Miracle-dz/UniFAR-FTUs huggingface dataset:
Antifungal Therapeutic Drug Monitoring: Established and Emerging Indications

The successful management of invasive fungal infections continues to pose a difficult challenge to clinicians. As the population of at-risk immunocompromised patients increases, the incidence of invasive mycosis has risen in parallel (57). Despite recent advances in antifungal pharmacology, the morbidity and mortality due to invasive fungal infections remain unacceptably high. Numerous factors determine the outcome of these infections, including the host immune state, pathogen variables including drug susceptibility, location of the infection, timing of diagnosis relative to initiation of antifungal therapy, management of the infection source (e.g., surgery or vascular catheter removal), and effective administration of the appropriate dose of the most potent and safe antifungal drug (Fig. ​(Fig.1). 1). Few of these variables are under the control of the clinician. The choices of antifungal drug and dosing regimen are among the factors which the clinician can dictate. However, even if the appropriate drug and regimen are initiated, drug exposure at the site of infection may be inadequate due to pharmacokinetic variability and may contribute to treatment failure. Conversely, antifungal exposures may exceed those anticipated and may result in toxicity. Many antifungal drugs exhibit marked variability in drug blood concentrations due to inconsistent absorption, metabolism, elimination, or interaction with concomitant medications. An understanding of the pharmacokinetics and pharmacodynamics of these drugs has been demonstrated to be important to optimize drug choice and dosing regimen design. One tool to detect drug exposures outside of the therapeutic window is monitoring of drug concentration in blood. The utility of this tool to inform drug choice and dosing decisions is being increasingly explored. FIG. 1. Determinants for outcome of invasive mycoses. Several factors must be considered in determining the role of therapeutic drug monitoring in patient management (32, 86, 88). An accurate, rapid, and cost-effective drug assay must be readily available to the clinician. Two pharmacological features then determine the relevance of monitoring of concentrations of drug in blood. The foremost variable is an unpredictable drug dose-exposure relationship. Next, there must be a clear relationship between concentrations of drug in blood and either toxicity or treatment efficacy. Consideration of these pharmacological variables for available antifungal compounds is the focus of this review.
Reliability and minimal detectable change of thoracoabdominal mobility measurements using photogrammetry

ABSTRACT The knowledge about measurement errors of the measuring tool is important before its use, as clinical decisions are going to be made based on its results. Here we investigate intrarater and interrater reliability and the minimal detectable change (MDC) of thoracoabdominal mobility measurements using photogrammetry, considering novice and experienced raters. Thoracoabdominal mobility of 17 healthy participants was assessed; photographs during apnea in maximal inspiration and expiration were used to calculate latero-lateral and anteroposterior diameters of the thorax (at axillary and xiphoid level) and abdomen. One novice and one experienced rater measured the same photographs three times. We found good reliability for the experienced rater (average Intraclass Correlation Coefficient (ICC): 0.98; average MDC: 0.3) and for interrater comparison (average ICC: 0.97; average MDC: 0.35) for all measures, with poorer results for latero-lateral mobility of abdomen. The novice rater presented moderate reliability for latero-lateral mobility of the thorax at axillary level and abdomen (ICC: 0.52 and 0.61; MDC: 1.42 and 2.05, respectively) and good reliability for the other measures (average ICC: 0.81; average MDC: 1.52). The photogrammetric analysis of thoracoabdominal mobility presented itself as a reliable method when used by an experienced professional. However, considering that the measurement of latero-lateral mobility is more subjected to errors, it should be used with caution. The MDC presented should be taken into account as a threshold to be certain that the measure is not under the measurement error due to rater variability.
Linear dichroism spectroscopy of nucleic acids

This review will consider solution studies of structure and interactions of DNA and DNA complexes using linear dichroism spectroscopy, with emphasis on the technique of orientation by flow. The theoretical and experimental background to be given may serve, in addition, as a general introduction into the state of the art of linear dichroism spectroscopy, particularly as it is applied to biophysical problems.
Comparison of Objective Screening and Self-Report for Alcohol and Drug Use in Traumatically Injured Patients

Alcohol and drug use is prevalent in trauma patients. Concerns over the validity of self-reporting drug use could make nonlaboratory screening problematic. This study sought to validate patient self-report of substance use against objective screening to determine the reliability of self-report in trauma patients. Patients admitted to either the Trauma or Burn services who were at least age 18 were screened for alcohol and drug use with validated screening tools. Exclusion criteria were altered mental status, non English speaking, inability to answer questions for other reasons, under police custody, or admission for <24 hours. Results from admission blood alcohol concentration (BAC) and urine drug screen (UDS) were also collected and compared to self-reported use to determine its reliability. Alcohol use was queried in 128 patients, 101 of whom had a BAC drawn. Of those 101, 34 (33.7%) had a BAC ≥ 0 mg%. Alcohol Use Disorder Identification Test creening revealed 13 (12.9%) patients who were self-reported non drinkers, none of which had a BAC > 0 mg%. Drug use was queried in 133 patients, 93 of whom had a UDS. A positive was found in 26 (28.0%) of the patients, only 12 (46.2%) of whom reported drug use in the past year. Although substance use in trauma patients is prevalent, self-report screening techniques for drugs may be inadequate at determining those patients whom could benefit from brief interventions while in the hospital. Further investigation is needed to determine the discrepancy between alcohol and drug use screening in trauma patients and more acceptable means of drug use discussion.
Bias of feedback cancellation algorithms in hearing aids based on direct closed loop identification

The undesired effects of acoustic feedback of hearing aids can be reduced with an internal feedback path that is an estimate of the external feedback path. This paper analyzes the limiting estimate of the feedback for feedback cancellation schemes that apply some recursive prediction error method with a quadratic norm, e.g., least mean square (LMS) and recursive least squares (RLS), to the output and input signals of the hearing aid to identify the feedback path. The data used for identification are then collected in a closed loop and the estimate used in one recursion will affect the data used in succeeding recursions. These properties have to be considered in the analysis. The analysis shows that the limiting estimate may be biased if there is an error in the used model of the input signal to the hearing aid, and that the system is not identifiable unless a second input signal to the system is added to the output of the hearing aid or the signal processing of the hearing aid used to modify the signal to the impaired ear is nonlinear. The limiting estimate is presented as the solution to an optimization problem in the frequency domain. An analytical expression of the limiting estimate is presented for a special case. For other cases an algorithm is presented that can be used to find a numerical solution. The results can be useful when the model structure used with the recursive identification is chosen.
Agenesis of the lung; report of a case, with a review of all previously reported cases.

WE ARE reporting an additional case of an agenesis of the lung. A critical and complete review of all previously reported cases is presented to serve as a useful reference concerning this rare anomaly. REPORT OF CASE A 2-day old baby girl was seen by one of us (B. M. G.) because of a slight cyanosis and the possibility of a dextrocardia. The baby was born at Mount Sinai Hospital after an apparently normal course of labor, weighing 5 lb. 11½ oz. (2,595 gm.). The mother, tertigravida and tertipara, with two normal living children, was in good health throughout pregnancy and at the time of the birth of the infant. The infant was cyanotic at birth and did not breathe for several minutes until aspiration was done with a tracheal catheter and oxygen was supplied. Physical examination revealed what appeared to be a normally developed, though somewhat cyanotic, infant. Dullness
THE USE OF RAINFALL PATTERNS IN PREDICTING POPULATION DENSITIES OF MULTIMAMMATE RATS, Mastomys natalensis

Author(s): Leirs, H. ; Verhagen, R. ; Verheyen, W. | Abstract: During 3 years we studied a population of multimammate rats, Mastomys natalensis (Smith 1834), in Morogoro, Tanzania. Data were collected in both removal and capture-recapture schemes. We present evidence that patterns of growth and reproduction were related to onset and abundance of rains. This partially explains differences in densities. Additionally, we investigated available literature data and related them with climatological data. A scenario is presented which enables us to predict how densities of multimammate rats may evolve in the following year and whether there will be a risk of outbreaks. The use and implications of this scenario in planning control actions are discussed.
The Effect of Good Corporate Governance, Firm Size and Financial Leverage on Income Smoothing and Its Implication on Stock Return

This study aims to analyze the effect of good corporate governance, company size and financial leverage on income smoothing and it’s implication on stock returns. The study population was 555 companies listed on the Indonesia Stock Exchange for the period 2011-2015, by using the purposive sampling method, obtained 40 companies. The analysis method uses penel data and Eviews 9.0 software. The research method used is quantitative by using secondary data, namely the company's annual financial statements. The results of the analysis show that good corporate governance, company size and financial leverage simultaneously have a significant effect on income smoothing. Partially, good corporate governance-independent commissioners and financial leverage have a positive and significant effect on income smoothing. But the variable size of the company has a negative effect and is significant for income smoothing. While income smoothing has a negative and significant effect on stock returns.
Digital-Gaming Trajectories and Second Language Development.

Recent research in digital game-based language learning has been encouraging, yet it would benefit from research methods that focus on the gaming processes and secondlanguage development (Larsen-Freeman, 2015) rather than learner/player reflection or individuals’ beliefs about the validity of gameplay. This has proven challenging as research methods which provide insight into the gameplay experiences and its many factors are needed. Having the gameplay experience occur extramurally is desirable, but makes the direct observation of the learners’ activities by a researcher difficult. For this reason, we suggest approaching digital game-based language learning through complex adaptive systems research (Larsen-Freeman & Cameron, 2008a) and employing Dörnyei’s (2014) retrodictive qualitative modeling to capture the complex synchronic and diachronic variability of the learners and their individual nonlinear gaming trajectories with requisite data density and over a considerable period of time.
Physician Workload and Treatment Choice: The Case of Primary Care

Primary care is a notable example of a service industry where capacity-constrained suppliers face fluctuating demand levels. Unable to adjust prices, such providers may degrade service quality when faced with high demand levels. Little is known, however, on the nature of such adjustments in the primary care context. We study how physicians trade off one key input --- their time with patients --- with other inputs, such as prescriptions, lab tests and referrals. Employing detailed administrative data from eleven clinics of a large Israeli HMO, we use the absence of colleagues as a source of exogenous variation in physician workload. We find no evidence that physicians' workload affects the intensity with which they prescribe painkillers, or refer patients to the Emergency Room, and very little evidence for an effect on the prescription of antibiotics. We do find, however, that physician time and the use of diagnostic inputs are complements: a one minute decrease in the (daily) average visit length causes a 9 percent decrease in referrals to specialists, and a 3.8 percent decrease in referrals to lab tests. Following recent literature, we complement the traditional use of an exclusion restriction within a linear model by estimating non-parametric bounds on Average Treatment Effects using alternative assumptions. Such alternative estimators rule out the possibility that physician time and the use of diagnostic tools are substitutes in an economically-meaningful fashion, while still leaving a broad scope for the possibility that those are complements. Taken together, the results indicate that the shadow cost of physician capacity is not reflected in poor treatment decisions, but may instead be manifested in the underprovision of tests and referrals to specialists --- fundamental aspects of long-term preventive care.
Association between antibiotic use and primary idiopathic intussusception.

BACKGROUND Intussusception is the leading cause of intestinal obstruction in young children. Antibiotics are the most frequently prescribed medication in the pediatric population and have common adverse effects on the gastrointestinal tract. OBJECTIVE To determine whether a relationship exists between primary idiopathic intussusception and antibiotic drug use. DESIGN Case-control study. PARTICIPANTS Ninety-three case patients with intussusception and 353 injury controls younger than 4 years who were seen at the emergency department of the Children's Hospital of Alabama between January 1, 1996, and April 30, 2001, were included. Controls were matched to cases by quarter and year of time of diagnosis, age, and sex. MAIN OUTCOME MEASURES Odds ratios and 2-sided 95% confidence intervals were estimated using conditional logistic regression. Prevalence of antibiotic use in an age-standardized, representative sample of US children from NHANES III (Third National Health and Nutrition Examination Survey) was used for external comparisons. RESULTS Antibiotic use within 48 hours of diagnosis was found in 23 cases (25%) and 33 controls (9%) (odds ratio, 4.15; 95% confidence interval, 2.17-7.92; attributable risk, 18.7%). Antibiotic use among US children according to NHANES III was 10.7%. In cases, the beta-lactam class accounted for 78% of all medications used. Cephalosporin use was associated with more than a 20-fold increased risk of intussusception. CONCLUSION An association between antibiotic drug use and intussusception was identified.
The Prognostic Role of Left Ventricular Hypertrophy in Patients with or without Coronary Artery Disease

OBJECTIVE To examine the association between echocardiographically determined left ventricular hypertrophy and mortality in patients with and without coronary artery disease. DESIGN Cohort study with a mean follow-up period of 4 years. SETTING An inner-city public hospital in Chicago. PATIENTS A cohort of 785 patients, most of whom were black and had hypertension. INTERVENTIONS Coronary arteriography for presumed coronary artery disease and echocardiography. MAIN OUTCOME MEASURE All-cause and cardiac mortality. RESULTS Left ventricular hypertrophy, based on left ventricular mass corrected for body surface area, was present in 194 of 381 patients (51%) with coronary artery disease and in 162 of 404 patients (40%) without coronary artery disease. Patients with left ventricular hypertrophy had worse survival than those without hypertrophy in both the group with coronary artery disease and the group without coronary artery disease. After adjustment was made for age at baseline, sex, and hypertension, the relative risk for death from any cause in patients with hypertrophy compared with patients without hypertrophy was 2.14 (95% CI, 1.24 to 3.68) among those with coronary artery disease and 4.14 (CI, 1.77 to 9.71) among those without coronary artery disease. CONCLUSIONS Echocardiographically determined left ventricular hypertrophy is an important prognostic marker in patients with or without coronary artery disease. The effect of reversing ventricular hypertrophy in patients with and without coronary disease deserves further study.
From perceptual corporate sustainability to customer loyalty: a multi-sectorial investigation in a developing country

Abstract The purpose of this paper is to investigate the impact of customer-based perceptual corporate sustainability on customer loyalty in a comparative manner, in four important industries (mobile telecommunications services, retail banking services, dairy products and personal care products) in a developing country. A consumer survey was implemented among a sample of 1464 consumers from the urban area of a developing European country. Our research reveals that customer-based perceptual corporate sustainability significantly and positively impacts customer loyalty in all investigated industries, with a stronger impact in retail banking services and a lower one in the case of personal care products. The research identifies those perceptual corporate sustainability dimensions which significantly impact customer loyalty and on which companies should focus within their marketing communication in order to increase customer loyalty. The paper brings relevant multi-sectorial insights, filling a regional knowledge gap, in the particular socio-cultural and economic context of a developing country, and thinking forward the general theoretical knowledge regarding the relationship between customer loyalty and perceptual corporate sustainability as complex constructs. Moreover, by using a quasi-exhaustive manner to conceptualise corporate sustainability, this paper complements previous research on the topic, in which corporate sustainability was constructed narrowly, within limited conceptual frameworks.
Assessment of Self-Medication Practice Among University Students in Palestine: Therapeutic and Toxicity Implications

self-medication is practiced significantly worldwide. No data is available on the current status of self-medication practice in Palestine. The objective of this study is to assess the extent of self-medication practice among a random sample of An-Najah National University students. Methods: this was a cross-sectional, anonymous, questionnaire-based survey that included 1581 students of different academic levels enrolled at different faculties at An-Najah National University. A pre-validated questionnaire with several open-ended and closed-ended questions was administered to the students. Data were coded, entered, and analyzed using SPSS version 13. Results: sixty three percent of respondents were females enrolled at non-medical schools. The mean age of respondents was 19.9 years. Ninety-eight percent of respondents reported practicing self-medication. There was no statistical difference between respondents who reported practicing self-medication based on gender or type of school (medical vs. non medical). The average number of medications reported by self-medication practitioners was 2.63 ± 1.38 medications per respondent. Analgesics, decongestants, herbal remedies, and antibiotics were the most common classes reported in self-medication. Headache, sore throat, flu, and dysmenorrhea were the most common aliments for which respondents seek self-medication. The majority of respondents practiced self-medication because the ailments they had were simple or because they had previous experience. The majority of respondents had good medication knowledge but did not posses high self-care orientation. Neither medication knowledge, nor self-care orientation was a predicting factor associated with the practice of self-medication. However, in selecting a particular type of medication the type of school, gender, and self-care orientation were influential. Conclusion: self-medication is very common among An-Najah students. This practice is common for treating clinical conditions that are either simple or previously experienced. Although, no significant predictors of self-medication did exist among the studied group, levels of self-care orientation and medication knowledge can be of value in analyzing the types of medications employed by self-medication practices.
Male pattern baldness and risk of incident skin cancer in a cohort of men

We examined the association between male‐pattern baldness and risk of incident skin cancer, including invasive melanoma, invasive squamous cell carcinoma (SCC), and basal cell carcinoma (BCC) in a prospective analysis, based on 36,032 participants from the Health Professionals' Follow‐up Study. In 1992, participants reported their status of male‐pattern baldness at age 45 years by choosing from five crown‐view pictograms based on Norwood's classification. Diagnosis of skin cancers was reported biennially and information on melanoma and SCC was pathologically confirmed. We identified 327 melanoma cases, 1324 SCC cases, and 8438 BCC cases during the follow‐up. Male‐pattern baldness was not significantly associated with risk of incident melanoma, but was significantly associated with increased risk of SCC and BCC. The multivariate‐adjusted hazard ratio (HR) (95% confidence interval, CI) for the highest category of baldness (frontal plus severe vertex baldness) was 1.33 (1.06–1.68) for SCC (ptrend = 0.001) and 1.23 (1.12–1.35) for BCC (ptrend < 0.0001), compared with no baldness. Analyses by body sites found significant associations between frontal plus moderate to severe vertex baldness and risk of melanoma (HR = 1.83, 95% CI: 1.01–3.34) and SCC (HR = 1.30, 95% CI: 1.02–1.66) at head and neck. The associations were particularly stronger for scalp melanoma (HR = 7.15, 95% CI: 1.29–39.42) and scalp SCC (HR = 7.09, 95% CI: 3.84–13.08), but not for non‐scalp head and neck sites. Information on body sites was not available for BCC. In conclusion, male pattern baldness may be associated with increased risk of skin cancer, but the associations may only exist for those occurring at head and neck, particularly at scalp.