Miracle-dz/UniFAR-FTUs huggingface dataset:
Initial Diagnostic Workup of Acute Leukemia: Guideline From the College of American Pathologists and the American Society of Hematology.

CONTEXT - A complete diagnosis of acute leukemia requires knowledge of clinical information combined with morphologic evaluation, immunophenotyping and karyotype analysis, and often, molecular genetic testing. Although many aspects of the workup for acute leukemia are well accepted, few guidelines have addressed the different aspects of the diagnostic evaluation of samples from patients suspected to have acute leukemia. OBJECTIVE - To develop a guideline for treating physicians and pathologists involved in the diagnostic and prognostic evaluation of new acute leukemia samples, including acute lymphoblastic leukemia, acute myeloid leukemia, and acute leukemias of ambiguous lineage. DESIGN - The College of American Pathologists and the American Society of Hematology convened a panel of experts in hematology and hematopathology to develop recommendations. A systematic evidence review was conducted to address 6 key questions. Recommendations were derived from strength of evidence, feedback received during the public comment period, and expert panel consensus. RESULTS - Twenty-seven guideline statements were established, which ranged from recommendations on what clinical and laboratory information should be available as part of the diagnostic and prognostic evaluation of acute leukemia samples to what types of testing should be performed routinely, with recommendations on where such testing should be performed and how the results should be reported. CONCLUSIONS - The guideline provides a framework for the multiple steps, including laboratory testing, in the evaluation of acute leukemia samples. Some aspects of the guideline, especially molecular genetic testing in acute leukemia, are rapidly changing with new supportive literature, which will require on-going updates for the guideline to remain relevant.
Lysine Residues Direct the Chlorination of Tyrosines in YXXK Motifs of Apolipoprotein A-I When Hypochlorous Acid Oxidizes High Density Lipoprotein*

Oxidized lipoproteins may play an important role in the pathogenesis of atherosclerosis. Elevated levels of 3-chlorotyrosine, a specific end product of the reaction between hypochlorous acid (HOCl) and tyrosine residues of proteins, have been detected in atherosclerotic tissue. Thus, HOCl generated by the phagocyte enzyme myeloperoxidase represents one pathway for protein oxidation in humans. One important target of the myeloperoxidase pathway may be high density lipoprotein (HDL), which mobilizes cholesterol from artery wall cells. To determine whether activated phagocytes preferentially chlorinate specific sites in HDL, we used tandem mass spectrometry (MS/MS) to analyze apolipoprotein A-I that had been oxidized by HOCl. The major site of chlorination was a single tyrosine residue located in one of the protein's YXXK motifs (where X represents a nonreactive amino acid). To investigate the mechanism of chlorination, we exposed synthetic peptides to HOCl. The peptides encompassed the amino acid sequences YKXXY, YXXKY, or YXXXY. MS/MS analysis demonstrated that chlorination of tyrosine in the peptides that contained lysine was regioselective and occurred in high yield if the substrate was KXXY or YXXK. NMR and MS analyses revealed that the Nϵ amino group of lysine was initially chlorinated, which suggests that chloramine formation is the first step in tyrosine chlorination. Molecular modeling of the YXXK motif in apolipoprotein A-I demonstrated that these tyrosine and lysine residues are adjacent on the same face of an amphipathic α-helix. Our observations suggest that HOCl selectively targets tyrosine residues that are suitably juxtaposed to primary amino groups in proteins. This mechanism might enable phagocytes to efficiently damage proteins when they destroy microbial proteins during infection or damage host tissue during inflammation.
Monitoring Change in Mountainous Dry-heath Vegetation at a Regional ScaleUsing Multitemporal Landsat TM Data

Abstract Vegetation cover-change analysis requires selection of an appropriate set of variables for measuring and characterizing change. Satellite sensors like landsat tm offer the advantages of wide spatial coverage while providing land-cover information. This facilitates the monitoring of surface processes. This study discusses change detection in mountainous dry-heath communities in jämtland county, sweden, using satellite data. Landsat-5 tm and landsat-7 etm+ data from 1984, 1994 and 2000, respectively, were used. Different change detection methods were compared after the images had been radiometrically normalized, georeferenced and corrected for topographic effects. For detection of the classes change – no change the ndvi image differencing method was the most accurate with an overall accuracy of 94% (k = 0.87). Additional change information was extracted from an alternative method called ndvi regression analysis and vegetation change in 3 categories within mountainous dry-heath communities were detected. By applying a fuzzy set thresholding technique the overall accuracy was improved from of 65% (k = 0.45) to 74% (k = 0.59). The methods used generate a change product showing the location of changed areas in sensitive mountainous heath communities, and it also indicates the extent of the change (high, moderate and unchanged vegetation cover decrease). A total of 17% of the dry and extremely dry-heath vegetation within the study area has changed between 1984 and 2000. On average 4% of the studied heath communities have been classified as high change, i.e. have experienced “high vegetation cover decrease” during the period. The results show that the low alpine zone of the southern part of the study area shows the highest amount of “high vegetation cover decrease". The results also show that the main change occurred between 1994 and 2000.
Lactate efflux and the neuroenergetic basis of brain function

In the unstimulated brain energy is primarily supplied by the oxidation of glucose. However the oxygen‐to‐glucose index (OGI), which is the ratio of metabolic rates of oxygen to glucose, CMRO2/CMRglc, diverges from the theoretical value of 6 as activity is increased. In vivo measurements of brain lactate show its concentration to increase with stimulation. The decreasing OGI with stimulation had led to the suggestion that activation, unlike resting activity, is supported by anaerobic glycolysis. To date a unifying concept that accommodates glucose oxidation at rest with lactate generation and OGI decrease during stimulation of brain is lacking. Furthermore, energetics that change with increasing activity are not consistent with a neuroenergetic model that has been proposed from 1‐13C‐glucose MRS experiments. That model, based upon in vivo MRS measurements and cellular studies by Pellerin and Magistretti, showed that glutamate neurotransmitter cycling was coupled to glucose oxidation over a wide range of brain activities from rest down to deep anesthesia. Here we reconcile these paradoxical observations by suggesting that anaerobic glucose consumption (which can provide energy rapidly) increases with activation to meet the power requirements of millisecond neuronal firing. It is proposed, in accord with our neuroenergetic model, that the extra glucose mobilized rapidly for glial clearance of glutamate, is not needed for the oxidative processes that are responsible for neuronal firing and glutamate release, and consequently it is effluxed as lactate. A stoichiometric relation between OGI and lactate concentration is derived from the neuroenergetic model, showing that the enhanced glucose uptake during activation is consistent with neuronal activity being energetically supported by glucose oxidation. Copyright © 2001 John Wiley & Sons, Ltd.
Converting Patients from Brand-Name Clozapine to Generic Clozapine

OBJECTIVE: To evaluate safety and dosage requirements when patients taking brand-name clozapine (Clozaril, Novartis Pharmaceuticals) are converted to generic clozapine (Zenith Goldline). METHODS: In November 1999, patients at Colorado Mental Health Institute at Pueblo taking Clozaril were changed to generic clozapine. Seventeen patients had been prescribed Clozaril for three years and were included in the study. Drug dosage, white blood cell (WBC) count values, and adverse drug reaction reports were compared. Data regarding patients on the brand-name product were evaluated retrospectively for the months of November, December, January, and February during the years 1996/1997, 1997/1998, and 1998/1999. These data were compared with those from the same patients after switching to generic clozapine for the same months in 1999/2000. A one-year comparison of brand-name (1998/1999) with generic drug (1999/2000) was also performed. Statistical analysis included a standard t-test comparing WBC values and a Brown—Forsythe test for comparing dosages. RESULTS: There were no differences between the values obtained for the brand-name and generic products. WBC counts for the three-year data resulted in a p value of 0.9992. There was no difference when comparing the samples one year prior to switching and after the switch (p = 0.9991). There was no difference in dosages at three years or one year (p = 0.9999 and p = 0.9993, respectively). No adverse events were noted with the generic product. CONCLUSIONS: No differences were found between the brand-name and generic clozapine groups with regard to WBC count, dosage, and adverse events. The conversion to the generic product is projected to save the pharmacy $90 000 annually.
Invited review: Motor unit estimation: Methods, results, and present status

The renewed interest in motor unit estimation (counting) has coincided with the introduction of computer‐based methodology and with the application of the technique to proximal as well as distal muscles. The advantages and disadvantages of the different methods are considered, together with the assumptions inherent in this type of examination. In normal subjects, the extensor digitorum brevis (EDB) muscle has approximately 200 motor units while each of the intrinsic muscles of the hand has about 100 units; larger muscles in the limbs contain greater numbers of units. Beyond the age of 60 years, there is a decline in the number of functioning motor units in both proximal and distal muscles. In denervating disorders, motor unit estimation is useful for diagnosis and assessment; abnormal values may often be observed in muscles judged clinically to be unaffected. Serial studies have enabled the rate of motor unit loss to be determined in ALS and in spinal muscular atrophy. Depletion of motor units has also been found following upper motoneuron lesions caused by injury to the spinal cord or by cerebral hemorrhage; trans‐synaptic dysfunction has been presumed responsible. Rather surprisingly, reduced numbers of motor units have been observed in a variety of myopathic disorders; of these, the most consistent abnormalities have been reported in myotonic muscular dystrophy.
The immunosuppressive effect of ursodeoxycholic acid: A comparative in vitro study on human peripheral blood mononuclear cells

Ursodeoxycholic acid is an efficient treatment for putatively immune‐mediated liver diseases, but its mechanism of action is unknown. We studied human mononuclear cell proliferation as an in vitro model for cell‐mediated immunity in the presence of ursodeoxycholic acid, its glycoconjugate and tauroconjugate and chenodeoxycholic acid at concentrations of 5, 25 and 50 μmol/L. Proliferation was inhibited in a dose‐dependent manner compared with control values (15% to 54% depending on the bile acid, concentration and mitogen used), except at 5 μmol/L where inhibition was significant with only one mitogenic stimulus of the three used. With one mitogen (phorbolester) the inhibition was additive with that of cyclosporine. The number of cell‐surface receptors studied was not modified by bile acids. Interleukin‐2 production was decreased 35% to 60% by ursodeoxycholic acid and its conjugates. The proliferation of the interleukin‐2–dependent cell line CTLL‐2 was also inhibited. The immunosuppression was reversible except at a chenodeoxycholic acid concentration of 50 μmol/L. Because bile acids are able to partition into membranes and change their properties, we speculate that this allows them to interact with cell‐surface receptors or signaling systems within the membrane or on its inner face, thus impairing their function. This would inhibit the numerous extracellular messages that lymphocytes need to proliferate. (HEPATOLOGY 1993;18:165–172).
Fourth-order partial differential equations for noise removal

A class of fourth-order partial differential equations (PDEs) are proposed to optimize the trade-off between noise removal and edge preservation. The time evolution of these PDEs seeks to minimize a cost functional which is an increasing function of the absolute value of the Laplacian of the image intensity function. Since the Laplacian of an image at a pixel is zero if the image is planar in its neighborhood, these PDEs attempt to remove noise and preserve edges by approximating an observed image with a piecewise planar image. Piecewise planar images look more natural than step images which anisotropic diffusion (second order PDEs) uses to approximate an observed image. So the proposed PDEs are able to avoid the blocky effects widely seen in images processed by anisotropic diffusion, while achieving the degree of noise removal and edge preservation comparable to anisotropic diffusion. Although both approaches seem to be comparable in removing speckles in the observed images, speckles are more visible in images processed by the proposed PDEs, because piecewise planar images are less likely to mask speckles than step images and anisotropic diffusion tends to generate multiple false edges. Speckles can be easily removed by simple algorithms such as the one presented in this paper.
Evaluation and management codes: From current procedural terminology through relative update commission to Center for Medicare and Medicaid Services

Background:Physicians should have a working knowledge of the process by which patient care codes are created and subsequently assigned values. The Society of Critical Care Medicine has representatives on the national committees that focus on code creation and definition and on assignment of relative value units. In addition, a better understanding of documentation requirements and the audit process will facilitate improved compliance and minimize liability. Discussion:The authors discuss the current procedural terminology (CPT) process for defining care codes and the relative update commission (RUC) process for assigning values to those codes, with each code assigned a separate value in three separate categories. Steps for managing any concern or dispute about billing, denials, or an audit are subsequently addressed. Tenets of proper documentation are discussed, and some future developments are identified that are likely to affect critical care. Conclusion:Knowledge of the procedures by which care codes are defined and valued is necessary for using these codes properly, as well as for addressing needs unmet by existing codes. Preventing audits is the best approach to proper coding and billing, and documentation is key.
A Comprehensive Survey of Prognostics and Health Management Based on Deep Learning for Autonomous Ships

The maritime industry widely expects to have autonomous and semiautonomous ships (autoships) in the near future. In order to operate and maintain complex and integrated systems in a safe, efficient, and cost-beneficial manner, autoships will require intelligent Prognostics and Health Management (PHM) systems. Deep learning (DL) is a potential area for this development, as it is rapidly finding applications in a variety of domains, including self-driving cars, smartphones, vision systems, and more recently in PHM applications. This paper introduces and reviews four well-established DL techniques recently applied to various practical PHM problems. The purpose is to support creativity and provide inspiration toward the PHM based on DL in autoships and the maritime industry. This paper discusses benefits, challenges, suggestions, existing problems, and future research opportunities with respect to this significant new technology.
THE TABLET FORMULATIONS EFERVESEN EXTRACT OF CINNAMON BARK WITH VARIATIONS IN THE TYPE OF SWEETENER

Cinnamon Bark contains flavonoids, tannins, alkaloids, and phenols. Phenolic compounds contained in cinnamon is a sinamat acid is effective as anti diabetic. This research aims to determine the formula preparations tablets efervesen extract of cinnamon bark with a certain type of sweetener that favored the panelists and the levels of sinamat acid in efervesen tablets and extracts. The formula is made with different types of sweeteners such as aspartame stevia 1.5%, 3.5% and 1% sukralosa. The results of the analysis showed no difference in sweeteners influence against the parameters of color and scent but the effect on the parameters of taste every formula. Formula tablets efervesen extract of cinnamon bark that is favored by panelists based on based on the parameters of taste is formula 1 with the sweetener aspartame concentration of 1.5% and a formula 3 with sweetener sukralosa concentration 1% preferred formula panelists. The results of the analysis of the levels of sinamat acid in extract of cinnamon bark obtained the level of 471, 13 mg/g as for Formula 1 tablet efervesen acquired the levels of 369.76 mg/gram
Outbreak of Healthcare-Associated Infection and Colonization With Multidrug-Resistant Salmonella enterica Serovar Senftenberg in Florida

Background. In July 1999, a rare strain of multidrug-resistant Salmonella enterica serovar Senftenberg was isolated from the sputum of a trauma patient. Over a 6-year period (1999-2005) in northeast Florida, this Salmonella serovar spread to 66 other patients in 16 different healthcare facilities as a result of frequent transfers of patients among institutions. To our knowledge, this is the first outbreak of healthcare-associated infection and colonization with a fluoroquinolone-resistant strain of S. Senftenberg in the United States. Objectives. To investigate an outbreak of infection and colonization with an unusual strain of S. Senftenberg and assist with infection control measures. Design. A case series, outbreak investigation, and microbiological study of all samples positive for S. Senftenberg on culture. Setting. Cases of S. Senftenberg infection and colonization occurred in hospitals and long-term care facilities in 2 counties in northeast Florida. Results. The affected patients were mostly elderly persons with multiple medical conditions. They were frequently transferred between healthcare facilities. This Salmonella serovar was capable of long-term colonization of chronically ill patients. All S. Senftenberg isolates tested shared a similar pulsed-field gel electrophoresis (PFGE) pattern. Conclusion. A prolonged outbreak of infection and colonization with multidrug-resistant S. Senftenberg was identified in several healthcare facilities throughout the Jacksonville, Florida, area and became established when infection control measures failed. The bacterial agent was capable of long-term colonization in chronically ill patients. Because the dispersal pattern of this strain suggested a breakdown of infection control practices, a multipronged intervention approach was undertaken that included intense education of personnel in the different institutions, interinstitutional cooperation, and transfer paperwork notification.
Sparse principal component extraction and classification of long-term biomedical signals

This article focuses on finding a solution of sparse representation for signal classification in long-term observational studies. An approach that involves sparse principal component analysis (SPCA) is proposed. This method first uses a non-overlapping moving window for signal segmentation and makes use of SPCA to select a limited number of signal segments for constructing sparse principal components. A set of supervised predictive models based on sparse principal components of training signal segments is then constructed for signal approximation. Within this approach, their model residuals are estimated and used for signal classification. A nearly perfect classification accuracy is obtained for both the synthetic data and EEG signals that we considered. This highly positive result suggests that the proposed method may be useful for automatic event detection in long-term observational signals.
Designing cable-driven actuation networks for kinematic chains and trees

In this paper we present an optimization-based approach for the design of cable-driven kinematic chains and trees. Our system takes as input a hierarchical assembly consisting of rigid links jointed together with hinges. The user also specifies a set of target poses or keyframes using inverse kinematics. Our approach places torsional springs at the joints and computes a cable network that allows us to reproduce the specified target poses. We start with a large set of cables that have randomly chosen routing points and we gradually remove the redundancy. Then we refine the routing points taking into account the path between poses or keyframes in order to further reduce the number of cables and minimize required control forces. We propose a reduced coordinate formulation that links control forces to joint angles and routing points, enabling the co-optimization of a cable network together with the required actuation forces. We demonstrate the efficacy of our technique by designing and fabricating a cable-driven, animated character, an animatronic hand, and a specialized gripper.
Sex Differences in the Economic Advantages of Physician Board Certification

The study of wage differentials has received considerable attention in the economic literature. Economists who have studied minority-majority wage differentials have observed that for minority workers, the earnings advantage associated with the investment to obtain above average credentials is greater than the earnings advantage for majority workers who have obtained identical credentials. However, for minority workers of average credentials or below average credentials, the effect of investment in human capital on their earnings is lower than it is for majority workers [6; 22]. Some researchers have argued that these differences in earnings related to human capital arise as a result of uncertainty about productivity levels combined with differential signaling costs. Golbe [8], for example, provides a theoretical model that indicates that differences in signaling costs between minority and majority workers can lead to the observed pattern of differences in the earnings of minority-majority workers, even in the absence of discrimination. This differential in earnings results if low-productivity minority workers have a lower probability of providing a high market signal than low-productivity majority workers, or if high-productivity minority workers have a higher probability of providing a high market signal than high-productivity majority workers. Under these circumstances, employers offer lower wages to low-signal minority workers and higher wages to high-signal minority workers, relative to majority workers [8, 846-47]. Even in the absence of differential signaling costs, this wage differential will result if employers face an "affirmative action" constraint. The affirmative action constraint would