Miracle-dz/UniFAR-FTUs huggingface dataset:
Elevated levels of the receptor for advanced glycation end products, a marker of alveolar epithelial type I cell injury, predict impaired alveolar fluid clearance in isolated perfused human lungs.

BACKGROUND Although alveolar epithelial injury is a major determinant of outcome in patients with acute lung injury, there is no reliable biological marker of alveolar epithelial injury. The primary objective was to determine whether elevated levels of the receptor for advanced glycation end products (RAGE), a marker of alveolar epithelial injury, reflect impaired alveolar fluid clearance (AFC) in an ex vivo perfused human lung preparation. A second objective was to determine whether levels of a marker of endothelial injury, von Willebrand factor antigen (vWF:Ag), are associated with impaired AFC. METHODS Human lungs (N = 30) declined for transplantation by the California Transplant Donor Network were perfused at a constant pulmonary artery pressure of 12 mm Hg. Following rewarming to 36 degrees C, the lungs were inflated with a continuous positive airway pressure of 10 cm H(2)O. RAGE and vWF:Ag levels and AFC rates were then measured. RESULTS The rate of AFC was inversely correlated with RAGE levels in the alveolar fluid (p < 0.005). Similarly, the concentration of RAGE in the alveolar fluid was significantly higher in lungs with submaximal AFC, defined in a prespecified analysis as <or= 14%/h, when compared with lungs with preserved AFC (median 0.82 vs 0.43 microg/mL; p < 0.05). In contrast, vWF:Ag levels did not correlate with the rate of AFC. CONCLUSIONS RAGE may be a useful biological marker of alveolar epithelial injury and impaired AFC in donor lungs prior to transplant and perhaps in patients with acute lung injury.
The Impact of an Online Evidence System on Confidence in Decision Making in a Controlled Setting

Objective . To examine the impact of online evidence retrieval on clinicians’ decision-making confidence and to determine if this differs for experienced doctors and nurses. Methods . A sample of 44 doctors and 31 clinical nurse consultants (CNCs) answered 8 clinical scenarios (600 scenario answers) before and after the use of online evidence resources. Clinicians rated their confidence in scenario answers and in the evidence they found using the information system. Results . Prior to using online evidence, 37% of doctors and 18% of CNCs answered the scenarios correctly. These clinicians were more confident (56% very confident or confident) in their answers than those with incorrect (34%) answers. Doctors with incorrect answers prior to searching rated their confidence significantly higher than did nurses who were incorrect. After searching, both groups answered 50% of scenarios correctly. Clinicians with correct answers had greater confidence in the evidence found compared to those with incorrect answers. Doctors were more confident in evidence found confirming an initially correct answer than were nurses. More than 50% of clinicians who persisted with an incorrect answer after searching reported that they were confident or very confident in the evidence found. Clinicians who did not know scenario answers before searching placed equal confidence in evidence that led them to a correct or incorrect answer. Conclusions . The information obtained from an online evidence system influenced clinicians’ confidence in their answers to the clinical scenarios. The relationship between confidence in answers and correctness is complex. Both existing knowledge and professional role were mediating factors. The finding that many clinicians placed confidence in information that led them to incorrect answers warrants further investigation.
Laparoscopic staging in women older than 75 years with early-stage endometrial cancer: comparison with open surgical operation

ObjectiveOlder age is a relevant risk factor for developing endometrial cancer (EC) and has been traditionally regarded as a relative contraindication to laparoscopy. Our aim was to analyze the safety and effectiveness of laparoscopic staging in older women with EC. MethodsConsecutive women aged 75 years or older who underwent laparoscopic staging for EC between May 2002 and October 2012 were compared with consecutive women aged 75 years or older who underwent abdominal staging before the adoption of the laparoscopic approach in our institution. Postoperative complications were graded according to the Accordion Severity Grading System. ResultsFifty-nine women aged 75 years or older who underwent laparoscopy were compared with a cohort of 66 women aged 75 years or older who underwent open staging before the incorporation of laparoscopy. Demographic and disease characteristics, as well as the Charlson comorbidity index, were balanced between groups. Women who underwent laparoscopy had similar operative time (P = 0.14), lower blood loss (P = 0.005), and shorter length of stay (P < 0.001) in comparison with women who underwent open surgical operation. Overall, women who underwent laparoscopy experienced less postoperative complications than women in the control group (P < 0.001). In addition, focusing only on complications grade 3 or higher, we observed a trend toward decreased complication rates in the laparoscopic group (P = 0.06). No differences in survival outcomes (including time of recurrence, site of recurrence, disease-free survival, and overall survival) were recorded (P > 0.05). ConclusionsOur findings suggest that EC patients older than 75 years may benefit from minimally invasive surgical operation and should not be denied laparoscopy based on mere chronological age.
Adjuvant chemotherapy in elderly patients with breast cancer: key challenges

ABSTRACT Elderly women with early breast cancer (BC) form a heterogeneous and large subgroup (41.8% of women with BC are over 65). Decision making in this subgroup is made more difficult by lack of familiarity with their physical, cognitive and social issues. Adequate management depends on biological factors and accurate clinical evaluation through comprehensive geriatric assessment (CGA). CGA can help to better select and determine potential risks factors for patients who are candidates for adjuvant chemotherapy. It is still recently introduced in geriatric oncology and there is a lack of awareness of its importance. Available data on adjuvant chemotherapy for BC is limited but suggests it can be of benefit for well selected patients, though the risk of short and long-term toxicity is significant. Here we provide a discussion of the key practical issues in decision making in the setting of adjuvant chemotherapy for elderly BC patients.
Rise of nano effects in electrode during electrocatalytic CO2 conversion

The electrocatalytic conversion of CO2 into value-added fuels has received increasing attention as a promising way to mitigate the atmospheric CO2 concentration and close the broken carbon-cycle. Early studies, focused on polycrystalline metal electrodes, outlined in detail the overall trends in the catalytic activity and product selectivity of pure metals; however, several inherent limitations were found, such as low current density and high overpotential, which hindered electrocatalytic CO2 reduction from practical application. Fortunately, the recent development of precisely synthesized nanocatalysts has led to several breakthroughs in catalytic CO2 conversion. By carefully controlling the thermodynamic adsorption energies and flow dynamics of reaction intermediates, nanosized electrocatalysts afford more versatile and energetically efficient routes to convert CO2 into desired chemicals. In this article, we review the state-of-the-art nanocatalysts applied for CO2 conversion and discuss newly found phenomena at the local environment near the catalyst surface. The mechanistic understanding of these findings can provide insight into the future design of catalysts for the efficient and selective reduction of CO2.
Cell turnover in the vomeronasal epithelium: evidence for differential migration and maturation of subclasses of vomeronasal neurons in the adult opossum.

Previous investigations of cell turnover in the mammalian vomeronasal sensory epithelium (VN-SE) raised two issues. First, if, in addition to the already demonstrated vertical migration, horizontal migration from the edges of the VN-SE participates in neuronal replacement. Second, whether or not migration and maturation is differential in upper and lower populations of vomeronasal neurons, since these two cell populations are chemically, physiologically, functionally, and perhaps evolutionarily different. By injecting bromodeoxyuridine (BrdU) into adult opossum (Monodelphis domestica) and permitting different survival times, the pattern of distribution of BrdU-labeled cells was analyzed. No evidence of horizontal migration in neuronal replacement was found. To investigate vertical migration and maturation of subclasses of vomeronasal neurons, double immunohistochemistry of BrdU and markers of the lower (G(oalpha) protein) and upper [G(i2alpha) protein and olfactory marker protein (OMP)] cell populations were performed. Three days after administration of BrdU, some mature neurons were observed in both lower and upper layers of the VN-SE, as demonstrated by coexpression of BrdU with G(oalpha) protein and OMP, respectively. The data on vertical distribution, however, indicate that most of the daughter cells enter the G(oalpha)-protein-expressing zone of the VN-SE by day 5, whereas most daughter cells do not reach the G(i2alpha)-protein-expressing zone until day 7, suggesting that these two populations mature at slightly different rates. These results are the first evidence of differential neurogenesis of subclasses of vomeronasal neurons.
Patterns of psychiatric comorbidity, cognition, and psychosocial functioning in adults with attention deficit hyperactivity disorder.

OBJECTIVE Although attention deficit hyperactivity disorder is a common disorder of childhood, its status as a disorder in adults is not clear. The authors reasoned that if the adult diagnosis of the disorder is a valid clinical entity, it should be similar to the childhood disorder with regard to patterns of psychiatric and cognitive findings. METHODS Eighty-four adults with a clinical diagnosis of childhood-onset attention deficit hyperactivity disorder confirmed by structured interview who were referred for treatment were studied. Findings were compared with those from a preexisting study group of referred children with attention deficit hyperactivity disorder, nonreferred adult relatives of those children who also had attention deficit hyperactivity disorder, and adults without the disorder who were relatives of normal children. Subjects were evaluated with a comprehensive battery of psychiatric, cognitive, and psychosocial assessments. RESULTS The referred and nonreferred adults with attention deficit hyperactivity disorder were similar to one another but more disturbed and impaired than the comparison subjects without the disorder. The pattern of psychopathology, cognition, and functioning among the adults with attention deficit hyperactivity disorder approximated the findings for children with the disorder. CONCLUSIONS These results show that referred and nonreferred adults with attention deficit hyperactivity disorder have a pattern of demographic, psychosocial, psychiatric, and cognitive features that mirrors well-documented findings among children with the disorder. These findings further support the validity of the diagnosis for adults.
Interaction between Mycobacterium avium and human immunodeficiency virus type 1 (HIV-1) in bronchoalveolar macrophages of normal and HIV-1-infected subjects.

Bronchoalveolar lavage (BAL) macrophages from patients with symptomatic or asymptomatic HIV-1 infections were obtained, and their ability to restrict in vitro the growth of an AIDS-associated strain of Mycobacterium avium was compared with cells obtained from normal volunteers. BAL macrophage populations from HIV-1-infected subjects (symptomatic or asymptomatic) spontaneously released significant amounts of IL-6, IL-1 beta, and TNF-alpha, whereas BAL macrophages from normal volunteers released very low amounts of these cytokines. Phagocytosis of M. avium was shown to be similar in both HIV-1-infected subjects and in control subjects. BAL macrophages from HIV-1-infected subjects released significantly greater quantities of IL-6, IL-1 beta, and TNF-alpha than did cells from normal volunteers upon M. avium ingestion. Growth of M. avium was similar in BAL macrophages from all three subject groups. Finally, BAL macrophages from normal volunteers were obtained, and these cells were doubly infected with a macrophage tropic isolate of HIV-1 at a low multiplicity of infection and with an AIDS-associated strain of M. avium. There were no significant differences in cytokine release by cells co-infected with M. avium and HIV-1 and cells infected with M. avium alone. The growth of mycobacteria and the viral replication in doubly infected cells were compared with those in cells infected with only one of the pathogens, and it was shown that HIV-1 infection had no significant effect on M. avium growth. (ABSTRACT TRUNCATED AT 250 WORDS)
Self- and registry-reported cancer in a population-based longitudinal study.

PURPOSE To evaluate the concordance of cancer diagnosis from self- and registry reports. METHODS Self-reported diagnosis information from participants in a cohort study was compared with linkage data from the Wisconsin Cancer Reporting System. RESULTS Overall, there was good agreement between self- and registry-reported cancers, with 90% of all matches being considered an exact match. Concordance varied by cancer site; agreement was excellent for breast (85.4%) and prostate (78.9%) cancers. CONCLUSIONS While self-reported cancer diagnoses for some cancers such as breast and prostate cancer are important sources of information and may be reliable substitutes when registry data are incomplete or not available, a combination of self and registry reports with mortality information may yield the most accurate information about cancer for purposes of health care planning and conducting epidemiologic studies.
Career satisfaction of psychiatrists.

OBJECTIVE According to recent estimates, there is a shortage of around 45,000 psychiatrists in the United States. It will be very difficult to address this problem without attracting more medical students to psychiatry and motivating the current crop of psychiatrists to see more patients and delay retirement. In this study the authors sought to identify factors that have a significant impact on the career satisfaction of psychiatrists. METHODS Data were gathered from 314 psychiatrists who participated in the 2008 Health Tracking Physician Survey conducted by the Center for Studying Health System Change. Independent variables were grouped as practice-related factors, compensation-related factors, patient-related factors, and demographic characteristics of psychiatrists. Career satisfaction of psychiatrists was the outcome measure of this study. RESULTS Threat of malpractice and the need to consider in treatment decisions out-of-pocket cost to patients had a significant negative impact on career satisfaction. Adequate time with a patient had a significant positive impact on career satisfaction. None of the compensation-related factors was significant. Psychiatrists who worked in practices that accepted new Medicare patients reported significantly higher levels of career dissatisfaction, whereas those who worked in practices that accepted new Medicaid patients reported significantly higher levels of career satisfaction. Older psychiatrists were more satisfied than younger psychiatrists, and white, non-Hispanic psychiatrists were more satisfied than African-American or Hispanic psychiatrists. CONCLUSIONS The results of this study highlight the need for policy makers and health care administrators to develop specific strategies to increase career satisfaction, which in return may help alleviate the shortage of psychiatrists.
An adaptive energy-efficient MAC for wireless sensor network

This paper presents an infrastructure sensor network and an adaptive MAC. The sensor network is intended for low power wireless senor monitoring network which could tolerate certain amount of packet loss. Trade-off between power consumption and packet loss rate which application could tolerate is made. An adaptive MAC, which will choose Just-Send mechanism or classic pure ALOHA technique according to present packet loss rate to reduce energy consumption, is proposed. Analytical expressions are given to compute the energy consumption and packet loss rate. And the effect of collision is given through the simulation.
The development of Teacher Academic Emotions (TAE) Scale

The purpose of this study was to design a comprehensive and native scale, and to investigate the validity and reliability of teachers' academic emotions scale including anxiety, happiness, anger, pride, hope and despair, exhaustion, shame and guilt through a nine-factors TAE model (second order hierarchy) and a two-factors TAE model (third-order hierarchy). A sample of 114 teachers was obtained from the population through multistage random sampling. Considering the questionnaire items and sample size, Partial Least Square Structural Equation Modeling (SEM-PLS) method was used to analyze the data of the questionnaire. Reliability was measured by three criteria: Cronbach alpha, composite reliability (CR), and consistency and validity of the questionnaire by two convergent and divergent validity criteria. Findings indicate that the reliability and validity of all dimensions were acceptable. Standardized coefficients and significance coefficients (t values) indicate the effect of specific structures in that path on each other are significant, and subsequently, the research hypotheses are confirmed. Furthermore, the contribution of R2 values in all dimensions was evaluated moderate to high in measuring all teachers ‘emotions. The CVRed and CVCom coefficients indicate that the quality of the internal model and the external model are higher than average and according to GOF, the predictive value is generally much higher than strong, and this TAE model has a prediction power up to 97% of the covariance based models. Finally, in order to compare two models of second order and third order hierarchical TAE, the goodness of fit information measures were evaluated and the second-order hierarchical model was considered a better model for TAE.
Analytical Models of Competition with Implications for Marketing: Issues, Findings, and Outlook

The authors review a representative cross-section of analytical models of competition using a framework for competitive analysis developed from a marketing perspective. Models are classified by the substantive issues they address and by the underlying modeling strategy. The implications of the various models are presented and discussed, and a set of empirically testable propositions is given. Some substantive areas that have been neglected by analytical modelers are identified. Other issues that warrant research attention by marketing behavioral scientists and econometricians are suggested as opportunities for future research.
Broadcast Levels: Efficient and Lightweight Schedule Construction for Push-Based Data Broadcasting Systems

In wireless push-based systems traffic is asymmetric meaning that the server has much more bandwidth available, as compared to the clients. Since it is often not possible or desirable for the clients to send any requests, the server should broadcast the data periodically. The performance of this system relies heavily on the proper scheduling of the broadcast data. The well known algorithm proposed by Vaidya and Hameed battles this challenge and achieves state-of-the-art performance. However, this performance comes with a computational complexity linear to the number of data items that are broadcast. Furthermore, Vaidya's and Hameed's proposed solution for this time complexity degenerates performance. This paper proposes a scheduling algorithm for wireless push-based data broadcasting systems, which performs near optimal and has low computational complexity. Performance evaluation results are presented to demonstrate its efficient performance despite its low computational demands.
Colonic Inflammation after Acute Diverticulitis - A Chronic Disease?

Diverticular disease of the colon is a common condition in western societies; by the age of 85 two thirds of the population in developed countries will have developed colonic diverticula [1,2]. While most patients will remain asymptomatic, a sizable portion will suffer from complications associated with diverticulosis, the most common of which acute diverticulitis (AD) is occurring in 10-25% of the patients [2]. In most patients, the disease is mild, responds well to antibiotic therapy and does not recur [3].
Rational approach to the diagnosis of severe growth hormone deficiency in the newborn.

CONTEXT Severe congenital GH deficiency (GHD) of the newborn is a rare disease, which can cause life-threatening hypoglycemias beginning in the first week of life. Reviews and consensus papers on the diagnosis of GHD repeatedly state the lack of a practical evidence-based approach to the diagnosis of GHD in the newborn. OBJECTIVE Here we provide for the first time sound reference values and a diagnostic cutoff for the GH levels in newborns at the age between d 3 and 5. DESIGN, SETTING, AND PATIENTS GH was measured in the eluate from 314 filter papers of the newborn screening test performed in our university hospital by using a highly sensitive human GH-ELISA. Reference data are compared with measurements from nine newborns with very high likelihood of having severe GHD, and cutoffs for the diagnostic work-up are defined. RESULTS In the presence of clinical evidence, the diagnosis of neonatal GHD can be confirmed during the first week of life by a single randomly taken GH level less than 7 microg/liter with 100% sensitivity and 98% specificity on the basis of our assay method. GH content in newborn screening cards stored for almost 3 yr were not different from the content found in recently used screening cards indicating high immunological stability of GH over time. Therefore, the diagnostic approach can use stored screening cards. In addition, we observed a clear gender dichotomy in respect to GH, with healthy female newborns having significantly higher GH levels than males. Cigarette smoking during pregnancy was associated with higher, transient tachypnea of the newborn with lower GH levels. CONCLUSIONS We provide the first rational approach to the diagnosis of severe GHD in the newborn and evidence for gender dichotomy of the neonatal GH axis.