Miracle-dz/UniFAR-FTUs huggingface dataset:
Twenty-five years of the trauma audit and research network: a continuing evolution to drive improvement

In 1988, the Royal College of Surgeons (England) Committee on Trauma—chaired by Professor Sir Miles Irving—reviewed the anonimised case notes of 1000 UK patients with major injuries who had died after reaching hospital alive. Each patient record was scrutinised by four clinical experts in trauma care with a brief to state whether or not the death could have been prevented by better care—such as that available in a late 1980s North American level 1 trauma centre. The majority of reviewers found that one-third of trauma deaths were preventable by this yard stick—two-thirds of those dying from haemorrhage. This ‘preventable death review’ has since been consigned to a 20th century research technique as it is highly prone to bias (impossible not to conclude errors were contributory if death is the known outcome)—however, it is nevertheless a seminal study—not least because the authors understood the limitations of their findings. In making their recommendations the Committee highlighted failings throughout the trauma patient pathway (scene to rehabilitation) and a general lack of evidence on institutional (hospital/network/system) performance.1 Their recognition of the need to address this gap led David Yates (DWY)—Professor of Emergency Medicine and Maralyn Woodford (MW)—co-author on the RCS report; both from Hope (now Salford Royal) Hospital—to pick up the baton. To this end Hope Hospital became the sole subscribing UK member of the then USA Major Trauma Outcome Study (US MTOS)—at that time in the vanguard of using risk-adjusted mortality rates to inform quality of care comparisons. The US MTOS led by Howard Champion, Wayne Sacco, William Boyd and colleagues at the Washington Hospital Centre built on the extraordinary development of the Injury Severity Score (ISS) by Susan Baker et al and the Abbreviated Injury Scale (AIS) from the Association for the Advancement of Automotive Medicine.2 ,3 We all …
Contraceptive Services of the District Health System in Tribal and Rural Areas of Visakhapatnam District, Andhra Pradesh

The present article reports communities’ acceptance of and perceptions on contraceptive services provided by district health system among tribal and rural population of Andhra Pradesh, India. The study has been conducted in two tribal and two rural developmental blocks of Visakhapatnam district. Both quantitative and qualitative data were collected from married women of the age up to 40 years. Around 72 per cent of tribal women and 85 per cent of rural women had used or were currently using contraception. Currently the number of contraception users are higher among rural than tribal areas. The predominant method among both tribal and rural areas is female sterilisation, that is, tubectomy. These results suggest that despite the increased emphasis on contraceptive choice and on spacing methods in government programmes, female sterilisation continues to dominate the method mix, and spacing methods still account for only a negligible amount of contraceptive use. A majority of women received information on family planning from government health staff. Similarly, government institutions are the main source of contraception in both tribal and rural areas. Though, the quality of pre- and post-contraception care among the community is very important, the perceptions of the community on contraception care are not at desirable levels. Also, remarkably higher number of women who have undergone tubectomy (33 per cent of tribal and 45 per cent of rural women) had experienced various problems. These findings emphasise the continuing need to strengthen post-operative care and counselling for sterilisation acceptors. Some of the indicators of contraceptive service outreach are poor among the Scheduled Tribes as well as in rural population. Thus, the centralized top-down planning of healthcare services could not facilitate the tribal and rural people to articulate needs for services.
A 3-D position and attitude measurement system using laser scanners and corner cubes

This work proposes a new method for measuring the position and attitude of an autonomous land vehicle navigating in a rough terrain. The measurement system proposed here provides precise information on position and heading quickly and continuously. It consists of two laser scanners mounted on the vehicle and corner cubes placed in the environment as landmarks. Each laser scanner rotates a fan-shaped laser beam for detecting the retro-reflections by the corner cubes and measures their azimuth angles. This work presents the principle of measurement and method of positional and attitude estimation. Simulation results are given to show the accuracy of the proposed method.
International phase 3 study of azacitidine vs conventional care regimens in older patients with newly diagnosed AML with >30% blasts.

This multicenter, randomized, open-label, phase 3 trial evaluated azacitidine efficacy and safety vs conventional care regimens (CCRs) in 488 patients age ≥65 years with newly diagnosed acute myeloid leukemia (AML) with >30% bone marrow blasts. Before randomization, a CCR (standard induction chemotherapy, low-dose ara-c, or supportive care only) was preselected for each patient. Patients then were assigned 1:1 to azacitidine (n = 241) or CCR (n = 247). Patients assigned to CCR received their preselected treatment. Median overall survival (OS) was increased with azacitidine vs CCR: 10.4 months (95% confidence interval [CI], 8.0-12.7 months) vs 6.5 months (95% CI, 5.0-8.6 months), respectively (hazard ratio [HR] was 0.85; 95% CI, 0.69-1.03; stratified log-rank P = .1009). One-year survival rates with azacitidine and CCR were 46.5% and 34.2%, respectively (difference, 12.3%; 95% CI, 3.5%-21.0%). A prespecified analysis censoring patients who received AML treatment after discontinuing study drug showed median OS with azacitidine vs CCR was 12.1 months (95% CI, 9.2-14.2 months) vs 6.9 months (95% CI, 5.1-9.6 months; HR, 0.76; 95% CI, 0.60-0.96; stratified log-rank P = .0190). Univariate analysis showed favorable trends for azacitidine compared with CCR across all subgroups defined by baseline demographic and disease features. Adverse events were consistent with the well-established safety profile of azacitidine. Azacitidine may be an important treatment option for this difficult-to-treat AML population. This trial was registered at www.clinicaltrials. gov as #NCT01074047.
A roadmap for discovery and translation in lymphoma.

To the editor: Non-Hodgkin lymphomas, Hodgkin lymphoma, and chronic lymphocytic leukemia comprise more than 80 unique subtypes[1][1] that can be further divided based on histology, immunophenotype, genetics, and other aspects of biology. Despite this diversity, advances in the treatment of lymphoma
PHAGOCYTES , GRANULOCYTES , AND MYELOPOIESIS Platelet-derived Wnt antagonist Dickkopf-1 is implicated in ICAM-1 / VCAM-1 – mediated neutrophilic acute lung in fl ammation

Acute lung injury (ALI) and its more severe form, the acute respiratory distress syndrome (ARDS), are life-threatening diseases with a variety of causes, including sepsis, trauma, and viral or bacterial pneumonia. ALI/ARDS is characterized by the acute onset of hypoxemia, the damage of the capillary-alveolar interface, initiation of a proinflammatory cytokine and chemokine storm, and infiltration of inflammatory cells. ALI/ARDS is clearly recognized as a syndrome of acute inflammation with a mortality rate of up to 40% in human patients. Activation and transmigration of neutrophils through the endothelium, interstitium, and epithelium is the central event in the development of ALI/ARDS. Platelets are the central mediators of hemostasis of the circulatory system and also contribute to acute pulmonary inflammation by regulating the inflammatory responseof endothelial cells and the activation of leukocytes. Acute pulmonary inflammation is associated with the activation of aggressive platelets in the blood and sequestration in pulmonary vascular beds. Platelet production following the onset of thrombocytopenia is increased up to 20-fold under the conditions of peripheral demand and inflammation. Platelets also aggregate with neutrophils or monocytes via cell surface P-selectin and provide supportive juxtacrine and paracrine signals. By interacting with endothelial cells, activated platelets cause increases in vascular permeability and promote the release of proinflammatory cytokines (interleukin-6 [IL-6]) or chemokines (IL-8) from endothelial cells. Platelet components are found in the bronchoalveolar (BAL) fluid from ARDS patients. However, it remains unclear whether platelets directly affect the functions of the alveolar epitheliumduring the development ofALI. Wnt/b-catenin signaling is essential in maintaining proper embryonic lung development and regeneration of the lung epithelium after injury in adults. However, only limited evidence is available for a role ofWnt/b-catenin signaling in acute pulmonary inflammation. Wnt/b-catenin signaling inhibits the endothelial and epithelial inflammatory responses by suppressing proinflammatory cytokines (tumor necrosis factor a [TNFa] and IL-6), chemokines (IL-8 and CC chemokine ligand 2), adhesion molecules (vascular cell adhesion molecule1[VCAM-1]and intercellularadhesionmolecule1[ICAM-1]), and other inflammatory regulators (nitric oxide synthase type 2, C8orf4 [TC1], and cyclooxygenase type 2) through interacting with nuclear factor-kB (NF-kB) signaling and Toll-like receptor–mediated signaling. In inflammatory lung diseases, suppression of Wnt/ b-catenin signaling is observed in COPD and asthma patients, contributing to their dysfunctional epithelial repair. Inhibition of Wnt/b-catenin signaling is also reported in mechanical ventilation (MV)-insulted and Streptococcus pneumoniae–infected lungs. Elevation of the Wnt antagonist secreted frizzled-related protein 1
New prognostic tools for myeloma.

In this issue of Blood, Palumbo et al show, in a study performed with the cooperation of the International Myeloma Working Group (IMWG), that detailed systematic geriatric assessment of elderly myeloma patients might be a useful tool for identifying fit and frail individuals. Like most malignancies, multiple myeloma mainly affects elderly patients. Even so, in daily clinical practice, we usually only consider chronological age (i.e., is the patient under or above 65 years of age? ). However, it is quite obvious that there is a huge difference between a 70-year-old fit patient and a frail patient above the age of 80.
A discrimination system using neural network for SMA prosthesis

The electromyographic(=EMG) signal of active muscle is observed on the surface of living body. It has been considered that the EMG signal is useful for controlling an externally powered upper extremity prosthesis. In these researches, it is reported that the signal processing system using a neural network system are effective for generating commands to the prosthesis because this system is robust on the location error of electrodes. In this paper, a new simple discrimination system using a neural network for EMG and SMA controlled prosthesis are proposed. The discrimination system is composed of two processes: rectifying and integrating EMG signals; and neural network process. The former process was adopted for faster calculation and simpler device than FFT processing. This new process will contribute to the portability of a prosthesis. Moreover SMA (shape memory alloy) actuators were used for designing a prosthesis in order to make it light and compact. As a result, a SMA prosthesis which has 3 degrees of freedom and weight 400 gr was designed. <<ETX>>
Survey of cases of paracetamol overdose in the UK referred to National Poisons Information Service (NPIS) consultants

Background: Paracetamol is the most common means of drug overdose in the UK. Guidance on management is available to junior doctors through TOXBASE, the online resource managed by the UK National Poisons Information Service (NPIS) and in poster form. TOXBASE is supported by NPIS units and further by a UK national rota of clinical toxicologists. A study was undertaken to examine reasons why calls about paracetamol are referred to consultants to better understand issues in managing this common poisoning. Methods: Calls relating to paracetamol overdose referred by a poisons information specialist to the duty NPIS consultant between 1 May 2005 and 30 April 2006 were identified from the database and the number of TOXBASE accesses during the same time period was determined. Enquiries that resulted in consultant referral were classified into six categories. Results: Calls referred to NPIS consultants pertain mainly to patients who present late, staggered overdoses, adverse reactions to N-acetylcysteine, and interpretation of blood results. This information has been used to inform the development of TOXBASE so that comprehensive advice is readily available to end users. Conclusions: The operation of a national consultant rota enables information on difficult or unusual cases of poisoning to be pooled so that treatment guidelines can be developed to optimise treatment throughout the UK.
Emergency department information system diagnosis: how accurate is it?

Emergency department information systems (EDIS) have been heralded as a “must” for the modern emergency department (ED),1 and it is claimed that use of these systems will enhance patient care. Over the past decade, information systems have been rolled out to the ED; however, flaws have been recognised. An American study found 90% accuracy for discharge diagnosis data held …
The incidental impact of music on hospital staff: An Italian case study

Objective: This study focuses on a group of nurses (n = 11) and doctors (n = 9) who have been regularly exposed to live music for the past five years, as part of a music programme targeted on children, in an Italian paediatric hospital. The aims of the study were to focus on the impact of incidental exposure to music of the hospital staff and to analyse any repercussion that such exposure had on their work. Methods: Grounded theory research method informed the analysis of the semi-structured interviews (N = 20). Results: Results suggest that the hospital staff have a positive view of the music intervention in the light of its perceived benefit on the patients. However, some aspects of the programme, such as the selection of music, were reported to impact negatively on their work. Conclusions: Implications for the development of music programmes in hospitals are discussed.
3-D path planning in a dynamic environment using an octree and an artificial potential field

Proposes an efficient and simple method for finding a collision-free path and orientation for a rigid robot in a dynamic observable 3-D environment for unmanned aerial vehicles (UAVs). The method uses an octree for representing every object (robot and static/dynamic obstacles) in the environment without any distinction of the movability of objects; therefore, all objects are dealt with in the same way. The path of a robot from its starting position to the given goal with arbitrary motion (i.e., translation and rotation) in a 3-D environment is efficiently searched for in successive adjoining regions (octree white cells) by using the potential field generated from each black cell of the octree. The algorithm is simple, so it can easily be accelerated by using parallelization techniques. Experimental results obtained under several conditions, such as a point shaped robot and arbitrarily shaped robots in static/dynamic environments, are reported.
Generativity as a positive mental health outcome: The long-term impacts of Better Beginnings, Better Futures on youth at ages 18-19

This study examined the long-term impacts of the Better Beginnings, Better Futures project, a universal, community-based prevention program. Generativity was studied as an indicator of positive mental health, using a narrative analysis of youths’ stories about turning points in their lives. A quasi-experimental design was used to compare youths aged 18–19 who participated in Better Beginnings when they were 4–8 (n = 62) and with youths from comparison communities who did not participate in Better Beginnings (n = 34). Significant differences between the 2 groups were found on 2 measures of generativity. The findings suggest the utility of adopting a narrative approach to evaluate the long-term outcomes of prevention programs for children and youth.
A study of casting manipulation (swing motion control and planning of throwing motion)

We propose a new type of manipulator, a casting manipulator, which includes flexible parts, such as a string, in the link mechanism. A gripper is attached at the end of the string. In order to let the gripper reach a target, the rigid link is swung until the necessary motion of the gripper is generated. The gripper is then thrown to the target by releasing the string at the suitable time. In this paper we describe the manipulation of a casting manipulator. We present a method of oscillating a casting manipulator by considering it as a two-degrees-of-freedom nonholonomic system. First, we propose a method to swing the manipulator for casting motion, and then discuss the selection of swing motion and decision of the timing for releasing the string.
Predicting admission and mortality with the Emergency Severity Index and the Manchester Triage System: a retrospective observational study

Objective: To compare the degree to which the Emergency Severity Index (ESI) and the Manchester Triage System (MTS) predict admission and mortality. Methods: A retrospective observational study of four emergency department (ED) databases was conducted. Patients who presented to the ED between 1 January and 18 July 2006 and were triaged with the ESI or MTS were included in the study. Results: 37 974 patients triaged with the ESI and 34 258 patients triaged with the MTS were included. The likelihood of admission decreased significantly with urgency categories in both populations, and was greater for patients triaged with the ESI than with the MTS. Mortality rates were low in both populations. Most patients who died were triaged in the most urgent triage categories of both systems. Conclusion: Both the ESI and MTS predicted admission well. The ESI was a better predictor of admission than the MTS. Mortality is associated with urgency categories of both triage systems.
PHAGOCYTES , GRANULOCYTES , AND MYELOPOIESIS Neutrophil oxidative burst activates ATM to regulate cytokine production and apoptosis

Department of Cellular Microbiology, Max Planck Institute for Infection Biology, Berlin, Germany; Department of Pathology, Federal University of Maranhão, Maranhão, Brazil; Department of Pediatric Pneumology and Immunology, Outpatient Clinic for Primary Immunodeficiencies, Charité Medical School, Berlin, Germany; Labor Berlin, Section for Immunology, Charité–Vivantes GmbH, Berlin, Germany; Institute of Cell Biology and Neurobiology, Department of Pediatric Neurology, and Sozialpädiatrisches Zentrum (SPZ), Charité–Universitätsmedizin Berlin, Berlin, Germany; Department of Pediatrics, Federal University of São Paulo Medical School, São Paulo, Brazil; Department of Immunology, Institute of Biomedical Sciences–University of São Paulo, São Paulo, Brazil; Division of Immunology, University Children’s Hospital, and Children’s Research Centre, Swiss Center for Regenerative Medicine, Center for Applied Biotechnology and Molecular Medicine, and Zurich Centre for Integrative Human Physiology (ZIHP), University of Zürich, Zürich, Switzerland; and Department of Pediatrics, University Hospital TU Dresden, Dresden, Germany
An Introduction to Periodization Training for the Triathlete

FOR ATHLETES, THE PURPOSE of any training method is to prepare them for competition. Periodization is a training method that has gained popularity over the past few years. Periodization is a process of adapting the training regimen into phases in order to maximize the athlete’s capacity to meet the specific demands of a sport. Each phase is planned according to an organized schedule of varying length. This is accomplished via a gradual cycling of resistance, volume, intensity, and specificity in order to achieve peak levels of performance (4). Although it is often used as a method to enhance strength, periodization can be used to aid triathletes in reaching peak conditioning levels and an optimal level of performance for the most important competitions during the year. Inasmuch as this systematic process has helped athletes improve performance in a chosen sport, the efficacy of training athletes who participate in several ultraendurance sports simultaneously, such as a triathlon, has seldom been discussed. ■ Activities Involved in Periodization
Atherogenic Risk Factors and Growth Hormone Treatment

Children with Growth Hormone deficiency (GHD) are relatively obese. Adults suffering from GHD show early mortality and morbidity related to cardiovascular diseases. This study focuses on atherogenic risk factors in children with GHD. We examined changes in body composition and lipid profiles in 18 males and 6 females with GHD, aged 6-14 year; height standerd deviation score (HSDS) -4.5 to -2.0, during 12 months of treatment with GH. HSDS significantly increased by 0.41 in males and 0.47 in females after 12 months of treatment. Body weight increased in both sexes. The percentage of body fat decreased especially at 5 months of therapy in males and at 3 months in females (P<0.001). Body fat in kg decreased rapidly at 1 month in both groups (P<0.05). The lean body mass showcd a significant increase from 2 months in females and from 1 month in males until the end of the study. High density lipoprotein cholesterol (HDLC) increased in males throughout the study (P<0.05) without significant changes in total cholesterol. The atherogenic index decreased significantly at 12 months in males (P<0.01) and in females (P<0.05). We conclude that GH therapy is important in reducing atherogenic risk factors during childhood.
An implementation of landmark-based position estimation function as an autonomous and distributed system for a mobile robot

We developed APCS (autonomous position correction system) that can autonomously cancel the error of the estimated robot position from odometry by detecting flat walls using ultrasonic sensing. When it detects flat walls in the environment, this system corrects the estimated position using maximum likelihood estimation (MLE). The feature of this system is that it can correct the position not being concerned with the behavior of the robot because the system autonomously decides the trigger of the position correction. We show the algorithm and implementation of APCS, and some experimental results to confirm feasibility of the system in a disordered environment.