Miracle-dz/UniFAR-FTUs huggingface dataset:
The effect of race and ethnicity on outcomes among patients in the intensive care unit: A comprehensive study involving socioeconomic status and resuscitation preferences*

Objective:We sought to determine whether race or ethnicity is independently associated with mortality or intensive care unit length of stay among critically ill patients after accounting for patients' clinical and demographic characteristics including socioeconomic status and resuscitation preferences. Design:Historical cohort study of patients hospitalized in intensive care units. Setting:Adult intensive care units in 35 California hospitals during the years 2001–2004. Patients:A total of 9,518 intensive care unit patients (6,334 white, 655 black, 1,917 Hispanic, and 612 Asian/Pacific Islander patients). Measurements and Main Results:The primary outcome was risk-adjusted mortality and a secondary outcome was risk-adjusted intensive care unit length of stay. Crude hospital mortality was 15.9% among the entire cohort. Asian patients had the highest crude hospital mortality at 18.6% and black patients had the lowest at 15.0%. After adjusting for age and gender, Hispanic and Asian patients had a higher risk of death compared to white patients, but these differences were not significant after additional adjustment for severity of illness. Black patients had more acute physiologic derangements at intensive care unit admission and longer unadjusted intensive care unit lengths of stay. Intensive care unit length of stay was not significantly different among racial/ethnic groups after adjustment for demographic, clinical, and socioeconomic factors and do-not-resuscitate status. In an analysis restricted only to those who died, decedent black patients averaged 1.1 additional days in the intensive care unit (95% confidence interval, 0.26–2.6) compared to white patients who died, although this was not statistically significant. Conclusions:Hospital mortality and intensive care unit length of stay did not differ by race or ethnicity among this diverse cohort of critically ill patients after adjustment for severity of illness, resuscitation status, socioeconomic status, insurance status, and admission type. Black patients had more acute physiologic derangements at intensive care unit admission and were less likely to have a do-not-resuscitate order. These results suggest that among intensive care unit patients, there are no racial or ethnic differences in mortality within individual hospitals. If disparities in intensive care unit care exist, they may be explained by differences in the quality of care provided by hospitals that serve high proportions of minority patients.
Treatment of young patients with Philadelphia chromosome‐positive acute lymphoblastic leukaemia using increased dose of imatinib and deintensified chemotherapy before allogeneic stem cell transplantation

The main outcomes of the Programa Español para Tratamiento de Hemopatías (PETHEMA)‐acute lymphoblastic leukaemia (ALL)‐Ph‐08 trial were described and compared with those of the historical PETHEMA‐CSTIBES02 trial. The trials differed in imatinib dose (600 vs. 400 mg/d) and amount of chemotherapy (one vs. two consolidation cycles) before stem cell transplantation (SCT). All patients (n = 29) enrolled in the ALL‐Ph‐08 trial achieved complete remission (CR) (vs. 90% in CSTIBES02), and SCT was performed in CR in 90% (vs. 78%). The reduction in early death, relapse before SCT and transplant‐related mortality observed in the ALL‐Ph‐08 trial resulted in an improved 2‐year event‐free survival (63% vs. 37%, P = 0·009).
Nurses’ Knowledge, Attitudes, and Practices: Regarding Children’s Pain

Purpose:To describe nurses’ knowledge and attitudes about relieving children’s pain, perceived barriers to optimal pain management, and analgesics administered by nurses in relation to levels of children’s pain. Study Design and Methods:Data were collected from 67 nurses and 132 children in their care. Outcomes were measured with The Nurses’ Knowledge and Attitudes Survey Regarding Pain, the Nurses’ Perceived Barriers to Optimal Pain Management for Children Survey, calculations of the ordered analgesia administered by the nurse, and the Oucher scale for intensity of children’s pain. Results:Most nurses demonstrated knowledge and positive attitudes about relieving children’s pain but lacked knowledge about the incidence of respiratory depression and thought that children overreport their pain. Inadequate or insufficient physician medication orders for pain were identified by 99% of nurses as the greatest barrier to optimal pain management. The children’s mean pain level was 1.63 (scale of 0 to 5). Of the 117 children who reported pain, 74% received analgesia. Nurses administered means of 37.9% of available morphine and 22.8% of available total analgesia. Clinical Implications:Nurses in practice need to become more aware of the adequacy of their analgesic administration, the value of children’s self-report of pain, and the limitations of relying on children’s behavioral manifestations to judge pain intensity. This study also demonstrates the importance of examining attitudes about children’s pain relief and learning more about respiratory depression in children receiving opioids.
Sjögren's syndrome: managed care data from a large United States population highlight real-world health care burden and lack of treatment options.

OBJECTIVES To better understand the real-world characteristics and costs of Sjögren's syndrome (SS). METHODS Analysing the MarketScan Commercial Claims database from Jan. 1, 2006 to Dec. 31, 2011, we identified 10,414 patients ≥18 years old newly diagnosed with SS. Patient characteristics, drugs (commonly used for SS), resource utilisation, and medical costs were evaluated for 12 months pre- and post-diagnosis. RESULTS Mean age was 55 years; 90% were female. At diagnosis, SS patients were most often seen by rheumatologists (39%) or internists (14.2%); the most common concurrent autoimmune conditions were rheumatoid arthritis (17.9%) and systemic lupus erythematosus (14.6%). Other common comorbidities were hypertension (37.6%), osteoarthritis (31.4%), and hyperlipidaemia/dyslipidaemia (30.3%). Post diagnosis of SS, claims for myocardial infarction and coronary artery bypass graft doubled. Medications of interest prescribed post-diagnosis were eye/mouth drugs (32.2%) and synthetic immunosuppressants (32.1%). Biologic drugs were prescribed to a minority (TNF inhibitors, ~5.0%; non-TNF inhibitors, 1%). Of note, prescriptions for all systemic immunotherapies (synthetic and biologic) were significantly lower in the subgroup without concurrent autoimmune disease, and 15.1% of the overall population had no SS-related prescriptions. Post diagnosis, total medical resource utilisation and total medical costs increased (1.2 and 1.4-fold, respectively). CONCLUSIONS In this retrospective, real-world analysis, medical claims in the first year after SS diagnosis revealed that cardiovascular (CV) events increased and all-cause healthcare costs grew by 40%. Pharmacologic management consisted primarily of low potency immunomodulation and symptomatic treatments. Systemic disease-modifying therapies were used mostly in patients who had another concurrent autoimmune disease, suggesting a lack of treatment options for SS.
Construction costs and physico-chemical properties of the assimilatory organs of Nepenthes species in Northern Borneo.

BACKGROUND AND AIMS Species of the Nepenthaceae family are under-represented in studies of leaf traits and the consequent view of mineral nutrition and limitation in carnivorous plants. This study is aimed to complement existing data on leaf traits of carnivorous plants. METHODS Physico-chemical properties, including construction costs (CC), of the assimilatory organs (leaf and pitcher) of a guild of lowland Nepenthes species inhabiting heath and/or peat swamp forests of Brunei, Northern Borneo were determined. KEY RESULTS Stoichiometry analyses indicate that Nepenthes species are nitrogen limited. Most traits vary appreciably across species, but greater variations exist between the assimilatory organs. Organ mass per unit area, dry matter tissue concentration (density), nitrogen (N), phosphorus (P), carbon, heat of combustion (H(c)) and CC values were higher in the leaf relative to the pitcher, while organ thickness, potassium (K) and ash showed the opposite trend. Cross-species correlations indicate that joint rather than individual consideration of the leaf and the pitcher give better predictive relationships between variables, signalling tight coupling and functional interdependence of the two assimilatory organs. Across species, mass-based CC did not vary with N or P, but increases significantly with tissue density, carbon and H(c), and decreases with K and ash contents. Area-based CC gave the same trends (though weaker in strength) in addition to a significant positive correlation with tissue mass per unit area. CONCLUSIONS The lower CC value for the pitcher is in agreement with the concept of low marginal cost for carnivory relative to conventional autotrophy. The poor explanatory power of N, P or N : P ratio with CC suggests that factors other than production of expensive photosynthetic machinery (which calls for a high N input), including concentrations of lignin, wax/lipids or osmoregulatory ions like K(+), may give a better explanation of the CC variation across Nepenthes species.
Androgen and estrogen receptors expression in the rat exorbital lacrimal gland in relation to "harderianization".

The rat exorbital lacrimal glands (ELG) are particularly interesting for their biochemical and morphological sexual differences. Our histochemical and ultrastuctural observations confirm a phenomenon termed "harderianization" that occurs in the ELG of males and females at three months of age. The "harderianization" consists of the appearance of lipid foci in the ELG; this effect increases at six months of age only in the male glands, while it is not detectable in those of females. Histochemical tests for mucosubstances and proteins evidenced that while the secretory granules of male ELG are prevalently composed of sulphate substances, those of the female are composed of acid substances, and only a few cells positive to proteins were seen in the acinar epithelium of the glands. Moreover, we demonstrated by RT-PCR the presence of androgen and estrogen receptors in the rat ELG of both sexes. Androgen receptor transcript is always present in male and female ELG while the expression of estrogen receptor is not more detectable in the ELG of males at six months of life. In conclusion, our results suggest that estradiol may prevent the further lipid degeneration of the female ELG at six months of life. In addition, the disappearance of both the "harderian lipid" foci in the female gland and of estrogen receptor in the male gland indicates a probable involvement of estrogens in the phenomenon of "harderianization. "
Using MATLAB to Model Inhomogeneous Media in Commercial Computational Electromagnetics Software

─ This paper presents a new method to model inhomogeneous media in commercial electromagnetics software, especially FEKO. In this method, the inhomogeneous medium is fragmented to some homogeneous pieces. If the size of these pieces is chosen correctly, then the electromagnetic behaviors of them and inhomogeneous medium are the same. Since creating these homogeneous pieces in FEKO manually is very difficult and time consuming, MATLAB is employed to create these pieces in FEKO. Index Terms ─ FEKO, inhomogeneous media, MATLAB.
Reconstitution of protein transport from the endoplasmic reticulum to the Golgi complex in yeast: the acceptor Golgi compartment is defective in the sec23 mutant

Using either permeabilized cells or microsomes we have reconstituted the early events of the yeast secretory pathway in vitro. In the first stage of the reaction approximately 50-70% of the prepro-alpha-factor, synthesized in a yeast translation lysate, is translocated into the endoplasmic reticulum (ER) of permeabilized yeast cells or directly into yeast microsomes. In the second stage of the reaction 48-66% of the ER form of alpha-factor (26,000 D) is then converted to the high molecular weight Golgi form in the presence of ATP, soluble factors and an acceptor membrane fraction; GTP gamma S inhibits this transport reaction. Donor, acceptor, and soluble fractions can be separated in this assay. This has enabled us to determine the defective fraction in sec23, a secretory mutant that blocks ER to Golgi transport in vivo. When fractions were prepared from mutant cells grown at the permissive or restrictive temperature and then assayed in vitro, the acceptor Golgi fraction was found to be defective.
Hereditary epidermolysis bullosa

The term epidermolysis bullosa (EB) includes a group of rare genodermatoses characterized by mutational impairment of the structural and functional integrity of intraepidermal adhesion and dermoepidermal anchorage. Clinically, these disorders are marked by increased skin fragility as well as characteristic mechanically inducible blisters on the skin and mucous membranes. Extracutaneous manifestations and their complications in other epithelialized organs render EB a multi‐system disease associated with significant morbidity and mortality. Cornerstones of a dynamically changing healthcare structure include precise and early diagnosis; coordinated, multidisciplinary, individually adjusted patient care at specialized centers; optimized symptomatic therapies; and access to research‐based, potentially curative therapeutic strategies.
Hemophagocytic lymphohistiocytic syndrome: Unrecognized cause of multiple organ failure

Objective To describe an often-unrecognized clinical picture of multiple organ failure in hemophagocytic lymphohistiocytic syndrome (HLS). Design Retrospective chart review. Setting A ten-bed pediatric intensive care unit (PICU) in a tertiary children’s university hospital. Patients A total of 11 children (age, 5 months to 13 yrs) who fulfilled the criteria for the diagnosis of familial- or infectious-associated hemophagocytic lymphohistiocytosis and who required intensive care support for organ failure. Intervention None. Main Results During a 10-yr period, 5,439 children were hospitalized in our PICU. A total of 11 children were diagnosed as suffering with HLS. Of these 11 patients, three (27%) had the familial form and eight had the infectious-associated form. After admission to the PICU, seven patients (63%) were diagnosed as suffering with HLS and each had one or more organ failures (patients 3–7, 9, and 10). All presented with fever, hepatomegaly, and splenomegaly; in addition, all had at least two of the following: anemia, neutropenia, or thrombocytopenia. All 11 had lymphohistiocytic accumulation in bone marrow (n = 10), lymph node (n = 2), lung (n = 2), and/or liver (n = 1). Organ failure was noted most often in the respiratory system (n = 7) attributable to severe, acute respiratory distress syndrome and pleural effusion. Of the 11 patients, six had cardiovascular involvement that manifested as shock in three and as capillary leak syndrome in three. Renal failure occurred in four patients. Of these, two required hemodiafiltration and one required peritoneal dialysis. Liver failure occurred in three and central nervous system involvement and coma in three. Most of the patients required massive therapeutic intervention, including assisted ventilation (n = 6), inotropic support (n = 3), and hemofiltration (n = 3). A total of seven patients (63%) died. Conclusions Hemophagocytic lymphohistiocytic syndrome in the pediatric population may have a dramatic clinical picture, with multiple organ failure as a presenting symptom or early in the disease course, mandating intensive support in the PICU.
SENSITIVITY OF LEISHMANIA BRAZILIENSIS PROMASTIGOTES TO MEGLUMINE ANTIMONIATE (GLUCANTIME) IS HIGHER THAN THAT OF OTHER LEISHMANIA SPECIES AND CORRELATES WITH RESPONSE TO THERAPY IN AMERICAN TEGUMENTARY LEISHMANIASIS

The first line drugs for the treatment of leishmaniasis are antimonial derivatives. Poor clinical response may be credited to factors linked to the host, the drug, or the parasite. We determined the sensitivity of Leishmania sp. promastigotes and amastigotes by counting parasites exposed to increasing concentrations of meglumine antimoniate (Glucantime). Leishmania braziliensis promastigotes were significantly more sensitive than those belonging to other species. The sensitivity of L. braziliensis isolates from patients with unfavorable clinical outcome, such as therapeutic failure or relapse, was significantly lower than those from patients who had clinical cure. Poor clinical response to therapy (therapeutic failure or relapse) was also associated with inadequate antimonial therapy. We also found a significant and positive correlation between promastigotes and intracellular amastigotes with regard to their in vitro susceptibilities to meglumine antimoniate. Our data provide evidence for an association between the sensitivity of promastigotes to antimonials in vitro and clinical response to therapy in American tegumentary leishmaniasis. The high sensitivity of the local L. braziliensis to meglumine antimoniate in vitro provides an explanation for the good clinical response of cutaneous leishmaniasis in the municipality of Rio de Janeiro, Brazil, even when low-dose regimens are employed.
A Review and perspective on surveillance of Bernoulli processes

Bernoulli processes have been monitored using a wide variety of techniques in statistical process control. The data consist of information on successive items classified as conforming (nondefective) or nonconforming (defective). In some cases, the probability of obtaining a nonconforming item is very small; this is known as a high quality process. This area of statistical process control is also applied to health‐related monitoring, where the incidence rate of a medical problem such as a congenital malformation is of interest. In these applications, standard Shewhart control charts based on the binomial distribution are no longer useful. In our expository paper, we review the methods implemented for these scenarios and present ideas for future work in this area. We offer advice to practitioners and present a comprehensive literature review for researchers. Copyright © 2011 John Wiley & Sons, Ltd.
A study of the relative frequency of carcinoma of the cervix in the Negro

ACIAL selectivity for squamous carcinoma R of the cervix has often been implied by relative frequency data obtained from many parts of the world.4 From our own available data, based on the screening of more than 60,000 women, it would seem that squamous carcinoma of the cervix is more than twice as common in the Negro race as in the Caucasian race. The higher prevalence rate among Negroes in various regions of the United States has been amply demonstrated by several studies.2339 8.7 Many workers have doubted that the obviously higher rate among Negroes is a matter of racial susceptibility. Rather they have felt it is the result of other factors that could be grouped as socioeconomic. '. 5 ,s Stocks* studied mortality data from Great Britain and concluded that there was a relationship between incidence and overcrowded housing, social class distribution, and predominant industry 20 years before. I n order to determine the factors that might account for the apparent impressive racial difference in the prevalence of squamous carcinoma of the cervix among our own patients, we attempted to match them according to economic conditions.
Epidural Hydromorphone With and Without Epinephrine for Post‐Operative Analgesia After Cesarean Delivery

The efficacy of epidural hydromorphone alone or in combination with epinephrine for postoperative analgesia was evaluated in 30 healthy women who underwent cesarean delivery with epidural anesthesia. They were assigned randomly to receive either 1.5 mg hydromorphone alone (N = 15) or 1.5 mg hydromorphone with 1/200,000 epinephrine (N = 15). Duration of analgesia (mean ± SD) was 24.3 ± 9.4 hours after the epidural injection of hydromorphone plus epinephrine. This was significantly greater (p < 0.01) than the duration of 18.2 ± 5.9 hours after the same dose of plain hydromorphone. Analgesia was more rapid in onset and significantly better at the 0.5, 1, 3, and 12 hours postoperatively in the hydromorphone-epinephrine group. Side effects including pruritus (73%), nausea (20%), and vomiting (15%) were of similar frequency with and without epinephrine. Although mean venous PCO2 (Pv,CO2) levels three and six hours after the hydromorphone-epinephrine dose were elevated significantly over the pre-drug PvCO2 levels, no respiratory depression was detected by an apnea monitor to which all patients were connected. The addition of epinephrine to epidural hydromorphone hastened onset and prolonged the duration of analgesia after cesarean section.
Low-Complexity Carrier Phase Recovery for Square M-QAM Based on S-BPS Algorithm

Minimum distance blind phase search (BPS) algorithm has good tolerance to laser linewidth but with high computational complexity. In this letter, a novel substitution algorithm, i.e., symmetry BPS (S-BPS) is proposed for arbitrary square M-ary quadrature amplitude modulation (M-QAM) coherent optical systems. Based on the symmetry of square M-QAM, it can reduce the complexity directly by simplifying the phase error detection in the real plane and without multiplication. Taking square 4-QAM, 16-QAM, and 64-QAM as examples, the effectiveness of the proposed S-BPS algorithm is demonstrated by numerical simulations.
Development of glaucoma after phacoemulsification for removal of cataracts in dogs: 22 cases (1987-1997).

OBJECTIVE To determine factors contributing to glaucoma after lens extraction via phacoemulsification in dogs. DESIGN Retrospective study. ANIMALS 22 dogs (29 eyes) with glaucoma and 21 dogs (30 eyes) without glaucoma after phacoemulsification. PROCEDURE Medical record review. RESULTS Eyes at increased risk for glaucoma included those of Boston Terriers, those with uveal or retinal abnormalities before surgery, and those with intraoperative intraocular hemorrhage. Significant differences between groups were not detected for incidence of preoperative lens-induced uveitis, presence of an intraocular lens, or frequency of an acute postoperative increase in intraocular pressure. Glaucoma developed (mean +/- SD) 12.8+/-14.1 months (median, 10 months; range, 0.25 to 55 months) after surgery. Eighteen of 29 (62%) eyes with potential for vision after onset of glaucoma retained vision for a mean of 16.5+/-12.8 months (median, 10.8 months; range, 1.5 to 37 months) after glaucoma was diagnosed. Most of these eyes still had vision at the conclusion of the study period. CONCLUSIONS AND CLINICAL RELEVANCE Risk factors identified by this study will aid in preoperative counseling of clients and refining selection criteria for candidates for phacoemulsification. Careful follow-up for the remainder of the dog's life after surgery may improve long-term success rates by permitting early intervention before intraocular pressure increases substantially and vision is irreversibly lost. Surgery for cataracts may still be worthwhile in dogs with increased risk of glaucoma, especially if elderly, because of the lengthy period to onset of glaucoma after surgery and the beneficial effects of treatment after glaucoma develops.
Reconsidering mortality compression and deceleration: an alternative model of mortality rates

In this research we develop a model of mortality rates that parameterizes mortality deceleration and compression, permits hypothesis tests for change in these parameters over time, and allows for formal gender comparisons. Our model fits mortality data well across all adult ages 20–105 for 1968–1992 U.S. white data, and the results offer some confirmation of findings of mortality research using conventional methods. We find that the age at which mortality deceleration begins is increasing over time, that decompression of mortality is occurring, and that these trends vary substantially across genders, although male and female mortality patterns appear to be converging to some extent.