Miracle-dz/UniFAR-FTUs huggingface dataset:
Clinical decision rule to identify febrile young girls at risk for urinary tract infection.

OBJECTIVE To develop a clinical prediction rule to identify febrile young girls needing urine culture for evaluation of urinary tract infection (UTI). DESIGN Prospective cohort study. SETTING Urban children's hospital emergency department. PATIENTS All girls younger than 2 years (N = 1469) presenting to the emergency department with fever (temperature > or =38.3 degrees C) and without an unequivocal source of fever during a 12-month period. MAIN OUTCOME MEASURES The outcome of interest was UTI, defined as a catheterized urine culture with pure growth of 10(4) colonies/mL or greater. Candidate predictors included demographic, historical, and physical examination variables. Clinical prediction rules were developed using multiple logistic regression after screening variables for univariate association and reliability. RESULTS The presence of 2 or more of the following 5 variables-less than 12 months old, white race, temperature of 39.0 degrees C or higher, fever for 2 days or more, and absence of another source of fever on examination-predicted UTI with a sensitivity of 0.95 (95% confidence interval, 0.85-0.99) and a specificity of 0.31 (95% confidence interval, 0.28-0.34). In the study population, with an overall prevalence of UTI of 4.3%, the positive predictive value of a score of 2 or more was 6.4% and the negative predictive value of a score of less than 2 was 0.8%. CONCLUSION Using this clinical decision rule, a strategy of obtaining urine cultures from girls younger than 2 years with a score of 2 or more would lead to identification of 95% of children with UTI and elimination of 30% of unnecessary urine cultures.
Toxicological considerations for antithyroid drugs in children

Introduction: Propylthiouracil (PTU), methimazole (MMI) and carbimazole are indicated for the treatment of hyperthyroidism in adult and pediatric patients. The aim of this review is to present all the relevant information regarding the use of antithyroid drugs (ATD) in pediatric thyrotoxic cases, the pediatric toxicology of ATD and the warning which has recently been issued for PTU by the FDA. Areas covered: Epidemiology, diagnosis and treatment of pediatric thyrotoxicosis are all presented in this article. The authors also extensively discuss the details regarding the pharmacology, bioactivation, biodisposition, bioavailability and pharmacokinetic properties of the two main ATD (MMI and PTU). Expert opinion: The FDA recently reported that use of PTU is associated with a higher risk for clinically serious or fatal liver injury compared to MMI in both adult and pediatric patients. They also found that congenital malformations were reported approximately three times more often with prenatal exposure to MMI compared with PTU and especially with the use of MMI during the first trimester of pregnancy. The authors believe that PTU should not be used in pediatric patients unless the patient is allergic to or intolerant of MMI, and there are no other treatment options available. That being said, PTU may be the treatment of choice during, and just before, the first trimester of pregnancy.
The Effect of Abdominoplasty and Outcome of Rectus Fascia Plication on Health-Related Quality of Life in Post–Bariatric Surgery Patients

Background: The authors prospectively evaluated the effect of isolated abdominoplasty with or without rectus fascia plication on the physical, functional, and psychosocial dimensions of health-related quality of life in post–bariatric surgery patients. They also evaluated whether the objectively measured amount of abdominal excess skin affects the discomfort of excess abdominal skin and changes in health-related quality of life after abdominoplasty. Methods: Ninety-four post–bariatric surgery patients answered questionnaires regarding their experience of excess skin and health-related quality of life before and 1 year after isolated abdominoplasty. An objective assessment of the amount of abdominal excess skin was also performed. All study participants were assigned randomly to either undergo or not undergo rectus fascia plication. Results: Significant improvements were reported at the follow-up concerning physical, functional, and psychosocial dimensions of health-related quality of life. A significant decrease was observed for the general health subscale of the 36-Item Short-Form Health Survey for the nonplicated group (p = 0.039). No significant differences were observed between the plicated and nonplicated groups. A significant low correlation was identified between the change in the Short-Form physical function subscale after abdominoplasty and measured amount of excess abdominal skin (rs = 0.26, p = 0.033) or resection weight (rs = 0.20, p = 0.10). Conclusions: Isolated abdominoplasty in post–bariatric surgery patients seems to improve both physical and psychosocial dimensions of health-related quality of life. However, rectus fascia plication does not appear to influence health-related quality of life. In addition, the correlation between the objectively measured amount of abdominal excess skin and improvements in health-related quality of life after abdominoplasty in post–bariatric surgery patients appears to be low. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.
Insulin therapy and acute kidney injury in critically ill patients a systematic review.

BACKGROUND Intensive insulin therapy has been found to reduce mortality in some critically ill patients. We performed a systematic review and meta-analysis to ascertain the effect of intensive insulin therapy on the incidence of acute kidney injury (AKI) in adult critically ill patients. METHODS We searched MEDLINE, SCOPUS and the Cochrane Central Register of Controlled Trials for studies that compared 'conventional' vs 'intensive' insulin therapy in critically ill patients. Studies were combined with random effects model meta-analyses. RESULTS Five studies, three of which were randomized controlled trials, reported AKI as a secondary outcome. Two of the studies were non-concurrent prospective cohort studies. All were single-centre studies conducted in intensive care unit settings. By meta-analysis across all studies, intensive insulin therapy reduced the incidence of AKI by 38% [risk ratio (RR) 0.62; 95% confidence interval (CI) 0.47, 0.83; P = 0.001]. The findings of the randomized and cohort studies were similar and the studies were not statistically heterogeneous. Three studies reported the effect of insulin therapy on dialysis requirement. Overall, intensive insulin therapy reduced the incidence of dialysis requirement by 35%, however, this was not statistically significant (RR 0.65; 95% CI 0.40, 1.05; P = 0.08). The overall rate of hypoglycaemia in the conventional insulin therapy group was 1.3% (range 0.3-3.4%). Intensive insulin therapy was associated with a >4-fold increase in the risk of hypoglycaemia (RR 4.5; 95% CI 2.4, 8.5; P < 0.00001) CONCLUSION There is evidence that intensive insulin therapy initiated in critically ill adult patients is associated with a reduction in the incidence of AKI in medical and surgical settings. A large trial primarily designed to examine the effect of insulin on the prevention of AKI is needed to confirm this finding.
Training increases collateral-dependent muscle blood flow in aged rats.

The potential for physical training to enhance collateral-dependent blood flow (BF) to the hindlimbs of aged male rats (Fischer 344) was evaluated following bilateral femoral artery ligation at 20.5 mo of age. Rats were either limited to cage activity (sedentary, n = 11) or trained by a mild-intensity treadmill program (trained, n = 14), which involved walking twice a day at 15 m/min (15% grade) to fatigue, 5 days/wk for 8-11 wk. Exercise tolerance of the trained rats increased from approximately 5 to approximately 25 min/bout by week 7, whereas exercise tolerance of the sedentary group changed little (to approximately 8 min/bout) during the training period. At approximately 23 mo age, animals were surgically prepared for hindquarter perfusion (aortic pressure = 100 +/- 1.3 mmHg) and force measurement of the left gastrocnemius-plantaris-soleus (GPS) muscle group during isometric contractions at 4, 8, 15, 30, and 45 tetani/min via sciatic nerve stimulation (approximately 6 V, 0.1-ms square waves at 100 Hz for 100 ms). Although initial force development was similar between groups (12.9 N/g), trained rats maintained tension better at 8, 15, 30, and 45 tetani/min (P < 0.01). BF to the entire hindlimb of the trained group, determined with 85Sr 15-microns microspheres, was 43% greater (P < 0.05) than in the sedentary group. Thus collateral-dependent BF was improved by physical training. The greatest increase in BF was to the distal limb muscles (approximately 78%), the tissues most at risk during intermittent claudication. (ABSTRACT TRUNCATED AT 250 WORDS)
Evaluation of the effect of adipose tissue-derived stem cells on the quality of bone healing around implants

ABSTRACT Purpose/Aim: This study evaluates the efficacy of grafted adipose-derived stem cells (ADSCs) on blade-type implants in improving osseointegration in rat femurs using a low-densitybone model. Materials and Methods: After isolating and expanding ADSCs, twice-passaged cells were seeded on blade-type implants on culture plates. Osteogenic induction of grafted cells began after attaching cells to the prepared titanium surfaces and it continued for 4 days. The scaffolds were then implanted in the femurs of Wistar rats. Osteogenic differentiation of these cells was confirmed using polymerase chain reaction (PCR) and alizarin red staining ofthe mineralized extracellular matrix. After 8 weeks, histological and histomorphometric evaluations of undecalcified resin sections (bone–implant contact [BIC] % and bone mineral index [BMI]) were performed using light microscopy and scanning electron microscopy. Results: Alizarin red staining in conjunction with gene expression results confirmed osteogenic differentiation. Histomorphometric assessment using scanning electron microscopy demonstrated improved BIC% and BMI near the treated surface compared with the untreated surface. Conclusions: The complex of differentiated grafted ADSCs and extracellular matrix and the macrodesign and microdesign of the implant can improve osseointegration in low-density bone.
Broad-based intangibles as generators of growth in Europe

ABSTRACT This paper analyzes broad performance-based measures of intangibles in European Union countries to find new sources of growth and shows that intangible capital (IC)-driven growth was halted in European industries during the 2008–2013 financial crisis period. Much of this IC, such as purchased organizational, research and development (R&D) and information and communication technology capital, is unaccounted for in systems of national accounts, so that total IC investment is 29.6% of value added, with R&D having the lowest gross domestic product share at 5.0%. On average, deteriorating IC growth has decreased labor productivity by −2.9% annually. Policies fostering multifactor productivity growth have been strongly biased and have ignored the loss of those skills necessary for long-term growth. During 2008–2013, innovation thus failed to compensate for Europe’s dwindling fixed-capital-intensive manufacturing and job losses, but broad-based IC offers a roadmap for recovery by relying on an increasing role for IC-producing services.
Noninvasive device readouts validated by immunohistochemical analysis enable objective quantitative assessment of acute wound healing in human skin

Objective evaluation of cutaneous wounds through use of noninvasive devices has important implications for diagnosis, monitoring treatment efficacy, progression and may lead to development of improved theranostic treatment strategies. However, there is a lack of validation in the use of certain devices in wound repair, where objective measurements taken by noninvasive devices have been corroborated by immunohistochemical analysis. Thus, data from three acute wound‐healing studies in healthy volunteers using three noninvasive objective devices were further evaluated by immunohistochemistry. One hundred ten participants had 5‐mm diameter skin biopsies to their arms. Spectrophotometric intracutaneous analysis (SIAscopy), full‐field laser perfusion imaging, and three‐dimensional imaging provided quantitative measurements of melanin, hemoglobin, collagen, blood flow, and wound size; all of which were validated by immunohistochemistry. Full‐field laser perfusion imaging showed blood flow increased to D7 and decreased by 40% to D14. SIAscopy showed that hemoglobin increased to D7 and reduced to D14. CD31 analysis corroborated this by showing a 76% increase in blood vessel density to D7 and a reduction by 14% to D14. Three‐dimensional imaging showed that wound surface area reduced by 50% from day 7 to day 14. Alpha‐smooth muscle Actin (Alpha‐SMA) staining supported these trends by showing increased levels by 72% from D0 to D14 (corresponding to wound contraction). Collagen, measured by SIAscopy, decreased to D7 and increased to D14, which was validated by collagen III analysis. Additionally, collagen I increased by 14% from D0 to D14. SIAscopy measurements for melanin showed an increase at D7 and a slight reduction to D14, while melanogenesis increased by 46.7% from D0 to D14. These findings show the utility of noninvasive objective devices in the quantitative evaluation of wound‐healing parameters in human skin as corroborated by immunohistochemistry. This may contribute to the development of prognostic parameters for assessment of response to wound therapy.
The Multiplicity of Performance Management Systems: Heterogeneity in Multinational Corporations and Management Sense-Making

This field study examines the workings of multiple performance measurement systems (PMSs) used within and between a division and Headquarters (HQ) of a large European corporation. We explore how multiple PMSs arose within the multinational corporation. We first provide a first‐order analysis which explains how managers make sense of the multiplicity and show how an organization's PMSs may be subject to competing processes for control that result in varied systems, all seemingly functioning, but with different rationales and effects. We then provide a second‐order analysis based on a sense‐making perspective that highlights the importance of retrospective understandings of the organization's history and the importance of various legitimacy expectations to different parts of the multinational. Finally, we emphasize the role of social skill in sense‐making that enables the persistence of multiple systems and the absence of overt tensions and conflict within organizations. Multiplicite des systemes de gestion du rendement : heterogeneite dans les societes multinationales et legitimation par les dirigeants Dans leur etude sur le terrain, les auteurs examinent le fonctionnement de systemes d’evaluation du rendement multiples utilises isolement et en commun par une division et le siege social d'une grande societe europeenne. Ils se demandent comment les systemes d’evaluation du rendement multiples ont vu le jour au sein de cette societe. Ils procedent d'abord a une analyse de premier ordre visant a expliquer comment les dirigeants legitiment la multiplicite et montrent comment les systemes d’evaluation du rendement d'une organisation peuvent etre soumis a des processus de controle concurrents qui engendrent des systemes varies, qui semblent tous fonctionnels mais dont les principes sous‐jacents et les resultats different. Les auteurs procedent ensuite a une analyse de second ordre dans une perspective de legitimation qui met en relief l'importance de la comprehension retrospective de l'historique de l'organisation et de l'importance des diverses attentes en matiere de legitimite pour differentes parties constituantes de la multinationale. Enfin, les auteurs mettent l'accent sur le role de l'aptitude sociale dans la legitimation qui permet le maintien de systemes multiples et l'absence de tensions et de conflits manifestes au sein des organisations.
Policy transfer and role of policy entrepreneur in international aid: exploring international development cases of Korea and Vietnam

ABSTRACT This paper looks at how an innovative policy comes to be transferred to another country and be successfully implemented. We explore three key dimensions (time, location, and people) in policy transfer studies using two cases of international aid (Saemaul Undong and e-Government projects). Utilizing a case study method, this paper upholds the predominant role of the policy entrepreneur over the environment (different time frame and different social, political, economic systems). The stakeholder analysis shows that policy entrepreneur’s role is critical in making policy transfer successful. In part, this argument is in line with previous “Advocacy Networks” studies, such as that of Keck and Sikkink (1998), highlighted the importance of policy entrepreneurs being able to navigate in the networks of international development. This paper aims to contribute to the literature by applying Dolowitz and Marsh’s policy transfer framework in the international aid context and calls for further empirical research employing the network analysis method.
Gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid–enhanced magnetic resonance imaging predicts the histological grade of hepatocellular carcinoma only in patients with child‐pugh class a cirrhosis

The aim of this study was to investigate the role of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd‐EOB‐DTPA)–enhanced magnetic resonance imaging (MRI) in predicting the histological grade of hepatocellular carcinoma (HCC) according to the hepatic function. Eighty‐one consecutive patients with 122 histologically proven HCCs who underwent Gd‐EOB‐DTPA–enhanced MRI before resection (45 HCCs in 42 patients) or transplantation (77 HCCs in 39 patients) were analyzed retrospectively. We calculated the relative enhancement ratios (RER), which is the ratio of the relative intensity of a tumor versus the surrounding parenchyma on hepatobiliary phase images to the relative intensity on unenhanced MRI scans. We then analyzed the correlation between the RER and the tumor differentiation grade in patients with various degrees of hepatic function. The degree of tumor enhancement, which included the precontrast relative intensity ratio (RIR), the postcontrast RIR, and the RER, for well‐differentiated (WD) HCCs was significantly higher than the degree of tumor enhancement for moderately differentiated and poorly differentiated (PD) HCCs (P = 0.001 and P = 0.001, respectively, for precontrast RIRs; P < 0.001 and P < 0.001, respectively, for postcontrast RIRs; and P = 0.01 and P = 0.001, respectively, for RERs). In a subgroup analysis based on liver function, the correlation between the histological grade and the enhancement ratio was demonstrated only in the group of patients with Child‐Pugh class A cirrhosis. The accuracy of postcontrast RIRs for predicting WD and PD HCCs was favorable; the areas under the receiver operating characteristic curves were 0.896 [95% confidence interval (CI) = 0.817‐0.974] and 0.769 (95% CI = 0.658‐0.879), respectively. In conclusion, the hepatobiliary phase of Gd‐EOB‐DTPA–enhanced MRI may help to predict the differentiation of HCCs, especially in HCC patients with Child‐Pugh class A cirrhosis before liver transplantation or resection. Liver Transpl, 2012. © 2012 AASLD.
A participatory evaluation of community-based rehabilitation programme in North Central Vietnam

Purpose: The purpose of this study was to conduct a participatory evaluation of the community-based rehabilitation (CBR) programme in North Central Vietnam to ascertain the extent of success with the World Health Organization (WHO) model. In 1992, for the first time a non-governmental organization (NGO) was formed in this region to plan and implement the CBR approach based on the WHO model for meeting the needs of persons with disabilities (PWD). The programme is currently being implemented in ten districts and has been able to affect 24.6% of PWD in this region. Methods: A framework of strengths, weaknesses, opportunities and threats (SWOT) analysis was used. Participatory data collection was done at the village, commune, district, provincial, and central levels using semi-structured interviews and focus group discussions. The data were examined against the five principles of the WHO model: available resource utilization, knowledge transfer, community participation, referral services strengthening and multisectoral coordination. Results: The strengths, weaknesses, opportunities, and threats across all levels were collated and presented. Conclusion: Specific strengths have been found in three out of five principles of the WHO Model. The programme would benefit by consolidating on the positive aspects in years to come.
On an InGaP/InGaAs Double Channel Pseudomorphic High Electron Mobility Transistor With Graded Triple $\delta$-Doped Sheets

An interesting InGaP/InGaAs double channel pseudomorphic high electron mobility transistor is fabricated and demonstrated. Due to the employed InGaP Schottky and buffer layers, InGaAs double channel structure, and graded triple delta-doped sheets, both DC and RF performances are improved. From experimental results, the studied device, with a gate dimension of 0.8 x 100 mum2 , shows a drain saturation current of 176 mA/mm, a maximum extrinsic transconductance of 176 mS/mm, a unity current gain cutoff frequency of 16 GHz, and a maximum oscillation frequency of 33.2 GHz at room temperature. Moreover, a theoretical analysis based on a 2-D semiconductor simulation package is used to study the device properties and compare the experimental results. Good agreement between the theoretical analyses and experimental results is found.
Prediction of Psychiatric Hospitalization, Diagnoses, Arrests, and Violent Behavior Through Scored Drawings and Associations

The article presents a completely empirical approach to using drawings and associations as a supplemental tool in forensic psychological assessment. The present system represents a modern alternative to prior theory-driven “projective technique” approaches that have failed to pass scientific scrutiny. Using an archival sample of 252 forensic cases, House-Tree-Person drawing protocols were scored according to preliminary test items developed from published handbooks, academic courses, and workshops on the use of drawings and related associations for assessment. Intermediate test items were selected according to their being significantly correlated with at least one external psychometric, behavioral, or clinical variable. Psychometric and editorial considerations guided the development of a final set of 66 test items. A “flagged for pathology” approach demonstrated modest convergent and discriminant validity for the final set of test items against clinical criteria on an independent sample of 150 cases of the same type used in the preliminary item development phase. Included are sample items and discussion of psychometric issues in working with this class of data.