Miracle-dz/UniFAR-FTUs huggingface dataset:
Performance of Contraceptive Patch Compared With Oral Contraceptive Pill in a High-Risk Population

OBJECTIVE: To evaluate the potential benefit of the transdermal contraceptive patch compared with the oral contraceptive pill for its acceptability and compliance in a population at high risk for future unintended pregnancies and abortions. METHODS: Assessment of the contraceptive patch and pill was prospective. We gathered information on women undergoing contraceptive counseling at three Planned Parenthood clinics. Discontinuation, adverse effects, and pregnancy outcomes were catalogued. The primary outcome was time to discontinuation of the patch or pill. Survival analyses with life tables and Cox proportional hazards were used to assess acceptability and compliance. Pearl indices were calculated for both the pill and patch. RESULTS: A total of 1,230 contraceptive-naïve women were identified. Subjects were a racially diverse group of primarily single women. Eighty-nine percent of the study population met our definition of being at high risk for a future unintended pregnancy or pregnancy termination. Loss to follow-up was higher among patch users (45.2% versus 29.5%, P<.001). Verified continued use beyond the first three cycles was lower with a patch (67% versus 89%, P<.001). Skin irritation and site reactions were the treatment-limiting factor for 3.3% of patch users. The 3,206 cycles captured in this study resulted in a Pearl index of 3.62 for the pill and 14.84 for the patch. Differences in the baseline demographic and contraceptive practices may account for this discrepancy although, in multivariate analysis, patch users continued to do worse. CONCLUSION: In this high-risk population, we found the contraceptive patch to have lower continuation and effectiveness rates. Further research should investigate factors contributing to poorer real-world performance by the patch. LEVEL OF EVIDENCE: II-2
Hospital characteristics, diagnoses, and staff reasons associated with use of seclusion and restraint.

OBJECTIVE Patterns of seclusion and restraint over a one-year period at 82 Veterans Affairs medical centers were examined to determine whether use of these interventions was influenced by hospital characteristics (such as geographic location, per diem cost, patient-staff ratio, and university affiliation), patient diagnoses, or reasons for use. METHODS For comparison, medical centers were grouped into seven geographic regions and into three frequency-of-use groups. Mean use rates and hospital characteristics were examined by rank correlational analysis. RESULTS Among hospital characteristics, only geographic location was associated with differences in use of seclusion and restraint. Mean rates of use in the Pacific and Mid-Atlantic regions were significantly lower than those in other regions. Total hours of seclusion and restraint at the 20 highest-use centers differed from those at the 20 lowest-use centers by a factor of ten. Patients with schizophrenic disorders were secluded or restrained most frequently. Centers with the highest rates used these interventions most frequently for reasons not associated with violent or potentially violent behaviors. CONCLUSIONS The large geographic variations in use of seclusion and restraint may be a function of different standards of practice or of different state laws.
Evaluation of surgical approaches to anatomical segmentectomies: the transition to minimal invasive surgery improves hospital outcomes.

Background We aim to evaluate the transition process from open to video-assisted thoracoscopic surgery (VATS) anatomical segmentectomies in a regional thoracic surgical unit. Methods In a retrospective study from January 2013 to December 2015, we identified all anatomical segmentectomies performed in our unit. Pre, peri and postoperative data were compared between the three years (2013, 2014 and 2015) and according to operative approach. Thoracotomy after VATS intraoperative biopsy was considered a conversion for the purposes of the study. Results A total of 86 consecutive cases [56 females and 30 males, median age 70 years (range, 43 to 83 years); median FEV1 of 78% predicted (range, 41% to 126%)] were included. There was a significant change in the surgical approach with time. Fifty-two cases underwent VATS (73% via single-port) and 34 open surgeries, including nine conversions. There were no postoperative deaths in the VATS group and one in the open group. Operative outcomes were similar over time with no haemorrhagic events, equivalent R1 resection and nodal stations explored in all lymph node positive patients. In node negative cases however, open surgery was associated with more extensive mediastinal exploration. Patients in 2015 had a shorter hospital stay in comparison to those in previous years [median 4 days (range, 1-15 days) vs. median 6 days (range, 3-27 days), P=0.01]. There were no differences in the incidence of complications or readmissions to hospital over time. Conclusions The transition over a short period of time from open to single-port VATS segmentectomy has allowed us to significantly reduce postoperative hospital stay without compromising operative or postoperative outcomes.
Adaptive prototype-based dissimilarity learning

In this thesis we focus on prototype-based learning techniques, namely three unsuper- vised techniques: generative topographic mapping (GTM), neural gas (NG) and affinity propagation (AP), and two supervised techniques: generalized learning vector quantiza- tion (GLVQ) and robust soft learning vector quantization (RSLVQ). We extend their abilities with respect to the following central aspects: • Applicability on dissimilarity data: Due to the increased complexity of data, in many cases data are only available in form of (dis)similarities which describe the relations between objects. Classical methods can not directly deal with this kind of data. For unsupervised methods this problem has been studied, here we transfer the same idea to the two supervised prototype-based techniques such that they can directly deal with dissimilarities without an explicit embedding into a vector space. • Quadratic complexity issue: For dealing with dissimilarity data, due to the need of the full dissimilarity matrix, the complexity becomes quadratic which is infeasible for large data sets. In this thesis we investigate two linear approximation techniques: Nystrom approximation and patch processing, and integrate them into unsupervised and supervised prototype-based techniques. • Reliability of prototype-based classifiers: In practical applications, a relia- bility measure is beneficial for evaluating the classification quality expected by the end users. Here we adopt concepts from conformal prediction (CP), which provides point-wise confidence measure of the prediction, and we combine those with supervised prototype-based techniques. • Model complexity: By means of the confidence values provided by CP, the model complexity can be automatically adjusted by adding new prototypes to cover low confidence data space. • Extendability to semi-supervised problems: Besides its ability to evaluate a classifier, conformal prediction can also be considered as a classifier. This opens a way that supervised techniques can be easily extended for semi-supervised settings by means of a self-training approach.
Application of a scaling model to establish and validate an interval level pain scale for assessment of acute pain in dogs.

OBJECTIVE To establish interval level measurement in a prototype composite measure pain scale (CMPS) for assessment of acute pain in dogs and to investigate the scale's validity. ANIMALS 20 clinically normal dogs, 20 dogs with medical conditions, and 117 dogs undergoing surgery. PROCEDURE First, a scaling model was applied to the CMPS descriptors to establish weights for each and create a continuous scale. Subsequently, 5 observers independently used the scale to score signs of pain in 4 groups of dogs (control dogs, dogs with medical conditions, and 40 dogs undergoing soft tissue or orthopedic surgery). Scores from each group and from groups of conditions perceived to cause no, mild, moderate, and severe pain were compared. In addition, the scale was applied to 77 dogs undergoing orthopedic or soft tissue surgery and scores were compared with simultaneously derived numeric rating scale (NRS) scores; comparisons were made between surgical groups and with time after surgery. RESULTS Calculated scale descriptor weights ranged from -2.0 to 2.0 and were transformed to create a continuous scale from 0 to 10. Median CMPS scores differed significantly among the 4 study groups and among pain severity groups and were typically greater with increasing perceived pain severity. Agreement was determined between CMPS and NRS scores, and there was a significant and expected time effect and difference between the CMPS scores of dogs undergoing orthopedic and soft tissue surgery. CONCLUSIONS AND CLINICAL RELEVANCE Results indicate that this interval level measurement scale is a valid measure of acute pain in dogs.
A critical review of techniques aiming at enhancing and sustaining worker's alertness during the night shift.

Two types of methods based on a particular principle allow enhancing and sustaining workers' alertness all along their night work. The first one rather consists in arousing workers by exposing them to stimulant environment conditions (light or noise.) or by giving them natural or pharmacological reactivating substances (caffeine or amphetamines.) for example. The second principle consists in increasing workers' possibilities for resting and allowing them to have short sleep periods or Short Rest Periods (SRP) in an adapted area at the workplace. In order to use these techniques in real work situations, after a critical review taking into account both efficiency, advantages and disadvantages but also applicability and acceptability, the SRP technique stands out as the most efficient method as it has a certain number of advantages with regard to our initial objective.
Specificity of human T lymphocytes expressing a gamma/delta T cell antigen receptor. Recognition of a polymorphic determinant of HLA class I molecules by a gamma/delta clone.

Alloreactive clones expressing T cell receptor (TcR) gamma/delta were derived by limiting dilution from CD3+ CD4- CD8- WT31- populations stimulated in allogeneic mixed lymphocyte culture. These clones specifically lysed phytohemagglutinin-induced blast cells bearing the stimulating alloantigens, whereas they had no effect on autologous or allogeneic unrelated target cells. Analysis of the reactivity with monoclonal antibodies (mAb) specific for two different subsets of TcR gamma/delta (BB3 and delta-TCS-1) showed that five out of nine clones were BB3+, whereas the remaining reacted with delta-TCS-1. Therefore, we can conclude that both subsets of TcR gamma/delta+ cells are able to specifically recognize and lyse allogeneic cells. mAb directed against the CD3-TcR gamma/delta molecular complex strongly inhibited the specific cytolytic activity of TcR gamma/delta+ clones, whereas they had no effect on the lysis of the natural killer-sensitive K-562 target cells mediated by the same clones. An alloreactive delta-TCS-1+ clone (LM12) was further characterized for its specificity. LM12 clone had been derived after stimulation in mixed lymphocyte culture against donor M.M. (HLA typing: Aw68, 24; B35, w55; DR1, 7). The analysis of a large panel of phytohemagglutinin-induced target cells revealed that only the HLA-A24+ target cells were lysed. The direct evidence that the A24 molecule represented the restriction element was provided by experiments using A24-transfected murine P815 target cells. Thus, clone LM12 efficiently lysed A24-transfected P815 cells, but not the same cells untransfected or transfected with the Cw3 gene. Therefore, it appears that polymorphic determinants of class I major histocompatibility complex molecules can be the target of TcR gamma/delta+ alloreactive cell recognition.
Involvement of ERK MAP kinase in endoplasmic reticulum stress in SH‐SY5Y human neuroblastoma cells

Endoplasmic reticulum (ER) stress has increasingly come into focus as a factor contributing to neuronal injury. Although caspase‐dependent mechanisms have been implicated in ER stress, the signaling pathways involved remain unclear. In this study, we examined the role of the extracellular signal‐regulated kinase (ERK), a mitogen‐activated protein (MAP) kinase pathway that is highly conserved in many systems for balancing cell survival and death. Prolonged treatment of the human neuroblastoma cell line SH‐SY5Y with thapsigargin, an inducer of ER stress, increased cell death over 24–48 h, as measured by LDH release. Caspases were involved; increased levels of active caspase‐3 and cleaved caspase substrate PARP were detected, and treatment with Z‐VAD‐FMK reduced thapsigargin‐induced cytotoxicity. In contrast, inhibition of calpain was not protective, although calpain was activated following thapsigargin treatment. An early and transient phosphorylation of ERK1/2 occurred after thapsigargin‐induced ER stress, and targeting this pathway with the MEK inhibitors U0126 or PD98059 significantly reduced cell death. Similar cytoprotection was obtained against brefeldin A, another ER stress agent. However, protection against ER stress via ERK inhibition was not accompanied by amelioration of caspase‐3 activation, PARP cleavage, or DNA laddering. These data indicate that ERK may contribute to non‐caspase‐dependent pathways of injury after ER stress.
Special senses: thermal receptors.

an en­ entirely new view of the peripheral afferent part of the thermoregulatory system, as well as of many sensory phenomena hitherto the subject of much debate. For that reason it was considered justified to limit this review en­ tirely to thermal receptors. The temperature movements in the skin have been subject to theoretical as well as experimental investigations by Hensel (2, 3), who has developed effective methods for recording the intracutaneous temperature gradient in stationary conditions as well as a precision-flow-ca lorimeter for measuring the steady heat flow given off from small skin areas, the mean error of the method being only ± 0.0001 cal. cm.2 sec. -1 The new "Stromungskalorime ter" constructed by Hensel (4) can be used clinically also for the determination of the blood flow through the skin. For details, see Hensel's monograph "Physiologie der Thermoreception" in Ergebnisse der Physiologie (5). The depths of cold receptors in the tongue of the cat have been recorded in aIi objective way by Hensel, Strom, and Zotterman (6). This method is based on the recording of the spike potential of specific cold fibres in the lingual nerve set up by applying rapid cold jumps to the tongue and by simul­ taneous recording of the temperature changes. The depth of the cold recep­ tors was calculated from determinations of (a) the threshold, (b) the tempera­ ture change of the thermode, (c) the latency of the specific cold spikes, (d) the thermal diffusion coefficient of the tongue. From a great number of meas­ urements on the tongue of the cat, a mean value of 0.18 mm. ±0.04 was ob­ tained. The cold receptors are thus situated closely beneath the epithelium. At this depth an abundance of afferent nerve endings of various configura­ tions have been described by histologists (ef. Sanders (7)). The investigations of the receptive field for thermoceptors has often led to much debate. The question is, as Jenkins (8) formulates it, whether it should be compared with an unsensitive surface with spread circumscript sensitive spots or rather as a continuum with peaks, valleys, and plateaus. The peaks should then cor­ respond to the spots according to the classical view. Hensel (5) maintains 1 The survey of the literature pertaining to this review was concluded in June,
The effect of recurrent laryngeal nerve stimulation on phonation in an in vivo canine model

The present investigation was designed to examine the effect of variation in recurrent laryngeal nerve stimulation (RLNS) on vocal fold vibration. Photoglottography (PGG), electroglottog‐raphy (EGG), and subglottic pressure (Psub) were measured in seven mongrel dogs using an in vivo canine model of phonation. The PGG, EGG, and Psub signals were examined at three fundamental frequencies (F0) (100 Hz, 130 Hz, and 160 Hz) for RLNS, using a constant rate of air flow. Increasing RLNS, which caused activation of the intrinsic laryngeal muscles, produced a modest increase in F0, a marked increase in Psub, no change in the open quotient (OQ), and an increase in the closing quotient (CQ). Phase quotient (Qp), which describes the interval between opening of the lower and upper fold margins, decreased with increasing RLNS.
Plasma glucose and insulin levels in genetically lean and fat sheep.

This study investigated whether genetically lean and fat sheep displayed differences in insulin and glucose statuses. Lean genotype sheep had significantly (P < 0.05) greater basal glucose concentrations than fat genotype sheep (4.78 versus 4.52, SED = 0. 104 mmol/l), although basal plasma insulin was not significantly different (mean 304, SEM = 37.3 pmol/l) between the genotypes. During glucose tolerance tests (GTT), carried out at 4 levels of injection: 0, 0.28, 1.39 or 2.78 mmol glucose/kg liveweight, the area under the plasma insulin curve was significantly (P < 0.05) greater for fat than lean genotype sheep, although there were no differences in any glucose parameters. There were no significant differences between genotypes in insulin or glucose concentrations during or following glucose infusion (GINF) experiments at 0, 0.09, 0.46 or 0.93 mmol glucose/kg live-weight/h over 3 hours. Elevated plasma insulin concentrations after a glucose tolerance test are concluded to be associated with increased fatness in this genetically selected line of sheep. However, the differences in insulin and glucose levels between the lean and fat genotype sheep are minor, relative to the differences in carcass composition.
Leveraging remote behavioral health interventions to improve medical outcomes and reduce costs.

OBJECTIVE The dramatic rise in healthcare expenditures calls for innovative and scalable strategies to achieve measurable, near-term improvements in health. Our objective was to determine whether a remotely delivered behavioral health intervention could improve medical health, reduce hospital admissions, and lower cost of care for individuals with a recent cardiovascular event. STUDY DESIGN This retrospective observational cohort study included members of a commercial health plan referred to participate in AbilTo’s Cardiac Health Program. AbilTo is a national provider of telehealth, behavioral change programs for high risk medical populations. METHODS The program is an 8-week behavioral health intervention delivered by a licensed clinical social worker and a behavioral coach via phone or secure video. RESULTS Among the 201 intervention and 180 comparison subjects, the study found that program participants had significantly fewer all-cause hospital admissions in 6 months (293 per 1000 persons/year vs 493 per 1000 persons/year in the comparison group) resulting in an adjusted percent reduction of 31% (P = .03), and significantly fewer total hospital days (1455 days per 1000 persons/year vs 3933 per 1000 persons/year) with an adjusted percent decline of 48% (P = .01). This resulted in an overall savings in the cost of care even after accounting for total program costs. CONCLUSIONS Successful patient engagement in a national, remotely delivered behavioral health intervention can reduce medical utilization in a targeted cardiac population. A restored focus on tackling barriers to behavior change in order to improve medical health is an effective, achievable population health strategy for reducing health costs in the United States.
Review of Coagulation's Rapid Mixing for NOM Removal

This review focuses on rapid mixing in the coagulation process for improved natural organic matter (NOM) removal in water treatment. Rapid mixing aims to instantly and efficiently disperse coagulant species into raw water, before flocculation, sedimentation, and filtration processes. Mechanical mixing with a longer retention time cannot guarantee an instantaneous and uniform coagulant dispersion. For this reason, the so-called pump diffusion mixer (PDM) has been proposed. Using various rapid mixing devices to test the sedimentation performance, it is showed that in-line hydraulic jet and static mixers are able to achieve performance equivalent to that of the mechanical mixing type at a lower coagulant dosage. On the other hand, the removal of NOM as disinfection by-products (DBPs) precursor by chemical coagulation (CC) has been extensively studied. It is well reported that enhanced coagulation (EC) by adjusting the pH downwards to 4-5 prior to coagulant addition will encourage the formation of soluble NOM–Al complex from low-turbidity waters. In case of most waters, therefore, acid must be added to maintain the desired coagulation pH for EC, and excess coagulant is required to improve the removal of NOM. However, CC using in-line hydraulic jet mixer such as PDM is a reasonable method for the improvement of coagulation process compared to EC, since it is possible to obtain good removals of NOM as well as turbidity using a lower dosages of coagulant without supplementary addition of chemicals for pH control and thus producing a smaller volume of waste solids.
Brain anatomic magnetic resonance imaging in childhood-onset schizophrenia.

BACKGROUND Early-onset schizophrenia (first psychotic symptoms by age 12 years) has been the subject of a small number of studies, and its biological continuity with later-onset disorder has not been established. In this study quantitative anatomic brain magnetic resonance images of children and adolescents with early-onset schizophrenia were compared with those of matched controls. Brain abnormalities in childhood-onset schizophrenia were examined in relation to those reported for later-onset schizophrenics. METHODS Anatomic brain magnetic resonance imaging scans were obtained for 21 patients (mean +/- SD age, 14.6 +/- 2.1 years; range, 10 to 18 years) with childhood-onset schizophrenia (13 males, eight females) and 33 age-, sex-, height-, and weight-matched normal controls. Quantitative measurements were obtained for the cerebrum, anterior frontal region, lateral ventricles, thalamus, caudate, putamen, and globus pallidus. RESULTS Total cerebral volume and midsagittal thalamic area were smaller in the patients (analysis of variance, P = .002, and analysis of covariance, P = .03, respectively); the caudate, putamen, and globus pallidus were larger in the patients (analysis of covariance, P = .05, P = .007, and P < .001, respectively); and the lateral ventricles tended to be larger in the patients (analysis of covariance, P = .06). Globus pallidus enlargement correlated with neuroleptic exposure and with age of onset of psychosis. The magnitude of abnormalities compared with controls was similar to that reported in adult studies, although there was a trend toward relatively smaller cerebral volumes for the childhood-onset group compared with controls. CONCLUSION Brain anatomic abnormalities in childhood-onset schizophrenia are similar to those reported for adult populations, indicating overall continuity between these rare childhood cases and the adult schizophrenia populations.