Miracle-dz/UniFAR-FTUs huggingface dataset:
Association between timing of intensive care unit admission and outcomes for emergency department patients with community-acquired pneumonia*

Objective:To compare the 28-day mortality and hospital length of stay of patients with community-acquired pneumonia who were transferred to an intensive care unit on the same day of emergency department presentation (direct-transfer patients) with those subsequently transferred within 3 days of presentation (delayed-transfer patients). Design:Secondary analysis of the original data from two North American and two European prospective, multicenter, cohort studies of adult patients with community-acquired pneumonia. Patients:In all, 453 non-institutionalized patients transferred within 3 days of emergency department presentation to an intensive care unit were included in the analysis. Supplementary analysis was restricted to patients without an obvious indication for immediate transfer to an intensive care unit. Interventions:None. Measurements and Main Results:The sample consisted of 138 delayed-transfer and 315 direct-transfer patients, among whom 150 (33.1%) were considered to have an obvious indication for immediate intensive care unit admission. After adjusting for the quintile of propensity score, delayed intensive care unit transfer was associated with an increased odds ratio for 28-day mortality (2.07; 95% confidence interval, 1.12–3.85) and a decreased odds ratio for discharge from hospital for survivors (0.53; 95% confidence interval, 0.39–0.71). In a propensity-matched analysis, delayed-transfer patients had a higher 28-day mortality rate (23.4% vs. 11.7%; p = 0.02) and a longer median hospital length of stay (13 days vs. 7 days; p < .001) than direct-transfer patients. Similar results were found after excluding the 150 patients with an obvious indication for immediate intensive care unit admission. Conclusions:Our findings suggest that some patients without major criteria for severe community-acquired pneumonia, according to the recent Infectious Diseases Society of America/American Thoracic Society consensus guideline, may benefit from direct transfer to the intensive care unit. Further studies are needed to prospectively identify patients who may benefit from direct intensive care unit admission despite a lack of major severity criteria for community-acquired pneumonia based on the current guidelines.
Cortical Low-Frequency Power and Progressive Phase Synchrony Precede Successful Memory Encoding

Neural activity preceding an event can influence subsequent memory formation, yet the precise cortical dynamics underlying this activity and the associated cognitive states remain unknown. We investigate these questions here by examining intracranial EEG recordings as 28 participants with electrodes placed for seizure monitoring participated in a verbal paired-associates memory task. We found that, preceding successfully remembered word pairs, an orientation cue triggered a low-frequency 2–4 Hz phase reset in the right temporoparietal junction with concurrent increases in low-frequency power across cortical regions that included the prefrontal cortex and left temporal lobe. Regions that exhibited a significant increase in 2–4 Hz power were functionally bound together through progressive low-frequency 2–4 Hz phase synchrony. Our data suggest that the interaction between power and phase synchrony reflects the engagement of attentional networks that in large part determine the extent to which memories are successfully encoded. SIGNIFICANCE STATEMENT Here we investigate the spatiotemporal cortical dynamics that precede successful memory encoding. Using intracranial EEG, we observed significant changes in oscillatory power, intertrial phase consistency, and pairwise phase synchrony that predict successful encoding. Our data suggest that the interaction between power and phase synchrony reflects the engagement of attentional networks that in large part determine the extent to which memories are successfully encoded.
The Integrated Knowledge Management Maturity Model

Although many organisations worldwide are introducing knowledge management (KM) practices, there is no generally acknowledged methodology for assessing where the organisation stands, compared to its competitors. Several knowledge management maturity models have been developed, but they are so heterogeneous that the practice is evidently calling for a universal and standardised knowledge management maturity model. Most of the models have something in common: they are all based on the selected KM factors and they all define maturity through different maturity levels. The main goal of this paper is to propose the integrated knowledge management maturity model (I-KMMM) based on literature review. The purpose of determining the model is to set a standard or a framework for future assessment of knowledge management.
Interruptions of Antiretroviral Therapy in HIV Infection : Are they Detrimental to Neurocognitive Functioning ?

1 Lluita contra la SIDA Foundation Germans Trias i Pujol University Hospital. Badalona, Barcelona, Catalonia, Spain 2 Autònoma de Barcelona University. Barcelona, Catalonia, Spain 3 Politècnica de Catalunya University. Barcelona, Catalonia, Spain 4 Consorci Sanitari de Terrassa Hospital. Terrassa, Barcelona, Catalonia, Spain 5 IrsiCaixa Foundation. Badalona, Barcelona, Catalonia, Spain Address of corresponding author: Jose A. Muñoz-Moreno, MS Lluita contra la SIDA Foundation HIV Unit Germans Trias i Pujol University Hospital Ctra. de Canyet, S/N 08916, Badalona, Barcelona, Catalonia, Spain Tel: +34 93 465 78 97 Fax: +34 93 465 76 02 e-mail: jmunoz@flsida.org
Crystal structure of the site-specific recombinase ,

pairs of strand exchanges that are positioned 6–8 bp apart. Hosahalli S.Subramanya1, In site-specific recombination reactions mediated by both Lidia K.Arciszewska2, Rachel A.Baker2, families, four recombinase molecules bound to two ~30 bp Louise E.Bird1, David J.Sherratt1,3 and recombination core sites catalyse the breaking and Dale B.Wigley1 rejoining of four DNA phosphodiester bonds. 1Laboratory of Molecular Biophysics and 2Microbiology Unit, The 298 amino acid site-specific recombinase XerD, Department of Biochemistry, University of Oxford, Oxford OX1 3QU, along with its related partner recombinase, XerC, belong UK to the λ integrase family of site-specific recombinases. 3Corresponding author They function in the stable inheritance of the Escherichia e-mail: Sherratt@bioch.ox. ac.uk coli chromosome and multicopy circular plasmids, apparently by converting to monomers the circular multimers The structure of the site-specific recombinase, XerD, that can arise by homologous recombination (Blakely that functions in circular chromosome separation, has et al., 1993; Sherratt et al., 1995). Recombinases of the been solved at 2.5 Å resolution and reveals that the integrase family are highly diverged in primary amino protein comprises two domains. The C-terminal acid sequence, with only four completely conserved amino domain contains two conserved sequence motifs that acids (RHRY) (Argos et al., 1986; Abremski and Hoess, are located in similar positions in the structures of 1992). All four of the conserved residues have been XerD, λ and HP1 integrases. However, the extreme implicated in catalysis (Pargellis et al., 1988; Evans et al., C-terminal regions of the three proteins, containing 1990; Chen et al., 1992a; Friesen and Sadowski, 1992; the active site tyrosine, are very different. In XerD, Lee et al., 1992). In XerD and XerC, the two conserved the arrangement of active site residues supports a cis arginines and the tyrosine are required for DNA cleavage, cleavage mechanism. Biochemical evidence for DNA while the conserved histidine is required for DNA rejoining bending is encompassed in a model that accommodates (Blakely et al., 1993; Arciszewska and Sherratt, 1995; extensive biochemical and genetic data, and in which Arciszewska et al., 1997; L.K.Arciszewska, R.A.Baker, the DNA is wrapped around an α-helix in a manner P.A.Wigge and D.J.Sherratt, unpublished data). Recombinsimilar to that observed for CAP complexed with DNA. ation is initiated when the conserved tyrosine hydroxyl
The Effect of Judicial Expedience on Attorney Fees in Class Actions

Judges facing exogenous constraints on their pecuniary income have an incentive to reduce their workload to increase their private welfare. In the face of an increase in caseload, this incentive will induce judges to attempt to terminate some cases more rapidly. In class action cases, failing to grant an attorney fee request will delay termination. This conflict is likely to lead judges to authorize higher fees as court congestion increases. Using two data sets of class action settlements, we show that attorney fees are significantly and positively related to the congestion level of the court hearing the case.
Insomnia Patients' Help-Seeking Experiences

Timely access to appropriate treatment is important for optimizing insomnia management. To date, little is known about insomnia patients' treatment experiences or how they access and engage with the available health care resources. This study sought to capture the help-seeking experiences and behavioral patterns of patients with insomnia who are seeking or receiving specialist care. A purposive sample of 26 insomnia patients from specialist sleep and mental health clinics located in metropolitan New South Wales, Australia was recruited. Participants completed a brief questionnaire, followed by an in-depth, semi-structured interview. Interviews were digitally recorded, transcribed verbatim, and analyzed using framework analysis. Three key themes emerged from the data: patients' sleep beliefs, treatment beliefs, and accessing specialized care. The findings show that daytime symptoms arising from insomnia serve as important illness cues for patients to seek medical help. In addition, participants' treatment pathways highlight factors that prevent the widespread use of cognitive behavioral therapy for insomnia (CBT–I), including limited awareness about CBT–I, tentative referral mechanisms, limited service providers, and the high cost of CBT–I.
High Energy Ionic Charge State Composition in the October / November 2003 and January 20 , 2005 SEP Events

The ionic charge states of solar energetic particles (SEPs) probe source-material temperatures and acceleration and transport conditions. The MAST instrument on SAMPEX measures SEP ionic charge states at energies greater than ~15 MeV/nuc and at iron energies up to ~90 MeV/nuc using the geomagnetic filter technique. Charge state measurements for large gradual SEP events by MAST and by other experiments suggest that event-to-event variations in the mean charge states of abundant elements are correlated with abundance ratios (e.g. Fe/0). We present charge state measurements for the October/November 2003 events that suggest different source material temperatures for these events. We also present charge state measurements for the January 20, 2005 event, which contrasts with the previously demonstrated Q(Fe) vs. Fe/0 correlation. In this event solar and SEP data indicate that the first high-energy particles left the Sun when the CME shock was ~ 1.5 solar radii above the solar surface. At this altitude charge-equilibration calculations and the observed mean charge state of+ 12 for Fe imply that <90 seconds were available to accelerate and release the particles. These observations therefore present a serious challenge to SEP acceleration models.
Régulation de la survie des cellules dendritiques plasmacytoïdes dans un contexte inflammatoire non viral

Les cellules dendritiques plasmacytoides (pDC) sont specialisees dans la lutte antivirale, notamment grâce a leur capacite a secreter des IFN de type I. Neanmoins, elles sont aussi impliquees dans Pactivation des reponses immunitaires adaptatives, et des lymphocytes T (LT) en particulier. C'est pourquoi, lors d'episodes inflammatoires chroniques ou incontroles, les pDC sont a l'origine de l'initiation ou du maintien de syndromes inflammatoires et du developpement de pathologies auto-immunes. Il doit donc exister des mecanismes permettant de controler l'activite de ces cellules. A l'aide d'un modele in vivo d'inflammation non virale induite par l'injection d'un anticorps anti-CD3 (Ac aCD3), nous avons observe une apoptose des pDC dans differents organes lymphoides, et ce de facon dependante de l'activation des lymphocytes T. De plus, nous avons pu observer que la diminution de la survie des pDC dans ce contexte inflammatoire n'etait pas associee a l'orage cytokinique induit par l'efiet mitogenique de l'Ac aCD3. En revanche nos resultats montrent que les LT CD8* et la voie cytotoxique de la perforine dans ce contexte inflammatoire aigu sont responsables de la depletion des pDC. Nous avons egalement etendu ces resultats a d'autres situations inflammatoires steriles comme lors de la maladie du greffon contre l'hote. Ces donnees suggerent que cette voie de regulation pourrait etre utilisee a des fins therapeutiques, afin de controler la survie des pDC impliquees dans la physiopathologie de syndromes auto-immuns comme le lupus erythemateux dissemine, le psoriasis, la sclerose en plaques ou encore le diabete de type I.
Comorbid depression and anxiety in later life: patterns of association, subjective well-being, and impairment.

OBJECTIVE Very little epidemiological work has examined comorbidity between depression and anxiety disorders in community-dwelling older adults, despite the fact these disorders are known to co-occur in younger adults and that this co-occurrence is associated with greater clinical severity. In this study, the authors examine psychiatric comorbidity and associated impairment of four disorders (major depression, panic disorder, social phobia, and agoraphobia) in a community-based sample of adults aged 55 and older. SETTING Population-based sample of older adults (N=12,792) from the Canadian Community Health Survey-Mental Health and Well-Being (CCHS 1.2). METHOD The World Mental Health Composite International Diagnostic Interview was used to identify cases of 12-month disorder. Descriptive analysis and regression analysis is used to examine patterns of association between disorders and related impairment. RESULTS Among adults aged 55 years and older, 4.4% met the criteria for at least one disorder and 0.8% had two or more. Social phobia was the most common comorbid disorder among respondents with depression, and depression was the most common comorbid disorder among respondents with any of the anxiety disorders. Respondents who report comorbid disorders reported significantly lower well-being and greater impairment. CONCLUSION Although comorbidity between physical health conditions and depression, and between dementias and depression, are well documented among older adults, these results suggest that comorbid depression and anxiety are also prevalent in later life. The significant impact of comorbidity on function and well-being underlines the need to screen for comorbid disorders in this population.
Spinal haematoma following epidural anaesthesia in a patient with eclampsia

A patient with a twin pregnancy required a Caesarean section for severe pre‐eclampsia. Her platelet count was 71 × 109.l−1. Epidural anaesthesia was performed after platelet transfusion. A spinal epidural haematoma was diagnosed postoperatively. A generalised tonic–clonic seizure sparing the lower limbs enabled early diagnosis to be made. The patient recovered with no permanent neurological damage after laminectomy and clot removal. The risks and benefits of regional techniques require careful consideration, and postoperative monitoring for recovery of neural blockade is essential.
A systematic review of capnography for sedation

We included six trials with 2524 participants. Capnography reduced hypoxaemic episodes, relative risk (95% CI) 0.71 (0.56–0.91), p = 0.02, but the quality of evidence was poor due to high risks of performance bias and detection bias and substantial statistical heterogeneity. The reduction in hypoxaemic episodes was statistically homogeneous in the subgroup of three trials of 1823 adults sedated for colonoscopy, relative risk (95% CI) 0.59 (0.48–0.73), p < 0.001, although the risks of performance and detection biases were high. There was no evidence that capnography affected other outcomes, including assisted ventilation, relative risk (95% CI) 0.58 (0.26–1.27), p = 0.17.
Community Based Mathematics Project: Conceptualizing Access through Locally Relevant Mathematics Curricula

In this article, we describe a conceptual framework for using locally relevant mathematics curricula to increase access to mathematics for marginalized youth. Drawing on different strands of research on equity in mathematics education, we propose that there are three kinds of access that are afforded by the use of contexts that have local and personal meaning: (1) access to mathematics that matters, (2) access to institutions, and (3) access to critical ways of thinking. This framework was developed in a grounded manner; it evolved through our work with middle school students and their teachers and through our critical analysis of the midand macro-level contexts (Irvine, 1990) in which their schooling is situated. In order to illustrate this process, we present this framework as it has emerged. After a brief introduction to the project, we review the research that informs our work and then explicate the three different forms of access that are embedded in our curriculum design.
Population Pharmacokinetic-Pharmacodynamic Analysis of Voriconazole and Anidulafungin in Adult Patients with Invasive Aspergillosis

ABSTRACT To evaluate the exposure-response relationships for efficacy and safety of voriconazole and anidulafungin in adult patients with invasive aspergillosis (IA), a population pharmacokinetic-pharmacodynamic (PK-PD) analysis was performed with data from a phase 3, prospective, double-blind, comparative study evaluating voriconazole and anidulafungin combination therapy versus voriconazole (and placebo) monotherapy. Anidulafungin/placebo treatment duration was 2 to 4 weeks, and voriconazole treatment duration was 6 weeks. Efficacy (6-week all-causality mortality and 6-week global response [n = 176]) and safety (hepatic [n = 238], visual [n = 199], and psychiatric [n = 183] adverse events [AEs]) endpoints were analyzed separately using a binary logistic regression model. In IA patients receiving voriconazole monotherapy, no positive associations between voriconazole exposure and efficacy or safety were identified. In IA patients receiving combination therapy, no positive associations between voriconazole or anidulafungin exposures and efficacy were identified. The 6-week survival rate tended to increase as anidulafungin treatment duration increased; this finding should be considered with caution. Additionally, in IA patients receiving combination therapy, a positive association between voriconazole and anidulafungin exposures (area under the curve [AUC] and trough concentration [Cmin]) and hepatic AEs was established; a weak positive association between voriconazole exposure (AUC and Cmin) and psychiatric AEs was also established, but no association between voriconazole exposure and visual AEs was identified. Besides the drug exposures, no other covariates (i.e., CYP2C19 genotype status, age, weight, body mass index, sex, race, or neutropenia status) were identified as significant predictors of the efficacy and safety endpoints in IA patients. This study was registered on ClinicalTrials.gov (NCT00531479).
Censored Fractional Response Model: Estimating Heterogeneous Relative Risk Aversion of European Households

This paper estimates relative risk aversion using the observed shares of risky assets and characteristics of households from the Household Finance and Consumption Survey of the European Central Bank. Given that the risky share is a fractional response variable belonging to [0, 1], this paper proposes a censored fractional response estimation method using extremal quantiles to approximate the censoring thresholds. Considering that participation in risky asset markets is costly, I estimate both the heterogeneous relative risk aversion and participation cost using a working sample that includes both risky asset holders and non-risky asset holders by treating the zero risky share as the result of heterogeneous self-censoring. Estimation results show lower participation costs and higher relative risk aversion than what was previously estimated. The estimated median relative risk aversions of eight European countries range from 4.6 to 13.6. However, the results are sensitive to households' perception of the risky asset market return and volatility.
Comparison of productive and carcass traits and economic value of lines selected for different criteria, slaughtered at similar weights

The aim of the experiment was to compare 3 genetic groups, slaughtered at similar weights, to examine their productive and carcass traits and economic value. Three lines of the Pannon Breeding Programme, selected for different criteria, were examined in the experiment. Pannon Ka (PKa, maternal line) does were inseminated with semen of PKa, Pannon White (PWhite) or Pannon Large (PLarge, terminal line) bucks. The kits (PKa×PKa, PWhite×PKa, PLarge×PKa; n=60 in each genetic group) were weaned at 35 d of age and reared until 88, 83 and 79, respectively, when they reached similar body weights for slaughtering (2.8 kg). The weight gain of PLarge×PKa was the largest (51.0 g/d) and that of PKa×PKa was the smallest (47.2 g/d), while PWhite×PKa (41.8 g/d) was intermediate (P<0.001). Difference was found in feed conversion ratio between weaning and the age of slaughter PKa×PKa: 3.03 respect to PWhite×PKa: 2.75 and PLarge×PKa: 2.66; , P<0.05). Dressing out percentage and ratio of hind part to reference carcass of PWhite×PKa, PLarge×PKa and PKa×PKa were 62.4 and 37.7, 61.8 and 37.5, 61.3 and 36.8%, respectively (P<0.01). Results show that PLarge×PKa rabbits were able to exceed the average economic indicators compared to other groups. It may be concluded that the production performance of growing rabbits was affected by the adult weight, but the carcass traits were influenced by the computer tomography (CT)-based selection.
A probabilistic approach to block sizes in random maps

We present a probabilistic approach to the core-size in random maps, which yields straightforward and singularity analysis-free proofs of some results of Banderier, Flajolet, Schaeffer and Soria. The proof also yields convergence in distribution of the rescaled size of the k'th largest 2-connected block in a large random map, for any fixed k > 1, to a Fr\'echet-type extreme order statistic. This seems to be a new result even when k=2.
The mechanism of the irreversible antimicrobial effects of penicillins: how the beta-lactam antibiotics kill and lyse bacteria.

INTRODUCTION . THE "SINGLE-TARGET-UNBALANCED GROWTH" MODEL OF PENICILLIN ACTION . Autolysins and the Penicillin-Induced Lysis . Multiple Targets oj Penicillin . Multiple Forms oj the Penicillin-Sensitive Enzymes; Variation oj the Target with Bacterial Species . Penicillin Tolerance . Penicillin Binding Proteins. Penicillin-Sensitive Enzymes. and Murein Hydrolases . THE NATURE OF PENICILLIN-INDUCED LETHALITY AND LYSIS . Murein Hydrolases and the Penicill in-Induced Lysis of Bacteria . Autolysin-Defective Pneumococci . Murein Hydrolases and the Loss of Bacterial Viability . The Negative Control of Murein Hydrolase in Pneumococci . Triggering of Murein Hydrolase . Model for the Mechanism of the Irreversible Effects of Penicillin . Antimicrobial Effects of Penicillin . Loss oj Viability and Lysis . SUMMARY .