Miracle-dz/UniFAR-FTUs huggingface dataset:
The new agenda for general practice computing.

proportion of the daily calcium requirements, may well reduce the prevalence of bladder stones,7 but again, the effect of differing water hardness on the distribution of stones is completely unknown. Development may result in endemic stones disappearing, but there is no evidence that the poor of the bladder stone belt in Asia have reached the stage of the declining disease experienced by the poor in England at the turn of the century. The new agenda for general practice computing Time to exploit the potentialfor improving patient care In the past few years general practice computers have moved from innovation to implementation. The proportion of practices with computers has risen from a quarter in 1989' to half this year,2 and within another two years 90% of practices will probably have them. This process has been accelerated by the new contract for general practice, with its requirements for screening and its reimbursement of some computer costs,3 and by the imminent arrival of indicative drug budgets, fund holding, and medical audit.4 Modern practice management demands computers. This should not, however, be the end of the story. Most general practice computer systems still emphasise data entry and repetitive tasks rather than exploiting the full potential of the technology. Though they are adequate for entering and storing administrative data on patients and performing routine jobs, such as repeat prescribing and prevention recalls,2 they need to be developed to handle three key aspects: the computer clinical record, communications, and the quality of patient care. Clinical recording is possible-just-with the more complex general practice computer systems, but there are many outstanding issues. The Read clinical classification is the only coding system to offer full cover for the symptoms, procedures, and events of primary care.5 Other classifications used in general practice computers may suffice for epidemiology and problem listing, but they fail as tools for recording everyday clinical care. The government's recent purchase of the rights to the Read clinical classification is therefore welcome because it removes the main obstacle to its general use. Using the most appropriate classification system is not in itself enough. Techniques for entering clinical data need to be refined so that it takes no longer and is no more difficult than writing the paper record. Furthermore, the format of data entry and presentation needs to be flexible enough to allow the user to emphasise personal interests and incorporate new knowledge. If, for example, …
Variations in Air Temperature during the Last Century Revealed by delta18O in the Chongce Ice Core from the Tibetan Plateau

Through analyzing the isotopic ratio δ18O variation characteristics of Chongce ice core, it exhibited an increase trend in the 20th century, and the temperature near the Chongce Ice Cap rose about 1.1 °C during last century. Through wavelet analysis, the δ18O in Chongce ice core showed three heating periods and two cooling periods. The wavelet variance analysis of the isotopic ratio δ18O variation indicates 13-year, 25-year and qusia-46-year periods. Compared with the ground weather observation stations in the high north Tibetan Plateau and the low Taklimakan Desert, and the June-September mean temperature of the MUT (500hPa and 300hPa) above the whole Asia for 1948-92, the results show that the climatic information on the TP in Chongce ice core is likely very less, and the δ18O of Chongce ice core may represent the summer temperature of Taklimkan Desert and the summer temperature of the middle-upper tropsphere above the middle-high latitude Asia especially the central Asia.
Cloning of Ammopiptanthus mongolicus C-repeat-binding factor gene and its cold-induced tolerance in transgenic tobacco

ABSTRACT C-repeat-binding factors (CBFs) are a type of important regulon in stress-related signal transduction pathways that control plant tolerance of abiotic stress. Ammopiptanthus mongolicus is the only evergreen broadleaf shrub in the northwest desert of China. The species shows strong resistance to environmental stress, especially to cold stress. An A. mongolicus CBF1 gene (AmCBF1) was cloned and transformed into tobacco. Expression of AmCBF1 could be detected in A. mongolicus shortly after exposure to low temperature of 4°C. Analysis on ratio of electrolytic leakage, soluble sugar content, free proline content, malondialdehyde (MDA) content and peroxidase (POD) activity before and after cold treatment (4°C) for 24 h indicated AmCBF1 conferred higher cold tolerance to AmCBF1 transgenic tobacco compared with the wild type and empty vector transformed tobacco. Key words: Ammopiptanthus mongolicus , C-repeat-binding factor, Gene transformation, Physiological index detection
Response Entropy Increases During Painful Stimulation

Frontal electromyography (FEMG) may increase during painful stimulation and indicate patient arousal. The Datex-Ohmeda Entropy Module calculates state entropy (SE) of the electroencephalogram (EEG; 0.8-32 Hz) and response entropy (RE) of EEG and FEMG (0.8-47 Hz). We determined whether RE increases above SE (RE − SE), an indication of FEMG, increase during painful stimuli and if this is related to paralysis or level of anesthesia. With the unanesthetized baseline measurement, SE was 89 ± 2 and RE was 98 ± 2. During paralysis and anesthesia with either 0.8% (n = 10) or 1.4% (n = 10) isoflurane, SE decreased to 63 ± 7 and 34 ± 14, respectively, and the RE − SE difference decreased 90%. Before recovery from paralysis, arterial catheter or head pin placement increased RE − SE above unanesthetized levels in eight patients (five treated with 0.8% and three with 1.4% isoflurane), consistent with an increase in FEMG. The elevated RE − SE difference was related to a significant increase in SE, blood pressure, and heart rate. After recovery from paralysis, tetanic stimulation of the ulnar nerve increased the RE − SE difference above unanesthetized levels in 8 of 20 patients (6 treated with 0.8% and 2 with 1.4% isoflurane). In these patients, SE increased significantly. The remaining 12 patients did not show an increase in RE − SE during tetanic stimulation and SE did not increase. We conclude that increased RE during painful stimulation was not dependent on recovery from paralysis but was seen more often in patients anesthetized with 0.8% compared with 1.4% isoflurane. This suggests that RE reflects FEMG and may be useful to identify inadequate anesthesia and patient arousal during painful stimuli.
A GLOBAL MODEL OF CLIMATE CHANGE IMPACTS ON TIMBER MARKETS

Several papers have now estimated the impact of climate change on national timber markets, but few studies have measured impacts globally. Further, the literature on impacts has focused heavily on changes in productivity and has not integrated movements of biomes as well. Here, a dynamic model of ecological change and economic change is developed to capture the impact of climate change on world timber markets. Climate change is predicted to increase global timber production as producers in low-mid latitude forests react quickly with more productive short-rotation plantations, driving down timber prices. Producers in mid-high latitude forests, in contrast, are likely to be hurt by the lower prices, dieback, and slower productivity increases because of long-rotation species. Consumers in all regions benefit from the lower prices, and the overall impacts of climate change in timber markets are expected to be beneficial, increasing welfare in those markets from 2% to 8%.
Similar patterns of cognitive deficits in the preclinical phases of vascular dementia and Alzheimer's disease

We investigated whether (1) cognitive deficits are present among persons who will be diagnosed with vascular dementia (VaD) 3 years later, and (2) the pattern of such deficits is similar to that observed in preclinical Alzheimer's disease (AD). The VaD diagnosis was a diagnosis of post-stroke dementia. Population-based samples of 15 incident VaD cases, 43 incident AD cases, and 149 normal controls were compared on tests of episodic and short-term memory, verbal fluency, and visuospatial skill. Both dementia groups showed preclinical impairment relative controls on tasks assessing episodic memory 3 years before diagnosis, and there were no differences between these groups on any cognitive measure. The existence of a preclinical phase in the present VaD cases suggests that circulatory disturbance may affect cognitive performance before the occurrence of stroke that leads to clinical VaD. These results extend previous findings of similar patterns of cognitive deficits in the early clinical phases of AD and VaD to the preclinical phases of these diseases. (JINS, 2004, 10, 382–391.)
[Epidemic outbreak of 81 cases of brucellosis following the consumption of fresh cheese without pasteurization].

BACKGROUND In spite of the great effort that has been made in recent years in Castilla-La Mancha to control brucelosis, a lack of awareness on the part of producers and consumers leads to major epidemic outbreak, such as the one described below. METHODS A description of the outbreak is described and a study is conducted of cases and controls to determine the factors which are responsible for the epidemic. Unadjusted and adjusted Odds Ratios (O.R.) are obtained together with their confidence intervals, for the main epidemiological factors studied. RESULTS A total of 81 cases of brucelosis were recorded in a period of 25 weeks. All the cases occurred in the same borough or were in some way linked to it. In the case and controls study no differences were found with regard to age, sex, contact with livestock or the consumption of pasteurised milk or cheese. A strong link was established between the illness and the consumption of home-made cottage cheese prepared by a small-scale producer in the borough, (O.R. = 311.9; C.I. = 95% = 41.48-12735). , whose livestock turned out to be infected with Brucella Mellitensis. CONCLUSIONS This outbreak showed that in Spain, there is a risk of contracting brucelosis by consuming non-pasteurised dairy products, particularly cheese, when these are not subjected to the normal sanitary and health controls. The benefits of epidemiological research in the search for cases and determining the factors responsible for the outbreak are also demonstrated. An intensification of controls, the cleansing of the herds and flocks and health education in general, are suitable instruments for controlling this zoonosis in Spain.
A double‐blind trial of hyperbaric oxygen in the treatment of multiple sclerosis

A randomized double‐blind trial of hyperbaric oxygen (2 atmospheres absolute for 20 sessions of 90 minutes, over a period of one month) demonstrated no advantage over a placebo gas mixture in the treatment of multiple sclerosis. Of 41 patients completing the trial, 21 had been treated with oxygen, eight of whom reported improvement (two confirmed objectively). Of 20 patients in the placebo group, seven claimed improvement (four confirmed objectively). Even when patients with mild disease were considered separately, or when functional systems were assessed individually, no benefit could be shown to result from hyperbaric oxygen therapy.
Transcriptional regulation of the lactase-phlorizin hydrolase gene by polymorphisms associated with adult-type hypolactasia

Background and aims: The mechanism of the developmental downregulation of the lactase-phlorizin hydrolase (LPH) gene underlying adult-type hypolactasia is unknown. We have determined the functional significance of the recently identified two single nucleotide polymorphisms (SNPs), C/T−13910 and G/A−22018, associated with adult-type hypolactasia by studying LPH mRNA levels in intestinal biopsy samples with different genotypes. Methods: Intestinal biopsy samples were taken from 52 patients with abdominal complaints. Hypolactasia was diagnosed by determining lactase and sucrase activities and calculating their ratio (L/S ratio). The functional effect of the C/T−13910 and G/A−22018 genotype on expression of LPH mRNA was demonstrated in patients heterozygous for the C/T−13910 and G/A−22018 polymorphism and an informative expressed SNP located in the coding region of the LPH mRNA. Reverse transcription-polymerase chain reaction followed by solid phase minisequencing was used for accessing the relative expression levels of the LPH alleles using informative SNPs located in exons 1, 2, 6, 10, 13, or 17 as markers. Results: Statistically significant differences between the three different genotypes CC−13910 GG−22018, CT−13910 GA−22018, and TT−13910 AA-22018 and their respective L/S ratios were observed. Relative quantitation of the expressed LPH alleles showed that the persistent allele represented 92 (6)% (mean (SEM), range 78–99%; n=14) of the expressed LPH mRNA. The patient with the homozygous persistent TT−13910 AA−22018, as well as hypolactasic patients with CC−13910 GG−22018, showed equal expression of both alleles (47 (1)%; n=7). Conclusions: Expression of LPH mRNA in the intestinal mucosa in individuals with T−13910 A−22018 alleles is several times higher than that found in individuals with C−13910, G−22018 alleles. These findings suggest that the two SNPs, C/T−13910 and G/A−22018, associated with adult-type hypolactasia, are associated with the transcriptional regulation of the LPH gene. The presence of the T−13910 A−22018 allele also shows significant elevation of the L/S ratio.
Real Options : Managing Strategic Investment in an Uncertain World

The purpose of this text is to understand the circumstances where option methodology is applicable to strategic investment. In other words, it is a manual to teach decision-makers how to think in a real-options framework. Although the text makes reference to some option-pricing techniques, no true option-pricing training is given. However, wherever computational rigor exists, the reader is referenced to the bookÕs website: www.real-options.com for downloadable spreadsheets. The book also carefully notes the relevant academic research. The text is refreshing in that it does create a method of logic for the study of real options without an excessive amount of new vocabulary. In a sense, the method is a standardization of real-options thought. However, it is disappointing to need a second reference to actually do the computational work to ®nd the value of a real option. Although I am delighted by this textÕs contribution, I am also disappointed in that it only gives me half of what I really need to apply real-options techniques. The text consists of three parts: the real-options potential, the real-options solution process, and a portfolio of applications. A concluding chapter summarizes the text. The ®rst part has six chapters and behaves as an extended introduction. The second part, with three chapters, produces the standardized technique for implementing a real-options framework. Each of the 10 chapters in part three provides a mini case study of particular real-options techniques. More speci®cally, Chapters 1±3 introduce the concept of a real option. The reader is made aware that `uncertainty creates opportunity' and how an option-pricing framework captures this issue. Chapter 3 does a nice job of explaining option payos and option pricing without the aid of an equation. The presentation is clear and particularly good for a novice. Chapters 4±6 further develop the use of option techniques to real assets. Chapter 4 discusses `tracking error' in relation to using a tracking portfolio to replicate an option. Since a real option is generally not an exchange-traded security nor does it have an underlying security that is exchange-traded, the issue of tracking error is signi®cant. Chapters 5 and 6 shape the actual focus of Journal of Banking & Finance 24 (2000) 828±829 www.elsevier. com/locate/econbase
Diagnostic Evaluation for Patients with Ischemic Stroke: Are There Sex Differences?

Background and Purpose: Differences in the management of women and men with acute coronary symptoms are well documented, but relatively little is known about practices for patients with ischemic stroke. We sought to determine whether there are sex-associated differences in the utilization of diagnostic tests for ischemic stroke patients treated at academic hospitals in the United States. Methods: Medical records were abstracted for consecutive ischemic stroke patients admitted to 32 US academic medical centers from January through June, 2004, as part of the University HealthSystem Consortium Ischemic Stroke Benchmarking Project. We compared the utilization rates of diagnostic tests including neuroimaging (CT or MRI), electrocardiogram (ECG), ultrasound of the carotid arteries, and echocardiography (transthoracic or transesophageal) for women and men. Multivariate logistic regression was used to test for sex differences with adjustment for potential confounders. Results: The study included 1,256 ischemic stroke patients (611 women; 645 men; mean age 66.6 ± 14.6 years; 56% white). There were no differences between women and men in the use of neuroimaging (odds ratio, OR = 1.37; 95% confidence interval, CI = 0.58–3.24), ECG (OR = 1.00, 95% CI = 0.70–1.44), carotid artery ultrasound (OR = 0.93, 95% CI = 0.72–1.21) or echocardiography (OR = 0.70, 95% CI = 0.70–1.22). The results were similar after covariate adjustment. Conclusions: Women and men admitted to US academic hospitals receive comparable diagnostic evaluations, even after adjusting for sociodemographic and clinical factors.
Excess protein in nuclei isolated from heat‐shocked cells results from a reduced extractability of nuclear proteins

An excellent correlation has been established between the quantity of protein associated with nuclei isolated from heat‐shocked cells and the level of hyperthermic cell killing. However, controversy remains about whether increases in nuclear‐associated protein result from a heat‐induced migration of cytoplasmic proteins into the nucleus or because hyperthermia reduces the solubility of nuclear proteins in the detergent buffers commonly used to isolate nuclei. To address this controversy, the nuclear protein content was measured in whole and detergent‐extracted cells before and following hyperthermia. It was found that hyperthermia caused no significant change in the nuclear protein content of whole, unextracted cells, and when fluorescently labeled proteins were microinjected into the cytoplasm no gross change in the selective permeability of the nuclear membrane to soluble proteins was observed during or following hyperthermia. Measurements in extracted cells showed that the detergent buffers removed protein from both the nucleus and cytoplasm of control, nonheated cells and that hyperthermia reduced the extractability of both nuclear and cytoplasmic proteins. The amount of protein found in nuclei isolated from heated cells approached that observed in nuclei within nonheated whole cells as the hyperthermic exposure was increased. Thus, the dose‐dependent, two‐ to threefold increase in the protein content of nuclei isolated from heated cells represents a heat‐induced reduction in the extractability of proteins normally present within cell nuclei and does not result from a mass migration of cytoplasmic proteins into the nucleus, although some specific proteins (e.g., the 70 KDa heat shock protein) do migrate to the nucleus following heat shock. Differential scanning calorimetry (DSC) measurements of whole cells, isolated nuclei, cytoplasts, and karyoplasts supported these conclusions and suggested that most of the detergent‐insoluble proteins remaining in the nuclei and cytoplasm of heated cells are in their native state. Thus, a relatively small amount of denatured protein may be sufficient to initiate and sustain insoluble protein aggregates comprised of mostly native proteins. Analyses of the DSC data also implied that the previously identified critical target proteins, predicted to have a Tm of 46.0°C, are present in both the nucleus and cytoplasm. © 1996 Wiley‐Liss, Inc.
Common Knowledge , Coherent Uncertainties and Consensus

In this paper we study info-gap analogs of the classical game-theoretic concepts of informationand knowledge-functions, common knowledge and consensus. Our main results are that knowledge is constricted as info-gap-uncertainty grows (theorem 1), common knowledge is limited by the presence of info-gap uncertainty (theorem 2), and that common knowledge is related to consensus via the infogap coherence functions (theorem 3). We discuss several examples, including the prisoners’ dilemma, principal-agent contract negotiations, search and evasion strategies, and teamwork and the need for costly transfer of information.
Pedicle Morphology of the Lower Thoracic, Lumbar, and S1 Vertebrae: An Indian Perspective

Study Design. Analysis of morphometric data obtained from computed tomography scans in relation to the lower thoracic, lumbar, and S1 pedicle in patients from the Indian subcontinent. Objectives. To record the surgically relevant parameters of transverse pedicle isthmus width, transverse pedicle angle, and depth to anterior cortex along the midline axis and the pedicle axis and to compare the results with those of similar studies in literature. Summary of Background Data. Most studies reported are for white populations. Considerable differences are documented in the few reports in Oriental populations compared with Western populations. To the authors’ knowledge, no similar study has been published for patients from the Indian subcontinent. Methods. Computed tomography scans of the lower thoracic and lumbosacral spine of patients from the Indian subcontinent were reviewed. We selected and analyzed 86 vertebrae in 31 patients. Parameters recorded were transverse pedicle isthmus width, transverse pedicle angle, and depth to anterior cortex along the midline axis and the pedicle axis. Results. The mean transverse pedicle isthmus width was least at the T9 level (5.02 mm). Of the pedicles at T9, 46.15% had a diameter of less than 5 mm, followed by T10 (12.5%), T11 (11.11%), and L1 (11.11%). Of the pedicles at T9, 76.92% had a diameter of less than 6 mm, followed by T11 (33.33%), L1 (33.33%), T10 (25%), T12 (25%), L2 (20%), and L3 (5.56%). The mean transverse pedicle angle faced laterally at T11 (−2.97°) and T12 (−3.00°), being least at T12. The depth to the anterior cortex was more along the pedicle axis at all levels except T11 and T12, consistent with the laterally facing pedicles at these levels. Conclusions. Significant differences exist between the pedicles of Indian and white populations. It is suggested that preoperative computed tomography scans of the patients must be evaluated to choose the appropriately sized implant and avoid inadvertent complications. Preparation of the pedicle intraoperatively should take into account the orientation of the transverse pedicle angle.