Miracle-dz/UniFAR-FTUs huggingface dataset:
A critical assessment of published guidelines and other decision-support systems for the antibiotic treatment of community-acquired respiratory tract infections.

Guidelines are an important means by which professional associations and governments have sought to improve the quality and cost-effectiveness of disease management for infectious diseases. Prescribing of initial antibiotic therapy for community-acquired respiratory tract infections (RTIs) is primarily empiric and physicians may often have a limited appreciation of bacterial resistance. Recent guidelines for managing RTIs have adopted a more evidence-based approach. This process has highlighted important gaps in the existing knowledge base, e.g. concerning the impact of resistance on the effectiveness of oral antibiotics for outpatient community-acquired pneumonia and the level of resistance that should prompt a change in empiric prescribing. In upper RTIs, the challenge is to identify patients in whom antibiotic therapy is warranted. Concentrated, sustained efforts are needed to secure physicians' use of guidelines. The information should be distilled into a simple format available at the point of prescribing and supported by other behavioral change techniques (e.g. educational outreach visits). Advances in information technology offer the promise of more dynamic, computer-assisted forms of guidance. Thus, RTI prescribing guidelines and other prescribing support systems should help control bacterial resistance in the community. However, their effect on resistance patterns is largely unknown and there is an urgent need for collaborative research in this area. Rapid, cost-effective diagnostic techniques are also required and new antibiotics will continue to have a role in disease management.
Polarization Rotation in Twisted Polarization Maintaining Fibers Using a Fixed Reference Frame

In previous studies addressing polarization evolution in optical fibers, the frame of reference in which polarization rotation in twisted optical fibers is described lacks the compatibility with the modeling of some fiber sensor applications. We therefore introduce a formulation of the polarization evolution in a twisted optical and birefringent fiber, which is based on a laboratory coordinate system. We employ coupled mode theory using the fundamental modes of a single mode fiber as a basis. We treat the birefringence of the polarization maintaining fiber and the twist induced birefringence as perturbations introduced into this mode system. We demonstrate the derivation of the coupling coefficients and solve the coupled mode equations for different sets of problems. We compare our results to existing formulations and find an excellent agreement between the theories for highly birefringent fibers.
Sudden Onset of Psychosis in Association with Vitamin-B12 Deficiency

signs. Chest radiography showed bilateral granular and nodular shadowing. A patch test for berylliosis was negative. Drill biopsy of the right lower lobe showed miliary granulomata, the outstanding feature of which was the presence of numerous conchoid bodies. The appearances were those of chronic berylliosis. A shallow right pneumothorax resulted from the drill biopsy but absorbed unevent-fully. Treatment was started with corticosteroids, but without appreciable clinical or radiological improvement. He was awarded 20% industrial compensation.
Design and Analysis of a Two-Speed Line Start Synchronous Motor: Scheme One

Line-start permanent magnet motors have many advantages, such as high efficiency, high power factor, high power density, and good thermal performances. Also, they do not need to use an inverter in comparison with brushless dc motors. The mentioned advantages have introduced these motors as a good alternative for induction motors in industry. However, there are some drawbacks that limit the use of them. One of these drawbacks is that line start permanent magnet (LSPM) motors could only rotate at one speed due to the fixed polarity of permanent magnets. This matter limits the implementation of LSPM motor for some applications that need two rotating speeds, such as fans and pumps. This paper presents a good scheme that enables LSPM motors to rotate at two different speeds. This scheme is based on combining LSPM motor with synchronous reluctance motor. To validate the proposed scheme, the designed motor has been analyzed by using finite-element method. Simulation results verify the theoretical findings, and show that the proposed scheme leads to good performances at both low- and high-speed operation of the motor.
Can we measure integration of healthcare from administrative and clinical records?

BACKGROUND A major component of integrated care is shared information. Computer-based clinical and administrative systems, particularly in multidisciplinary environments, provide an opportunity to directly measure the degree of integration. OBJECTIVE The objective of this article is to explore the viability of automated measurement of integration within a multidisciplinary healthcare centre. METHODS With the assistance of practice staff, researchers explored the structure and content of selected patient records in two practices to understand the viability of automated measurement. RESULTS Extracted patient records can be used to understand integration to the degree that communication is recorded, but at significant expense to the practices and researchers. Automated systems are practical to the degree that clinicians complete all relevant identifying fields. DISCUSSION Computerised clinical systems provide opportunities for exploring integration of care if they include a range of care providers and all relevant fields are always completed. The latter condition will always be difficult to achieve.
Parametric differential SAR tomography of decorrelating volume scatterers

Much interest is continuing to grow in advanced interferometric SAR methods for full 3D imaging, in particular of volumetric forest scatterers. Multibaseline SAR tomographic elevation beam forming i.e. spatial spectral estimation is a promising technique in this framework. In this paper, the important effect of temporal decorrelation during the repeat pass multibaseline acquisition is analyzed on superresolution (MUSIC) tomography with limited sparse data. Moreover, the ultimate achievable estimation performance of the volume height parameters is investigated by deriving the Cramér-Rao bound in the partially coherent scenario. Finally, new tomographic methods are proposed robust to temporal decorrelation phenomena, exploiting the advanced differential tomography concept which produces ‘space-time’ signatures of scattering dynamics in the SAR cell. To this aim, the 2D version of MUSIC, and a generalized MUSIC matched to non-line spectra, are applied to decouple the nuisance temporal signal histories in the spatial spectral estimation. First differential tomography results with real P-band forest data are presented.
Focus on Primary Care: From Nevus to Neoplasm: Myths of Melanoma in Pregnancy

Malignant melanoma is one of the few malignancies that regularly affect women during their childbearing years. Additionally, the incidence of melanoma has been increasing over the last several decades. Early diagnosis of stage I disease may lead to curative therapy; thus it is important for physicians and midwives to do a full examination of the skin. However, the myth that nevi may naturally grow or change during pregnancy has been shown not to be true and should not delay a diagnostic evaluation of a suspicious nevus. Older studies had theorized a worse outcome for pregnant women with melanoma. However, multiple controlled series and investigations have found that stage for stage this cancer is not affected adversely by pregnancy. Prognosis, recurrence, and incidence of melanoma seemed to be unaffected. Estrogen-containing oral contraceptives, as well as hormone replacement therapy, have no adverse affect on the disease. Target Audience: Obstetricians & Gynecologists, Family Physicians Learning Objectives: After completion of this article, the reader will be able to list the various types of melanomas, to outline potential risk factors for melanomas, to summarize the misconceptions about melanomas and pregnancy, and to describe the management of melanomas.
Appearance of immune complexes during experimental hepatitis A infection in chimpanzees

Circulating immune complexes (CICs) were detected during the course of experimental hepatitis A virus (HAV) infection in 8 of 9 chimpanzees. In all cases, the predominant class of antibody detected in the CIC was IgM. The appearance of IgM‐CIC usually preceded the onset of liver enzyme elevations, and in all instances, the appearance of IgM‐CIC correlated with the presence of IgM anti‐HAV. Six of 8 animals tested had significant depression of C3 concentrations during the course of infection, and this depression occurred at the peak of CIC activity. Immunohistologic studies demonstrated granular deposits of IgM localized in sinusoidal cells during peak of IgM‐CIC activity. IgM‐CICs appear to be a fairly consistent finding during HAV infection and probably represent the viremic phase of the disease. However, they do not appear to mediate hepatocellular injury by direct action on hepatocytes.
A Geriatric Emergency Service for Acutely Ill Elderly Patients: Pattern of Use and Comparison with a Conventional Emergency Department in Italy

The current disease‐oriented, episodic model of emergency care does not adequately address the complex needs of older adults presenting to emergency departments (EDs). Dedicated ED facilities with a specific organization (e.g., geriatric EDs (GEDs)) have been advocated. One of the few GED experiences in the world is described and its outcomes compared with those of a conventional ED (CED). In a secondary analysis of a prospective observational cohort of 200 acutely ill elderly patients presenting to two urban EDs in Ancona, Italy, identifiers and triage, clinical, and social data were collected and the following outcomes considered: early (30‐day) and late (6‐month) ED revisit, frequent ED return, hospital admission, and functional decline. Death, functional decline, any ED revisit and any hospital admission were also considered as a composite outcome. Odds ratios and 95% confidence intervals (CIs) were calculated. Overall, GED patients were older and frailer than CED patients. The two EDs did not differ in terms of early, late, or frequent ED return or in 6‐month hospital admission or functional decline. The mortality rate was slightly but significantly lower in the GED patients (hazard ratio=0.47, 95% CI=0.22–0.99, P=.047). The data suggest noninferiority and, indirectly, a slight superiority for the GED system in the acute care of elderly people, supporting the hypothesis that ED facilities specially designed for older adults may provide better care.
Introduction to the history of plant pathology

G. C. AINSWORTH, Introduction to the history ofplant pathology, Cambridge University Press, 1981, 8vo, pp. xii, 315, illus. , £27.50. This well-produced and -illustrated book is, of course, primarily intended for those dealing specifically with botany or agriculture. Yet much of it will be of interest to doctors and medical historians, and the author himself notes the importance of interdisciplinary studies to all professions. Plants, like man and other animals, suffer predominantly from diseases caused by fungi, bacteria, and viruses. Dr. Ainsworth shows that the plant pathologist is in fact a plant doctor or, rather, an epidemiologist whose task it is to diagnose, treat, and prevent diseases of plant populations, and he has organized his book on this basis. The medical historian is reminded that some of the fundamental discoveries concerning human medicine have been the outcome of research into plant diseases. The first experimental evidence of the pathogenicity of any micro-organism was provided, at the beginning of the nineteenth century, by the demonstration that bunt of wheat is caused by a fungus; while the existence of viruses was revealed, at the very end of the century, by experiments on tobacco mosaic disease. For the plant world, however, the fungi are by far the most important pathogenic agents, whereas in human and animal pathology the bacteria and viruses predominate. Since the fungi rarely proliferate within the human or animal body, their possible pathogenicity to man and animals has, until very recently, been largely ignored outside Russia and Eastern Europe. Yet, it has long been known that a toxic fungus was responsible for the outbreaks of ergotism which ravaged Europe from the Middle Ages up to the nineteenth century. Since the second World War, if not earlier, the Russians have incriminated exo-toxins of various fungi as the cause of other serious epidemic conditions in man and animals. More recently, it has been shown that some of these toxins may be carcinogenic in animals, and that such aflatoxins are widely present in groundnuts, wheat, and other crops used for human and animal food, and can even enter the milk of cattle. Thus, it should come as no surprise that the Russians have now been accused of initiating mycological warfare, with a "yellow rain" containing fungal exo-toxins. It is, therefore, somewhat disappointing that Dr. Ainsworth, one of the world's foremost mycologists, should confine this book almost entirely to the quantitative effects of plant diseases. Their qualitative aspects must surely be of interest to us all, and not least to plant pathologists and medical historians. Elinor Lieber Green College, Oxford
Minorities Not Tokens, Toward Gender Equality within Cabinets

More women are being appointed to full cabinet-rank posts and they are holding more diverse portfolios. Are these women able to be as effective as the men once they are in the cabinet – in essence have the women become true political players at the highest level of the executive branch, or are they still tokens, but more numerous tokens? We present a theory that uses the political capital resources that ministers, both men and women, bring to the cabinet to predict ministerial success. We predict that ministers who bring more political capital resources to the cabinet will perform more successfully in their job than those with fewer political capital resources. If treatment is equal for women and men with the same quantity of political capital resources that constitutes evidence of gender integration in cabinets. We use three benchmarks for minister effectiveness: duration in post, avoiding a “bad end”, and legislative productivity. Our dataset includes all ministers of full cabinet rank (447 ministers of which 110 are women) from recent presidential administrations in Argentina, Chile, Colombia, Costa Rica, and the U.S. Our analysis provides evidence of equal treatment of women. This finding holds across different types of posts, for initial and replacement ministers, and across countries, and indicates that gender integration is occurring in these presidential cabinets. We conclude that while women are still numerical minorities in cabinets they are not treated as tokens.
A Monomeric, Tightly Folded Stromal Intermediate on the pH-dependent Thylakoidal Protein Transport Pathway (*)

Two distinct mechanisms have been previously identified for the transport of proteins across the chloroplast thylakoid membrane, one of which is unusual in that neither soluble factors nor ATP are required; the system requires only the transthylakoidal ΔpH. We have examined this mechanism by studying the properties of one of its substrates: the extrinsic 23-kDa protein (23K) of photosystem II. Previous work has shown that this protein can be transported into isolated thylakoids as the full-length precursor protein; we show that the stromal import intermediate form of this protein is similarly translocation-competent. Gel filtration tests indicate that the stromal intermediate is probably monomeric. Protease sensitivity tests on both the initial in vitro translation product and the stromal import intermediate show that the presequence is highly susceptible to digestion whereas the mature protein is resistant to high concentrations of trypsin. The mature protein becomes very sensitive to digestion if unfolded in urea, or after heating, and we therefore propose that the natural substrate for this translocation system consists of a relatively unfolded presequence together with a tightly folded passenger protein. The ability of thylakoids to import pre-23K is destroyed by prior treatment of the thylakoids with low concentrations of trypsin, demonstrating the involvement of surface-exposed proteins in the import process. However, we can find no evidence for the binding of pre-23K or i23K to the thylakoid surface, and we therefore propose that the initial interaction of these substrates with the thylakoidal translocase is weak, reversible, and probably ΔpH-independent. In the second phase of the translocation mechanism, the ΔpH drives either the translocation and unfolding of proteins, or the translocation of a fully folded protein.
Necessary and Sufficient No-Arbitrage Conditions for the SSVI/S3 Volatility Curve

The "SSVI" (aka "S3") implied volatility curve is the simplest curve that has three parameters to describe the at-the-money behavior of implied volatilities for a given term, while also having a sensible functional form in the call and put wings. We describe the necessary and sufficient conditions on its three parameters to avoid butterfly arbitrage. By considering dimensionless parameters in normalized strike space, a simple picture of the no-arbitrage region emerges. For fixed (normalized) volatility it is compact, simply connected, and surprisingly large for realistic volatilities. For very large (normalized) volatility the asymptotic wing constraints of Lee are not just necessary but also sufficient for the absence of arbitrage everywhere.
The quantitative impact of read mapping to non-native reference genomes in comparative RNA-Seq studies

Sequence read alignment to a reference genome is a fundamental step in many genomics studies. Accuracy in this fundamental step is crucial for correct interpretation of biological data. In cases where two or more closely related bacterial strains are being studied, a common approach is to simply map reads from all strains to a common reference genome, whether because there is no closed reference for some strains or for ease of comparison. The assumption is that the differences between bacterial strains are insignificant enough that the results of differential expression analysis will not be influenced by choice of reference. Genes that are common among the strains under study are used for differential expression analysis, while the remaining genes, which may fail to express in one sample or the other because they are simply absent, are analyzed separately. In this study, we investigate the practice of using a common reference in transcriptomic analysis. We analyze two multi-strain transcriptomic data sets that were initially presented in the literature as comparisons based on a common reference, but which have available closed genomic sequence for all strains, allowing a detailed examination of the impact of reference choice. We provide a method for identifying regions that are most affected by non-native alignments, leading to false positives in differential expression analysis, and perform an in depth analysis identifying the extent of expression loss. We also simulate several data sets to identify best practices for non-native reference use.
Factors affecting outcome in ocular myasthenia gravis

ABSTRACT Aim of the study: 50%–60% of patients with ocular myasthenia gravis (OMG) progress to generalized myasthenia gravis (GMG) within two years. The aim of our study was to explore factors affecting prognosis of OMG and to test the predictive role of several independent clinical variables. Materials and methods: We reviewed a cohort of 168 Caucasian patients followed from September 2000 to January 2016. Several independent variables were considered as prognostic factors: gender, age of onset, results on electrophysiological tests, presence and level of antibodies against acetylcholine receptors (AChR Abs), treatments, thymic abnormalities. The primary outcome was the progression to GMG and/or the presence of bulbar symptoms. Secondary outcomes were either achievement of sustained minimal manifestation status or worsening in ocular quantitative MG subscore (O-QMGS) or worsening in total QMG score (T-QMGS), assessed by Myasthenia Gravis Foundation of America (MGFA) quantitative scores. Changes in mental and physical subscores of health-related quality of life (HRQoL) were assessed with SF-36 questionnaire. Variance analysis was used to interpret the differences between AChR Ab titers at different times of follow up among the generalized and non-generalized patients. Results: Conversion to GMG occurred in 18.4% of patients; it was significantly associated with sex, later onset of disease and anti-AChR Ab positivity. Antibody titer above the mean value of 25.8 pmol/mL showed no significant effect on generalization. Sex and late onset of disease significantly affected T-QMGS worsening. None of the other independent variables significantly affected O-QMGS and HRQoL. Conclusions: Sex, later onset and anti-AChR Ab positivity were significantly associated with clinical worsening.
[Brain-immune interactions and implications in psychiatric disorders].

OBJECTIVE This review will focus on the role of cytokines in the central nervous system and its implications to depressive disorder. We will then discuss the main findings of cytokine measurements in patients with major depressive disorder. METHOD We searched Pubmed for studies published from 1999-2007, using the keywords depression and cytokine; and depressive disorder and cytokine. We have focused on pro-inflammatory cytokine measurements in patients with depression syndrome using DSM-criteria. RESULTS Several lines of evidence suggest that cytokines have effects on depression, such as the induction of sickness behavior; clinical conditions related to cytokines that also overlap depressive symptoms; and immunotherapy that can lead to depressive symptoms attenuated by antidepressant treatment. Finally, patients with depression exhibit increased levels of pro-inflammatory cytokines, although conflicting results have been described. CONCLUSION Cytokines may play a role in the pathophysiology of some cases of depression, although a causal link has not been established yet. Further longitudinal studies are needed to determine patterns of cytokine in patients with major depressive disorder, taking into account confounding factors closely associated with the activation of pro-inflammatory cytokines. In addition, simultaneous measurements of multiple biomarkers could provide critical insights into mechanisms underlying major depressive disorder and a variety of common cytokine-related diseases.
A Cross-Section Study on the Demand for State Lottery Tickets

One basic economic issue concerning lotteries and other forms of gambling activities is "Who participates, why, and how much? "1 In the litera ture, there are several competing hypotheses which give utility interpretations on the question "why". These hypotheses also have their implications for the questions "who" and "how much. "2 The purpose of this study is to establish some quantitative relationships between the consumer's demand for lottery tickets and his social, economic characteristics by analyzing a sample collected in the Baltimore area. These relationships will help us to test the alternative hypotheses on why people buy lottery tickets, and to identify the factors which determine who purchases lottery tickets and how many tickets he purchases.