Miracle-dz/UniFAR-FTUs huggingface dataset:
Mixed Type Basal Cell Carcinoma of the Eyelids

Summary: A retrospective histopathologic review of 97 patients with basal cell carcinoma of the eyelid was performed to determine the prevalence and behavior of tumors with a mixed pattern of growth. A mixed type basal cell carcinoma was defined as a tumor having a significant nodular or ulcerative component combined with an infiltrative component. Histologic classification of the 97 tumors yielded four (4.1%) that were multicentric, 67 (69.1%) that were nodular, one (1%) that was ulcerative, 13 (13.4%) that were infiltrative, and 12 (12.4%) that were the mixed variant. Follow-up was obtained on 8 of the 12 patients with mixed basal cell carcinoma. Three tumors recurred, but there were no tumor-related deaths. One of these patients underwent numerous eyelid resections over a 2-year period and then underwent an orbital exenteration. The authors conclude that mixed type basal cell carcinomas are not infrequent and behave as aggressively as basal cell carcinomas of the morphea type. A greater awareness and recognition of mixed type basal cell carcinomas by ophthalmologists and pathologists should result in fewer recurrences and better patient management.
The prevalence of drug-resistant Streptococcus pneumoniae in Atlanta.

BACKGROUND Streptococcus pneumoniae is a major cause of illness, and the emergence of drug-resistant strains threatens to complicate the management of pneumococcal infections. We conducted a laboratory-based surveillance for drug-resistant S. pneumoniae among patients with invasive pneumococcal infections in Atlanta. METHODS From January through October 1994, pneumococcal isolates from 431 patients with invasive disease in metropolitan Atlanta were serotyped and tested to determine their susceptibility to various antimicrobial agents. Susceptibility to the antimicrobial agents was defined according to guidelines established by the National Committee for Clinical Laboratory Standards. RESULTS The annual incidence of invasive pneumococcal infection was 30 cases per 100,000 population. Isolates from 25 percent of the patients were resistant to penicillin (7 percent were highly resistant), and isolates from 26 percent were resistant to trimethoprim-sulfamethoxazole (7 percent highly resistant). Fifteen percent of the isolates were resistant to erythromycin, 9 percent to cefotaxime (4 percent were highly resistant), and 25 percent to multiple drugs. Drug-resistant pneumococci were found in both children and adults. Children under six years of age were more likely than older children and adults to have isolates resistant to multiple drugs or cefotaxime. Whites were more likely than blacks to have invasive pneumococcal infections caused by drug-resistant organisms. Among white children younger than six years, 41 percent of the S. pneumoniae isolates were resistant to penicillin. CONCLUSIONS Drug-resistant strains of S. pneumoniae are common among both children and adults in Atlanta. Although blacks had a higher incidence of invasive pneumococcal infections than whites, whites were more likely to be infected with a drug-resistant isolate. Control of drug-resistant pneumococci will require more judicious use of antimicrobial agents and wider use of the pneumococcal polysaccharide vaccine.
ost – benefit comparisons of investments in improved water supply and cholera accination programs

This paper presents the first cost–benefit comparison of improved water supply investments and cholera vaccination programs. Specifically, we compare two water supply interventions – deep wells with public hand pumps and biosand filters (an in-house, point-of-use water treatment technology) – with two types of cholera immunization programs with new-generation vaccines – general community-based and targeted and school-based programs. In addition to these four stand-alone investments, we also analyze five combinations of water and vaccine interventions: (1) borehole + hand pump and community-based cholera vaccination, (2) borehole + hand pump and school-based cholera vaccination, (3) biosand filter and community-based cholera vaccination, (4) biosand filter and school-based cholera vaccination, and (5) biosand filter and borehole + hand pump. Using recent data applicable to developing country locations for parameters such as disease incidence, the effectiveness of vaccine and water supply interventions against diarrheal diseases, and the value of a statistical life, we construct cost–benefit models for evaluating these interventions. We then employ probabilistic sensitivity analysis to estimate a frequency distribution of benefit–cost ratios for all four interventions, given a wide variety of possible parameter combinations. Our results demonstrate that there are many plausible conditions in developing countries under which these interventions will be attractive, but that the two improved water supply interventions and the targeted cholera vaccination program are much more likely to yield attractive cost–benefit outcomes than a community-based vaccination program. We show that implementing community-based cholera vaccination programs after borehole + hand pump or biosand filters have already been installed will rarely be justified. This is especially true when the biosand filters are already in place, because these achieve substantial cholera risk reductions on their own. On the other hand, implementing school-based cholera vaccination programs after the installation of boreholes with hand pump is more likely to be economically attractive. Also, if policymakers were to first invest in cholera vaccinations, then subsequently investing in water interventions is still likely to yield positive economic outcomes. This is because point-of-use water treatment delivers health benefits other than reduced cholera, and deep boreholes + hand pumps often yield non-health benefits such as time savings. However, cholera vaccination programs are much cheaper than the water supply interventions on a household basis. Donors and governments with limited budgets may thus determine that cholera vaccination programs are more equitable than water supply interventions because more people can receive benefits with a given budget. Practical considerations may also favor cholera vaccination programs in the f Sout se tec densely crowded slums o units for some point-of-u
Increased Expression of Inducible Cyclooxygenase-2 in Human Endothelial Cells by Antiphospholipid Antibodies

Summary The effect of IgGs from 4 patients with antiphospholipid antibodies and elevated excretion of urinary 11-dehydro-thromboxane B2 was evaluated on the production of prostacyclin by human endothelial cells in culture. After 6 h incubation, there was no change in 6-keto-prosta-glandin F1α in the supernatant. However patients’ IgGs induced a marked increase in cyclooxygenase (Cox) activity compared to IgGs from 2 normal individuals or a commercial pool of IgGs from normal donors, tested by adding exogenous arachidonic acid. Western blot analysis of the cellular Cox content using antibodies specific for the different forms of the enzymes revealed that patients’ IgGs stimulated the synthesis of the newly described inducible Cox-2 without affecting the constitutive Cox-1. This effect was partially neutralized by preincubating the IgGs with phospholipids. The induction was dependent on the amount of IgGs; it was visible at 2 h and persisted up to 24 h. Analysis of mRNA levels showed a pattern of variation in good agreement with the results obtained for protein. The protein kinase inhibitor H-7 or long-term incubation of cells with PMA strongly reduced the induction. These results suggest that antiphospholipid antibodies may not prevent the potential of the vascular cells from generating higher amounts of prostacyclin in response to acute episodes of thrombosis.
User satisfaction with a telemedicine amputee clinic in Saskatchewan

summary A group of 15 patients with amputee-related diagnoses were given a satisfaction survey after telemedicine assessment. Most of the videoconferencing sessions used an IP connection at 768 kbit/s. The patients were seen at four sites. The average connection time was less than 5min and the average time for a session was approximately 40min. Thirteen questions required scaled responses (poor, fair, good, excellent) and two required yes/no answers. The 13 categories broadly related to satisfaction with the telemedicine service and the quality of specialist care. In all categories, 97% of the responses fell in the good to excellent range. Concerns were raised about ease of access to local telemedicine sites, connection waiting times and lack of familiarity with telemedicine technology. The study showed that telemedicine was acceptable to patients with amputations and provided a reliable assessment of the amputee.
Captive supplies and the spot market price of fed cattle: The plant-level relationship

Numerous articles in the agricultural economics literature investigate the empirical relationship between the spot market price of fed cattle and the volume of packers' precommitted, or “captive,” supplies of cattle. In this article, we use an extensive data set on the cattle procurement activities of four large packing plants in the Texas Panhandle from early 1995 through mid-1996 to examine this relationship at the plant-level. We find evidence to support the hypothesis that plants that anticipate near-term future deliveries of captive supply cattle that are high relative to their regional-market rivals' degrees of reliance on captive supplies tend to pay spot market prices that are below average. The effect, while statistically significant, is relatively small in magnitude, however. lEconLit citations: Q130, L200r © 2003 Wiley Periodicals, Inc. Agribusiness 19: 489-504, 2003.
Optimization of Contribution Margins in Food Services by Modeling Independent Component Demand

We propose a methodology useful for food services, allowing contribution margins to be optimized. This is based on statistical tools, inventory models and financial indicators. To reduce the gap between theory and practice, we apply this methodology to the case study of a Chilean company to show its potential. We conduct a real-world demand data analysis for perishable and non-perishable products in the company’s inventory assortment. Then, we use suitable inventory models to optimize the associated costs. We compare the proposed optimized system with the non-optimized system currently employed by the company, using financial indicators.
Effect of Exercise and Respiratory Training on Clinical Progression and Survival in Patients with Severe Chronic Pulmonary Hypertension

Background: Even though specific agents for the treatment of patients with pulmonary hypertension (PH) are available, in PH patients, physical capacity and quality of life (QoL) are often restricted and survival is reduced. Objectives: This study prospectively investigated the long-term effects of respiratory and exercise training in patients with severe chronic PH regarding safety, time to clinical worsening and survival. Methods: Fifty-eight consecutive patients with severe PH on stable disease-targeted medication received exercise and respiratory training in hospital for 3 weeks and continued at home. They were prospectively followed for 24 ± 12 months. Primary endpoints were time to clinical worsening and survival. Adverse events and changes in the 6-min walking test, QoL, WHO functional class and gas exchange were secondary endpoints and were evaluated at baseline and at weeks 3 and 15. Results: All patients tolerated the exercise training well without severe adverse events. In week 15, 6-min walking test results were significantly improved compared to baseline (by 84 ± 49 m, p < 0.001), as well as QoL scores, WHO functional class (from 2.9 ± 0.5 to 2.6 ± 0.6, p < 0.01), peak oxygen consumption (from 12.5 ± 3.0 to 14.6 ± 3.9 ml/min/kg, p < 0.001), heart rate at rest (from 75 ± 12 to 61 ± 18 beats/min, p < 0.001) and maximal workload (from 65 ± 21 to 80 ± 25 W, p < 0.001). Survival at 1 and 2 years was 100 and 95%, respectively. Fifteen events occurred during the follow-up. Conclusion: This study indicates that exercise and respiratory training as add-on to medical treatment may improve exercise capacity and QoL, and that they have a good long-term safety in the described setting.
Gene Editing and Crop Improvement Using CRISPR-Cas9 System

Advancements in Genome editing technologies have revolutionized the fields of functional genomics and crop improvement. CRISPR/Cas9 (clustered regularly interspaced short palindromic repeat)-Cas9 is a multipurpose technology for genetic engineering that relies on the complementarity of the guideRNA (gRNA) to a specific sequence and the Cas9 endonuclease activity. It has broadened the agricultural research area, bringing in new opportunities to develop novel plant varieties with deletion of detrimental traits or addition of significant characters. This RNA guided genome editing technology is turning out to be a groundbreaking innovation in distinct branches of plant biology. CRISPR technology is constantly advancing including options for various genetic manipulations like generating knockouts; making precise modifications, multiplex genome engineering, and activation and repression of target genes. The review highlights the progression throughout the CRISPR legacy. We have studied the rapid evolution of CRISPR/Cas9 tools with myriad functionalities, capabilities, and specialized applications. Among varied diligences, plant nutritional improvement, enhancement of plant disease resistance and production of drought tolerant plants are reviewed. The review also includes some information on traditional delivery methods of Cas9-gRNA complexes into plant cells and incorporates the advent of CRISPR ribonucleoproteins (RNPs) that came up as a solution to various limitations that prevailed with plasmid-based CRISPR system.
Human Papillomavirus and Head and Neck Squamous Cell Carcinoma: Recent Evidence and Clinical Implications

Over the past 20 years, high-risk human papilloma-virus (HPV) infection has been established as a risk factor for developing head and neck squamous cell carcinoma, independent of tobacco and alcohol use. In particular, HPV is strongly associated with the development of oropharyngeal cancer and a small minority of oral cavity cancers. In this review, we summarize what is currently known about the biology of HPV, the mechanisms by which it effects malignant transformation, and the potential impact of HPV status on the clinical management of persons with head and neck cancer.
Physiological, morphological, and cytochemical characteristics of a layer 1 neuron in cat striate cortex

We have recorded from a small neuron in layer 1 of the striate visual cortex in a 34‐day‐old kitten. It had a simple, orientation‐selective receptive field that was nondirectional and showed length summation. The neuron was injected intracellularly with horseradish peroxidase. Computer‐aided reconstruction revealed that it had a dense axonal plexus confined to layer 1, elongated in the anteroposterior dimension. By means of an antibody directed against a GABA‐like antigen, and postembedding immunocytochemistry, the neuron was found to be strongly immunoreactive. The main input to soma and dendrites of the neuron was from synapses that were not GABA‐L‐immunoreactive, and probably originated from pyramidal cells. The axon of the cell formed synapses on dendritic shafts and spines, whose most likely sources were the apical tufts of pyramidal cell dendrites. These data suggest that such neurons may be involved in local circuits that contribute to the formation of pyramidal cell receptive fields.
The effect of gain thresholds on speech intelligibility for statistical model based noise reduction for cochlear implants: A simulation based verification

Noise corruption can dramatically decrease the speech intelligibility for listeners with cochlear implants (CI). Noise reduction is a key point in CI speech processing strategy. This paper proposes a statistical model based noise reduction algorithm for-CIs. A realistic noise estimator, which requires no prior knowledge of the noise, is adopted for noise estimation. An improved method for determining the user-specific gain function is proposed, in which the apparent gain threshold is incorporated to compute the optimal parameters, with which the optimal gain function for noise suppression can be determined accordingly. Vocoder simulation perceptual experiments with normal hearing listeners shows that the proposed algorithm can significantly improve the speech intelligibility of the denoised speech.
Patient desire and reasons for specialist referral in a gatekeeper-model managed care plan.

OBJECTIVE To describe patient desire and reasons for specialist referrals in a gatekeeper-model managed care plan. STUDY DESIGN Cross-sectional prospective study. PATIENTS AND METHODS We developed a patient questionnaire to gather demographic data and to gauge patients' desire for specialist referral and their reasons for seeking such referral. The survey was administered at 2 sites--an ambulatory care facility of a university hospital and an internal medicine clinic in a suburban ambulatory care site. Patients asked to complete the questionnaire at the university hospital site were enrolled in a gatekeeper-model managed care plan (called CU Gold); those seen at the internal medicine clinic were enrolled in a group-model health maintenance organization. Patients were asked to complete the 1-page questionnaire in the waiting room before being seen by their primary care physician. RESULTS Among the 860 CU Gold patients who met the inclusion criteria during the 3-month study period (September to December 1997), 112 (13%) reported a definite desire to see a specialist and 274 (32%) indicated a possible desire to see a specialist at the time of their primary care visit. Compared with the CU Gold patients, significantly fewer patients in the health maintenance organization indicated a definite desire to see a specialist (3% versus 13%), but a similar percentage expressed a possible desire to see a specialist (30% versus 32%). The difference in definite desire for referral between the 2 groups could not be explained by patient or primary care physician characteristics. The principal health concerns for which patients sought referral were musculoskeletal, genitourinary or gynecologic, or dermatologic problems. Need for reassurance (cited by 67% of patients), seeing a specialist before (56%), and believing the primary care physician lacked expertise (49%) were the primary reasons patients sought referral. Seventy-four percent of patients referred by their primary care provider and 54% of those not referred agreed it was a good idea to see their primary care physician first before seeing a specialist. CONCLUSIONS Patients have a significant desire for specialist referral, driven by their need for reassurance, previous specialist referral, and belief that their primary care physician does not have the requisite expertise. Patients' expectations for referral varied significantly, depending on the healthcare system (academic primary care clinic or health maintenance organization) in which they were enrolled.
ID-Based Rendering of Silhouettes on GPU

When rendering object-silhouettes preprocessing is generally done primarily on the CPU. To this end primitive normals must be made consistent and the silhouette-edges need to be extracted every time the view-point is changed. In this paper we propose a pure image-based GPU-method where IDs of triangles are rendered to a texture and silhouettes are extracted based on the information stored in that texture. With this method the geometry does not need to be preprocessed or reprocessed when the view-point or the geometry is changed. Another important advantage of the proposed method over any Z-buffer based method is that it does not require any threshold value to compare against the difference between depth-values of the neighboring pixels which is difﬁcult to adjust in perspective projection.
Systemic absorption of topical clindamycin.

To the Editor. — Although Algra et al were unable to detect clindamycin in the serum following topical application of a hydroalcoholic solution of clindamycin hydrochloride (Archives113:1390-1391, 1977), The Upjohn Company has observed clindamycin concentrations of up to 0.7 μg/ml in the urine of four of nine subjects who were receiving topical applications of 20 mg of clindamycin daily for one to seven weeks, which indicates that some systemic absorption does occur. In addition, The Upjohn Company has received three reports of diarrhea associated with topical clindamycin therapy for acne. Proctoscopy in one of these cases showed markedly inflamed mucosa, which resolved following cessation of clindamycin. In another patient, the diarrhea cleared with discontinuation of topical clindamycin and reappeared following resumption of this topical medication. In the third case, diarrhea occurred following topical application of clindamycin in a patient who had previously experienced diarrhea with oral clindamycin (H. W. Woodward,
Planar circularly polarized antenna with broadband operation for UHF RFID system

Novel circular polarization (CP) design of planar broadband antenna with square slot for UHF RFID system is proposed and experimentally studied. By insetting the arc-shaped strip into the square slot, the proposed CP design can easily be achieved with the impedance bandwidth (RL -10 dB) of about 142 MHz (15.3% @ 931 MHz) and the 3 dB axial-ratio (AR) bandwidth of about 166 MHz (17.7 % @ 940 MHz) for UHF RFID applications. The measured peak gain and radiation efficiency are about 6.8 dBic and 98% across the operating band, respectively, with nearly bidirectional pattern in the XZ- and YZ-plane.
Virulence evolution in a virus obeys a trade off

The evolution of virulence was studied in a virus subjected to alternating episodes of vertical and horizontal transmission. Bacteriophage f1 was used as the parasite because it establishes a debilitating but non–fatal infection that can be transmitted vertically (from a host to its progeny) as well as horizontally (infection of new hosts). Horizontal transmission was required of all phage at specific intervals, but was prevented otherwise. Each episode of horizontal transmission was followed by an interval of obligate vertical transmission, followed by an interval of obligate horizontal transmission etc. The duration of vertical transmission was eight times longer per episode in one treatment than in the other, thus varying the relative intensity of selection against virulence while maintaining selection for some level of virus production. Viral lines with the higher enforced rate of infectious transmission evolved higher virulence and higher rates of virus production. These results support the trade–off model for the evolution of virulence.