Miracle-dz/UniFAR-FTUs huggingface dataset:
Comparison of Nebulized Epinephrine to Albuterol in Bronchiolitis

Objectives To compare the effect of nebulized racemic epinephrine to nebulized racemic albuterol on successful discharge from the emergency department (ED). Methods Children up to their 18th month of life presenting to two teaching hospital EDs with a clinical diagnosis of bronchiolitis who were ill enough to warrant treatment but did not need immediate intubation were eligible for this double-blind randomized controlled trial (RCT). Patients received either three doses of racemic albuterol or one dose of racemic epinephrine plus two saline nebulizers. Disposition was decided 2 hours after the first nebulizer. Successful discharge was defined as not requiring additional bronchodilators in the ED after study drug administration and not subsequently admitted within 72 hours. Adjusted relative risks (aRR) were estimated using the modified Poisson regression with successful discharge as the dependent variable and study drug and severity of illness as exposures. Secondary analysis was performed for patients aged less than 12 months and first presentation. Results The authors analyzed 703 patients; 352 patients were given albuterol and 351 epinephrine. A total of 173 in the albuterol group and 160 in the epinephrine group were successfully discharged (crude RR = 1.08, 95% confidence interval [CI] = 0.92 to 1.26). When adjusted for severity of illness, patients who received albuterol were significantly more likely than patients receiving epinephrine to be successfully discharged (aRR = 1.18, 95% CI = 1.02 to 1.36). This was also true among those with first presentation and in those less than 12 months of age. Conclusions In children up to the 18th month of life, ED treatment of bronchiolitis with nebulized racemic albuterol led to more successful discharges than nebulized epinephrine. ACADEMIC EMERGENCY MEDICINE 2008; 15:305–313 © 2008 by the Society for Academic Emergency Medicine
Adaptive Multi-Resolution Scheme for Efficient Image Compression

CNRS UMR 6164 IETR laboratory / INSA Rennes 20, av des Buttes de Coemes, CS 14315, 35043 Rennes Cedex, France Contact : { odeforge, mbabel, jronsin}@insa-rennes.fr ABSTRACT The LAR (Locally Adaptive Resolution) method is a multi-layers still image coding scheme, efficient from very low to high bit rates. The first stage is devoted to the representation and compression of the global information (low resolution image), and relies on an adaptive resolution in the image. This paper presents some improvements on the first layer through an original quad-tree like decomposition based on a predictive scheme, and the integration of a powerful interpolation post-processing. Comparative results with state of the art compression method are also presented and discussed. Chromatic control1. INTRODUCTION Recent developments in image coding have demonstrated that H.264 appears as the most efficient solution for both video and still image compression [1]. In particular, it can over-class Jpeg2000 at every bit-rates but at the depend of computation time [2]. However, H.264 does not provide a scalable bitstream. The LAR (Locally Adaptive Resolution) method has been originally introduced as a fast method for high compression of gray-level images [3]. Extensions have permitted to address also middle and high quality encoding, automatic reconstruction of a region representation at the decoder allowing both Region Of Interest coding and region-level chromatic images encoding [4]. This paper is organized as follows : section 2 recalls the outlines of the LAR method, wh ile section 3 presents the new advances over the first high compression stage. Some comparative results are given in section 4, and we conclude in section 5. 2. LAR METHOD OVERVIEW One of the main improvements introduced in H.264 is the adaptation to the image content by considering different sizes of block. For Intra-picture mode, flat areas are encoded using 16x16 blocks, whereas more active ones involve 4x4 blocks. Our coding scheme is based on the same principle but declined much further. Indeed, the block size fits the actual local resolution so that a meaningful low resolution image is provided. The LAR method is a two layers codec (Fig. 1) : a spatial and a spectral one. Low bit rate compression can be achieved when considering only the spatial coder. The second layer allows encoding the image texture.
Seeking the supernatural: the Interactive Religious Experience Model

ABSTRACT We develop a new model of how human agency-detection capacities and other socio-cognitive biases are involved in forming religious beliefs. Crucially, we distinguish general religious beliefs (such as God exists) from personal religious beliefs that directly refer to the agent holding the belief or to her peripersonal time and space (such as God appeared to me last night). On our model, people acquire general religious beliefs mostly from their surrounding culture; however, people use agency-intuitions and other low-level experiences to form personal religious beliefs. We call our model the Interactive Religious Experience Model (IREM). IREM inverts received versions of Hyperactive Agency-Detection Device Theory (HADD Theory): instead of saying that agency-intuitions are major causes of religious belief in general, IREM says that general belief in supernatural agents causes people to seek situations that trigger agency-intuitions and other experiences, since these enable one to form personal beliefs about those agents. In addition to developing this model, we (1) present empirical and conceptual difficulties with received versions of HADD Theory, (2) explain how IREM incorporates philosophical work on indexical belief, (3) relate IREM to existing anthropological and psychological research, and (4) propose future empirical research programs based on IREM.
Making Better Use of All Those TCP ACK Packets

An internal combustion engine of the spark ignition type developing a maximum output power at about 8000 rpm includes at least two ignition plugs for each cylinder and projections formed on the inner wall surface of a cylinder head for producing a squishy current. The engine also includes an ignition device including a delay circuit for delaying the ignition time in the high-speed rotation range, to thereby provide improvements in the output power and fuel consumption rate over the entire rotation range.
Cytomegalovirus in the Neonate: Immune Correlates of Infection and Protection

Fetal and neonatal infections caused by human cytomegalovirus (CMV) are important causes of morbidity and occasional mortality. Development of a vaccine against congenital CMV infection is a major public health priority. Vaccine design is currently focused on strategies that aim to elicit neutralizing antibody and T-cell responses, toward the goal of preventing primary or recurrent infection in women of child-bearing age. However, there has been relatively little attention given to understanding the mechanisms of immune protection against acquisition of CMV infection in the fetus and newborn and how this information might be exploited for vaccine design. There has similarly been an insufficient study of what deficits in the immune response to CMV, both for mother and fetus, may increase susceptibility to congenital infection and disease. Protection of the fetus against vertical transmission can likely be achieved by protection of the placenta, which has its own unique immunological milieu, further complicating the analysis of the correlates of protective immunity. In this review, the current state of knowledge about immune effectors of protection against CMV in the maternal, placental, and fetal compartments is reviewed. A better understanding of immune responses that prevent and/or predispose to infection will help in the development of novel vaccine strategies.
Cellular Adaptation Facilitates Sparse and Reliable Coding in Sensory Pathways

Most neurons in peripheral sensory pathways initially respond vigorously when a preferred stimulus is presented, but adapt as stimulation continues. It is unclear how this phenomenon affects stimulus coding in the later stages of sensory processing. Here, we show that a temporally sparse and reliable stimulus representation develops naturally in sequential stages of a sensory network with adapting neurons. As a modeling framework we employ a mean-field approach together with an adaptive population density treatment, accompanied by numerical simulations of spiking neural networks. We find that cellular adaptation plays a critical role in the dynamic reduction of the trial-by-trial variability of cortical spike responses by transiently suppressing self-generated fast fluctuations in the cortical balanced network. This provides an explanation for a widespread cortical phenomenon by a simple mechanism. We further show that in the insect olfactory system cellular adaptation is sufficient to explain the emergence of the temporally sparse and reliable stimulus representation in the mushroom body. Our results reveal a generic, biophysically plausible mechanism that can explain the emergence of a temporally sparse and reliable stimulus representation within a sequential processing architecture.
Self-management counseling in patients with heart failure: the heart failure adherence and retention randomized behavioral trial.

CONTEXT Motivating patients with heart failure to adhere to medical advice has not translated into clinical benefit, but past trials have had methodological limitations. OBJECTIVE To determine the value of self-management counseling plus heart failure education, compared with heart failure education alone, for the primary end point of death or heart failure hospitalization. DESIGN, SETTING, AND PATIENTS The Heart Failure Adherence and Retention Trial (HART), a single-center, multiple-hospital, partially blinded behavioral efficacy randomized controlled trial involving 902 patients with mild to moderate heart failure and reduced or preserved systolic function, randomized from the Chicago metropolitan area between October 2001 and October 2004 and undergoing follow-up for 2 to 3 subsequent years. INTERVENTIONS All patients were offered 18 contacts and 18 heart failure educational tip sheets during the course of 1 year. Patients randomized to the education group received tip sheets in the mail and telephone calls to check comprehension. Patients randomized to the self-management group received tip sheets in groups and were taught self-management skills to implement the advice. MAIN OUTCOME MEASURE Death or heart failure hospitalization during a median of 2.56 years of follow-up. RESULTS Patients were representative of typical clinical populations (mean age, 63.6 years; 47% women, 40% racial/ethnic minority, 52% with annual family income less than $30,000, and 23% with preserved systolic function). The rate of the primary end point in the self-management group was no different from that in the education group (163 [40.1%)] vs 171 [41.2%], respectively; odds ratio, 0.95 [95% confidence interval, 0.72-1.26]). There were no significant differences on any secondary end points, including death, heart failure hospitalization, all-cause hospitalization, or quality of life. CONCLUSIONS Compared with an enhanced educational intervention alone, the addition of self-management counseling did not reduce death or heart failure hospitalization in patients with mild to moderate heart failure. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00018005.
Hierarchical Scheduling for Real-Time Distributed Systems Integrating a Validation Resource and a Performance Metric

The approximation followed here represents a distributed real-time system (DRTS) as a layered model with a real-time scheduler, based on hierarchical scheduling composition, thus providing the DRTS with larger integrity and flexibility. The utilization of a metric is proposed in order to determine the overall system performance, therefore helping with the design and configuration decisions.
Analysis of Two-Media Structures Using Longitudinal Spectrum: Space, Surface, and Zenneck Waves

The longitudinal spectral expansion method is extended to simplify the electromagnetic field analysis in a two-media structure with and without ground plane. A nonconventional Riemann sheet is invoked that clarifies some important characteristics of the fields. For instance, it is straightforward to prove that in a two-media half-space, no surface wave exists for lossless media. However, if a medium is lossy, then a fast surface wave, known as a Zenneck surface wave (ZSW), exists that dominates within a limited radial distance.
On the lowsource power regime of the DS/CDMA relay channel

This paper considers a DS/CDMA relay system where random spreading sequences are employed at the relays to allow multiple access to the channel between relays and destination. Two different protocols are considered and compared, the difference between them being whether the source remains silent or sends new information symbols during the relaying. For both protocols, we provide a low source power approximation for the spectral efficiency when employing, at the destination, either the optimal or the linear minimum mean square error receiver. The new expression is studied for the single relay case to identify under which conditions relaying results convenient over direct source-destination communication. Furthermore, we investigate the optimum percentage of relaying time in order to maximize the global spectral efficiency.
Earnings Quality Measures and Excess Returns

This paper examines how commonly used earnings quality measures fulfill a key objective of financial reporting, i.e., improving decision usefulness for investors. We propose a stock-price-based measure for assessing the quality of earnings quality measures. We predict that firms with higher earnings quality will be less mispriced than other firms. Mispricing is measured by the difference of the mean absolute excess returns of portfolios formed on high and low values of a measure. We examine persistence, predictability, two measures of smoothness, abnormal accruals, accruals quality, earnings response coefficient and value relevance. For a large sample of US non-financial firms over the period 1988–2007, we show that all measures except for smoothness are negatively associated with absolute excess returns, suggesting that smoothness is generally a favorable attribute of earnings. Accruals measures generate the largest spread in absolute excess returns, followed by smoothness and market-based measures. These results lend support to the widespread use of accruals measures as overall measures of earnings quality in the literature.
Validation of the instrument of health literacy competencies for Chinese-speaking health professionals

The study aimed to illustrate the constructs and test the psychometric properties of an instrument of health literacy competencies (IOHLC) for health professionals. A multi-phase questionnaire development method was used to develop the scale. The categorization of the knowledge and practice domains achieved consensus through a modified Delphi process. To reduce the number of items, the 92-item IOHLC was psychometrically evaluated through internal consistency, Rasch modeling, and two-stage factor analysis. In total, 736 practitioners, including nurses, nurse practitioners, health educators, case managers, and dieticians completed the 92-item IOHLC online from May 2012 to January 2013. The final version of the IOHLC covered 9 knowledge items and 40 skill items containing 9 dimensions, with good model fit, and explaining 72% of total variance. All domains had acceptable internal consistency and discriminant validity. The tool in this study is the first to verify health literacy competencies rigorously. Moreover, through psychometric testing, the 49-item IOHLC demonstrates adequate reliability and validity. The IOHLC may serve as a reference for the theoretical and in-service training of Chinese-speaking individuals’ health literacy competencies.
Timescale of variation and the size of the accretion disc in active galactic nuclei

This paper sets out to measure the timescale of quasar variability with a view to new understanding of the size of accretion discs in active galactic nuclei. Previous attempts to measure such timescales have been based on sparsely sampled data covering small ranges of time. Here we combine data from two large scale monitoring programmes to obtain Fourier power spectra of light curves covering nearly three orders of magnitude in frequency in blue and red passbands. If the variations are interpreted as due to gravitational microlensing, then timescale measurements in the observer's frame imply a minimum mass for the microlensing bodies of around $0.4~M_{\odot}$. On the assumption that the variations are intrinsic to the quasars, a correction must be made for time dilation. In this case the power spectrum shows a break corresponding to a timescale of about 11 years. This timescale is used to measure the size of the accretion disc, which is found to be about 10 -2 pc or 10 light days, in agreement with limits set by self-gravitation and coincident with the broad line region of the active galactic nucleus. It is suggested that the broad line region may be associated with the break up of the outer part of the accretion disc.
Biased Thinking in the Face of Uncertainty: Exploring the Process of Diagnostic Decision Making Within the Field of Psychiatry

A considerable amount of medical errors are indicated to occur during the diagnostic process. Various forms of faulty cognition on the part of the physicians have been identified as sources of diagnostic errors, including the susceptibility to several cognitive biases. It is therefore of interest to increase our knowledge of how biases may occur in diagnostic decision making. Our study aims to contribute to this knowledge by investigating the occurrence of anchoring bias, confirmation bias, and unwarranted confidence when making diagnostic decisions under uncertainty. For this purpose, we conducted two experiments on samples of Norwegian medical students (N = 128). The participants were presented with two hypothetical psychiatric cases. Anchoring bias was explored by manipulating presentation of the symptoms featured in the initial vignettes, investigating whether participants locked onto whichever symptoms were presented first when making a preliminary diagnosis. Confirmation bias and corresponding developments in diagnostic confidence were investigated through the participants’ subsequent selections and interpretations of additional information. The results from each experiment did not indicate any occurrence of the three investigated phenomena. The non-findings are discussed in terms of the methodological aspects of the study, shedding light on challenges that may exist when investigating the different phenomena simultaneously. We also discuss the true prevalence and detectability of such biases. Based on our discussions, we make several proposals for how our design may be revised and expanded for future studies.
Subcapsular Hepatic Hematoma After Endoscopic Retrograde Cholangiopancreatography

AbstractEndoscopic retrograde cholangiopancreatography (ERCP) is one of the most frequently performed procedures for the diagnosis and treatment of biliary-pancreatic diseases. ERCP-related complications total around 2.5% to 8%, with a mortality rate ranging from 0.5% to 1%. An exceptional ERCP complication is subcapsular hepatic hematoma, and few cases are reported worldwide.We present the case of a 52-year-old woman with a history of recurring upper abdominal pain and a clinical and ultrasonographic diagnosis of obstructive jaundice due to common bile duct stones. After 2 difficult endoscopic biliary procedures, common bile duct stones clearance was obtained. Post-ERCP course was symptomatic with upper abdominal pain and anemization with hemodynamic instability.CT scan demonstrated a 15 cm × 11 cm subcapsular hepatic hematoma filled with air and liquid on the surface of the right hepatic lobe. The patient was successfully treated with the embolization of a small branch of right hepatic artery angiographically identified as the cause of bleeding.Subcapsular hepatic hematoma after ERCP is a rare complication that must be taken into account in the differential diagnosis of symptomatic cases after ERCP. Its diagnosis is based on clinical and laboratory data and especially on imaging (ultrasound, CT, or MRI). Treatment is often conservative but, in some cases, embolization or percutaneous drainage or surgery may be necessary.
Optimization of In-vitro Permeation Pattern of Ketorolac Tromethamine Transdermal Patches

The present study was undertaken to develop a suitable transdermal matrix patch of ketorolac tromethamine with different proportions of polyvinyl pyrrolidone (PVP) and ethyl cellulose (EC) using a D-optimal mixture design. The prepared transdermal patches were subjected to different physicochemical evaluation. The surfacet opography of the patches was examined by scanning electron microscopy (SEM). The drug-polymer interaction studies were performed using Fourier transform infrared spectroscopic (FTIR) technique. A correlation between in-vitro drug-release and in-vitro skin permeation was established and the criterion of desirability was employed to optimize the formulation. The results of the physicochemical characterization and in-vitro permeation of the prepared patches were promising to formulate transdermal patches with PVP/EC combinations.
Blood culture bottle culture of pleural fluid in pleural infection

Background Pleural infection is common, and has a >30% major morbidity and mortality—particularly when infection is caused by Gram-negative, Staphylococcus aureus or mixed aerobic pathogens. Standard pleural fluid culture is negative in ∼40% of cases. Culturing pleural fluid in blood culture bottles may increase microbial yield, and is cheap and easy to perform. Objectives To determine whether inoculating pleural fluid into blood culture bottles increases the culture positivity of pleural infection over standard laboratory culture, and to assess the optimum volume of inoculum to introduce. Methods 62 patients with pleural infection were enrolled. Pairs of aerobic and anaerobic blood culture bottles were inoculated at the bedside with 2, 5 or 10 ml of pleural fluid, and two pleural fluid specimens were sent for standard culture. Pleural fluid from nine control patients was cultured to test for ‘false-positive’ results. Results The addition of blood culture bottle culture to standard culture increased the proportion of patients with identifiable pathogens by 20.8% (20/53 (37.7%) to 31/53 (58.5%) (difference 20.8%, 95% CI difference 8.9% to 20.8%, p<0.001)). The second standard culture did not similarly improve the culture positivity (19/49 (38.8%) to 22/49 (44.9%) (difference 6.1%, 95% CI difference −2.5% to 6.1%, p=0.08)). The culture inoculum volume did not influence bacterial isolation frequency. The control fluids were culture negative. Conclusions Blood culture bottle culture of infected pleural fluid increases microbial yield when used in addition to standard culture. This technique should be part of routine care.