Miracle-dz/UniFAR-FTUs huggingface dataset:
Calcitonin and procalcitonin in patients with medullary thyroid cancer or bacterial infection.

OBJECTIVES To evaluate procalcitonin (PCT) utility as a marker of medullary thyroid cancer (MTC). MATERIAL AND METHODS Calcitonin (CT) and PCT levels were measured in MTC patients and patients with serious bacterial infections. 70 patients were enrolled in the study: 6 MTC active patients: 4 with disseminated, unreoperable disease and 2 re-operated patients, in whom markers were checked before and after surgery; 23 MTC patients in remission after radical surgery; 11 non-toxic nodular goiter (NTNG) patients; 30 patients with severe, bacterial infection or sepsis. RESULTS All MTC active patients had greatly elevated CT and PCT levels. In two re-operated patients, marker levels decreased but were still above the reference range. In 15 MTC patients in remission, the levels of either marker were not increased. Both markers were slightly increased in 3 patients in this group, while CT was elevated in 5 patients. In all but 1 patient in the NTNG group, both marker levels were not elevated. Among patients with bacterial infection, PCT and CT levels showed no increase in 8 patients, both markers were elevated in 10 patients, and an increase of PCT levels was seen in 10 patients while of CT only in 2 patients. Correlations between CT and PCT values were very strong in MTC patients (r = 0.95; p = 0.004 for active MTC, r = 0.60; p = 0.002 for MTC patients in remission) and in patients with NTNG (r = 0.77; p = 0.02). In patients with infection, both parameters were completely independent (r = 0.002; p = 0.99). CONCLUSIONS PCT measurement could be an alternative to CT measurement for evaluation of MTC status.
The economics of alternative crop production systems in the context of farmer participation in carbon trading markets

ABSTRACT Using scaled up data from an experimental farm platform in Scotland, we examined the relative economics of a conventional and a low-carbon integrated management system for two (otherwise identical) farms. By employing a novel market-based approach, we factored the market costs of greenhouse gas (GHG) emissions on the relative economics of both systems. Specifically, farmers are considered to be awarded emission credits in accordance with Scotland’s agricultural emissions reduction targets. Farmers are then considered to trade their net GHG emissions in an emissions trading scheme, with the integrated system expected to benefit from this arrangement due to its lower emissions. In further sensitivity analyses, we also considered the effect of premium pricing of integrated system crops on the relative economics of both systems. We find that in both the status quo and emissions trading scenarios, the conventional system is significantly more profitable. In the emissions trading scenario, an emissions price roughly three times the reported median prices over the last five years is required for the integrated system’s profitability to break-even with the conventional system. However, even at prevailing emissions prices, a 20% premium pricing of the integrated system crops enables near parity in the profitability of both systems. We conclude that in order to facilitate greater adoption of low-carbon systems, policies may be needed to encourage farmers’ realization of the cost of their externalities, in particular GHG emissions. At the same time, support should be given to a market system that recognizes premium prices for low-carbon system products.
Effect of Nurse Staffing and Antimicrobial-Impregnated Central Venous Catheters on the Risk for Bloodstream Infections in Intensive Care Units

Abstract Background: Defining risk factors for central venous catheter (CVC)-associated bloodstream infections (BSIs) is critical to establishing prevention measures, especially for factors such as nurse staffing and antimicrobial-impregnated CVCs. Methods: We prospectively monitored CVCs, nurse staffing, and patient-related variables for CVC-associated BSIs among adults admitted to eight ICUs during 2 years. Results: A total of 240 CVC-associated BSIs (2.8%) were identified among 4,535 patients, representing 8,593 CVCs. Antimicrobial-impregnated CVCs reduced the risk for CVC-associated BSI only among patients whose CVC was used to administer total parenteral nutrition (TPN, 2.6 CVC-associated BSIs per 1,000 CVC-days vs no TPN, 7.5 CVC-associated BSIs per 1,000 CVC-days; P = .006). Among patients not receiving TPN, there was an increase in the risk of CVC-associated BSI in patients cared for by “float” nurses for more than 60% of the duration of the CVC. In multivariable analysis, risk factors for CVC-associated BSIs were the use of TPN in non-antimicrobial-impregnated CVCs (P = .0001), patient cared for by a float nurse for more than 60% of CVC-days (P = .0019), no antibiotics administered to the patient within 48 hours of insertion (P = .0001), and patient unarousable for 70% or more of the duration of the CVC (P = .0001). Peripherally inserted central catheters (PICCs) were associated with a lower risk for CVC-associated BSI (P = .0001). Conclusions: Antimicrobial-impregnated CVCs reduced the risk of CVC-associated BSI by 66% in patients receiving TPN. Limiting the use of float nurses for ICU patients with CVCs and the use of PICCs may also reduce the risk of CVC-associated BSI.
Effects of weight loss vs aerobic exercise training on risk factors for coronary disease in healthy, obese, middle-aged and older men. A randomized controlled trial.

OBJECTIVE To compare the effects of weight loss vs aerobic exercise training on coronary artery disease risk factors in healthy sedentary, obese, middle-aged and older men. DESIGN Randomized controlled trial. SUBJECTS A total of 170 obese (body mass index, 30 +/- 1 kg/m2 [mean +/- SEM]), middle-aged and older (61 +/- 1 years) men. INTERVENTIONS A 9-month diet-induced weight loss interventions, 9-month aerobic exercise training program, and a weight-maintenance control group. MAIN OUTCOME MEASURES Change in body composition, maximal aerobic capacity (V02 max), blood pressure, lipoprotein concentrations, and glucose tolerance. RESULTS Forty-four of 73 men randomized to weight loss completed the intervention and had a 10% mean reduction in weight (- 9.5 +/- 0.7 kg; P < .001), with no 22 change in VO2 max. Forty-nine of 71 men randomized to aerobic exercise completed the intervention, increased their VO2 max by a mean of 17% (P < .001), and did not change their weight, whereas the 18 men who completed in the control group had no significant changes in body composition or VO2 max. Weight loss decreased fasting glucose concentrations by 2%, insulin by 18%, and glucose and insulin areas during the oral glucose tolerance test (OGTT) by 8% and 26%, respectively (P < .01). By contrast, aerobic exercise did not improve fasting glucose or insulin concentrations or glucose responses during the OGTT but decreased insulin areas by 17% (P < .001). In analysis of variance, the decrement in fasting glucose and insulin levels and glucose areas with intervention differed between weight loss and aerobic exercise when compared with the control group (P < .05). Similarly, weight loss but not aerobic exercise increased high-density lipoprotein cholesterol levels (+ 13%) and decreased blood pressure compared with the control group. In multiple regression analyses, the improvement in lipoprotein and glucose metabolism was related primarily to the reduction in obesity. CONCLUSIONS These results suggest that weight loss is the preferred treatment to improve coronary artery disease risk factors in overweight, middle-aged and older men.
Remote Sensing With Simulated Unmanned Aircraft Imagery for Precision Agriculture Applications

An important application of unmanned aircraft systems (UAS) may be remote-sensing for precision agriculture, because of its ability to acquire images with very small pixel sizes from low altitude flights. The objective of this study was to compare information obtained from two different pixel sizes, one about a meter (the size of a small vegetation plot) and one about a millimeter. Cereal rye (Secale cereale) was planted at the Beltsville Agricultural Research Center for a winter cover crop with fall and spring fertilizer applications, which produced differences in biomass and leaf chlorophyll content. UAS imagery was simulated by placing a Fuji IS-Pro UVIR digital camera at 3-m height looking nadir. An external UV-IR cut filter was used to acquire true-color images; an external red cut filter was used to obtain color-infrared-like images with bands at near-infrared, green, and blue wavelengths. Plot-scale Green Normalized Difference Vegetation Index was correlated with dry aboveground biomass (r = 0.58), whereas the Triangular Greenness Index (TGI) was not correlated with chlorophyll content. We used the SamplePoint program to select 100 pixels systematically; we visually identified the cover type and acquired the digital numbers. The number of rye pixels in each image was better correlated with biomass (r = 0.73), and the average TGI from only leaf pixels was negatively correlated with chlorophyll content (r = -0.72). Thus, better information for crop requirements may be obtained using very small pixel sizes, but new algorithms based on computer vision are needed for analysis. It may not be necessary to geospatially register large numbers of photographs with very small pixel sizes. Instead, images could be analyzed as single plots along field transects.
A Study on the Possibilities and Limitations of Principal Leadership Affecting School Innovation

Chapter One. Introduction = 1 1.1 Statement of Problem = 1 1.2. Purpose of the Study = 4 1.3. Limitations of the Study = 5 1.4. Design of the Study = 6 Chapter Two. Literature review = 10 2.1. The Present Status of Charter Schools in the U.S = 10 2.
Endometrial carcinoma: The current role of adjuvant radiation

Summary Endometrial cancer is the most common gynaecological malignancy in the USA, expected to account for over 40,000 new cases and 7,400 deaths in 2008. Risk factors for local–regional recurrence after surgery have been identified in surgical–pathological studies as well as prospective randomised trials. While most women with early stage, low risk disease do well without adjuvant therapy, those in higher risk groups frequently recur both locally and distantly. The use of adjuvant radiation therapy has been controversial since randomised trials have demonstrated improvement in local control, without a clear impact on survival. The magnitude of potential benefit is dependent on combinations of risk factors. In this review, we use the available data to help guide the selection of patients for whom radiotherapy may be beneficial, and provide recommendations regarding treatment volumes and methods of delivery.
Cachectin/tumor necrosis factor induces cachexia, anemia, and inflammation

Cachexia is a potentially lethal syndrome of unknown etiology characterized by anorexia, weight loss, and protein wasting that frequently complicates the treatment of chronic inflammation and cancer. Cachectin/TNF was isolated during the search for a humoral mediator of cachexia and found to stimulate the breakdown of energy stores from adipocytes and myocytes in vitro, but the chronic effects of the monokine in vivo are not known. Sublethal doses of recombinant human cachectin administered twice daily for 7-10 d caused cachexia in rats, as evidenced by reduced food intake, weight loss, and depletion of whole-body lipid and protein stores. Significant anemia is also observed and found to be the result of decreased red blood cell mass, not expanded plasma volume. Leukocytosis and histopathological evidence of tissue injury and inflammation are observed in several organs, including omentum, liver, spleen, and heart. These data suggests that the exposure of the normal host to cachectin is capable of inducing a pathophysiological syndrome of cachexia, anemia, and inflammation similar to that observed during inflammatory states or malignancy.
Virus Entry by Endocytosis

Although viruses are simple in structure and composition, their interactions with host cells are complex. Merely to gain entry, animal viruses make use of a repertoire of cellular processes that involve hundreds of cellular proteins. Although some viruses have the capacity to penetrate into the cytosol directly through the plasma membrane, most depend on endocytic uptake, vesicular transport through the cytoplasm, and delivery to endosomes and other intracellular organelles. The internalization may involve clathrin-mediated endocytosis (CME), macropinocytosis, caveolar/lipid raft-mediated endocytosis, or a variety of other still poorly characterized mechanisms. This review focuses on the cell biology of virus entry and the different strategies and endocytic mechanisms used by animal viruses.
Clinical significance of the floating fetal head in nulliparous women in labor.

OBJECTIVE To examine the course of labor in nulliparous women in active labor with a floating fetal head. STUDY DESIGN A prospective, cohort study of nulliparous women presenting in active labor at term with a floating fetal head (station > or = -3, n = 108) or engaged fetal head (n = 241). All patients were examined by a senior physician. Assignment to the study or control group was noted in the investigator's records. However, management of labor was at the discretion of the labor ward team on duty. RESULTS Cesarean section rates for failure to progress were significantly higher in the study group (17.1% versus 4.2%, P < .0001), and the second stage of labor was prolonged (65.3 +/- 27.1 versus 54.9 +/- 30.2 minutes, P < .03). None of the women who had a persistently floating fetal head at 7 cm of cervical dilation delivered vaginally. Birth weights were larger (P < .03) and Apgar scores lower (P < .0001) in the study group. The lengths of the active phase and instrumental delivery rates were similar in the two groups. CONCLUSION Nulliparous women presenting in active labor at term with a floating head are at substantially increased risk of cesarean section for abnormal progress of labor. However, the majority of patients will still deliver vaginally. A persistently floating head with advanced cervical dilation (7 cm) should prompt consideration of cesarean section since little is to be gained by waiting.
Allogeneic transfusion and infection: economic and clinical implications.

An increased incidence of postoperative infection and risk of cancer recurrence in patients who have received allogeneic blood transfusions suggests that such transfusions may be associated with clinically significant immunomodulatory effects. Allogeneic transfusion increase humoral immunity and decrease cell-mediated immunity. The mechanism of allogeneic transfusion-induced immunomodulation may involve altered cytokine regulation with a shift toward a type-2 (Th2) immune response. In patients undergoing hip replacement or spine surgery, the postoperative infection rate with allogeneic blood transfusion appears to be 7- to 10-fold higher than with autologous blood or no transfusion. The occurrence of postoperative infection is largely abrogated through the use of autologous or leukocyte-depleted blood. In our orthopedic surgery patients, use of allogeneic blood was associated with a significantly increased length of hospital stay, resource consumption, and attendant hospital charges. Allogeneic, but not autologous, blood transfusion were associated in a dose-dependent manner with longer hospital stays and higher costs. Multiple linear regression analyses demonstrated that the number of units of allogeneic blood transfused, rather than surgeon and type of surgery, was the most statistically significant predictor of length of stay and hospital charges. Using data reported in the literature, we estimate that the death rate from allogeneic transfusion-related postoperative infection and cancer recurrence combined (215 deaths with 1% causality to 21,500 with 100% causality) may exceed the death rate due to all other transfusion risks combined. Improved clinical outcomes may result from techniques that minimize allogeneic blood use or its immunologic effects (e.g., autologous transfusion or other blood-sparing approaches in surgery, leukodepletion of allogeneic blood, and the use of growth factors [eg, epoetin alfa]).
Ecosystem services in adaptation projects in West Africa

Purpose The purpose of this paper is to assess the extent to which adaptation projects have incorporated ecosystem services, as well as their redesigning options. The projects selected are listed under National Adaptation Programme of Action in West African region. Design/methodology/approach A desktop survey approach was used to review 168 projects from 13 countries across West Africa. The projects were categorized and analyzed according to their adaptation goal, thematic focus, their implementation duration and level of investment. Findings The adaptation initiatives are dominated by actions in the agricultural sector accounting for 32 per cent of the total. Further, they were characterized by small grants consideration with 63 per cent falling under US$1m budget, short-term implementation duration with 46 per cent having three years’ execution period. A large portion of projects (55 per cent) mentioned directly one or more ecosystem services, with provisioning services being referred to in 50 per cent of the cases. Originality/value Adaptation projects with ecosystem services components are more sustainable and beneficial to the community. Hence, more consideration of nature benefits during project design, more financial consideration and localizing of the projects to realize the global adaptation goal should be considered.
Services Sector Export in Europe

In this paper, we consider the changes that occurred in the service exports of thirty-eight European countries in the period of 2005–2016. We have found that the existing world trend related to the growth of service exports is also present in Europe. However, the trend of the service exports’ share growth in the general volume of export is not common for all European countries. We found that higher growth rates are observed in European countries with lower levels of GDP per capita. We also discovered the presence of a strong positive correlation between growth in service exports and GDP growth, as well as between growth in service exports and GDP per capita. We also found that there is a linear correlation between the growth of service exports and the growth of GDP per capita, as well as between the growth in service exports and GDP growth. The data obtained allowed us to conclude that European countries, categorized as “Innovation Leaders” in accordance with the European Innovation Scoreboard, are not the leading countries in Europe with regard to the rates of service export growth. We also discovered that service exports in Europe are less sensitive to adverse macroeconomic effects than goods exports.
The factors inefficient allocation of investment between economies

The article deals with the problem of possibility of allocation of investment capital by economies. The situation, when the less effective investors find themselves in more favorable investment climate despite of rationality principle is considered, i.e. there is a situation adverse selection. The model describing investors’ behavior in the economy, characterized by an investment climate of some favorability, is developed. There was considered a behaviour of investors–maximizers and investors–satisficers. 2 cases are modeled: independence of the economic climate from the volume of available investments and limitedness of maximal volume of investments, and dependence of the economic climate from the volume of available investments and unlimitedness of maximal volume of investments. The profitableness of investments on the economic climate considered for exponential and logistic function. The analysis shows reasons for adverse selection have a fundamental behavioral basis. The given study allows concluding the investment market is not fully self-controlled and sometimes needs government intervention.
An Investigation of Developmental Changes in Interpretation and Construction of Graphic AAC Symbol Sequences through Systematic Combination of Input and Output Modalities

Abstract While research on spoken language has a long tradition of studying and contrasting language production and comprehension, the study of graphic symbol communication has focused more on production than comprehension. As a result, the relationships between the ability to construct and to interpret graphic symbol sequences are not well understood. This study explored the use of graphic symbol sequences in children without disabilities aged 3;0 to 6;11 (years; months) (n = 111). Children took part in nine tasks that systematically varied input and output modalities (speech, action, and graphic symbols). Results show that in 3- and 4-year-olds, attributing meaning to a sequence of symbols was particularly difficult even when the children knew the meaning of each symbol in the sequence. Similarly, while even 3- and 4-year-olds could produce a graphic symbol sequence following a model, transposing a spoken sentence into a graphic sequence was more difficult for them. Representing an action with graphic symbols was difficult even for 5-year-olds. Finally, the ability to comprehend graphic-symbol sequences preceded the ability to produce them. These developmental patterns, as well as memory-related variables, should be taken into account in choosing intervention strategies with young children who use AAC.
A Study of the Measurement and Sources of Teachers' Self and Collective Efficacy Beliefs in Professional Learning Environments.

This study examined relationships between sources of efficacy information available in teachers’ professional learning environments and teacher self-, work-group collective, and faculty collective efficacy beliefs. An argument is presented that teachers’ individual and collective efficacy beliefs are vital factors that mediate linkages between professional learning and meaningful change in schools. School professional learning environments are hypothesized to provide efficacy information that may serve to enhance teachers’ beliefs in their abilities to accomplish tasks that have been linked to effective teaching and learning. Social cognitive theory and triadic reciprocal causation provided a framework for this research, and self-efficacy theory, a sub-theory of social cognitive theory, and studies o f the socio-psychological characteristics of learning environments provided the conceptual foundation for the study. This study was presented in five parts. Chapter I included an overview', a brief review of pertinent literature that supports this study, a statement of the problem, purpose and significance of the study, a description of the study variables and research questions to guide the study. Chapter II consisted of an extensive review of the literature related to teacher self and collective efficacy beliefs and a review of pertinent studies of the learning environment. Chapter III included the methodology used in this study including a description of the sampling strategy, instrument development, data collection and data analysis techniques used to address research questions presented in Chapter I. Chapter 4 contained a summary of the results of the study. Chapter 5 presented a discussion of the results, implications o f the study results and directions for further research.