed and the affected deciduous and two permanent molars were extracted. The subjects were enrolled in a recall programme within the public dental services. Fourteen to 19 years after the initial examination, the subjects were recalled for clinical and radiographic examinations. RESULTS The re-examination disclosed that two of the subjects exhibited recurrence of disease with probing pocket depth > or = 6 mm and bone loss of 3-4 mm at several teeth, while another two subjects presented a limited number of sites with the disease. While bleeding on probing was a general finding in the group, no further loss of attachment was detected in seven subjects. Advanced attachment loss at the deciduous teeth as well as the presence of Aggregatibacter actinomycetemcomitans and its specific clone JP at the initial examination did not correlate with the recurrence of disease at the 14-19-year follow-up. CONCLUSION Children treated for LAP do not always exhibit recurrence of periodontitis in the absence of supportive periodontal therapy over periods of 14-19 years.
The dispersed, repeated family of MAL loci in Saccharomyces spp

This report concludes our analysis of the various standard maltose-fermenting strains of Saccharomyces spp. We showed that, in addition to either the MAL2 or MAL4 functional locus present in the standard MAL2 and MAL4 strains, both strains contain two cryptic MALg genes mapping to the MAL1 and MAL3 locus positions. (Functional MAL loci appear to consist of two linked complementing gene functions, MALp and MALg. Cryptic MALg genes lack a linked functional MALp gene.) Using a probe containing a DNA fragment derived from the MAL6 locus, we detected three genomic HindIII fragments in both the MAL2 and MAL4 strains. Each of these HindIII fragments is shown to segregate in a Mendelian fashion and to be linked to one of the three MAL loci in each of the strains. We also detected additional fragments having significant sequence homology to the MAL6 probe but lacking in MAL-related functions.