Miracle-dz/UniFAR-FTUs huggingface dataset:
Education-Related Differences in Case Fatality among Elderly with Stroke

Background and Purpose: There is strong evidence for the existence of a socioeconomic gradient in stroke incidence and mortality, but there seem to be contradictory findings concerning an association between socioeconomic status and case fatality after stroke. Moreover, there is still a lack of studies that include men and women as well as people over 75 years. Our aim was to investigate whether there were education-related differences in 28-day case fatality after stroke in different age groups. Methods: All patients who were diagnosed with a cerebral infarction at the Umeå University Hospital during a 2-year period were included in this study. Results: In total, 610 stroke patients (331 men, 279 women) aged 20–85 were hospitalized, of whom 77% were first-ever strokes. Overall, there were few education-related differences between the patients in different age groups (20–74 and 75–85 years). The 28-day case fatality after stroke was shown to be associated with a low educational level in patients above 75 years, also after controlling for sex, risk factors and acute stroke care measures. Conclusion: In this population-based study on patients with cerebral infarction, we found an education-related difference in 28-day case fatality in patients aged 75–85 years. The socioeconomic gradient persisted when we adjusted for risk factors and acute care variables. There is a need for more community-based stroke studies including all ages, with good case ascertainment.
Hypertension During Intravenous Immune Globulin Infusion for Kawasaki’s Disease

Kawasaki’s disease (KD) is one of the most common vasculitides of childhood and is characterized by fever and often prominent mucocutaneous disease. While generally self-limited, its potential complication of coronary artery aneurysms makes treatment warranted. The current standard of care is intravenous immune globulin (IVIG), which has been shown to prevent coronary artery aneurysm formation. Common adverse effects of IVIG treatment have been well documented, and include headache, malaise, fever, chills, nausea, and hypotension. We report the development of transient hypertension with IVIG infusion in a girl with KD.
Electronic health record innovations: Helping physicians – One less click at a time

Background: Physician burnout is becoming an epidemic, due to the pressures of being productive, an imperfect electronic health record (EHR) system, and limited face-to-face time with patients. Poor usability in EHR-user interface can force users to go through more steps (i.e. more clicks on the computer) in accomplishing a task. Objective: This increased ‘click burden’ is a source of frustration for physicians. In the light of increased click burden and time due to meaningful use requirements, there is a need to improve the physician’s experience by creating innovations in EHR. Method: This case study describes an attempt by physicians at NewYork-Presbyterian Brooklyn Methodist Hospital to enhance the EHR experience with more efficient methods of documentation, chart review, ordering and patient safety. Results: The EHR innovations trialled in this study were: a mobile documentation application; abnormal test results auto-populated into an EHR patient summary; physician alerts to reduce inappropriate test ordering; and a system of safety alerts on a dashboard. These innovations led to decreased click burden and allowed physicians to spend less time on the computer and more time with patients. Conclusion: Physician-driven changes to EHR systems have the potential to streamline virtual workflows and the management of health information and to improve patient safety, reduce physician burnout and increase physician job satisfaction.
Evidence-Based Parametric Design: Computationally Generated Spatial Morphologies Satisfying Behavioural-Based Design Constraints

Parametric design is an established method in engineering and architecture facilitating the rapid generation and evaluation of a large number of configurations and shapes of complex physical structures according to constraints specified by the designer. However, the emphasis of parametric design systems, particularly in the context of architectural design of large-scale spaces, is on numerical aspects (e.g., maximising areas, specifying dimensions of walls) and does not address human-centred design criteria, for example, as developed from behavioural evidence-based studies. This paper aims at providing an evidence-based human-centred approach for defining design constraints for parametric modelling systems. We determine design rules that address wayfinding issues through behavioural multi-modal data analysis of a wayfinding case study in two healthcare environments of the Parkland hospital (Dallas). Our rules are related to the environmental factors of visibility and positioning of manifest cues along the navigation route. We implement our rules in FreeCAD, an open-source parametric system.
Toward a theory of patient satisfaction with physiotherapy: Exploring the concept of satisfaction

Patient satisfaction is increasingly seen as an important area of research because it has been found that satisfied patients are more likely to benefit from their health care. However, there has been comparatively little work in this field within physiotherapy. Eliciting patients' expectations and needs of their care and addressing these during treatment could not only influence their subsequent health-related behaviour but could also contribute to a more favourable evaluation of the whole therapeutic experience. While various determinants of satisfaction have been identified and examined in the literature, there has been little work to develop a theory to underpin the concept of satisfaction. Such a theory is important in physiotherapy because it can inform current practice and its evaluation and have implications for future patient care. In this article satisfaction with physiotherapy is defined on the basis of a review of the satisfaction literature in health care. A theory of patient satisfaction with physiotherapy is then developed by exploring the concepts of need and expectations that are proposed as being important determinants of the construct in relation to the physiotherapeutic approach to care, drawing on need theory and relevant social science and marketing theories.
The role of impaired de novo Coenzyme A biosynthesis in pantothenate kinase-associated neurodegeneration

Coenzyme A (CoA) is an essential cofactor required for cellular metabolism. CoA is synthesized de novo from pantothenate (vitamin B5) by the action of five enzymes; pantothenate kinase (PANK), 4’-phosphopantothenoylcysteine synthetase (PPCS), (R)-4’-phospho-N-pantothenoylcysteine decarboxylase (PPCDC), 4’-phosphopantetheine adenylyltransferase (PPAT) and dephospho-CoA kinase (DPCK). These enzymes are well conserved among various species and the CoA biosynthesis pathway is biochemically well characterized. However, little is known about the physiological implications of an impaired CoA biosynthesis route in higher eukaryotes. More interestingly, in humans mutations in one gene coding for an enzyme of de novo CoA synthesis “ PANK ” have been genetically linked to the neurodegenerative disease “Pantothenate Kinase-Associated Neurodegeneration” or PKAN (OMIM 234200). The aim of this introductory chapter is to: 1) summarize knowledge about the role of CoA in cellular metabolism and highlight knowledge about CoA de novo biosynthesis, 2) summarize known physiological consequences of impaired CoA biosynthesis with a focus on the potential role of impaired CoA biosynthesis in PKAN pathogenesis, 3) discuss a potential niche for Drosophila as a model organism for PKAN-related research. The latter is of interest because an established animal model for PKAN is required to understand the physiological implication of impaired CoA biosynthesis; to understand PKAN etiology and pathogenesis and to screen for potential compounds which can ameliorate PKAN symptoms. effective in mammalian cells with impaired function of pantothenate kinase. These data suggest that pantethine may serve as a starting point to develop a possible treatment for PKAN.
First record of the painted bug Bagrada hilaris (Burmeister, 1835) (Heteroptera: Pentatomidae) in South America.

espanolSe registra por primera vez en Sudamerica a la chinche pintada Bagrada hilaris (Burmeister, 1835) (Heteroptera: Pentatomidae), con ejemplares procedentes de Quilicura en la Region Metropolitana de Chile. La gran cantidad de ejemplares colectados y avistados, junto con observaciones biologicas, sugieren que esta especie se encuentra plenamente establecida. Se proveen detalles para la identificacion de la especie y tambien se compara con otros pentatomoideos chilenos. EnglishThe painted bug Bagrada hilaris (Burmeister, 1835) (Heteroptera: Pentatomidae) is recorded for the first time from South America. Specimens were collected in Quilicura, Metropolitan Region of Chile. The large amounts of observed and collected specimens, as well as the biological observations, suggest that the species is well established. Identification tips are given to identify a species and it is also compared with another Chilean pentatomoids.
Pharmacokinetics of Intravenous Acyclovir, Zidovudine, and Acyclovir-Zidovudine in Pregnant Rats

ABSTRACT The pharmacokinetics and placental transfer of acyclovir and zidovudine monotherapies and acyclovir-zidovudine combination therapy were compared in the pregnant rat. Timed-pregnancy Sprague-Dawley rats were used for the study. Doses of 60 mg of each drug/kg of body weight in monotherapy and in combination therapy were given by intravenous bolus, and samples of maternal plasma, amniotic fluid, fetal tissue, and placental tissue were collected over a period of 8 h postdose. Concentrations of each drug in the various matrices were measured by high-performance liquid chromatography. All data were analyzed by using WinNonlin. A one-compartment model with first-order elimination was used to fit the AZT plasma data from the combination therapy rats, but the plasma data from the other groups were fit to a two-compartment model. Tissue data were analyzed by noncompartmental analysis to generate area-under-the-concentration-time-curve values. Implementation of the combination therapy altered the pharmacokinetics of each drug compared to its monotherapy pharmacokinetics. The combination of these two drugs may potentiate fetal and amniotic fluid exposures to each drug.
Phase III trial of sunitinib (Su) versus sorafenib (So) in advanced hepatocellular carcinoma (HCC).

4000 Background: The oral multitargeted tyrosine kinase inhibitor Su had antitumor activity in phase II HCC trials, leading to a phase III open-label trial comparing the efficacy and safety of Su with So. METHODS Patients (pts) with advanced HCC, Child-Pugh A, ECOG PS 0/1 and no prior systemic chemotherapy were stratified by geographic region, prior TACE and tumor invasion. Pts were randomized 1:1 to Su 37.5 mg/day or So 400 mg BID. The primary endpoint was overall survival (OS; 1-sided log-rank test; α=0.025, 90% power) with 600 pts/arm required in this superiority/non-inferiority trial design. Secondary endpoints were progression-free survival (PFS), time to progression (TTP) and safety. Efficacy and futility boundaries were set using the Lan-DeMets and O'Brien-Fleming methods for interim analyses. RESULTS 1,073 pts were randomized (Su 529/So 544) from July 2008 to May 2010. An Independent Data Monitoring Committee stopped the trial early for futility and safety concerns. Pts were notified. Su discontinuation was recommended with the option for investigator discretion in cases of clinical benefit. For Su/So: median follow-up 7.4/7.8 mo; median age 59/59 yr; Asian 76/75%; male 82/84%; ECOG PS 0 53/53%; >3 prior TACE 16/17%; tumor invasion 79/76%; ≥1 dose interruption 69/55% and ≥1 dose reduction 47/69%. Median OS was 8.1/10.0 mo (HR 1.31 [95% CI: 1.13-1.52], P=0.0019); PFS was 3.6/2.9 mo (HR 1.12 [95% CI: 0.98-1.29], P=0.1386) and TTP was 4.1/4.0 mo (HR 1.13 [95% CI: 0.97-1.31], P=0.1785). OS for pts with hepatitis B (Hep B; Su 290/So 288; post hoc analysis) was 7.8/7.9 mo (HR 1.09 [95%CI: 0.9-1.32], P=0.236). In 526/541 pts evaluable for safety, all-causality, grade 3/4 adverse events (AEs) occurred in 82/73% of pts; the most common were thrombocytopenia (19%) and neutropenia (16%) for Su, and skin disorders (21%) for So. Discontinuations due to AEs occurred in 26/23% of pts. Serious AEs were noted in 44/36% of pts, with grade 5 AEs in 18/16%. CONCLUSIONS In advanced HCC, Su failed its primary OS endpoint. However, PFS and TTP results were similar between Su and So. In a Hep-B pt subgroup, no significant difference in OS was detected between Su and So. Su was associated with more frequent toxicities vs So. 65 pts (Su 17/So 48) remain on study.
Long‐term Outcome Following Ablation of Atrial Flutter Occurring Late after Atrial Septal Defect Repair

Aims: In patients with surgical atrial septal defect (ASD) repair, late atrial flutters (AFLs), including cavotricuspid isthmus (CTI)‐dependent and non‐CTI‐dependent scar‐related flutter (AFL), are common. Radiofrequency ablation (RFA) of these arrhythmias has a high acute success rate. We aimed to characterize the long‐term freedom from atrial arrhythmias in this population.
Incremental Open Set Intrusion Recognition Using Extreme Value Machine

Typically, most network intrusion detection systems use supervised learning techniques to identify network anomalies. A problem exists when identifying the unknowns and automatically updating a classifier with new query classes. This is defined as an open set incremental learning problem and we propose to extend a recently introduced method, the Extreme Value Machine (EVM) to address the issue of identifying new classes during query time. The EVM is derived from the statistical extreme value theory and is the first classifier that can perform kernel-free, nonlinear, variable bandwidth outlier detection combined with incremental learning. In this paper, we utilize the EVM for intrusion detection and measure the open set recognition performance of identifying known and unknown classes. Additionally, we evaluate the performance on the KDDCUP’99 dataset and compare the results with the state-ofthe- art Weibull-SVM (W-SVM). Our findings demonstrate that the EVM mirrors the performance of the W-SVM classifier, while it supports incremental learning.
Exploring the Effect of Copying Incomprehensible Exemplars on Creative Drawings

Although cognitive studies have reported that exemplars negatively influence people’s creativity, they have not focused on the effect of varying the type of exemplar. In this study, we examined how copying incomprehensible exemplars affects students’ creative drawing ability. Participants who had copied these types of picture produced more creative drawings than those who had not copied them. Participants’ cognitive processes were investigated in detail, based on interviews and online protocol data. Copying incomprehensible exemplars seemed to help them to consciously construct a new representation for understanding the exemplars. Our data also indicated that participants who had copied exemplars produced creative drawings by applying their new representations. These findings suggest that exemplars have the potential to facilitate artistic creativity.
Repeated PR1 and WT1 peptide vaccination in Montanide-adjuvant fails to induce sustained high-avidity, epitope-specific CD8+ T cells in myeloid malignancies

Background We previously showed that vaccination with one dose of PR1 and WT1 peptides induces transient anti-leukemia immunity. We hypothesized that maintenance of a sustained anti-leukemia response may require frequent boost injections. Design and Methods Eight patients with myeloid malignancies were enrolled in this phase II study, and 6 completed 6 injections of PR1 and WT1 peptides in Montanide-adjuvant with GM-CSF, every two weeks. Results Both high- and low-avidity PR1 or WT1-specific CD8+ T cells were detected in all evaluable patients after the first vaccine dose. Repeated vaccination led to selective deletion of high avidity PR1- and WT1-specific CD8+ T cells and was not associated with significant reduction in WT1-expression. Additional boosting failed to increase vaccine-induced CD8+ T-cell frequencies further and in all patients the response was lost before the 6th dose. PR1- or WT1-specific CD8+ T cells were not detected in bone marrow samples, excluding their preferential localization to this site. Following a booster injection three months after the 6th vaccine dose, no high-avidity PR1 or WT1-specific CD8+ T cells could be detected, whereas low-avidity T cells were readily expanded. Conclusions These data support the immunogenicity of PR1 and WT1 peptide vaccines. However, repeated delivery of peptides with Montanide-adjuvant and GM-CSF leads to rapid loss of high-avidity peptide-specific CD8+ T cells. These results may offer an explanation for the lack of correlation between immune and clinical responses observed in a number of clinical trials of peptide vaccination. New approaches are needed to induce long-term high-avidity memory responses against leukemia antigens. (ClinicalTrials.gov Identifier: NCT00499772)
KIT and PDGFRA mutations and the risk of GI stromal tumor recurrence.

PURPOSE Mutated KIT and platelet-derived growth factor alpha gene (PDGFRA) drive GI stromal tumor (GIST) oncogenesis, but the clinical significance of their single mutations is known incompletely. PATIENTS AND METHODS We identified 11 population-based series of patients with GIST through a literature search and pooled individual data from 3,067 patients treated with macroscopically complete tumor excision. Mutation analysis was done from 1,505 tumors. We analyzed associations between KIT and PDGFRA mutations and recurrence-free survival (RFS) in the subsets in which patients were treated with surgery alone. RESULTS We identified 301 different single mutations in KIT and 33 in PDGFRA. Patients with PDGFRA mutations had more favorable RFS than those with KIT mutations (hazard ratio, 0.34; P = .004). Only one of the 35 GISTs with KIT exon 11 duplication mutations recurred. Patients with deletions of only one codon of KIT exon 11 had better RFS than those with another deletion type, and some KIT exon 11 substitution mutations (Trp557Arg, Val559Ala, and Leu576Pro) were also associated with favorable RFS. Patients with an identical mutation had greatly variable outcomes depending on the standard prognostic factors, notably, mitotic count. Commonly used risk stratification schemes tended to overestimate the risk for recurrence in subgroups with prognostically favorable mutations. CONCLUSION GISTs with an identical KIT or PDGFRA mutation may have widely varying risks for recurrence. Most of the patients with PDGFRA mutations and those with KIT exon 11 duplication mutation or deletion of one codon have favorable RFS with surgery alone and are usually not candidates for adjuvant therapy.
Seismic moment ratio of aftershocks with respect to main shocks

The empirical Båth's law indicates that the earthquake process is self‐similar and provides an opportunity to estimate the magnitude of the largest aftershock subsequent to a main shock. However, the analysis of this relation is limited to a small magnitude range and also depends on the aftershock selection rules. As an alternative, we analyze, in this paper, the cumulative seismic moment of aftershocks relative to the main shock moment, because (i) it is a physical quantity that does not only take the largest aftershock into account; (ii) background activity can be considered and as a result estimations are less affected by selection rules; and (iii) the effects of the catalog cut‐off magnitude can be corrected, what leads to larger magnitude range for the analysis. We analyze the global preliminary determination of epicenters U.S. Geological Society catalog (combined with centroid moment tensor focal mechanisms) and find that the seismic moment release of aftershocks is on average approximately 5% of the main shock seismic moment. We show that the results can be well fitted by simulations of the Epidemic Type Aftershock Sequence model. In particular, we test whether simulations constrained by predictions of the static stress‐triggering model, proposing a break of self‐similarity due to the finite seismogenic width, are in agreement with observations. Our analysis shows that the observed dependency on the main shock magnitude as well as systematic variations with the main shock fault plane solution can be both explained by the constraints based on the static stress triggering.
U Wave: Facts, Hypotheses, Misconceptions, and Misnomers

U Wave. The clinical significance of U wave is limited to the occasional obfuscation of the end of T wave and an inadequately explained U wave inversion associated with myocardial ischemia, infarction, and ventricular hypertrophy and dilatation. Lengthening of QT interval often interferes with the recognition of U wave. The characteristics of U wave are not compatible with the Purkinje or ventricular muscle repolarization hypotheses. The timing of the U wave during ventricular relaxation and the links between U wave and mechanical events favor the mechanoelectrical hypothesis of U wave genesis. Unfortunately, little research has been done to test this hypothesis.
Occipital Lobe Seizures as the Major Clinical Manifestation of Reversible Posterior Leukoencephalopathy Syndrome: Magnetic Resonance Imaging Findings

Summary: Purpose: Reversible posterior leukoencephalopathy syndrome (RPLS) is an increasingly recognized brain disorder most commonly associated with malignant hypertension, toxemia of pregnancy, or the use of immunosuppressive agents. When associated with acute hypertension, RPLS typically occurs concurrently with the fulminant clinical syndrome of hypertensive encephalopathy. We describe occipital lobe seizures, in the setting of only moderate elevations of blood pressure, as the major clinical manifestation of RPLS.
Instructional Goals and Grading Practices of Graduate Students after One Semester of Teaching Experience

Teaching assistants (TAs) are often responsible for grading student solutions. Since grading communicates instructors' expectations, TAs' grading decisions play a crucial role in forming students' approaches to problem solving (PS) in physics. We investigated the change in grading practices and considerations of 18 first-year graduate students participating in a TA professional development (PD) course. The TAs were asked to state their beliefs about the purpose of grading, to grade a set of specially designed student solutions, and to explain their grading decisions. We found that after one semester of teaching experience and participation in PD, TAs did not significantly change their goals for grading (i.e., a learning opportunity for both the student and the instructor) or their grading practice. In addition, TAs' grading practice frequently did not align with their goals. However, some TAs' perceptions of the level of explication required in a student solution did change. Our findings suggest that in order for PD to help TAs better coordinate their goals with appropriate grading practices, PD should focus on TAs' perception of sufficient reasoning in student solutions.