Miracle-dz/UniFAR-FTUs huggingface dataset:
"Allow Natural Death" versus "Do Not Resuscitate": What Do Patients with Advanced Cancer Choose?

BACKGROUND Many patients with advanced cancer at our hospital request full resuscitative efforts at the end of life. We assessed the knowledge and attitudes of these patients towards end-of-life (EOL) care, and their preferences about "Do Not Resuscitate" (DNR), "Allow Natural Death" (AND), and "full code" orders. METHODS The first 100 consenting adult patients with advanced cancer were surveyed regarding their diagnosis, prognosis, and attitudes about critical care and resuscitation. They were then presented with hypothetical scenarios in which a decision on their code status had to be made if they had one year, six months, or one month left to live. Half were given a choice between being "full code" and "DNR," and half could choose between "full code" and "AND. " RESULTS All 93 of the participants who completed the survey were considered by their attending physician to have a terminal illness, but only 42% of these interviewees believed they were terminally ill. In addition, only 25% of participants thought that their primary oncologist knew their EOL wishes. Participants were equally likely to choose either of the "no code" options in all hypothetical scenarios (p>0.54), regardless of age, sex, race, type of cancer, education, or income level. A similar proportion of patients who had a living will chose "AND" and "DNR" orders instead of "full code" in all the scenarios (47%-74% and 63%-71%). In contrast, among patients who did not have a living will, 52% chose "DNR," while 19% opted for "AND. " CONCLUSIONS We hypothesized that "AND" orders may be more acceptable to patients with advanced cancer, but there was no statistically significant difference in acceptability between "AND" and "DNR" orders.
Antibody Breadth and Protective Efficacy Are Increased by Vaccination with Computationally Optimized Hemagglutinin but Not with Polyvalent Hemagglutinin-Based H5N1 Virus-Like Particle Vaccines

ABSTRACT One of the challenges for developing an H5N1 influenza vaccine is the diversity of antigenically distinct isolates within this subtype. Previously, our group described a novel hemagglutinin (HA) derived from a methodology termed computationally optimized broadly reactive antigen (COBRA). This COBRA HA, when used as an immunogen, elicits a broad antibody response against H5N1 isolates from different clades. In this report, the immune responses elicited by the COBRA HA virus-like particle (VLP) vaccine were compared to responses elicited by a mixture of VLPs expressing representative HA molecules from clade 2.1, 2.2, and 2.3 primary H5N1 isolates (polyvalent). The COBRA HA VLP vaccine elicited higher-titer antibodies to a panel of H5N1 HA proteins than did the other VLPs. Both COBRA and polyvalent vaccines protected vaccinated mice and ferrets from experimental infection with highly lethal H5N1 influenza viruses, but COBRA-vaccinated animals had decreased viral replication, less inflammation in the lungs of mice, and reduced virus recovery in ferret nasal washes. Both vaccines had similar cellular responses postchallenge, indicating that higher-titer serum antibodies likely restrict the duration of viral replication. Furthermore, passively transferred immune serum from the COBRA HA VLP-vaccinated mice protected recipient animals more efficiently than immune serum from polyvalent-vaccinated mice. This is the first report comparing these two vaccine strategies. The single COBRA HA antigen elicited a broader antibody response and reduced morbidity and viral titers more effectively than a polyvalent mixture of primary H5N1 HA antigens.
La industria colombiana en el siglo XXI

Que factores determinaron el desempeno de las firmas manufactureras colombianas desde 2000? Este analisis esta informado por un entendimiento teorico de los mecanismos que determinan el comportamiento de las firmas. En el analisis macroeconomico, encontramos que ni la tasa de cambio ni la demanda externa explican el grueso de la variacion en la produccion industrial agregada. La variable agregada que explica mejor las fluctuaciones de la produccion industrial es una variable no observada que interpretamos como un choque de demanda interna. Basados en el analisis microeconometrico, encontramos que son las grandes diferencias en productividad las que explican las diferencias en el desempeno de las firmas industriales. Tambien encontramos que las firmas con mejor desempeno son las que comercian mas con el resto del mundo. Asi mismo, la probabilidad de supervivencia de las firmas esta correlacionada de forma inversa y significativa con la tasa de tributacion sobre las utilidades de las firmas. Constatamos que hay oportunidades de mejoramiento de la capacidad productiva de la industria en el cierre de las brechas de productividad entre firmas, en su exposicion al comercio exterior y su tributacion. Este tipo de evidencia sirve de base para politicas publicas efectivas en la promocion de la actividad industria. ****** Which factors were determinant in the performance of Colombian manufacturing firms since 2000? This analysis is based on a deep understanding of the theoretical mechanisms that underline firms’ behavior. The macroeconomic analysis concludes that most of the variation in aggregate industrial production is not explained neither by the exchange rate nor by the external demand. The aggregate variable that explains most of the variation in industrial output is an unobservable variable that we interpret as a demand shock. The microeconometric analysis allow us to conclude that differences in their productivity explains most of the differences in performance among industrial firms. Additionally, we show that firms with higher international trade are the ones with better outcomes. Likewise, firms’ survival probability is significantly negatively correlated with the tax rate on their profits. Our analysis indicates that there are opportunities for improving industry’s productive capacity by reducing their productivity differences, by increasing international trade, and by improving the tax code. This evidence is useful for formulating public policies that effectively promotes industrial activity.
The protease domain of procollagen C-proteinase (BMP1) lacks substrate selectivity, which is conferred by non-proteolytic domains

Abstract Procollagen C-proteinase (PCP) removes the C-terminal pro-peptides of procollagens and also processes other matrix proteins. The major splice form of the PCP is termed BMP1 (bone morphogenetic protein 1). Active BMP1 is composed of an astacin-like protease domain, three CUB (complement, sea urchin Uegf, BMP1) domains and one EGF-like domain. Here we compare the recombinant human full-length BMP1 with its isolated proteolytic domain to further unravel the functional influence of the CUB and EGF domains. We show that the protease domain alone cleaves truncated procollagen VII within the short telopeptide region into fragments of similar size as the full-length enzyme does. However, unlike full-length BMP1, the protease domain does not stop at this point, but degrades its substrate completely. Moreover, the protease domain cleaves other matrix proteins such as fibronectin, collagen I and collagen IV, which are left intact by the full-length enzyme. In addition, we show for the first time that thrombospondin-1 is differently cleaved by both BMP1 and its catalytic domain. In summary, our data support the concept that the C-terminal domains of BMP1 are important for substrate recognition and for controlling and restricting its proteolytic activity via exosite binding.
Subspace identification of an aircraft linear parameter-varying flutter model

The process of system identification of an linear parameter-varying (LPV) system using subspace techniques is demonstrated by application to the widely used pitch-plunge model of an aircraft flutter simulation. The identification is done using a recently published subspace identification (SID) algorithm [1] for LPV systems. The objective is to demonstrate the ability of this method to not only identify a highly accurate model in state space form, but to also determine the state order of the system. As the identification data are gained from simulation, a comparison is given between the noiseless and the noisy case, and the effects of noise especially on the model order estimation are discussed.
Risk factors, management, and prognosis for liver abscess after radical resection of hilar cholangiocarcinoma.

OBJECTIVES Pyogenic liver abscess (PLA) is a rare but potentially lethal infectious complication after radical surgical resection of hilar cholangiocarcinoma (HC), this study is aimed to identify the risk factors, management and prognosis of PLA after curative surgical resection of HC. METHODS Between January 2003 and October 2013, 95 patients who underwent surgical resection of HC at a tertiary center were included in this study. The risk factors pertaining to PLA formation were identified by exact logistic regression. RESULTS PLA developed in 8 of 95 patients. The median duration of PLA formation following surgical procedure was 145 days (range, 16-295 days) and the most commonly isolated microorganism was Escherichia coli (4/8). Though most patients who developed PLA after surgery were successfully managed with antibiotics and invasive therapy, the overall survival was statistically poorer than those without PLA formation (median, 16.9 vs. 34.2 months, P=0.048). Univariate analysis revealed that coexisting biliary disorders (37.5% vs. 8.0%, P=0.036), vascular reconstruction (37.5% vs. 9.2%, P=0.041) and margin status (62.5% vs. 21.8%, P=0.023) were associated with PLA formation, whereas only vascular reconstruction (odds ratio (OR), 10.31; 95% confidence interval (CI), 1.03-142.73; P=0.047) and margin status (OR, 8.45; 95% CI, 1.13-109.38; P=0.035) were identified as independent risk factors by multivariate analysis. CONCLUSIONS Intraoperative vascular reconstruction and positive margin status pose greater risks for PLA formation after radical resection of HC. For patients with high risk factors, careful follow-up is needed for early detection and management of this infrequent complication.
Gestational age at initiation of 17-hydroxyprogesterone caproate (17P) and recurrent preterm delivery

Objective. To compare rates of recurrent preterm birth between women starting treatment with 17α-hydroxyprogesterone caproate (17P) at 16–20.9 weeks of gestation versus 21–26.9 weeks. Methods. Women enrolled in an outpatient program of education, nursing assessment and weekly 17P injections beginning at 16–26.9 weeks were eligible. Included were patients with singleton pregnancies and a history of preterm delivery (PTD). Pregnancy outcome was compared between women starting 17P at 16–20.9 weeks (n = 156) and those starting 17P at 21–26.9 weeks (n = 119) using Fisher's exact and Mann–Whitney U test statistics (p < 0.05 considered significant). Results. Mean gestational age at delivery (36.8 ± 3.0 vs. 36.7 ± 2.5) and rates of PTD at <37 weeks (40.4% vs. 48.7%), <35 weeks (16.7% vs. 16.8%) and <32 weeks (5.1% vs. 5.0%) were similar between the groups; all p > 0.05. Conclusions. Rates of preterm delivery were similar in patients initiating 17P at 16–20.9 or 21–26.9 weeks. A larger sample size is warranted in order to confirm our findings.
Bricolage and growth in social entrepreneurship organisations

Abstract This paper explores the role of bricolage in the growth of social entrepreneurship organisations (SEOs). Building on the premises that (1) bricolage is based on the resources at hand and the subjective perspectives that individuals have of these resources, and (2) the characteristics of the top management team (TMT) are an indicator of the resources they make available to the organisation and their ability to put different perspectives into play to interpret resource environments, we seek to determine which configurations of resource endowment, autonomy in the use of resources, TMT diversity and bricolage promote organisational growth. Using a fuzzy-set theoretical technique (fsQCA), we show that the effect of bricolage on organisational growth is contingent on the availability of resources, the degree of autonomy in using these resources and TMT diversity in organisational tenure. Our findings also indicate that TMT gender diversity is not a relevant condition to the growth of SEOs that use bricolage and that TMTs incorporating members with differing levels of previous experience in for-profit organisations exert a negative impact on organisational growth.
Informal urban green space as anti-gentrification strategy?

Access to urban greenspace is vital for urban residents’ wellbeing. Yet investment in new parks can trigger housing price inflation through a process termed environmental gentrification. This can in turn potentially displace marginalized and vulnerable residents. In this chapter, we examine cases from Japan and Australia, investigating how informal urban greenspaces (IGS) (e.g. vacant lots, street or railway verges, brownfields, and power line corridors) could function as an ‘anti-gentrification’ urban greening strategy. Employing conceptual insights from political ecology and environmental justice, we use spatial and statistical analysis to test whether IGS is socio-spatially differentiated by (dis)advantage, and whether factors such as income and education affect residents’ perception and use of IGS. Results suggest that IGS holds considerable potential as a ‘just green enough’ intervention, because it does not appear to trigger gentrification as occurs with more ‘intentional’ green spaces. We argue that a key difference between intentional and informal greenspaces is the apparent empowerment of residents as co-creators, designers, managers and users of greenspace – not as passive consumers. Informal greenspaces may thus fulfill recreational needs while avoiding demands for a ‘return on investment’, a driver of environmental-gentrification. Insights from Japan suggest that planners and urban managers should identify and reduce IGS use barriers, provide better information (e.g. IGS maps), and work with residents to promote its use.
Resolving the Reliance on Fixed Estimation Dates in the Implied Cost of Equity Capital Approach

Abstract Our study’s objective is to develop and analyze a dynamic approach for estimating firms’ expected cost of equity capital. We contribute to the literature by enabling the usage of any required estimation date, resolving the major shortcoming of the existing models—their reliance on one fixed estimation date. This paper presents our model and discusses it from the perspective of the extant body of literature. We show that the current state of the art approach in dynamic estimation does not satisfy theoretical and practical demands, and offers scope for significant improvements. We conduct our analysis by specially considering capital market efficiency, the consistent appreciation of cash flows with respect to timing, and straightforward practical implementation for researchers and practitioners. Building on semi-strong capital market efficiency, the analysis reveals further insights into residual income valuation as we demonstrate that any realization of residual income in the course of the year is irrelevant to valuation in the absence of dividend realization. Consequently, assumptions regarding the shape of earnings in the course of the year are also irrelevant to valuation. Additionally, our theoretically founded model conveniently facilitates the undistorted incorporation of different fiscal year-ends in large samples and avoids stale measures of expected cost of equity capital.
Comparison of pleuropneumonectomy and limited surgery for lung cancer with pleural dissemination

The role of surgery in the management of lung cancer with pleural dissemination is controversial. We performed a retrospective analysis of our patients with lung cancer and pleural dissemination who were treated surgically. Between 1973 and 1993, 1,206 patients with lung cancer underwent pulmonary resection at Kanazawa University Hospital. Among them, 40 (3.3%) had pleural dissemination without pleural effusion. The 1‐, 3‐, and 5‐year survival rates for 38 patients (except 2 patients undergoing exploratory thoracotomy alone) were 51.5%, 19.4%, and 19.4%, respectively. The 1‐year survival rate in the 10 patients who underwent pleuropneumonectomy was only 20%, and 9 of these patients died within 18 months postoperatively (1 patient has survived for 25 months). In contrast, the 1‐, 3‐, and 5‐year survival rates for the 14 patients who underwent resection of the primary tumor plus parietal pleurectomy were 85.1%, 35.5%, and 35.5%, respectively, a significantly better outcome (P < 0.01). Seven patients are still alive (the longest survival time is 65 months with the disease). The average survival time in the seven fatal cases was 18 months. In patients with lung cancer accompanied by pleural dissemination, it is quite possible that local excision plus pleurectomy will be justified. © 1996 Wiley‐Liss, Inc.
Class IV-S versus class IV-G lupus nephritis: clinical and morphologic differences suggesting different pathogenesis.

BACKGROUND A recently proposed reclassification of lupus nephritis divides class IV (diffuse proliferative) lupus nephritis into those cases with predominantly segmental proliferative lesions (class IV-S) and those with predominantly global proliferative lesions (class IV-G). This report explores the validity of this distinction and possible differences in pathogenesis between the 2 types of lesions. METHODS Patients from a previously reported series of severe lupus nephritis, with initial biopsies (Bx1) and control biopsies (Bx2) at 6 months after induction therapy were reclassified according to the newly proposed classification. From the original series of 65 patients, 15 patients were reclassified as having class IV-S lesions and 31 patients class IV-G lesions. Clinical data at both biopsies and follow-up were available on all patients selected. RESULTS Patients with IV-G lesions had worse proteinuria, lower serum hemoglobins, lower CH50s, and likely higher SCrs (P = .06) and lower C3s (P = .08) than class IV-S patients. Serum CH50 and C3 correlated negatively with severity of class IV-G lesions, but not at all with class IV-S lesions. Patients with class IV-G lesions had greater overall immune deposits and subendothelial deposits on IF and greater hyaline deposits on light microscopy. By contrast, class IV-S showed predominant mesangial deposits and a much higher rate of glomerular fibrinoid necroses (13.3 +/- 15.3% vs. 5.6 +/- 8.0% of viable glomeruli, P = .03). Other distinctions included the fact that membranoproliferative features were found only in class IV-G lesions, and glomerular monocyte/macrophages were much more frequent in this group than in class IV-S lesions (1.77 +/- 0.92 vs. 0.86 +/- 0.77, P = .008). Finally, class IV-G frequently involved all viable glomeruli (74.2% of cases), whereas segmental proliferative lesions never did (P < .0001). Survivals from doubling of SCr at 10 years did not differ between the 2 types at Bx1: 72.5% segmental versus 60.4% global, P= . 53. However, among those with persistent lesions at Bx 2 (11 IV-S and 9 IV-G), there was a dramatic difference in 10-year survivals between IV-S lesions (63.6%) and IV-G lesions (0%), P = . 08. CONCLUSION There are definite clinical and morphologic differences between class IV-S and IV-G lesions. Data suggest that class IV-G lesions behave as an immune complex disease, having positive correlations with extent of immune deposits and negative correlations with serum complement levels, the model traditionally assumed for lupus nephritis as a whole. However, in class IV-S lesions, the presence of proportionally greater glomerular fibrinoid necroses and lack of correlation with extent of immune deposits suggest that these lesions may have a different pathogenesis.
Megakaryocytes and beyond: the birth of platelets

Summary. Megakaryocytes are highly specialized precursor cells that differentiate to produce blood platelets via intermediate cytoplasmic extensions known as proplatelets. Recent advances in the understanding of megakaryocyte differentiation and platelet formation rely on a combination of genetic and cell biological studies with detailed structural analysis of cultured cells. Visualization of sequential steps in endomitosis has expanded our views on how megakaryocytes acquire polyploid DNA content, whereas studies in mouse models of platelet disorders provide clues into transcriptional pathways and those leading to the assembly of platelet‐specific secretory granules. The experimental findings forge stronger links between cellular processes and molecular mechanisms, while observation of the underlying morphologic events in beginning to yield insights into the cytoskeletal mechanics of proplatelet formation. Here we review salient aspects of the emerging appreciation of the cellular and molecular basis of thrombopoiesis.
Evaluation of Quetiapine Abuse and Misuse Reported to Poison Centers

Objective:There are case reports of abuse of quetiapine, but no studies address quetiapine abuse or misuse. Most literature on the population that abuses quetiapine describes an older age group with previous substance abuse history, many of whom are in jail. The objective of this study was to evaluate national poison center data on misuse/abuse of quetiapine. Methods:A retrospective study of American Association of Poison Control Centers National Poison Data System data from 2005 to 2011 on single substance quetiapine exposures coded as intentional misuse or abuse and followed to known outcome was performed. Data were evaluated for age, toxicity, management sites, treatments, and medical outcomes. Results:There were 3116 cases meeting inclusion criteria; reason was misuse in 1948 cases and abuse in 1168 cases. The median age was 23 years. Misuse was reported most often in adults, whereas abuse occurred most frequently in adolescents. The male-to-female ratio was 1.7 for abuse and 1.0 for misuse. There were no deaths. Moderate or major toxicity occurred in 23.7% and 27.1% of misuse and abuse cases, respectively. Seventy-six percent were treated in the emergency department and/or received medical admission. Conclusions:Misuse was more common than abuse, except in adolescents for whom abuse was more frequent. Although outcomes were generally good, significant toxicity occurred in 25% of cases and more than 75% of the patients were treated in the emergency department and/or received medical admission. The consequences of nonmedical use of quetiapine are serious in some patients.