Miracle-dz/UniFAR-FTUs huggingface dataset:
Improving Capacity Management in the Emergency Department: A Review of the Literature, 2000‐2012

EXECUTIVE SUMMARY Capacity management (CM) is a critical component of maintaining and improving healthcare quality and patient safety. One particular area for concern has been the emergency department and the growing issues of patient overcrowding, boarding, and ambulance diversion, which can result in poor patient care and less efficient operations. This study provides a review of the current and most relevant academic literature on capacity management directly related to hospital emergency departments, identifies strengths and weaknesses of the approaches discussed in the literature, and provides practical recommendations for health services administrators implementing CM in their organizations. An extensive literature search was conducted using several search engines and scholarly databases. Articles were identified based on a combination of keywords and then were reviewed and selected for inclusion in the study in adherence to specified criteria. The CM literature includes a great divergence of themes, topics, and definitions. Twenty‐two articles were selected for their relevance to emergency department CM with a focus on operations management concepts. A categorization scheme was used, resulting in four thematic groups of articles: problems, solutions, outcomes, and metrics. Healthcare managers wishing to implement solutions to CM problems have a wide variety of operations literature to draw on that can address scheduling and patient throughput, but there are also a number of studies that consider electronic and technological solutions to CM problems. All of these solutions have the potential to positively influence the quality of patient care, including satisfaction.
Chronic lymphocytic leukemia: diagnosis and treatment.

Traditionally, the goal of therapy in chronic lymphocytic leukemia (CLL) has been palliative, with first-line therapy using alkylating agents and/or involved field radiotherapy (depending on the stage of disease and sites of involvement) because of the older age of affected patients and the low rate of complete remissions (CRs) with no improvement in overall survival despite treatment. With increasing knowledge about the biology, molecular genetics, and prognostic factors of the disease, the philosophy of care for patients with CLL has evolved from palliation to aiming for a potential cure, especially in younger patients. Furthermore, multiple treatment options have emerged, including purine analogues, monoclonal antibodies, and potentially stem cell transplantation. These have been associated with higher frequencies of CRs and longer durations of responses compared to conventional chemotherapy. In addition, a subset of patients treated with chemoimmunotherapy can achieve durable CRs and molecular remissions. This may translate into improved disease-free survival and potentially a "cure. " Because of the heterogeneous nature of CLL, new prognostic markers are currently being incorporated into clinical trials to determine their role in routine clinical practice. This review summarizes current therapeutic regimens that are being evaluated in patients with CLL and management of disease-related complications.
Outcomes With Intravascular Ultrasound-Guided Stent Implantation: A Meta-Analysis of Randomized Trials in the Era of Drug-Eluting Stents

Background—In the era of drug-eluting stents, it is unknown if intravascular ultrasound (IVUS) guidance for percutaneous coronary intervention should be routinely endorsed. This study aimed to determine if IVUS-guided stent implantation is associated with improved outcomes. Methods and Results—Randomized trials that reported clinical outcomes and compared routine IVUS-guided stent implantation with an angiography-guided approach in the era of drug-eluting stents were included. Summary estimates were constructed primarily using the Peto model. Seven trials with 3192 patients were analyzed. The mean length of the coronary lesions was 32 mm. At a mean of 15 months, routine IVUS-guided percutaneous coronary intervention was associated with a reduction in the risk of major adverse cardiac events (6.5% versus 10.3%; odds ratio, 0.60; 95% confidence interval, 0.46–0.77; P<0.0001), mainly because of reduction in the risk of ischemia-driven target lesion revascularization (4.1% versus 6.6%; odds ratio, 0.60; 95% confidence interval, 0.43–0.84; P=0.003). The risk of cardiovascular mortality (0.5% versus 1.2%; odds ratio, 0.46; 95% confidence interval, 0.21–1.00; P=0.05), and stent thrombosis (0.6% versus 1.3%; odds ratio, 0.49; 95% confidence interval, 0.24–0.99; P=0.04) also appeared to be lower in the IVUS-guided group. Conclusions—In the era of drug-eluting stents for diffuse coronary lesions, IVUS-guided percutaneous coronary intervention is superior to angiography-guided percutaneous coronary intervention in reducing the risk of major adverse cardiac events. This is primarily because of reduction in the risk of ischemia-driven target lesion revascularization. This analysis also suggests that risk of cardiovascular mortality and stent thrombosis might be lower with an IVUS-guided approach.
The Sensitivity of Renal Color Doppler Sonography In Differentiating Obstructive and Nonobstructive Urinary Calculi In Patients With Acute Renal Colic Prospective Study

objective: The purpose of this study was to determine the sensitivity of renal color Doppler sonography in differentiating obstructive and nonobstructive urinary calculi in patients with acute renal colic and to compare findings with nonenhanced helical computed tomography (CT) PATIENTS AND METHODS Between January 2009 and May 2012. Eighty five patients referred to the emergency department of Hilla teaching hospital with acute renal colic underwent nonenhanced CT and renal resistive index (RI) measurement with color pulsed Doppler sonography within 8 to 10 hours of the onset of the symptoms. Computed tomographic evaluation was based on the detection of urolithiasis and the presence of obstruction. The mean RI of each kidney and the difference between the mean RI of both kidneys were calculated and compared with CT findings. RESULTS: Tomography revealed obstruction in 43 patients and nonobstucted in 42 patients . Mean RI values for the obstructive and nonobstructive groups were 0.64 and 0.63, respectively. The differences in the mean RI for the patients with and without obstruction were statistically insignificant (P = .73). No significant relationship was found between the RI values, calculus location, and degree of obstruction. CONCLUSION: No significant relationship was found between the RI and obstruction, obstruction degree, or location. The use of this modality will be time-consuming and ineffective in routine practice. The RI is not sensitive for detection of obstruction in patients with acute renal colic
Behavior-Based Recommender Systems as Value-Added Services for Scientific Libraries

Amazon.com paved the way for several large-scale, behavior-based recommendation services as an important value-added expert advice service for online book shops. In this contribution we discuss the effects (and possible reductions of transaction costs) for such services and investigate how such a value-added service can be implemented in the context of scientific libraries. For this purpose we present a new, recently developed recommender system based on a stochastic purchase incidence model, present the underlying stochastic model from repeat-buying theory and analyze whether the underlying assumptions on consumer behavior hold for users of scientific libraries, too. We have analyzed the logfiles with approximately 85 million http-transactions of the web-based online public access catalog (OPAC) of the library of the Universitat Karlsruhe (TH) since January 2001 and performed some diagnostic checks. A test prototype is already operational and is currently being evaluated. The recommender service will be fully operational within the library system of the Universitat Karlsruhe (TH) by the end of June 2002.
Can we switch microglia's phenotype to foster neuroprotection? Focus on multiple sclerosis

Microglia cells, the resident innate immune cells in the brain, are highly active, extending and retracting highly motile processes through which they continuously survey their microenvironment for ‘danger signals’ and interact dynamically with surrounding cells. Upon sensing changes in their central nervous system microenvironment, microglia become activated, undergoing morphological and functional changes. Microglia activation is not an ‘all‐or‐none’ process, but rather a continuum depending on encountered stimuli, which is expressed through a spectrum of molecular and functional phenotypes ranging from so‐called ‘classically activated’, with a highly pro‐inflammatory profile, to ‘alternatively activated’ associated with a beneficial, less inflammatory, neuroprotective profile. Microglia activation has been demonstrated in most neurological diseases of diverse aetiology and has been implicated as a contributor to neurodegeneration. The possibility to promote microglia’s neuroprotective phenotype has therefore become a therapeutic goal. We have focused our discussion on the role of microglia in multiple sclerosis, a prototype of inflammatory, demyelinating, neurodegenerative disease, and on the effect of currently approved or on‐trial anti‐inflammatory therapeutic strategies that might mediate neuroprotection at least in part through their effect on microglia by modifying their behaviour via a switch of their functional phenotype from a detrimental to a protective one. In addition to pharmaceutical approaches, such as treatment with glatiramer acetate, interferon‐β, fingolimod or dimethyl fumarate, we address the alternative therapeutic approach of treatment with mesenchymal stem cells and their potential role in neuroprotection through their ‘calming’ effect on microglia.
In Vivo Efficacy and Pharmacokinetics of AC98-6446, a Novel Cyclic Glycopeptide, in Experimental Infection Models

ABSTRACT AC98-6446 is a novel semisynthetic derivative of a natural product related to the mannopeptimycins produced by Streptomyces hygroscopicus. Naturally occurring esterified mannopeptimycins exhibited excellent in vitro activity but only moderate in vivo efficacy against staphylococcal infection. The in vivo efficacy and pharmacokinetics of AC98-6446 were investigated in murine acute lethal, bacterial thigh and rat endocarditis infections. Pharmacokinetics were performed in mice, rats, monkeys, and dogs. Acute lethal infections were performed with several gram-positive isolates: Staphylococcus aureus (methicillin-susceptible and methicillin-resistant staphylococci), vancomycin-resistant Enterococcus faecalis, and penicillin-susceptible and -resistant Streptococcus pneumoniae. The 50% effective dose for all isolates tested ranged from 0.05 to 0.39 mg/kg of body weight after intravenous (i.v.) administration. Vancomycin was more than fivefold less efficacious against all of these same infections. Results of the thigh infection with S. aureus showed a static dose for AC98-6446 of 0.4 mg/kg by i.v. administration. Reduction of counts in the thigh of >2 log10 CFU were achieved with doses of 1 mg/kg. i.v. administration of 3 mg/kg twice a day for 3 days resulted in a >3 log10 reduction in bacterial counts of vancomycin-susceptible and -resistant E. faecalis in a rat endocarditis model. Pharmacokinetics of AC98-6446 showed an increase in exposure (area under the concentration-time curve) from mouse to dog species. The i.v. half-life (t1/2) increased threefold between rodents and the higher species dosed. Efficacy of AC98-6446 has been demonstrated in several models of infection with resistant gram-positive pathogens. This glycopeptide exhibited bactericidal activity in these models, resulting in efficacy at low doses with reduction in bacterial load.
Política 2.0: Internet y el trabajo de los partidos

Internet tiene cada vez mas importancia, mientras que las formas de compromiso politico se transforman: la militancia tal como la conociamos esta en retirada y en muchos casos los compromisos son menos durables y a menudo virtuales. En este contexto, si bien los partidos han ido adaptando sus estructuras a las nuevas realidades (incluyendo el microtargeting en las campanas), en la mayor parte de los casos, las acciones son reactivas. Los partidos tradicionales tienden mas a seguir modas que a imponer tendencias.
An Answer Extraction Method of Simple Question Based on Web Knowledge Library

The answer extraction is an important step in Q&A System and other fields of the Natural Language Processing; the result of answer extraction is directly associated with the quality of Q&A System. In this paper, the method, answer extraction of simple question based on web knowledge library, is realized through computing the similarity of simple question; the question with the most similarity is used as the recommended answer, and questions that the similarity is above 0.5 are used as candidate answers. Experiment shows that the method is feasible, and the accuracy rate is 79.8%. The result of experiment shows that the system is significant for simple informative questions, and the MRR value of tested FAQ is 0.50.
The Arginine-Rich Domains Present in Human Immunodeficiency Virus Type 1 Tat and Rev Function as Direct Importin β-Dependent Nuclear Localization Signals

ABSTRACT Protein nuclear import is generally mediated by basic nuclear localization signals (NLSs) that serve as targets for the importin α (Imp α) NLS receptor. Imp α is in turn bound by importin β (Imp β), which targets the resultant protein complex to the nucleus. Here, we report that the arginine-rich NLS sequences present in the human immunodeficiency virus type 1 regulatory proteins Tat and Rev fail to interact with Imp α and instead bind directly to Imp β. Using in vitro nuclear import assays, we demonstrate that Imp α is entirely dispensable for Tat and Rev nuclear import. In contrast, Imp β proved both sufficient and necessary, in that other β-like import factors, such as transportin, were unable to support Tat or Rev nuclear import. Using in vitro competition assays, it was demonstrated that the target sites on Imp β for Imp α, Tat, and Rev binding either are identical or at least overlap. The interaction of Tat and Rev with Imp β is also similar to Imp α binding in that it is inhibited by RanGTP but not RanGDP, a finding that may in part explain why the interaction of the Rev nuclear RNA export factor with target RNA species is efficient in the cell nucleus yet is released in the cytoplasm. Together, these studies define a novel class of arginine-rich NLS sequences that are direct targets for Imp β and that therefore function independently of Imp α.
Semi-automatic Annotation Tool for Medieval Manuscripts

Medieval manuscript layouts are quite complex. They contain textual elements such as insertions, annotations, and corrections. They may be richly decorated with ornaments, illustrations, and decorative initials making their layout even more complex. In this paper we describe a semi-automatic tool which annotates medieval manuscripts using our generic format. This format allows to represent the physical structure of such manuscripts. Our semi-automatic tool is composed of two parts. The first part achieves a layout analysis which automatically segments manuscripts into text blocks and text lines. That is, a Multi-Layer Perceptron (MLP) identifies layout elements by using color features, it extracts the textual content image of the manuscript. Then, a segmentation based on Connected Component (CC) is performed on the textual content in order to retrieve text blocks and lines. The second part provides an interactive interface allowing the user to customize the automatic analysis, to visualize its results, and to correct them. Our tool is still a prototype, nevertheless, first experiments give encouraging results. Thus, in this paper, we show how to generate a ground truth for medieval manuscripts layouts.
The physiological effects of hydrostatic pressure are not equivalent to those of helium pressure on Rana pipiens.

The effects of helium pressure and hydrostatic pressure on Rana pipiens were compared. Both agents caused paralysis at pressures greater than 135 atmospheres (1 atm = 101.325 kPa), but the median pressure for hydrostatic‐pressure‐induced paralysis was 35 atm less than that for helium pressure. When the ability of both pressurizing agents to reverse urethane‐induced anaesthesia was compared, it was found that hydrostatic pressure raised the median dose for anaesthesia 2.2‐fold more per atmosphere than did helium pressure. Animals that were lightly anaesthetized by urethane at 110 atm hydrostatic pressure became more deeply anaesthetized when helium was admitted isobarically into the pressure chamber. This difference in depth of anaesthesia between hydrostatic pressure and helium pressure is consistent with helium possessing an inherent anaesthetic effect. The abilities of other gases to pressure‐reverse urethane anaesthesia were also determined. The degree of attenuation of the full pressure reversal effect observed with hydrostatic pressure was proportional to the lipid solubility of the gases, increasing in the order helium, neon, hydrogen, nitrogen and argon. Our data on the difference between hydrostatic and helium pressure are consistent with the critical volume hypothesis.
ELECTROCARDIOGRAM DIAGNOSIS USING HYBRID CASE-BASED REASONING

ABSTRACT This paper proposes a hybrid architecture that combines correlation dimension and feature extraction techniques into the case-based reasoning (CBR) technique to do electrocardiogram (ECG) diagnosis. CBR is used in the system as the core problem-solving method, which applies the expert experience to analyze ECG and propose diagnosis. The correlation dimension values of ECGs are used for clustering of cases for CBR. A Min-Max Turning Points Selection (MTPS) algorithm is used to quickly extract turning points from an ECG waveform as wave features for retrieval of the most promising solution cases from a specific cluster of cases. Finally, the CBR can learn representative cases from the problem-solving process by an approximation-based training method. This hybrid architecture manifests several interesting features. First, high-quality representative cases can be effectively learned, thanks to the correlation dimension values-based clustering and approximation-based training methods. This feature not only reduces the number of cases needed to be stored in the case library, but improves the correctness of the proposed solutions. Second, the proposed MTPS algorithm for extraction of turning points is fast, simple, and noise-tolerant, which helps a lot in the calculation of similarity among cases. Finally, the clustering algorithm can automatically re-cluster the cases in the case library in response to new diseases, which prevents our system from degradation due to the increase of new cases. Our experiments with the MIT-BIH arrhythmia database demonstrate that the architecture has very high sensitivity and specificity, as well as speedy response.
Flow Cytometry Analysis of Murine B Cell Lymphoma Differentiation

The differentiation of lymphoid cells is a process that is fundamentally associated with the expression of all types of immune responses. Since the initial recognition of two distinct lineages of lymphoid cells in birds (Wamer et al. 1962) and mammals (Miller & Mitchell 1969, Claman & Chaperon 1969, Davies 1969), it has become increasingly evident that these two major streams of lymphocyte differentiation can become further separated into divergent pathways which lead to cells having distinctly different functional roles in the immune response. This concept has been most clearly defined in terms of T cell differentiation, in which distinct functional subpopulations of T cells mediate the different T cell activities of help, suppression, delayed sensitivity, certain alloreactivities, cytotoxicity and initiator amplifier functions (see reviews Cantor & Boyse 1976, 1977). This characterization of T cells into distinct functional subpopulations, has been shown to be associated with distinct
Fast, Antigen-Saving Multiplex Immunoassay To Determine Levels and Avidity of Mouse Serum Antibodies to Pertussis, Diphtheria, and Tetanus Antigens

ABSTRACT To enhance preclinical evaluation of serological immune responses to the individual diphtheria, tetanus, and pertussis (DTP) components of DTP combination vaccines, a fast hexavalent bead-based method was developed. This multiplex immunoassay (MIA) can simultaneously determine levels of specific mouse serum IgG antibodies to P antigens P.69 pertactin (P.69 Prn), filamentous hemagglutinin (FHA), pertussis toxin (Ptx), and combined fimbria type 2 and 3 antigens (Fim2/3) and to diphtheria toxin (Dtx) and tetanus toxin (TT) in a single well. The mouse DTP MIA was shown to be specific and sensitive and to correlate with the six single in-house enzyme-linked immunosorbent assays (ELISAs) for all antigens. Moreover, the MIA was expanded to include avidity measurements of DTP antigens in a multivalent manner. The sensitivities of the mouse DTP avidity MIA per antigen were comparable to those of the six individual in-house avidity ELISAs, and good correlations between IgG concentrations obtained by both methods for all antigens tested were shown. The regular and avidity mouse DTP MIAs were reproducible, with good intra- and interassay coefficients of variability (CV) for all antigens. Finally, the usefulness of the assay was demonstrated in a longitudinal study of the development and avidity maturation of specific IgG antibodies in mice having received different DTP vaccines. We conclude that the hexaplex mouse DTP MIA is a specific, sensitive, and high-throughput alternative for ELISA to investigate the quantity and quality of serological responses to DTP antigens in preclinical vaccine studies.
Identification of vaccine candidate antigens of Staphylococcus aureus by serological proteome analysis

In this study we applied serological proteome analysis (Klade, C. S. et al. Proteomics 2001, 1, 890–898) for identification of bacterial vaccine candidate antigens. First, approximately one hundred sera from healthy individuals and patients suffering from Staphylococcus aureus infections were screened for antibodies against staphylococcal lysates and recombinant proteins representing surface antigens. Two pools (healthy donors, patients) each consisting of five sera with the highest antiproteinaceous IgG reactivity were selected. Second, S. aureus COL was grown under different conditions and the number of antigens expressed was monitored by Western blot analysis. Third, surface proteins were enriched by digesting the bacterial cell wall under isotonic conditions and subsequent removal of protoplasts. These protein preparations were resolved by two‐dimensional electrophoresis (2‐DE) (pI 4–7). 2‐DE immunoblotting using the preselected serum pools at 1:10 000–1:100 000 dilutions revealed a number of highly immunogenic staphylococcal proteins. Twenty‐one spots were isolated by preparative 2‐DE, and analysed by matrix‐assisted laser desorption/ionization mass spectrometry and tandem mass spectrometry sequencing of tryptic peptides. This led to the identification of 15 proteins including known and novel vaccine candidates. Seroreactivity of several antigens including serine‐aspartate repeat containing protein D, immuno‐dominant staphylococcal antigen and a novel 309 amino acid lipoprotein was independently confirmed by enzyme‐linked immunosorbent assay and Western blot analysis of purified recombinant proteins. In conclusion, serological proteome analysis proved to be a powerful tool for the identification of novel staphylococcal antigens, which provide a basis for rational vaccine design.