Miracle-dz/UniFAR-FTUs huggingface dataset:
Using On-scene EMS Responders’ Assessment and Electronic Patient Care Records to Evaluate the Suitability of EMD-triaged, Low-acuity Calls for Secondary Nurse Triage in 911 Centers

Abstract Introduction Using the Medical Priority Dispatch System (MPDS) – a systematic 911 triage process – to identify a large subset of low-acuity patients for secondary nurse triage in the 911 center is a largely unstudied practice in North America. This study examines the ALPHA-level subset of low-acuity patients in the MPDS to determine the suitability of these patients for secondary triage by evaluating vital signs and necessity of lights-and-siren transport, as determined by attending Emergency Medical Services (EMS) ambulance crews. Objectives The primary objective of this study was to determine the clinical status of MPDS ALPHA-level (low-acuity) patients, as determined by on-scene EMS crews’ patient care records, in two US agencies. A secondary objective was to determine which ALPHA-level codes are suitable candidates for secondary triage by a trained Emergency Communication Nurse (ECN). Methods In this retrospective study, one full year (2013) of both dispatch data and EMS patient records data, associated with all calls coded at the ALPHA-level (low-acuity) in the dispatch protocol, were collected. The primary outcome measure was the number and percentage of ALPHA-level codes categorized as low-acuity, moderate-acuity, high-acuity, and critical using four common vital signs to assign these categories: systolic blood pressure (SBP), pulse rate (PR), oxygen saturation (SpO2), and Glasgow Coma Score (GCS). Vital sign data were obtained from ambulance crew electronic patient care records (ePCRs). The secondary endpoint was the number and percentage of ALPHA-level codes that received a “hot” (lights-and-siren) transport. Results Out of 19,300 cases, 16,763 (86.9%) were included in the final analysis, after excluding cases from health care providers and those with missing data. Of those, 89% of all cases did not have even one vital sign indicator of unstable patient status (high or critical vital sign). Of all cases, only 1.1% were transported lights-and-siren. Conclusion With the exception of the low-acuity, ALPHA-level seizure cases, the ALPHA-level patients are suitable to transfer for secondary triage in a best-practices, accredited, emergency medical dispatch center that utilizes the MPDS at very high compliance rates. The secondary nurse triage process should identify the few at-risk patients that exist in the low-acuity calls. ScottG, ClawsonJ, FivazMC, McQueenJ, GardettMI, SchultzB, YoungquistS, OlolaCHO. Using on-scene EMS responders’ assessment and electronic patient care records to evaluate the suitability of EMD-triaged, low-acuity calls for secondary nurse triage in 911 centers. Prehosp Disaster Med. 2016;31(1):46–57.
Association of microRNA‐34a overexpression with proliferation is cell type‐dependent

Recently Welch et al. reported that microRNA (miRNA)‐34a functions as a potential tumor suppressor in neuroblastoma cells (Oncogene 26: 5017–22, 2007). Here, we conversely show that miRNA‐34a supports cell proliferation in rat oxidative stress‐induced renal carcinogenesis and is overexpressed in various types of human cancers. While searching for genetically unstable chromosomal areas in rat renal carcinogenesis, we found the miRNA‐34 family reciprocally overexpressed in chromosomal areas with frequent allelic loss. By in situ hybridization and reverse transcription‐polymerase chain reaction, cerebral neurons and Purkinje cells showed the highest expression of a major type, miRNA‐34a, followed by a variety of endocrine cells and proliferating cells including germinal center lymphocytes and mouse embryonic fibroblasts and stem cells. In contrast, normal renal tubules, hepatocytes and myocardial cells showed faint expression. After 3 weeks of ferric nitrilotriacetate (Fe‐NTA)‐induced oxidative stress, regenerating renal proximal tubular cells showed high miRNA‐34a expression. All of the Fe‐NTA‐induced rat renal carcinomas and an array of human cancers (151 positive cases of 177) showed high expression of miRNA‐34a. Furthermore, knockdown of miRNA‐34a with small interfering RNA significantly suppressed proliferation not only of renal carcinoma cells but also of HeLa and MCF7 cells. These results indicate that miRNA‐34a overexpression, an acquired trait during carcinogenesis, supports cell proliferation in the majority of cancers suggesting an unexpected link in the cellular metabolism between cancer and neuronal and/or endocrine cells, which warrants further investigation. (Cancer Sci 2007; 98: 1845–1852)
Morphological Development of the Gastrointestinal Tract Of Helmeted Guinea Fowl (Numida meleagris) at Pre-Hatch and Post-Hatch.

This study was conducted to inves- tigate the morphological develop- ment of the Helmeted Guinea fowl (Numida meleagris) gastrointestinal tract pre- and post-hatch. Eighty seven (87) eggs were purchased from the Poultry unit of National Veterinary Research Institute (NVRI), out of which eighty one (81) were used for pre-hatch and six (6) were allowed to hatch for post hatch studies. The development was rec- orded daily at pre-hatch while it was observed at day 1 and 8 at post- hatch. The result revealed that at day 8 of incubation a digestive tube appeared with a roundish structure in the middle of the tube. By day 10 of incubation, a dilatation had ap- peared cranial to the roundish structure identified as the proventriculus. At the same time a small outgrowth appeared at the caudal end of the tube also identified as one of the caeca. By day 11 of incubation, the crop had appeared separating the oesophagus into cervical and thoracic parts, respectively. By days 12 and 13 of incubation the second caecum and the duodenal loop became apparent. With the appear- ance of the duodenal loop, the gross anatomical development of the guinea fowl GIT was completed. The residual yolk decreased with age until it became vestigial by day 8 post-hatch. This study revealed that days 8-13 of incubation are the most critical period for the gross formation of the GIT in the guinea fowl.
Switching doctors: predictors of voluntary disenrollment from a primary physician's practice.

BACKGROUND Our objective was to evaluate 8 interpersonal and structural features of care as predictors of patients' voluntary disenrollment from their primary care physician's practice. METHODS We performed a longitudinal observational study in which participants completed a validated questionnaire at baseline (1996) and follow-up (1999). The questionnaire measured 4 elements of the quality of physician-patient relations (communication, interpersonal treatment, physician's knowledge of the patient, and patient trust) and 4 structural features of care (access, visit-based continuity, relationship duration, and integration of care). Study participants were insured adults who reported having a regular personal physician at baseline and who completed both baseline and follow-up questionnaires (n=4108). The outcome measured was voluntary disenrollment from the primary physician's practice between baseline and follow-up. RESULTS One fifth of the patients voluntarily left their primary physician's practice during the study period. When tested independently, all 8 scales significantly predicted voluntary disenrollment (P <.001), with somewhat larger effects associated with the 4 relationship quality measures. In multivariable models, a composite relationship quality factor most strongly predicted voluntary disenrollment (odds ratio [OR]=1.6; P<.001), and the 2 continuity scales also significantly predicted disenrollment (OR=1.1; P<.05). Access and integration did not significantly predict disenrollment in the presence of these variables. CONCLUSIONS These findings highlight the importance of relationship quality in determining patients' loyalty to a physician's practice. They suggest that in the race to the bottom line medical practices and health plans cannot afford to ignore that the essence of medical care involves the interaction of one human being with another.
Family planning attitudes of women and affecting factors.

OBJECTIVE This descriptive research was conducted to determine the attitudes of women towards family planning and the factors affecting these attitudes. MATERIAL AND METHODS Universe of the study has been composed of women who are married and older than 15 years and living in Ankara Kale district. 300 women were included. Kale district is a low socioeconomical slum area of the capital city of Turkey. Questionnaire and Family Planning Attitude Scale were used to collect data. RESULTS 38% of the women were in the 30-39 years age group and 66.7% of them were graduates of primary school. 73.3% of the women had information about some contraceptive method and 53% of them had used an effective method. Mean score taken from the Family Planning Attitude Scale was 120.11±13.8. The scores obtained from the scale were significantly higher in the women who were graduates of elementary school, whose husbands were graduates from high school and higher, who had heard about any contraceptive method and had been using some method and who had had 1-3 pregnancies (p<0.05). Economical status, family type, presence of a chronic disease, using regular medicine and smoking have not affected family planning attitude (p>0.05). CONCLUSION It was found that the attitudes of the women towards family planning were at a good level, nearly half of the women were using an effective method, and the level of education, number of pregnancies, unwillingness to have another child in the future, having information about contraceptive methods and using some contraceptive method had influenced family planning attitudes. In order to turn this attitude into practice with high rate, family planning education programs and consultancy services must be planned and implemented.
Antennes miniatures et structures électromagnétiques à circuits non-Foster

La recherche de nouveaux materiaux a permis de nouveaux developpements au cours de ces dernieres decennies. Ce sont entre autres les dielectriques artificiels ou encore les metamateriaux. Cependant, si ces materiaux restent passifs, malgre tous les developpements possibles, les performances des antennes, ou autres structures electromagnetiques qui decoulent d’eux seront toujours confrontes aux memes limitations fondamentales. En integrant des circuits actifs dans ces materiaux, par exemple des resistances negatives, des capacites negatives et des inductances negatives, il est possible de depasser ces limitations ainsi les proprietes synthetisables et les applications d’ingenierie pourront etre significativement elargies. En effet, cela permettrait de creer des materiaux et des dispositifs dont les proprietes ne seront pas possibles autrement et surpasseraient celles des materiaux existant dans la nature. Cette these a ete l’occasion dans un premier temps d’utiliser les circuits non-Foster qui sont des circuits a retroaction actif, pour l’adaptation d’une antenne electriquement petite a basses frequence. Ceci a permis de mettre en evidence ses avantages par rapport a une adaptation passive plus conventionnelle.Ensuite, des capacites negatives ainsi que des inductances negatives et positives ont ete concues. Leur fonctionnement totalement different des composants passifs a ete mis en exergue. Ce qui nous a conduit a les appliquer sur des structures periodiques. Cela a donne des resultats interessants comme la propagation supraluminique sur une ligne de transmission des ondes. Et en les appliquant a la cellule unitaire d’une surface de metamateriaux qui est aussi une structure periodique, sa taille est reduite pour une plus grande compacite des antennes a cavites concues pour les basses frequences ou la longueur d’onde est tres grande.
Biologic Risk Markers for Coronary Heart Disease: Nonlinear Associations With Income

Background: It is unclear whether a linear relationship is an appropriate description of the association between income and biologic markers of coronary heart disease risk. Stronger associations at certain levels of income would have implications for underlying mechanisms. Methods: The study is based on a healthy sample of 25–64 year olds (n = 14,022) from a nationally representative cross-sectional study (the 1988–1994 United States Third National Health and Nutrition Examination Survey). We use regression splines to model the shape of the association between income and 8 biologic markers for coronary heart disease risk, controlling for age, race/ethnicity, marital status, and education. Results: Substantial income-biomarker associations were found for 5 outcomes among women (HDL cholesterol, triglycerides, C-reactive protein, systolic blood pressure, and venous blood lead) and for 3 outcomes among men (HDL cholesterol, triglycerides, and venous blood lead). The most common shapes of association were a stronger association at lower income levels and a greater risk level of biomarker near median income. Conclusions: We find that the associations of income with biologic risk markers are often nonlinear. The differences in the shape of association suggest there are multiple pathways through which income is associated with coronary heart disease risk.
Ontología para la recuperación semántica de imágenes DICOM en bases de datos objeto-relacional

Resumen. Las imágenes digitales en medicina están reemplazando cada día más a los antiguos formatos físicos que ocupaban inmensos espacios destinados a almacenar placas, hojas de papel, y otros medios. Para los profesionales en medicina, al momento de efectuar el diagnóstico de un paciente, es muy importante contar con imágenes similares a la obtenida en un estudio efectuado a dicho paciente. Sin embargo, para la obtención de estas imágenes, es necesario contar la información del contexto en el que se ha tomado la misma. En este sentido, el estándar DICOM describe detalladamente los medios para dar formato e intercambiar imágenes e información entre diferentes dispositivos o equipos médicos de diagnóstico por imágenes. En este trabajo se presenta una arquitectura para la recuperación de imágenes DICOM, basada en una ontología propuesta, implementada en una base de datos objeto relacional. Esta arquitectura permite extender las consultas SQL permitiendo la recuperación imágenes por similitud semántica, de manera simple y escalable.
Approximate Controllability of Parameter-Dependent Linear Systems

In this paper we derive necessary as well as sufficient conditions for approximate controllability of parameter-dependent linear systems in the supremum norm. An extension to L approximate observability of families of linear systems is derived, too. Using tools from complex approximation theory, we prove the existence of parameter-independent open-loop controls that steer the zero initial state of an ensemble of linear systems uniformly to a prescribed family of terminal states. New necessary conditions for uniform ensemble controllability of single-input systems are derived. Our results extend earlier ones of Li [19] for ensemble controllability of linear systems.
A major histocompatibility complex class I – dependent subset of memory phenotype CD 8 + cells

JEM © The Rockefeller University Press $8.00 Vol. 203, No. 7, July 10, 2006 1817–1825 www.jem. org/cgi/doi/10.1084/jem.20052495 1817 Depending on their stage of diff erentiation, mature T cells require contact with peptide/ MHC complexes and/or cytokines, most notably the common γ chain (γc) cytokines IL-7 and IL-15 (1–4). Naive CD4+ T cells show low expression of CD44, and these CD44lo cells are controlled by IL-7 and possibly MHC-II molecules, although the importance of the latter is controversial (5–7). The factors controlling naturally occurring memory phenotype (MP) CD44hi CD4+ are not well characterized, although antigen-specifi c memory CD4+ cells are known to be sustained by IL-7 and, to a lesser extent, IL-15 (8–10). For CD8+ cells, naive CD44lo cells are maintained by IL-7 and MHC-I molecules (5, 11, 12), whereas MP and antigen-specifi c memory cells are controlled by IL-15 and IL-7 and do not require contact with MHC-I complexes (13–16). For naive T cells, TCR contact with foreign antigen causes CD44lo cells to convert to CD44hi cells and show transient up-regulation of several surface markers, including IL-2Rα (CD25), CD69, and CD43 (1–4). Many of the responding cells also show decreased levels of CD62L (L-selectin) and IL-7Rα (CD127). Interestingly, naive T cells normally maintain a resting (CD25lo, CD69lo, CD43lo, CD62Lhi, CD127hi) phenotype despite continuous TCR contact with self-MHC ligands, implying that this form of TCR–MHC interaction delivers only a weak signal, adequate for maintaining cell viability but insuffi cient for overt stimulation and subsequent proliferation. Except for their CD44hi phenotype, MP CD8+ cells show a similar pattern of cell surface markers as naive CD8+ cells, with the exception that 60–70% of MP CD8+ cells display high levels of the IL-2/IL-15Rβ chain (CD122). This receptor chain is crucially important for controlling sensitivity to IL-15 (13, 17). Thus, CD122hi MP CD8+ cells are overrepresented in IL-15 transgenic (tg) mice (18, 19). Conversely, IL-15–/– (13, 20) and IL-15Rα–/– (21) mice show a marked and selective reduction of CD122hi MP CD8+ cells. This subset of MP CD8+ cells is highly dependent on IL-15 for IFN-induced bystander proliferation as well as for normal A major histocompatibility complex class I–dependent subset of memory phenotype CD8+ cells
Implicit Arguments in Verb-Particle Constructions

∗This work owes thanks to Jane Grimshaw, Mark Baker, and Bruce Tesar, in addition to Ken Safir, Adam Szczegielniak, Hope McManus, Satarupa Das, Nagarajan Selvanathan, Matt Barros, and the members of Qualfying Paper Workshop in Fall 2012 and Spring 2013. All English data presented conform to my own native judgements, except where indicated otherwise. †nick.danis@rutgers.edu 1By Kayne (1985), den Dikken (1995, 2003), Svenonius (1996), for small clause approaches, or Ramchand & Svenonius (2002) and McIntyre (2004) for “extended VP approaches”. But this is by no means universal. See also: Johnson (1991), Dehé (2002, 2005), among others.
Cord Blood Gases and Abnormal Fetal Biophysical Assessment in Preterm Premature Rupture of the Membranes

The relationship between cord blood gases and infection outcome was determined in 53 consecutive patients with preterm premature rupture of the membranes who were delivered because of abnormal fetal biophysical assessment. Measures of infection outcome included the presence of clinical amnionitis, possible neonatal sepsis, and neonatal sepsis. Fetal acidosis at birth, as defined by cord arterial pH less than 7.20, was found in six fetuses; five of these developed neonatal sepsis and the other was born to a mother who had intrapartum clinical amnionitis. The mean cord blood pH (artery and vein) of fetuses with neonatal sepsis was significantly less than in fetuses with possible neonatal sepsis or no sepsis; however, two thirds (10 of 15) of the neonates with sepsis had normal acid-base status at birth. These data suggest that the fetal biophysical assessment becomes abnormal before the development of fetal acidosis. The possible mechanisms by which fetal infection diminishes fetal biophysical activities prior to the development of acidosis are discussed.
A 4.9-dB NF 53.5–62-GHz micro-machined CMOS wideband LNA with small group-delay-variation

A 53.5–62-GHz wideband CMOS low-noise amplifier (LNA) with excellent phase linearity property is reported. Current-sharing technique is adopted to reduce power dissipation. The LNA (STD LNA) consumed 29.1 mW and achieved input return loss (S11) of −10.3∼ −19.5 dB, output return loss (S<inf>22</inf>) of −13.8∼ −27.8 dB, forward gain (S<inf>21</inf>) of 8.1∼ 11.1 dB, and reverse isolation (S<inf>12</inf>) of −49.9∼ −60.2 dB over the 53.5–62-GHz-band. The minimum NF (NF<inf>min</inf>) is 5.4 dB at 62 GHz. To reduce the substrate loss, the CMOS process compatible backside inductively-coupled-plasma (ICP) deep trench technology is used to remove the silicon underneath the LNA. After the ICP etching, the LNA (ICP LNA) achieved maximum S<inf>21</inf> (S<inf>21-max</inf>) of 13.2 dB, 2.1 dB higher than that (11.1 dB) of the STD LNA. In addition, the ICP LNA achieved NF<inf>min</inf> of 4.9 dB, 0.5 dB lower than that (5.4 dB) of the STD LNA. These results demonstrate the proposed LNA architecture in conjunction with the backside ICP technology is very promising for 60-GHz-band RFIC applications.
Histological patterns of head and neck tumors: An insight to tumor histology

This article emphasizes the basis for origin and importance of tumor patterns in diagnosis of oral and maxillofacial tumors. In this article, histological patterns and subpatterns of head and neck tumors are enlisted. Although, undifferentiated tumors remain a challenge to the histopathologist, by describing the histological patterns and the subpatterns of the tumors, an attempt has been made for the diagnosis of the tumors and subsequently for implementation of precise treatment plan for the same.
Evidence for a relation between metabolic derangements and increased levels of inflammatory mediators in a subgroup of patients with chronic obstructive pulmonary disease.

BACKGROUND: An increase in resting energy expenditure (REE) commonly occurs in patients with chronic obstructive pulmonary disease (COPD), the cause of which is as yet unknown. The objective of this study was to assess the relationship between REE, acute phase proteins, and inflammatory mediators in patients with COPD. METHODS: Thirty patients were studied and 26 healthy age-matched subjects served as controls. REE was measured by indirect calorimetry and adjusted for fat-free mass (FFM) by bioelectrical impedance analysis. Tumour necrosis factor alpha (TNF-alpha), soluble tumour necrosis receptor (sTNF-R)55 and sTNF-R75, interleukin (IL)-6, IL-8, and lipopolysaccharide binding protein (LBP) were measured by ELISA. RESULTS: Fourteen patients had a normal REE and in 16 it was raised. The mean body mass index and fat mass were significantly lower in the latter but pulmonary function data were similar in the two groups. In the 30 patients with COPD the mean (SD) sTNF-R75 was 1.7 (1.0) ng/ml compared with 1.1 (0.4) ng/ml in the controls; C-reactive protein (CRP) was detectable (> 5 micrograms/ml) in eight patients compared with none of the control subjects, and LBP was 13.2 (7.7) micrograms/ml compared with 8.6 (3.1) micrograms/ml in the controls. The patients with a raised REE had increased mean levels of CRP compared with the patients with a normal REE (median 5.5 micrograms/ml (range 5-193) and < 5 micrograms/ml, respectively); the same was true for LBP (median 12.4 micrograms/ml (range 8.1-39.1) and 9.5 micrograms/ml (range 5.0-16.6), respectively), but sTNF-R55 and R75 and IL-8 were similar in the two groups. Of the 16 patients with a raised REE, the CRP level was increased in eight and normal in eight. In those with an increased level of CRP the FFM was decreased and LBP, IL-8, and sTNF-R55 and R75 were increased compared with those with normal CRP levels. CONCLUSIONS: A subset of patients with COPD with an increased REE and decreased FFM have increased levels of acute phase reactant proteins and inflammatory cytokines in their serum; these phenomena may be causally related.