Miracle-dz/UniFAR-FTUs huggingface dataset:
Endobronchial ultrasound-guided transbronchial needle aspiration of undiagnosed mediastinal lymphadenopathy.

BACKGROUND Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) can sample the enlarged mediastinal lymph nodes which are unreachable by conventional bronchoscopy. It is a relatively simple and safe method to see beyond the bronchial tree. We describe and discuss its initial application and our experience. METHODS From July 2009 to December 2009, 52 patients with undiagnosed enlarged mediastinal lymph nodes were accessed with EBUS-TBNA in the People's Liberation Army General Hospital. Conventional bronchoscopy was performed before EBUS-TBNA, and patients with endobronchial lesions were excluded from this study. Smears fixed in 95% alcohol and histological specimens fixed in formalin were sent to Department of Pathology. RESULTS EBUS-TBNA was diagnostic in 33 (63%) patients, with diagnosis of lung cancer in 23 patients (14 patients of small cell lung cancer, eight patients with adenocarcinoma, and one patient of squamous carcinoma). Four patients, who had negative EBUS-TBNA results, were later diagnosed with malignancy at thoracotomy. One patient with negative EBUS-TBNA results died of cancer cachexia. The sensitivity, specificity, and positive and negative predictive value of EBUS-TBNA for the diagnosis of neoplastic disease were 85%, 100%, 100%, and 50% respectively. Among the 16 sarcoidosis patients, who were diagnosed by a combination of the clinical and radiological information as well as pathological results obtained by EBUS-TBNA, nine of them had granulomas and benign lymphoid cells detected by EBUS-TBNA. The sensitivity, specificity, and positive and negative predictive value of EBUS-TBNA for the diagnosis of sarcoidosis were 56%, 100%, 100%, and 13%, respectively. Five patients with no definite diagnosis from EBUS-TNBA examination are under close follow-up. CONCLUSIONS EBUS-TBNA can provide a safe and effective method to sample mediastinal leisions suspected of malignancy. It also adds pathological information needed to make the diagnosis of sarcoidosis.
The effect of the heights and thicknesses of the remaining root segments on buccal bone resorption in the socket‐shield technique: An experimental study in dogs

BACKGROUND To date only a few studies have been done on the use of the socket-shield technique for preserving the resorption of the buccal bone in aesthetically sensitive sites. Besides, there have been no further studies on the effect of the heights and thicknesses of the remaining root segments on buccal bone resorption when using this method. PURPOSE The aim of this study was to evaluate the effect of different heights and thicknesses of the remaining root segments on bone resorption in the socket-shield technique. MATERIALS AND METHODS Four healthy female beagle dogs were used in this study. The third premolar (P3) and the fourth premolar (P4) on both sides of the mandible were hemisected in the buccal-lingual direction, and the clinical crown of the distal root was beheaded. In the experimental groups, the roots were worn down in the apical direction until they were located at the buccal crestal level (Group A) or 1 mm higher than that level (Group B). In the control group, the distal root segments were extracted. Then, implant placement was performed into the distal root. After 3 months of healing, the specimens were prepared for histological diagnosis. RESULTS There was no difference between Group A and Group B when using the socket-shield technique, but the results of both groups were better than those of the control group. CONCLUSIONS The height of the root segments has little effect on the bone absorption of alveolar bone, while the bone absorption was strongly influenced by the thickness of the root segments. More precisely, the absorption may decrease if the thickness of the root fragment increases, when the thickness of the root plate is in the 0.5-1.5 mm range.
Age and other risk factors for corneal infiltrative and inflammatory events in young soft contact lens wearers from the Contact Lens Assessment in Youth (CLAY) study.

PURPOSE To describe age and other risk factors for corneal infiltrative and inflammatory events (CIEs) in young, soft contact lens (SCL) wearers and to model the age-related risk. METHODS A multicenter, retrospective chart review of 3549 SCL wearers (8-33 years at first observed visit, +8.00 to -12.00D, oversampling <18 years) captured CIEs from January 2006 to September 2009. The review noted age, sex, SCL worn, use of lens care products, and SCL wearing history. Event diagnoses were adjudicated to consensus by reviewers masked to wearer identity, age, and SCL parameters. Significant univariate risk factors for CIEs were subsequently tested in multivariate generalized estimating equations. RESULTS Charts from 14,305 visits observing 4,663 SCL years yielded 187 CIEs in 168 wearers. Age was a significant nonlinear risk factor, peaking between 15 and 25 years (P < 0.008). Less than 1 year of SCL use was protective versus longer years of wear (P < 0.0003). Use of multipurpose care products (2.86×), silicone hydrogels (1.85×), and extended wear (2.37×) were significantly associated with CIEs in the multivariate model (P < 0.0001 each). CONCLUSIONS Patient age, years of lens wear, use of multipurpose care products, silicone hydrogels, and extended wear were all significantly associated with CIEs with SCL wear. Use of SCLs in young patients aged 8 to 15 years was associated with a lower risk of infiltrative events compared with teens and young adults. In terms of safety outcomes, SCLs appear to be an acceptable method of delivering optics designed to manage myopia progression in children and young teens in the future.
Industry- and firm-level determinants of employment relations in China: a two-level analysis

Abstract Factors influencing the adoption of human resource management (HRM) policies and practices are nested within the multilevel contexts of firms and industries. Institutional theory focuses on environmental pressure and suggests that an organization’s choice of an HR system is partly attributable to mimetic isomorphism. This paper contributes to the strategic HRM literature by estimating the relative effects of industry-level isomorphism and firm-level contingencies on employers’ choice of labor contracts. Drawing on different theoretical perspectives, this study examines multilevel environmental and organizational factors as determinants of HR systems and tests their impacts on the use of short-term labor contracts and weighted average labor contract duration, using a survey of 313 manufacturing plants in China. Utilizing a hierarchical linear model, our analysis shows that while most of the variance in HR systems occurred at the firm level, approximately 7% of the total variance in the four HR programs we studied are explained by industry-level factors. Findings suggest that international competitive pressure, capital intensity, firm size, unionization and ownership type have significant effects on use of labor contracts in a manufacturing context.
INSIDER TRADING: COMO A CVM ATUOU ENTRE 2000 E 2013 PARA INIBIR ESSA PRÁTICA?

The practice of insider trading – the undue use of privileged information to gain an advantage, for either oneself or others, by way of the purchase or sale of securities – is considered illegal in many countries, including Brazil, which charges the Comissao de Valores Mobiliarios (CVM) with the investigation and sentencing of such crimes. The objective of this study is the identification of how the CVM acted to deter the practice of insider trading in Brazil from 2000-13. In order to achieve this, analysis was carried out on each of the Administrative Sanctioning Cases (PAS) brought before the CVM during the years in question that were based on allegations of insider trading. Thirty-nine cases involving the crime of insider trading were found, all undergoing regular procedures, involving 201 suspects. In total, more than R$51 million in penalties were imposed by the CVM as a punishment for the individuals that made undue use of privileged information. Finally, the study concludes that this practice must be combated, chiefly in light of the need to ensure the credibility of the securities market before investors. Further, new mechanisms stand to assist investigations carried out by the CVM, such as financial incentives for whistleblowers in cases of undue use of privileged information, itself currently seen in practice in the United States.
Molecular ecology studies of species radiations: current research gaps, opportunities and challenges

Understanding the drivers and limits of species radiations is a crucial goal of evolutionary genetics and molecular ecology, yet research on this topic has been hampered by the notorious difficulty of connecting micro‐ and macroevolutionary approaches to studying the drivers of diversification. To chart the current research gaps, opportunities and challenges of molecular ecology approaches to studying radiations, we examine the literature in the journal Molecular Ecology and revisit recent high‐profile examples of evolutionary genomic research on radiations. We find that available studies of radiations are highly unevenly distributed among taxa, with many ecologically important and species‐rich organismal groups remaining severely understudied, including arthropods, plants and fungi. Most studies employed molecular methods suitable over either short or long evolutionary time scales, such as microsatellites or restriction site‐associated DNA sequencing (RAD‐seq) in the former case and conventional amplicon sequencing of organellar DNA in the latter. The potential of molecular ecology studies to address and resolve patterns and processes around the species level in radiating groups of taxa is currently limited primarily by sample size and a dearth of information on radiating nuclear genomes as opposed to organellar ones. Based on our literature survey and personal experience, we suggest possible ways forward in the coming years. We touch on the potential and current limitations of whole‐genome sequencing (WGS) in studies of radiations. We suggest that WGS and targeted (‘capture’) resequencing emerge as the methods of choice for scaling up the sampling of populations, species and genomes, including currently understudied organismal groups and the genes or regulatory elements expected to matter most to species radiations.
Research on the Provider Contribution to Race/Ethnicity Disparities in Medical Care

Objective. Little is known about why black patients and other ethnic/racial minorities are less likely to receive the best treatments independent of clinical appropriateness, payer, and treatment site. Although both provider and patient behavior have been suggested as possible explanatory factors, the potential role of provider behavior has remained largely unexplored. Does provider behavior contribute to systematic inequities? If so, why? The purpose of this paper is to build on existing evidence to provide an integrated, coherent, and sound approach to future research on the provider contribution to race/ethnicity disparities in medical care. First, the existing evidence suggestive of a provider contribution to race/ethnicity variance in medical care is discussed. Second, a proposed causal model, based on a review of the social cognition and provider behavior literature, representing an integrated set of hypothesized mechanisms through which physician behavior may contribute to race/ethnicity disparities in care is presented. Conclusion. There is sufficient evidence for the hypothesis that provider behavior contributes to race/ethnicity disparities in care to warrant further study. Although there is some evidence of support of the hypotheses that both provider beliefs about of patients and provider behavior during encounters are independently influenced by patient race/ethnicity further systematic rigorous study is needed and is proposed as a major immediate research priority. These mechanisms deserve intensive research focus as they may prove to be the most promising targets for interventions intended to ameliorate the provider contribution to disparities in care.
A Formative Approach to Student Remediation

Nursing instructors strive to use the most effective means when remediating students who are failing to meet clinical course objectives in clinical and practicum courses. Building on teaching and learning theory, the authors critically analyze the merits of using a simulation framework and a clinical judgment rubric as tools to create an effective formative remedial strategy to support student learning. Suggestions for future research and implications for faculty practice are included.
Is impaired renal function a contraindication to the use of low-molecular-weight heparin?

BACKGROUND Because of the risk of accumulation of anticoagulant effect, it has been suggested that patients with a creatinine clearance of 30 mL/min or less (< or =0.50 mL/s) should be excluded from treatment with low-molecular-weight (LMW) heparin, or have anti-factor Xa heparin level monitoring performed. OBJECTIVE To assess the appropriateness of this recommendation. METHODS We performed a systematic search of MEDLINE, EMBASE, and International Pharmaceutical Abstracts to identify prospective articles comparing differences in the pharmacokinetics of LMW heparins in nondialyzed patients with varying degrees of renal function. Reference lists of retrieved reports were checked for additional articles. RESULTS Three single-dose pharmacokinetic trials and 2 multiple-dose deep vein thrombosis (treatment trials met our selection criteria. The 3 trials that could address our primary objective did not support the use of a 30-mL/min (0.50-mL/s) cutoff of creatinine clearance to select individuals at risk of accumulation when LMW heparin is used. Four of the 5 trials support the notion that anti-factor Xa activity of some LMW heparin preparations accumulates in patients with impaired creatinine clearance. Tinzaparin sodium, an LMW heparin with a higher-than-average molecular weight distribution, appears to be the exception, since it did not exhibit accumulation in patients with creatinine clearances as low as 20 mL/min (0.33 mL/s). CONCLUSIONS The use of a 30-mL/min (0.50-mL/s) cutoff is not justified, on the basis of currently available evidence, to select individuals at increased risk of accumulation when LMW heparin is used. The pharmacokinetic response to impaired renal function may differ among LMW heparin preparations.
Pulmonary system limitations to endurance exercise performance in humans

Accumulating evidence over the past 25 years depicts the healthy pulmonary system as a limiting factor of whole‐body endurance exercise performance. This brief overview emphasizes three respiratory system‐related mechanisms which impair O2 transport to the locomotor musculature [arterial O2 content ( ) × leg blood flow ( )], i.e. the key determinant of an individual's aerobic capacity and ability to resist fatigue. First, the respiratory system often fails to prevent arterial desaturation substantially below resting values and thus compromises . Especially susceptible to this threat to convective O2 transport are well‐trained endurance athletes characterized by high metabolic and ventilatory demands and, probably due to anatomical and morphological gender differences, active women. Second, fatiguing respiratory muscle work (Wresp) associated with strenuous exercise elicits sympathetically mediated vasoconstriction in limb‐muscle vasculature, which compromises . This impact on limb O2 transport is independent of fitness level and affects all individuals, but only during sustained, high‐intensity endurance exercise performed above ∼85% maximal oxygen uptake. Third, excessive fluctuations in intrathoracic pressures accompanying Wresp can limit cardiac output and therefore . Exposure to altitude exacerbates the respiratory system limitations observed at sea level, further reducing and substantially increasing exercise‐induced Wresp. Taken together, the intact pulmonary system of healthy endurance athletes impairs locomotor muscle O2 transport during strenuous exercise by failing to ensure optimal arterial oxygenation and compromising . This respiratory system‐related impact exacerbates the exercise‐induced development of fatigue and compromises endurance performance.
Hydrogen photoproduction by use of photosynthetic organisms and biomimetic systems

Hydrogen can be important clean fuel for future. Among different technologies for hydrogen production, oxygenic natural and artificial photosyntheses using direct photochemistry in synthetic complexes have a great potential to produce hydrogen, since both use clean and cheap sources: water and solar energy. Artificial photosynthesis is one way to produce hydrogen from water using sunlight by employing biomimetic complexes. However, splitting of water into protons and oxygen is energetically demanding and chemically difficult. In oxygenic photosynthetic microorganisms such as algae and cyanobacteria, water is split into electrons and protons, which during primary photosynthetic process are redirected by photosynthetic electron transport chain, and ferredoxin, to the hydrogen-producing enzymes hydrogenase or nitrogenase. By these enzymes, e^− and H^+ recombine and form gaseous hydrogen. Biohydrogen activity of hydrogenase can be very high but it is extremely sensitive to photosynthetic O_2. In contrast, nitrogenase is insensitive to O_2, but has lower activity. At the moment, the efficiency of biohydrogen production is low. However, theoretical expectations suggest that the rates of photon conversion efficiency for H_2 bioproduction can be high enough (>10%). Our review examines the main pathways of H_2 photoproduction by using of photosynthetic organisms and biomimetic photosynthetic systems.
Selective PPAR modulators, dual and pan PPAR agonists: multimodal drugs for the treatment of Type 2 diabetes and atherosclerosis

More than 70% of patients with Type 2 diabetes mellitus (T2DM) die because of cardiovascular diseases. Current therapeutic strategies are based on separate treatment of insulin resistance and dyslipidaemia. Development of drugs with multimodal activities should improve management of the global cardiovascular risk of T2DM patients and result in better patient compliance. New therapeutic strategies are aimed at targeting the entire spectrum of dysfunctioning organs, cells and regulatory pathways implicated in the pathogenesis of T2DM, dyslipidaemia and atherosclerosis. PPAR family members play major roles in the regulation of lipid metabolism, glucose homeostasis and inflammatory processes, making these transcription factors ideal targets for therapeutic strategies against these diseases. This review discusses why PPARs and development of novel selective PPAR modulators, dual and pan PPAR agonists constitute promising approaches for the treatment of diabetes, dyslipidaemia and atherosclerosis.
Factors associated with attitudes toward the elderly in a sample of elderly caregivers

ABSTRACT Background: The number of elderly caregivers is increasing in the world. It is important to know the attitudes toward the elderly, because they can influence a range of behaviors. Our aim was to determine factors associated with attitudes toward the elderly in a sample of older carers. Methods: Three hundred and thirteen elderly caregivers (75.4% women, mean age 69.7 ± 7.1) who cared for a dependent older person at home completed a cross-sectional household interview. In addition to the four domains of the Neri Scale to Assess Attitudes Toward the Elderly, participants were evaluated regarding the demographics, care recipient (CR) characteristics, functional and cognitive status, general health, life satisfaction, perceived stress, and depressive symptoms. Results: Overall, attitudes toward the elderly were neutral in this sample. More negative attitudes in some Neri Scale domains were associated with being older, living in an urban setting, taking more medications per day, caring for an elderly dependent in basic Activities of Daily Living (ADLs), being “more or less” satisfied with life, and having higher levels of perceived stress. There was a negative association between positive attitudes and educational level. Conclusions: The results highlight the need for public policies to promote more positive attitudes toward aging and change negative stereotypes usually used to designate older people. These public policies can try to modify some predictors of negative attitudes, such as perceived stress, which was associated with all four domains of Neri Scale.
Clinical Evaluation of Recombinant Human Platelet-Derived Growth Factor for the Treatment of Lower Extremity Ulcers

Background: Diabetic foot ulcer is a major health care problem that leads to amputation. Methods: Patients with full-thickness diabetic neurotrophic foot ulcers present for longer than 8 weeks without healing were entered into one of five randomized, prospective, blinded clinical trials comparing treatment with platelet-derived growth factor (PDGF) or placebo gel for up to 20 weeks. The purpose of these trials was to assess the safety and efficacy of PDGF used with good wound care. Each patient had an adequate arterial blood supply, was free of infection, was off-loaded, and was extensively débrided. The ulcers had been present for at least 8 weeks. Results: A total of 922 patients were entered into the study. Analysis of ulcers with a baseline area of less than 10 cm2 (95 percent of patients) showed that patients treated with PDGF at 100 μg/g had a significant increase in complete healing compared with patients given placebo (50 percent versus 36 percent, p < 0.007). PDGF also decreased the time to complete healing by 30 percent (14 weeks versus 20 weeks, p = 0.01). Adverse events were similar in both treatment groups, as were recurrent ulcer rates. Conclusion: PDGF applied once daily was effective in healing chronic diabetic neurotrophic foot ulcers when used in conjunction with good wound care.
3D Modeling and Section Properties of Ancient Irregular Timber Structures by Means of Digital Photogrammetry

Abstract: This article deals with the application of low‐cost Close Range Digital Photogrammetry to obtain an accurate three‐dimensional (3D) re‐construction of irregular geometry structures in the field of building construction, with special attention to the evaluation of old structures. Photogrammetry can be used as a non‐destructive tool to give precise 3D information about the size and shape of some elements of a structure, quickly and with no risk to the surveyors. The geometric data achieved can be used by engineers and architects to obtain the section properties, and also to estimate the influence of geometric variations in the distribution of stress. This allows us to compare areas subject to higher stress, and could be of special interest regarding some historic and cultural heritage constructions—such as the timber roof structure included as a case study in this work—from two points of view: On the one hand, Photogrammetry makes it possible to obtain precise 3D models of highly irregular elements, as old timber purlines and trusses in the case of ancient constructions; on the other, Photogrammetry is a non‐contact method that minimizes the measurement time and allows us to obtain the section properties, which can be used together with some material testing characterization to evaluate the structural safety of the construction.
A general class of recapture models based on the conditional capture probabilities

We propose an Mhotb model for population size estimation in capture‐recapture studies. The tb part is based on equality constraints for the conditional capture probabilities, leading to an extremely rich model class. Observed and unobserved heterogeneity are dealt with by means of a logistic parameterization. In order to explore the model class, we introduce a penalized version of the likelihood. The conditional likelihood and penalized conditional likelihood are maximized by means of efficient EM algorithms. Simulations and two real data examples illustrate the approach.