Miracle-dz/UniFAR-FTUs huggingface dataset:
Thrombocitopenia in sepsis: an important prognosis factor.

OBJECTIVE To demonstrate an association between thrombocytopenia and platelet behavior in predicting mortality in septic patients. METHODS Patients with criteria for sepsis at admission or at any time during hospitalization were selected; patients hospitalized for less than 24 hours were excluded. Thrombocytopenia was defined as a platelet count lower than 150.000/mm³, and recovery was defined as returning to levels above 150.000/mm³ after showing thrombocytopenia. We assessed the admission prognosis variables (APACHE II), platelet counts during the hospitalization and outcomes. RESULTS Of the 56 patients included, 34 developed thrombocytopenia during sepsis (Group 1) and had a 76.4% mortality rate. The mortality rate among patients not showing thrombocytopenia (Group 2) was 40.9% (RR 1.87; 95% CI 1.12 - 3.12; p = 0.0163). In 44.1% of Group 1 patients, the platelet counts drops by >50% compared with the admission counts; 93.3% of these patients eventually died (RR 1.48; 95% CI 0.93 - 2.36; p = 0.0528). Among the Group 1 patients showing recovered platelet counts, 53.3% survived; 100% of the patients with unrecovered thrombocytopenia died (RR 2.14; 95% CI 1.35 - 3.39; p = 0.0003). Among the patients with APACHE II scores > 22, the thrombocytopenic patients had an 81.8% mortality rate (p = 0.25), while no deaths occurred among the non-thrombocytopenic patients. For the patients with APACHE II scores ≤ 22, the mortality rate of the thrombocytopenic patients was 74% (p = 0.0741), versus 42.8% for the non-thrombocytopenic patients. CONCLUSION For this sample of septic patients, thrombocytopenia and its progression, defined as a >50% drop or failure to recover platelet count, were shown to be markers of poor prognosis.
Trade Liberalization, Growth, and FDI: A Structural Estimation Framework

We develop a structural framework that accounts for and decomposes the relationships between trade, physical capital accumulation, and FDI. As a byproduct, our theory delivers a FDI-gravity system. The FDI-gravity estimates are similar to the corresponding trade indexes, however, we also document some notable differences between them. A counterfactual experiment simulating the effects of trade liberalization between Canada and the EU demonstrates the capabilities of our framework.
[Diagnostic values of salivary versus and plasma microRNA-21 for early esophageal cancer].

OBJECTIVE To evaluate the diagnostic value of salivary and plasma miR-21 in patients with esophageal cancer (EC). METHODS Total RNA was extracted from saliva and plasma samples from 50 stage I and 50 stage II patients with EC and 50 healthy controls for measurement of miR-21 levels using qPCR. The diagnostic values of salivary and plasma miR-21 levels were assessed for stage I, stage II, and stage I+II EC. RESULTS Salivary and plasma miR-21 were significantly higher in the EC patients than in the control group. The diagnostic sensitivities of plasma miR-21 for stage I, stage II, and stage I+II EC were 96%, 64% and 97%, with specificities of 44%, 84%, and 56%, respectively; the sensitivities of salivary miR-21 were 90%, 88%, and 89%, respectively, with the same specificities of 64%. Regardless of EC staging, the expression of plasma miR-21 showed a significant positive correlation with that of salivary miR-21, and their diagnostic values were comparable. CONCLUSION Both salivary and plasmatic miR-21 can be sensitive biomarkers for EC, and salivary miR-21 detection has the potential to replace plasma detection for EC diagnosis.
Early adversity and brain response to faces in young adulthood

Early stressors play a key role in shaping interindividual differences in vulnerability to various psychopathologies, which according to the diathesis‐stress model might relate to the elevated glucocorticoid secretion and impaired responsiveness to stress. Furthermore, previous studies have shown that individuals exposed to early adversity have deficits in emotion processing from faces. This study aims to explore whether early adversities associate with brain response to faces and whether this association might associate with the regional variations in mRNA expression of the glucocorticoid receptor gene (NR3C1). A total of 104 individuals drawn from the Northern Finland Brith Cohort 1986 participated in a face‐task functional magnetic resonance imaging (fMRI) study. A large independent dataset (IMAGEN, N = 1739) was utilized for reducing fMRI data‐analytical space in the NFBC 1986 dataset. Early adversities were associated with deviant brain response to fearful faces (MANCOVA, P = 0.006) and with weaker performance in fearful facial expression recognition (P = 0.01). Glucocorticoid receptor gene expression (data from the Allen Human Brain Atlas) correlated with the degree of associations between early adversities and brain response to fearful faces (R2 = 0.25, P = 0.01) across different brain regions. Our results suggest that early adversities contribute to brain response to faces and that this association is mediated in part by the glucocorticoid system. Hum Brain Mapp 38:4470–4478, 2017. © 2017 Wiley Periodicals, Inc.
Increase in involuntary psychiatric admissions of minors. A register study.

OBJECTIVE The aim of this study was to assess the frequency and trend over time of involuntary psychiatric admissions of minors, and to examine the psychiatric diagnoses in involuntary admissions of minors as compared to those admitted on a voluntary basis. METHOD A retrospective register study was made during the period 1996-2000 of a nationally representative hospital discharge register in Finland. RESULTS Involuntary admissions of children (aged < 12) and adolescents (aged 12-17) increased vastly over the study period, both in absolute figures and in proportion to all admissions in the age groups. Although some disorders were more likely to be linked to compulsory admission than others, a variety of individual diagnoses were represented under compulsory admission. CONCLUSION More comprehensive guidance for clinicians is needed regarding the involuntary admission of minors. More theoretical and empirical research is needed on minors' competence to consent to or refuse treatment.
Development and reliability testing of the quality clinical placement evaluation tool.

AIMS AND OBJECTIVES To develop and test the content and face validity, and reliability of the quality clinical placement evaluation tool. BACKGROUND The importance of clinical experience during undergraduate nursing degrees is undisputed. To date, tools available to measure quality of clinical placements have focused on single perspectives, that of the undergraduate or that of the supervising nurse. The quality clinical placement evaluation tool was proposed to provide an assessment of clinical placement experiences informed by supervising ward nurses and undergraduate stakeholders. DESIGN The study employed a cross-sectional design. METHODS The internal validity of an existing instrument was evaluated by an expert panel and modified for use in the acute care sector. Surveys were completed by undergraduate students (n = 48) and supervising ward nurses (n = 47). Factor analysis was used to identify themes drawn from the literature and explore redundancy of items. Reliability was assessed using Cronbach's alpha for internal consistency and test-retest (five to seven days apart). RESULTS Reliability testing showed good internal consistency for the tool; test-retest reliability testing results were moderate to good for students and fair to moderate for nurses. Factor analysis identified three core themes related to supervising ward nurse responses that could also be applied to undergraduate nurses. The domains identified were the following: welcome and belonging; support to meet learning needs; and confidence and competence: reflections on learning. CONCLUSIONS The quality clinical placement evaluation has shown statistically acceptable levels of reliability and validity for measuring the quality of clinical placement from perspectives of undergraduates and supervising ward nurses. RELEVANCE TO CLINICAL PRACTICE The tool provides tertiary institutions, acute care facilities, wards and individuals with the means to capture views of the quality of clinical placement which can also be used to undertake comparisons over time and between sites.
The Economic Impact of Capital Expenditures: Environmental Regulatory Delay as a Source of Competitive Advantage?

This study tests the proposal that by undertaking voluntary capital expenditures that are subject to lengthy environmental regulatory delays, listed companies can gain a competitive advantage. The stock market is found to react positively to new capital expenditure announcements when projects are expected to experience long delays in obtaining environmental regulatory approval. Two sources of potential competitive advantage are firm learning and first mover advantages. Lengthy delays in regulatory processes and high compliance costs incurred for environmentally‐sensitive projects may allow firms opportunities to develop specialised capabilities and/or to deter industry competitors and new entrants, resulting in greater expected project NPVs. The findings also underscore the importance of non‐financial environmental information to investors in their assessment of firm value.
Anticoagulant characteristics of HD1‐22, a bivalent aptamer that specifically inhibits thrombin and prothrombinase

Summary. Background: HD1‐22 is a bivalent aptamer that binds to thrombin with high affinity (Kd = 0.65 nm) and occupies both anion binding exosites without blocking the active centre of the enzyme. HD1‐22 has been developed by connecting the exosite 1 binding aptamer HD1 and the exosite 2 binding aptamer HD22 through a poly‐dA linker. Objectives: To characterize the anticoagulant profile of HD1‐22 in comparison to the clinically established direct acting thrombin inhibitors bivalirudin and argatroban, and to test the efficacy of antidote‐oligodeoxynucleotides. Methods and Results: HD1‐22 prolongs clotting times of the thrombin time, activated partial thromboplastin time, ecarin clotting time, and lag‐time of the tissue factor triggered thrombin generation assay in a dose‐dependent manner. On a molar basis, its anticoagulant activity was nearly identical to bivalirudin and superior to argatroban. Thrombin‐induced platelet aggregation was more effectively inhibited by HD1‐22 than by bivalirudin. The HD1‐22 aptamer retains the ability of the HD1‐moiety to bind to (pro)exosite 1 of prothrombin and inhibits the prothrombinase activity nearly 2‐fold better than HD1. The anticoagulant activities of HD1‐22 are fully reversed by addition of antidote‐oligodeoxynucleotides. Conclusions: The strong thrombin‐inhibiting activity, together with the availability of a rapid acting antidote strategy, makes HD1‐22 an interesting anticoagulant candidate, especially for use in clinical situations where effective anticoagulation and rapid reversal of the anticoagulant effect are required. The data obtained warrant further clinical studies.
Effects of tetracaine on displacement currents and contraction of frog skeletal muscle.

The kinetics of mechanical activation of intact fibres were examined with a voltage‐clamp technique. Tetracaine (2 mM) increases fifteen‐ to seventyfold the time required to produce a just visible contraction by cell membrane depolarization. 2. Displacement currents thought to be related to contractile activation remain in 2 mM tetracaine. Their characteristics are virtually identical to those found in the absence of the drug. Displacement currents also remain in fibres immobilized by treatment with 10 mM formaldehyde. 3. Despite its effect on contraction of intact fibres, tetracaine does not diminish contraction tension when Ca is applied directly to the contractile proteins of 'skinned' muscle fibres. The sensitivity of the myofilaments to Ca2+ also remains undiminished. 4. When acting on intact fibres the drug must therefore inhibit Ca2+‐release from the sarcoplasmic reticulum. It is estimated that 2 mM tetracaine diminishes more than tenfold the capacity for Ca2+‐release in response to cell membrane depolarization.5. If muscle displacement currents represent events linking depolarization to Ca2+‐release, then tetracaine must be able to block the release without affecting the potential‐sensing portion of the release regulating mechanism. 6. Further experiments on skinned fibres show that tetracaine blocks or greatly diminishes caffeine contractions, but that Cl‐induced contractions of normal amplitude are still possible.
A realist investigation of the impact of Healthy Start on the diets of low-income pregnant women in the UK

Healthy Start is the United Kingdom government’s food voucher programme for low-income, pregnant women and young children. Eligible women receive vouchers worth £3.10 per week, which can be exchanged for fruit and vegetables, plain cow’s milk or infant formula. There has been no robust evaluation of the impact of Healthy Start on nutritional outcomes since its introduction in 2006. Therefore, this study aimed to explore potential outcomes of the programme (including intended and unintended outcomes) and develop explanations for how and why these outcomes might occur. A realist review was conducted in two iterative and overlapping stages: 1) developing theories or hypotheses about how the Healthy Start programme works, for who, in what circumstances and why; 2) testing those theories using relevant evidence from existing studies of Healthy Start and a similar food voucher programme in the United States. The review findings comprised three ‘evidence-informed programme theories’ about how low-income pregnant women use Healthy Start vouchers and why. A qualitative study was undertaken to further refine and consolidate the programme theories derived from the realist review, and to develop new and emerging programme theories. Semi-structured interviews were conducted with 11 low-income women from North West England, who received Healthy Start vouchers during pregnancy. An innovative combination of realist interview techniques and vignettes was used to communicate and exchange theories with low-income women. A realist logic of analysis was applied to generate clear and transparent linkages between outcomes and explanations. Five ‘evidence-based programme theories’ were developed to explain why low-income pregnant women may experience one or more of the following outcomes from the Healthy Start programme: dietary improvements, shared benefits, financial assistance, stockpiling formula, misuse of vouchers. These programme theories were integrated with existing behaviour change theories and an overarching theoretical model for Healthy Start was developed. This model illustrates the combination of context and resources needed to generate the intended outcome of dietary improvements for low-income pregnant women, and the mechanisms by which this outcome may be generated.
Paraoxonase-1 (PON1) activity, but not PON1Q192R phenotype, is a predictor of coronary artery disease in a middle-aged Serbian population

Abstract Background: Paraoxonase-1 (PON1) is a high-density lipoprotein (HDL)-associated serum enzyme that protects lipoproteins from oxidative modifications. Polymorphisms in the gene, including PON1Q192R, have been studied. However, inconsistencies regarding the above-mentioned polymorphism obscure its association with vascular disease. Methods: Using a two-substrate (paraoxon/diazoxon) activity method, we investigated the frequencies of PON1Q192R phenotypes in 261 middle-aged subjects: 156 patients with angiographically assessed coronary heart disease (CHD) and 105 CHD-free subjects as the control group. The PON1192 phenotype was predicted from examination of the two-dimensional plot of hydrolysis rates of diazoxon vs. paraoxon and by using the antimode of the histogram of the ratio of diazoxonase/paraoxonase activity. Results: The PON1Q192R phenotype frequencies in 113 patients with occlusion >50% (coronary artery disease-positive, CAD+ group) vs. control population were as follows: QQ (0.552 vs. 0.510), QR (0.382 vs. 0.408) and RR (0.066 vs. 0.082); χ2=0.414, p=0.813. We found lower paraoxonase (POase) and diazoxonase (DZOase) activities in the CAD+ patients when compared to the control population. According to logistic regression analysis, POase activity was a better predictor of coronary disease onset compared with DZOase activity measurements and PON1Q192R phenotyping. Conclusions: We conclude that enzyme activity (within a particular phenotypic group) is more important than phenotype alone in predicting susceptibility to coronary artery disease. Clin Chem Lab Med 2006;44:1206–13.
The role of anxiety sensitivity in the relationship between posttraumatic stress symptoms and negative outcomes in trauma-exposed adults

Background: The development of posttraumatic stress symptoms (PTSs) following a trauma is related to impairment, diminished quality of life, and physical health issues. Yet it is not clear why some trauma-exposed individuals experience negative outcomes while others do not. The purpose of this study was to determine the role of several influential factors related to PTS severity and negative outcomes. Methods: One hundred and twenty-two trauma-exposed adults were administered the following self-report measures: the Posttraumatic Stress Disorder Checklist-Civilian, the Trauma History Questionnaire-Short, the Anxiety Sensitivity Index-3, Depression and Anxiety Stress Scale 21, Sheehan Disability Scale, World Health Organization Quality of Life-BREF, and an abbreviated Patient Health Questionnaire. Primary Results: PTS severity was positively correlated with depressive symptom severity (r = 0.54, p < 0.001), chronicity of the most distressing trauma (r = 0.21, p = 0.017), and number of traumas (r = 0.22, p = 0.012). Main effects were found for PTS severity (β = −0.38, p < 0.01) and anxiety sensitivity (AS; β = −0.39, p < 0.01) on quality of life. No interaction was found between PTS severity and AS with any negative outcome. PTS severity mediated the relationship between AS and physical health issues (0.05; 95% CI: 0.02–0.08). Conclusion: This study helps clarify the role of various factors in the relationship between trauma and negative outcomes. Clinical and research implications are discussed.
A comparison of sonographic examinations for trauma performed by surgeons and radiologists.

BACKGROUND It has been demonstrated that surgeons and surgery residents, trained in the focused abdominal sonographic examination, are able to accurately and reliably evaluate trauma patients. Despite this, radiologists have objected to surgeon-performed sonography for several reasons. We set out to compare the accuracy of sonographic examinations performed by surgery residents and radiologists. METHODS A retrospective review of medical records of all trauma patients who received focused ultrasound examinations from January 1, 1995, through June 30, 1996, at one of two American College of Surgeons-verified Level I trauma centers in the same city was undertaken. Ultrasound examinations were performed by surgery residents at trauma center A (TCA) and by radiologists or radiology residents at trauma center B (TCB). Findings for each patient were compared with the results of computed tomography, diagnostic peritoneal lavage, operative exploration, or observation. Sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were calculated for each group of patients. Comparison of patient charges for the trauma ultrasound examinations at each of the trauma centers was also made. RESULTS Patient populations at the two centers were similar except that the mean Injury Severity Score at TCB was higher than at TCA (11.74 vs. 9.6). Sensitivity, specificity, accuracy, or negative predictive value were not significantly different between the two cohorts. A significantly lower positive predictive value for examinations performed by surgery residents was noted and attributed to a lower threshold of the surgery residents to confirm their findings by computed tomography. Billing data revealed that the average charge for trauma sonography by radiologists (TCB) was $406.30. At TCA, trauma sonography did not generate a specific charge; however, a $20.00 sum was added to the trauma activation fee to cover ultrasound machine maintenance and supplies. CONCLUSION Focused ultrasound examination in the trauma suite can be as safely and accurately performed by surgery residents as by radiologists and radiology residents and should be a routine part of the initial trauma evaluation process.
Decentralized optimal flow control with constrained source rates

We study optimal flow control in multiservice networks, in which users (controllers) optimize their performance objectives in a decentralized manner. We adopt a model that differs from previously considered ones in that a user's strategy (viz., flow or average rate) is constrained between two numbers: those are specified by the user's quality of service (QoS) requirements or by the user's technology. Adopting the generalized power as the performance measure, we prove existence and uniqueness of the Nash equilibrium point (NEP) and suggest a simple algorithm to determine this NEP.
Burkholderia cepacia Complex Phage-Antibiotic Synergy (PAS): Antibiotics Stimulate Lytic Phage Activity

ABSTRACT The Burkholderia cepacia complex (Bcc) is a group of at least 18 species of Gram-negative opportunistic pathogens that can cause chronic lung infection in cystic fibrosis (CF) patients. Bcc organisms possess high levels of innate antimicrobial resistance, and alternative therapeutic strategies are urgently needed. One proposed alternative treatment is phage therapy, the therapeutic application of bacterial viruses (or bacteriophages). Recently, some phages have been observed to form larger plaques in the presence of sublethal concentrations of certain antibiotics; this effect has been termed phage-antibiotic synergy (PAS). Those reports suggest that some antibiotics stimulate increased production of phages under certain conditions. The aim of this study is to examine PAS in phages that infect Burkholderia cenocepacia strains C6433 and K56-2. Bcc phages KS12 and KS14 were tested for PAS, using 6 antibiotics representing 4 different drug classes. Of the antibiotics tested, the most pronounced effects were observed for meropenem, ciprofloxacin, and tetracycline. When grown with subinhibitory concentrations of these three antibiotics, cells developed a chain-like arrangement, an elongated morphology, and a clustered arrangement, respectively. When treated with progressively higher antibiotic concentrations, both the sizes of plaques and phage titers increased, up to a maximum. B. cenocepacia K56-2-infected Galleria mellonella larvae treated with phage KS12 and low-dose meropenem demonstrated increased survival over controls treated with KS12 or antibiotic alone. These results suggest that antibiotics can be combined with phages to stimulate increased phage production and/or activity and thus improve the efficacy of bacterial killing.
Disability and consumption: A state of the art

This article considers the cultural and social aspects of disability through a critical review of marketing research. Two main issues are explored. First, how do these works portray consumers with disabilities? Two profiles become apparent: the passive consumers who are targeted by the construction of offers that are adapted to their needs and the more active consumers who wish to play an active role within the marketplace. Second, does this academic research process have a participatory approach that includes the involvement of consumers with disabilities? After defining participatory research, we show that a minority of works applied this approach and discuss the methodological problems involved in its use. Possible future research avenues are then raised to improve this approach and thus attain a better understanding of the consumer with disabilities.