Miracle-dz/UniFAR-FTUs huggingface dataset:
UpToDate adherence to GRADE criteria for strong recommendations: an analytical survey

Introduction UpToDate is widely used by clinicians worldwide and includes more than 9400 recommendations that apply the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. GRADE guidance warns against strong recommendations when certainty of the evidence is low or very low (discordant recommendations) but has identified five paradigmatic situations in which discordant recommendations may be justified. Objectives Our objective was to document the strength of recommendations in UpToDate and assess the frequency and appropriateness of discordant recommendations. Design Analytical survey of all recommendations in UpToDate. Methods We identified all GRADE recommendations in UpToDate and examined their strength (strong or weak) and certainty of the evidence (high, moderate or low certainty). We identified all discordant recommendations as of January 2015, and pairs of reviewers independently classified them either into one of the five appropriate paradigms or into one of three categories inconsistent with GRADE guidance, based on the evidence presented in UpToDate. Results UpToDate included 9451 GRADE recommendations, of which 6501 (68.8%) were formulated as weak recommendations and 2950 (31.2%) as strong. Among the strong, 844 (28.6%) were based on high certainty in effect estimates, 1740 (59.0%) on moderate certainty and 366 (12.4%) on low certainty. Of the 349 discordant recommendations 204 (58.5%) were judged appropriately (consistent with one of the five paradigms); we classified 47 (13.5%) as good practice statements; 38 (10.9%) misclassified the evidence as low certainty when it was at least moderate and 60 (17.2%) warranted a weak rather than a strong recommendation. Conclusion The proportion of discordant recommendations in UpToDate is small (3.7% of all recommendations) and the proportion that is truly problematic (strong recommendations that would best have been weak) is very small (0.6%). Clinicians should nevertheless be cautious and look for clear explanations—in UpToDate and elsewhere—when guidelines offer strong recommendations based on low certainty evidence.
Advanced alveolar soft part sarcoma responds to apatinib

Alveolar soft part sarcoma (ASPS) is a rare, hypervascular soft tissue sarcoma with a low chemotherapy response rate. Here, we report an ASPS case with multiple lung metastases on initial presentation. The primary tumor, a hypervascular soft tissue mass 4.1×3.2×2.0 cm, located in the right thigh, was resected prior to chemotherapy. The patient suffered disease progression after two cycles of gemcitabine-docetaxel treatment. Immunohistochemical examination of the tumor tissue revealed strong positive staining for vascular endothelial growth factor (VEGF) and VEGF receptor-2 (VEGFR-2). The patient was subsequently treated with apatinib (500 mg/day), a specific VEGFR-2 inhibitor. Treatment was well tolerated, and the patient exhibited a partial response, with the lung metastases reduced in size and number after one month of therapy. To date, 12-month progression-free survival has been achieved. Apatinib may provide an additional treatment option for metastatic ASPS, particularly in cases resistant to other chemotherapeutic options. Furtherstudies with more cases with longer follow-up times will be necessary to determine the clinical efficacy of apatinib for treatment of ASPS.
Leader-Member Exchange and Transformational Leadership: An Empirical Examination of Innovative Behaviors in Leader-Member Dyads

This paper evoked leader-member exchange (LMX) and transformational leadership theories to explain innovative behavior in leader-member dyads. Data from 225 leader-member dyads in a Fortune 500 manufacturing plant found exchange quality to be positively related to follower autonomy, leader support of followers, and follower commitment to the organization. Further, followers who were supported by their leaders and who were committed to the organization were more likely to be innovative. Also, exchange quality was directly related to innovative behaviors. Contrary to expectations, transformational leadership was negatively related to innovative behaviors of followers.
Regulating Hate Speech in Cyberspace: Issues of Desirability and Efficacy

Cyber-libertarians advocate a free and unfettered cyberspace, unencumbered by regulation. Despite this idealised view, nations around the world are asserting their right to enforce individual regimes of content regulation. Universal agreement on Internet content regulation is almost impossible to obtain. Even in an area that is universally abhorrent--child pornography--the First Amendment to the United States Constitution stands as a stumbling block to effective government regulation. When the content under discussion concerns hate speech, consensus becomes more elusive. There are those who argue that freedom of speech principles preclude censorship of opinion, and that more speech is the best antidote to racist views. Others argue that hate speech silences minority opinion and is really an equality issue, which if not addressed, runs counter to International Human Rights principles. Nations such as Germany and France have prohibited hate speech on the Internet, and have brought both criminal and civil penalties against defendants. However, enforcement is fraught with difficulties, especially when the defendants are not nationals, and when the content emanates from foreign jurisdictions. The Council of Europe has recently moved to include an additional Protocol to the Convention on Cybercrime. This Protocol would cover offences of racist or xenophobic propaganda, making them subject to reciprocal enforcement provisions by Member States. Whether international efforts can succeed where a piecemeal approach has failed is yet to be seen. Although the United States and its First Amendment currently present the greatest obstacle to hate speech regulation, technological advances as well as judicial development in First Amendment jurisprudence may yet provide an avenue for regulating hate speech in cyberspace.
Guess Who’s Coming to Dinner: A Discursus on Knowledge, Power, and Presence in “A Symposium”

This article critiques the predominantly Eurocentric and phallocentric focus of Rachal’s “A Symposium,” recently published in Adult Education Quarterly. It is argued that Rachal constructs a dialogue that privileges a philosophical canon whose continued legitimacy is being challenged both in philosophical and adult education circles. The form of presentation in “A Symposium,” the Socratic method, belies the universal and eternal nature of knowledge, a theme that is evident throughout “A Symposium”’s dialogue. Also questioned is the selection of guests to the dinner party as reflecting a male and Eurocentric bias that masks the centrality of identity, social location, and power in the construction of knowledge. “A Symposium” represents a missed opportunity to raise some critical and substantive issues of relevance to adult educators concerning the construction and consequence of knowledge as reflected in current educational and philosophical debates on knowledge and power.
MRI image segmentation based on new fuzzy c-means algorithm

The fuzzy c-means clustering algorithm is one of the most important procedures of unsupervised clustering. It had always involved inadequacy for the necessity of determining the initial quantities and lack of ways on theoretical bases for choosing it, in view of the fact that in fuzzy c-means algorithm like unlinear optimizing procedures of initial quantities(like the cluster number and initial center and membership matrix) is efficient in convergence of this algorithm. So, if these quantities are not selected correctly for a noisy data, this algorithm will stop in local minimum. Therefore this algorithm becomes limit. This work develops a specific method to construct the initial cluster center to construct initial membership to clusters in order to improve the strength of the clusters. The algorithm is realized by incorporating the spatial neighborhood information to calculate the initial cluster center. So this paper finds a reasonable way to get the initial cluster center to initialized membership matrix. The new FCM are tested on a set of dataset and then the application to the segmentation of real MRI image is presented and compared with the results obtained using FCM.
Contemporary Social Change as the Context for Geographical Enquiry: Towards a Reinvigoration of the Concept of Place

The nature of contemporary social change is explored by posing questions about the implications of neoliberalism, the character of leisure, the perils of materialism, and the shift from consumption to consumerism. Momentum is a powerful force in human affairs. Investigating its nature illustrates how the concept of equilibrium has been given undue emphasis in models of human behaviour. Momentum encourages ‘more of the same’ and is implicated in the way people fail to use leisure fully or effectively and in the way they subscribe to an emphasis on materialism and consumption as a path to happiness. Geography needs to engage with popular social scientific writing if it is to have a place in public intellectual debate. In many ways contemporary social change promises a reinvigoration of the concept of place and therefore challenges to both the substance and nature of geographical inquiry.
Association Rules Mining Algorithm

Many algorithms to mine the association rules are divided into two stages, the first is to find the frequent set; the second is use the frequent set to generate association rules. This proposal discuss the respective characteristics and . shortcoming of the current algorithms to mine association rules and propose another method to mine faster; unlike the other algorithms, this algorithm emphasis on the usage of domain knowledge and the preparation of the systematicly using of the association rules.
Dissemination of Two Methicillin-Resistant Staphylococcus aureus Clones Exhibiting Negative Staphylase Reactions in Intensive Care Units

ABSTRACT From December 1997 to March 1998, 25 methicillin-resistantStaphylococcus aureus (MRSA) isolates exhibiting negative Staphylase (Oxoid Ltd., Basingstoke, England) reactions were identified from various clinical specimens from 13 patients in six intensive care units (ICUs) or in wards following a stay in an ICU at the National Taiwan University Hospital. The characteristics of these isolates have not been previously noted in other MRSA isolates from this hospital. Colonies of all these isolates were grown on Trypticase soy agar supplemented with 5% sheep blood and were nonhemolytic and unpigmented. Seven isolates, initially reported as Staphylococcus haemolyticus (5 isolates) and Staphylococcus epidermidis (2 isolates) by the routine identification scheme and with the Vitek GPI system (bioMerieux Vitek, Inc., Hazelwood, Mo.), were subsequently identified as S. aureus by positive tube coagulase tests, standard biochemical reactions, and characteristic cellular fatty acid chromatograms. The antibiotypes obtained by the E test, coagulase types, restriction fragment length polymorphism profiles of the staphylococcal coagulase gene, and random amplified polymorphic DNA patterns generated by arbitrarily primed PCR of the isolates disclosed that two major clones disseminated in the ICUs. Clone 1 (16 isolates) was resistant to clindamycin and was susceptible to trimethoprim-sulfamethoxazole (TMP-SMZ) and was coagulase type II. Clone 2 (eight isolates) was resistant to clindamycin and TMP-SMZ and was coagulase type IV. These two epidemic clones from ICUs are unique and underline the need for caution in identifying MRSA strains with colonial morphologies not of the typical type and with negative Staphylase reactions.
Perianesthetic thermoregulation and heat balance in humans

General anesthesia markedly impairs normal control of body temperature, reducing the threshold (triggering core temperature) for thermoregulatory vasoconstriction from ≍37 to ≍34.5°C. Sweating and active vasodilation thresholds similarly are increased, widening the range of temperatures not triggering regulatory compensations from ≍0.2 to ≌ 4°C. However, once initiated, the gains (slopes of response intensity vs. core temperature curves) and maximum intensities of thermoregulatory responses are nearly normal. Intraoperative core temperature initially decreases rapidly because anesthetic‐induced inhibition of tonic thermoregulatory vasoconstriction causes a core‐to‐peripheral redistribution of body heat. The subsequent slower, linear decrease in body temperature results from heat loss exceeding metabolic heat production. And finally, after 3‐4 h of anesthesia, core temperature stabilizes at an abnormally low value. In patients experiencing minimal heat loss, and therefore not becoming sufficiently hypothermic to trigger vasoconstriction, this plateau can be passive steady state in which heat loss equals production. Conversely, patients becoming sufficiently hypothermic will trigger thermoregulatory vasoconstriction that both decreases cutaneous heat loss and sequesters some metabolic heat in the core. Epidural and spinal anesthesia also cause core hypothermia by inhibiting tonic thermoregulatory vasoconstriction, producing an internal redistribution of heat from the warm core to cooler peripheral tissues. Core hypothermia provokes thermoregulatory responses including vasoconstriction (above the block level) and shivering. Nonetheless, many patients feel warmer after induction of regional anesthesia, apparently because perceived skin temperature is elevated. The following review will focus on anesthetic‐induced impairment of normal thermoregulatory control and the resulting alterations in heat balance. —Sessler, D. I. Perianesthetic thermoregulation and heat balance in humans. FASEB J. 7: 638‐644; 1993.
Evaluating coparenting and family-level dynamics during infancy and early childhood: The Coparenting and Family Rating System.

Excerpt only. Full-text chapter is available only through licensed access provided by the publisher. Published in P. Kerig & K. Lindahl (Eds.) Family Observational Coding Systems: Resources for Systemic Research. New Jersey: Erlbaum (pp. 151-170). Members of the USF System may access the full-text of the article through the authenticated link provided below.
Visualization of Tumor Blockage and Rerouting of Lymphatic Drainage in Penile Cancer Patients by Use of SPECT/CT

The reliability of sentinel node biopsy is dependent on the accurate visualization and identification of the sentinel node(s). It has been suggested that extensive metastatic involvement of a sentinel node can lead to blocked inflow and rerouting of lymph fluid to a “neo–sentinel node” that may not yet contain tumor cells, causing a false-negative result. However, there is little evidence to support this hypothesis. Recently introduced hybrid SPECT/CT scanners provide both tomographic lymphoscintigraphy and anatomic detail. Such a scanner enabled the present study of the concept of tumor blockage and rerouting of lymphatic drainage in patients with palpable groin metastases. Methods: Seventeen patients with unilateral palpable and cytologically proven metastases in the groin underwent bilateral conventional lymphoscintigraphy and SPECT/CT before sentinel node biopsy of the contralateral groin. The pattern of lymphatic drainage in the 17 palpable groin metastases was evaluated for signs of tumor blockage or rerouting. Results: On the CT images, the palpable node metastases could be identified in all 17 groins. Four of the 17 palpable node metastases (24%) showed uptake of radioactivity on the SPECT/CT images. In 10 groins, rerouting of lymphatic drainage to a neo–sentinel node was seen; one neo–sentinel node was located in the contralateral groin. A complete absence of lymphatic drainage was seen in the remaining 3 groins. Conclusion: The concept of tumor blockage and rerouting was visualized in 76% of the groins with palpable metastases. Precise physical examination and preoperative ultrasound with fine-needle aspiration cytology may identify nodes with considerable tumor invasion at an earlier stage and thereby reduce the incidence of false-negative results.
Enhancing TCP Incast congestion control over large-scale datacenter networks

Many-to-one traffic pattern in datacenter networks introduces the problem of Incast congestion for Transmission Control Protocol (TCP) and puts unprecedented pressure to the cloud service providers. To address heavy Incast, we present an Receiver-oriented Datacenter TCP (RDTCP). The proposal is motivated by oscillatory queue size when handling heavy Incast traffic and substantial potential of receiver in congestion control. Finally, RDTCP adopts both open- and closed-loop congestion controls. We provide a systematic discussion on its design issues and implement a prototype to examine its performance. The evaluation results indicate that RDTCP has an average decrease of 47.5% in the mean queue size, 51.2% in the 99th-percentile latency in the increasingly heavy Incast over TCP, and 43.6% and 11.7% over Incast congestion Control for TCP (ICTCP).
Long-Term X-Ray Spectral Variability of the Radio-Loud Narrow-Line Seyfert 1 Galaxy PKS 0558–504

We present X-ray observations of the narrow-line Seyfert 1 (NLS1) galaxy PKS 0558-504 obtained with RXTE during a 1 yr monitoring campaign. This source, which is one of the very few radio-loud NLS1 galaxies, shows strong X-ray flux variability on timescales of weeks to months, accompanied by spectral variability. The main goal of this study is to investigate the spectral variability with model-independent methods and time-resolved spectroscopy in order to shed light on the origin of the X-rays. The main results can be summarized as follows: (1) The flux typically changes by a factor of 1.5-2 on timescales of 10-30 days, with few extreme events where the flux increases by a factor of ~4 in 3 days. (2) We do not observe any large amplitude, flux-related spectral variations. During the flux variations, the spectrum varies mainly in normalization and not in shape. We do observe some small-amplitude spectral variations, which do not correlate with flux, although there is a hint of spectral hardening as the source brightens. (3) There is no evidence for reprocessing features, such as the Fe Kα line or a Compton hump. We argue that PKS 0558-504 is a peculiar object that appears to be different from most of the radio-quiet and radio-loud active galactic nuclei (AGNs). If a jet is responsible for the bulk of the X-rays, it must operate in an unusual way. If instead a corona is responsible for the X-rays, the system might be a large-scale analog of the Galactic black holes in the transient intermediate state.
Difference Scores versus Direct Effects in Service Quality Measurement

Difference scores have been widely used in many areas of marketing research. There have been numerous criticisms of difference scores, and the authors add to these criticisms by testing an implicit assumption of difference scores that has not been tested in consumer research. Specifically, difference scores assume that the components have equal and opposite effects on the dependent variable. This assumption is tested in a services setting in which difference scores are still widely used and in a laboratory experiment using a product. An alternative operationalization, the Direct Effects Model, is shown to be superior. In addition, as a result of treating the antecedents as separate predictors, it is shown that performance is the much stronger predictor of satisfaction compared to expectations. Such a finding could not be uncovered using difference scores.
Mothers' Speech to Hearing‐Impaired Infants and Children With Cochlear Implants

This study investigated the effects of age, hearing loss, and cochlear implantation on mothers' speech to infants and children. We recorded normal-hearing (NH) mothers speaking to their children as they typically would do at home and speaking to an adult experimenter. Nine infants (10–37 months) were hearing-impaired and had used a cochlear implant (CI) for 3 to 18 months. Eighteen NH infants and children were matched either by chronological age (10–37 months) or hearing experience (3–18 months) to the CI children. Prosodic characteristics such as fundamental frequency, utterance duration, and pause duration were measured across utterances in the speech samples. The results revealed that mothers use a typical infant-directed speech style when speaking to hearing-impaired children with CIs. The results also suggested that NH mothers speak with more similar vocal styles to NH children and hearing-impaired children with CIs when matched by hearing experience rather than chronological age. Thus, mothers are s.
Presence of antioxidative agent, Pyrrolo[1,2-a]pyrazine-1,4-dione, hexahydro- in newly isolated Streptomyces mangrovisoli sp. nov.

A novel Streptomyces, strain MUSC 149T was isolated from mangrove soil. A polyphasic approach was used to study the taxonomy of MUSC 149T, which shows a range of phylogenetic and chemotaxonomic properties consistent with those of the members of the genus Streptomyces. The diamino acid of the cell wall peptidoglycan was LL-diaminopimelic acid. The predominant menaquinones were identified as MK9(H8) and MK9(H6). Phylogenetic analysis indicated that closely related strains include Streptomyces rhizophilus NBRC 108885T (99.2% sequence similarity), S. gramineus NBRC 107863T (98.7%) and S. graminisoli NBRC 108883T (98.5%). The DNA–DNA relatedness values between MUSC 149T and closely related type strains ranged from 12.4 ± 3.3% to 27.3 ± 1.9%. The DNA G + C content was determined to be 72.7 mol%. The extract of MUSC 149T exhibited strong antioxidant activity and chemical analysis reported identification of an antioxidant agent, Pyrrolo[1,2-a]pyrazine-1,4-dione, hexahydro-. These data showed that metabolites of MUSC 149T shall be useful as preventive agent against free-radical associated diseases. Based on the polyphasic study of MUSC 149T, the strain merits assignment to a novel species, for which the name S. mangrovisoli sp. nov. is proposed. The type strain is MUSC 149T (=MCCC 1K00699T=DSM 100438T).
Opening the doors of higher education to working class adults: a case study

This paper, which is situated within a discourse of inclusivity, is concerned with Higher Education's response to the needs of groups, such as working class adults with negative experiences of school, who are currently excluded from higher education throughout Europe. It argues, using illustrations from a case study, that there are a variety of organizational and pedagogical implications that must be addressed if participation is to be widened which relate to both individual ability and attitude and to institutional and situational barriers. It concludes that all universities have conceptions of equity which reflect ideological positions and influence the practice that is seen as acceptable. The dilemma facing those committed to social inclusion is that too much emphasis on the structural can imply that the efforts of individual students are of little consequence in determining success or failure. It is argued that a counter-balancing position is needed in which, whilst acknowledging the contribution of t.