Miracle-dz/UniFAR-FTUs huggingface dataset:
Addition of electronic prescription transmission to computerized prescriber order entry: Effect on dispensing errors in community pharmacies.

PURPOSE The addition of electronic prescription transmission to computerized prescriber order entry (CPOE) and its effect on dispensing errors in community pharmacies were evaluated. METHODS A controlled, before-and-after trial to measure the effect of electronic prescribing on dispensing errors in two control clinics and one e-prescribing clinic already using CPOE was conducted between January and November 2006. Prescriptions documented within the CPOE system were reconciled with dispensed prescription information from participating pharmacy chains via a national pharmacy information exchange network. Dispensing errors were defined as discrepancies between the prescriber's written orders and the dispensed prescription information. Prescriptions filled at nonparticipating pharmacies were not analyzed. RESULTS A total of 11,447 prescriptions were written in the control clinics, and 29,575 were written in the e-prescribing clinic. During the intervention period, 2,179 (22%) of 9,905 intervention clinic prescriptions were electronically transmitted, including 621 (28%) available for analysis. There was no significant difference in the dispensing-error rates between the baseline and intervention periods for the control clinics. Similarly, the dispensing-error rates did not differ significantly for the e-prescribing clinic between the baseline and intervention periods for prescriptions that were not electronically transmitted. The e-prescribing clinic's dispensing-error rate for electronically transmitted prescriptions during the intervention was significantly lower than its baseline dispensing-error rate (p = 0.03). CONCLUSION Electronic transmission of prescription data from physicians' offices to a pharmacy nearly halved the risk of dispensing errors compared with generating the prescription with outpatient CPOE and printing it and giving it to the patient.
Prosthetic Heart Valves and Pregnancy

In patients with prosthetic heart valves (PHV), pregnancy is associated with the risks of warfarin embryopathy in patients with mechanical PHV and of structural valve deterioration (SVD), both early and late, in patients with biological PHV. ### Warfarin The use of warfarin, particularly between the 6th and 12th weeks of pregnancy, is associated with an embryopathy, “warfarin embryopathy,”1,2 which is characterized by nasal hypoplasia and/or stippled epiphyses.3 Uncommon features, including central nervous system and eye abnormalities, may be due to warfarin exposure during the second and third trimester.3 There is a wide range of the reported incidence of warfarin embryopathy (Table 1). 3–18 Ten studies comprising 427 pregnancies reported the incidence was zero (Table 1). From the patient’s point of view, the incidence per live birth may be more important; four recent (between 1994 and 99) studies reported an incidence of 3/189 (1.6%) live births7,9,17,18 (Table 1). One group has shown that the risk of warfarin embryopathy was extremely low in the 33 women who needed ≤5 mg of warfarin to maintain an adequate INR.14,18 View this table: TABLE 1. Incidence of Warfarin Embryopathy The incidence of warfarin embryopathy will be lower with use of IV unfractionated heparin in the first 3 months (especially between the 6th to 12th weeks) of pregnancy; one review concluded that this strategy “eliminated the risk. ”19 IV unfractionated heparin use in the last 2 weeks of pregnancy is associated with a reduced risk of hemorrhage during delivery and the neonatal period in the mother, as well as in the baby, because warfarin crosses the placenta, and therefore, the fetus/baby is anticoagulated. To reduce the latter complication, some have suggested elective caesarian section in the 38th week of pregnancy.17,18 An earlier study reported the incidence of abortion and stillbirths in these patients was …
Lack of autonomic contributions to tonic nitric oxide‐mediated vasodilatation in unanesthetized free‐moving rats

Objective To clarify the controversial issue of whether autonomic influences modulate vascular nitric oxide-mediated vasodilatation or even directly contribute to production of nitric oxide (NO) via nitroxidergic fibers. Methods Chronic venous and arterial catheters were implanted in Wistar-Kyoto rats (n = 65) for continuous blood pressure measurement, drug administration and blood sampling. Tonic NO-dependent vasodilatation in the conscious free-moving animal was evaluated as the pressor response to inhibition of NO synthesis by intravenous L-monomethylarginine (a 100 mg/kg intravenous bolus plus 0.5 mg/kg per min infusion for 30 min). Experiments were performed under control conditions, chemical sympathectomy by 6-hydroxy-dopamine, ganglionic blockade by hexamethonium, and surgical denervation of sino-aortic baroreceptors. Results Baseline mean arterial pressure was 100 ± 4 mmHg (mean ± SEM) in control rats and 73 ± 3, 62 ± 5, and 105 ± 10 mmHg in sympathectomized, ganglion-blocked, and denervated rats, respectively. The peak increase in mean arterial pressure after administration of L-monomethylarginine was 38 ± 3 mmHg in control rats and 51 ± 3, 50 ± 6, and 63 ± 10 mmHg in sympathectomized, ganglion-blocked, and denervated rats, respectively. Epinephrine and norepinephrine levels in rats of separate groups of unanesthetized control, sympathectomized and ganglion-blocked animals were measured by high-performance liquid chromatography from an arterial blood sample, the results indicating drastic reductions in levels of both catecholamines in the ganglion-blocked (but not in the sympathectomized) rats compared with those in the control rats. Conclusions Tonic NO-dependent vasodilatation can normally be maintained in the unanesthetized unrestrained rat irrespective of autonomic or humoral adrenergic influences.
Sex chromosome evolution and speciation in Ficedula flycatchers

Speciation is the combination of evolutionary processes that leads to the reproductive isolation of different populations. We investigate the significance of sex-chromosome evolution on the development of post–and prezygotic isolation in two naturally hybridizing Ficedula flycatcher species. Applying a tag–array–based mini–sequencing assay to genotype single nucleotide polymorphisms (SNPs) and interspecific substitutions, we demonstrate rather extensive hybridization and backcrossing in sympatry. However, gene flow across the partial postzygotic barrier (introgression) is almost exclusively restricted to autosomal loci, suggesting strong selection against introgression of sex–linked genes. In addition to this partial postzygotic barrier, character displacement of male plumage characteristics has previously been shown to reinforce prezygotic isolation in these birds. We show that male plumage traits involved in reinforcing prezygotic isolation are sex linked. These results suggest a major role of sex–chromosome evolution in mediating post–and prezygotic barriers to gene flow and point to a causal link in the development of the two forms of reproductive isolation.
Morphological characters and ascorbic acid content of an elite genotype of Corchorus olitorius: the influence of moisture stress

Moisture stress can be deleterious to physicochemical properties of crop species to a varying degree. The influence of moisture stress on the ascorbic acid content in the leaf and morphological characters of an elite genotype of Corchorus olitorius were tested in a glasshouse experiment. The experiment was arranged in a completely randomized design replicated four times. The results of the study showed that a distinct moisture-stress threshold, described as heavy moisture stress, existed for the genotype and ascorbic acid accumulation in the leaves decreased by up to 88.7% because of moisture stress. A comparison of the control with heavy moisture stress showed a decline of 57.1% and 68.4% for plant height and number of leaves, respectively. A degree of resilience of C. olitorius to moisture stress was observed with increasing plant age, but with a significant trade-off in the nutritional quality of the genotype at harvest.
SELF-PROMOTION VERSUS COMPETITOR DEROGATION: THE INFLUENCE OF SEX AND ROMANTIC RELATIONSHIP STATUS ON INTRASEXUAL COMPETITION STRATEGY SELECTION

Abstract In a series of two studies, we explored people's selection of self-promotion or competitor derogation when intrasexually competing for mates, as influenced by sex and romantic relationship involvement. In Study 1, student participants completed a forced-choice survey outlining six hypothetical competitive tactics. The findings indicated that self-promotion was chosen more often than competitor derogation, regardless of sex and current relationship involvement. In Study 2, we relied upon a community sample that completed a continuous measure that expanded upon the survey of Study 1. We found that women reported significantly more self-promotion than men, and men reported significantly more competitor derogation. Individuals who were romantically uninvolved and those who were dating reported higher levels of self-promotion and competitor derogation than those who were married or in a common-law relationship. Social desirability impacted on competitor derogation but not self-promotion. In contrast, .
Plasma cytokines in polycythemia vera: Phenotypic correlates, prognostic relevance, and comparison with myelofibrosis

Plasma cytokine milieu is abnormal in primary myelofibrosis (PMF) and correlates with disease phenotype and prognosis. In this study, we show that several plasma cytokines are also abnormally expressed in polycythemia vera (PV; n = 65), compared to normal controls (n = 35), but with a significantly different pattern than that of PMF (n = 127). Direct phenotypic correlation in PV included levels of IL‐12 with hematocrit; IL‐1b, IL‐2, IL‐7, FGF‐b, and HGF with leukocytosis; and IFN‐α and IFN‐γ with thrombocytosis. In univariate analysis, levels of 13 cytokines (out of 30 analyzed) correlated with survival but only MIP‐1β remained significant on multivariable analysis that included the other cytokines as covariates. Increased level of MIP‐1β (P < 0.01), older age (P < 0.01), and leukocytosis (P = 0.03) maintained their association with shortened survival, on multivariable analysis. This study provides preliminary observations that warrant a larger scale study and suggests the value of plasma cytokines as prognostic biomarkers in PV. Am. J. Hematol. , 2012. © 2012 Wiley Periodicals, Inc.
Labour market discrimination against former juvenile delinquents: evidence from a field experiment

In view of policy action to integrate ex-offenders into society, it is important to identify the underlying mechanisms of the negative relationship between criminal record on the one hand and later employment and earnings on the other hand. In this study, we identify hiring discrimination against former juvenile delinquents in a direct way. To this end, we conduct a field experiment in the Belgian labour market. We find that labour market discrimination is indeed a major barrier in the transition to work for former juvenile delinquents. Labour market entrants disclosing a history of juvenile delinquency get about 22% less callback compared to their counterparts without a criminal record. This discrimination is heterogeneous by the occupation for which one applies.
Multimodal Imaging Characteristics and Functional Test Findings in a Case of Acute Macular Neuroretinopathy Accompanied by Behçet Disease

ABSTRACT Purpose: To report a case of acute macular neuroretinopathy (AMN) in Behçet Disease. Case: A 23-year-old male presented with a complaint for central scotoma in his right eye. He had been diagnosed with Behçet Disease 3 years ago. Best-corrected visual acuity (BCVA) was 20/20. Anterior chamber and fundus examinations were unremarkable. Optical coherence tomography revealed a paracentral area of outer nuclear layer thinning. Infrared reflectance showed a well-defined, circular, hyporeflective area. Optical coherence tomography angiography revealed an area of capillary dropout in deep retinal capillary plexus corresponding to that hyporeflective lesion. Microperimetry test showed decreased macular sensitivity on the lesion area and the loss of the macular integrity. In multifocal electroretinogram, diminished amplitudes of the central cone responses were detected nasal to fixation. Conclusion: Behçet disease is a cause of occlusive retinal vasculitis. Accompanied retinal microvascular disease may be a possible risk factor of AMN suggesting ischemic etiopathogenesis for AMN.
Treatment of complicated skin and soft tissue infections.

BACKGROUND Skin and soft tissue infections (SSTIs) may produce substantial morbidity and mortality rates, particularly those classified as complicated or necrotizing. OBJECTIVE To weigh the strength of recommendations using the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) methodology and to provide evidence-based recommendations for diagnosis and management for SSTIs. DATA SOURCES Computerized identification of published research and review of relevant articles. STUDY SELECTION All published reports on the management of complicated and necrotizing SSTIs were evaluated by an expert panel of members of the Surgical Infection Society according to published guidelines for evidence-based medicine. The quality of the evidence was judged by the GRADE methodology and criteria. Practice surveys, pharmacokinetic studies, and reviews or duplicative publications presenting primary data already considered were excluded from analysis. DATA EXTRACTION Information on demographics, study dates, microbiology findings, antibiotic type, surgical interventions, infection-related outcomes, and the methodologic quality of the studies was extracted. Results were submitted to the Therapeutic Agents Committee of the Surgical Infection Society for review prior to creation of the final consensus document. DATA SYNTHESIS Current surgical and antibiotic management of complicated SSTIs is based on a small number of studies that often have insufficient power to draw well-supported conclusions, with the exception of antimicrobial therapy for non-necrotizing soft tissue infections, for which ample data are available.
Difference in accuracy between gastroscopy and colonoscopy for detection of cancer.

BACKGROUND/AIMS There are few reports regarding the accuracy of endoscopy in detecting cancer. We investigated the difference in the false-negative rates for cancer detection between gastroscopy and colonoscopy using the records of a population-based cancer registry, which is the most accurate in Japan. METHODOLOGY Between 1990 and 1995, 51,411 gastroscopic and 7756 colonoscopic examinations were carried out in our hospital. These subjects were matched with the cancer registry and the patients whose gastric or colorectal cancers were missed by examinations were identified. RESULTS The false-negative rate for the detection with gastroscopy was 25.8 percent at three years but that with colonoscopy was 11.1 percent. This difference was statically significant p = 0.01. CONCLUSIONS We concluded that for routine examinations, surveillance after negative endoscopy should be discussed based on the difference in false-negative rates between gastroscopy and colonoscopy.
Nebivolol, But Not Metoprolol, Lowers Blood Pressure in Nitric Oxide–Sensitive Human Hypertension

Nebivolol, unlike other selective &bgr;1-receptor blockers, induces vasodilation attributable to increased NO bioavailability. The relative contribution of this mechanism to the blood pressure (BP)–lowering effects of nebivolol is unclear because it is normally masked by baroreflex buffering. Autonomic failure provides a unique model of hypertension devoid of autonomic modulation but sensitive to the hypotensive effects of NO potentiation. We tested the hypothesis that nebivolol would decrease BP in these patients through a mechanism independent of &bgr;-blockade. We randomized 20 autonomic failure patients with supine hypertension (14 men; 69±2 years) to receive a single oral dose of placebo, nebivolol 5 mg, metoprolol 50 mg (negative control), and sildenafil 25 mg (positive control) on separate nights in a double-blind, crossover study. Supine BP was monitored every 2 hours from 8:00 PM to 8:00 AM. Compared with placebo, sildenafil and nebivolol decreased systolic BP during the night (P<0.001 and P=0.036, by mixed-effects model, maximal systolic BP reduction 8-hour postdrug of −20±6 and −24±9 mm Hg, respectively), whereas metoprolol had no effect. In a subanalysis, we divided patients into sildenafil responders (BP fall >20 mm Hg at 4:00 AM) and nonresponders. Nebivolol significantly lowered systolic BP in sildenafil responders (−44±13 mm Hg) but not in nonresponders (1±11 mm Hg). Despite lowering nighttime BP, nebivolol did not worsen morning orthostatic tolerance compared with placebo. In conclusion, nebivolol effectively lowered supine hypertension in autonomic failure, independent of &bgr;1-blockade. These results are consistent with the hypothesis that NO potentiation contributes significantly to the antihypertensive effect of nebivolol.
Complete Amino Acid Sequence of the Mu Heavy Chain of a Human IgM Immunoglobulin

The amino acid sequence of the �, chain of a human IgM immunoglobulin, including the location of all disulfide bridges and oligosaccharides, has been determined. The homology of the constant regions of immunoglobulin �, γ, α, and ε heavy chains reveals evolutionary relationships and suggests that two genes code for each heavy chain.
Potential Role of Chitotriosidase Gene in Nonalcoholic Fatty Liver Disease Evolution

BACKGROUND:Nonalcoholic steatohepatitis (NASH) is a liver disease characterized by steatosis and periportal and lobular inflammation. The molecular mechanisms involved in the anomalous behavior of liver cells have only partially been disclosed. Human Chitotriosidase (Chit) is a member of the chitinase family that it is mainly synthesized by activated macrophages. We investigated chitotriosidase gene expression in Kupffer cells to determine the potential implication of this enzyme in the inflammation and in the progression from uncomplicated steatosis to steatohepatitis with progressive fibrosis.METHODS:Seventy-five liver biopsies from 40 subjects with NASH, 20 with simple steatosis, and 15 controls were used to detect CHIT expression, tumor necrosis factor-alpha (TNF-α), alpha-smooth muscle actin (α-SMA), and lipid peroxidation.RESULTS:CHIT was expressed exclusively by Kupffer cells. The levels of CHIT expression were significantly higher in NASH patients than in simple steatosis patients and in the control group. In addition, we found that CHIT over-expression influenced hepatic stellate cells activation, as demonstrated by the significant correlation between CHIT and α-SMA expression in NASH patients. A significant correlation was observed also between CHIT, TNF-α and lipid peroxidation in both NASH and simple steatosis.CONCLUSION:These results suggest that CHIT over-produced by Kupffer cells may contribute to the progression of hepatic fibrosis.
Optimierung der Zuchtwertschätzung für Milchleistungsmerkmale unter besonderer Berücksichtigung der Umwelteinflüsse in einem Testtagsmodell

Bei der Zuchtwertschatzung fur das Rind kann in Testtagsmodellen die Korrektur der Umwelteinflussfaktoren direkt auf der Basis des einzelnen Kontrolltagsgemelks erfolgen. Dies stellt einen grundlegenden Wechsel der Betrachtungsweise von Einflussfaktoren im Vergleich zu den bisherigen Abschnittsmodellen dar. In der vorliegenden Arbeit wurden Umwelteinflussfaktoren in einem Mehrmerkmals-Wiederholbarkeits-Testtagstiermodell auf Signifikanz gepruft und in ihrer Definition optimiert. Zur Beurteilung der Gute der Korrektur der Umwelteinflusse wurde zum einen die Anpassung des Auswertungsmodells an die beobachteten Leistungsdaten (Residual Mean Squared Error) und zum anderen der Einfluss von Modellanderungen auf die Genauigkeit der geschatzten Zuchtwerte herangezogen. Mit einer in der vorliegenden Arbeit abgeleiteten Methodik wurde der Einfluss unterschiedlicher Definitionen der Einflussfaktoren auf die Korrelation zwischen dem wahren und dem geschatzten Zuchtwert (r_HI) untersucht. Einen Schwerpunkt der Arbeit stellte die Optimierung der Zeitgefahrtengruppe auf der Basis des Herdenkontrolltags dar, da die durchschnittliche Anzahl der Beobachtungen an einem Herdenkontrolltag mit 11.3 bzw. 10.0 fur die Rassen Fleckvieh und Braunvieh in Bayern relativ klein ist. In verschiedenen Teildatensatzen wurde ein Anstieg von r_HI nachgewiesen, wenn die Wechselwirkung zwischen der Paritat der Kuh und dem Herdenkontrolltag nicht im Zuchtwertschatzmodell berucksichtigt wurde. Dies galt vor allem fur die Zuchtwerte von Kuhen aus kleineren Herden, aber auch fur die Zuchtwerte der Bullen und fuhrte zu der Empfehlung, diese Wechselwirkung nicht im Zuchtwertschatzmodell zu berucksichtigen. Bei der Korrektur des Trachtigkeitseinflusses im Testtagsmodell wurde ein Zusammenhang zwischen der Zwischenkalbezeit und den Milchleistungsmerkmalen festgestellt. Aus diesem Grund sollte die Korrektur des Trachtigkeitsstadiums mit Hilfe eines Polynoms dritter Ordnung fur den Trachtigkeitstag den Vorzug vor der Berucksichtigung mit Hilfe der Variablen Zwischenkalbezeit oder Gustzeit erhalten. Die Untersuchung der weiteren Einflussfaktoren Laktationsstadium, Kalbejahr, -monat, -alter und Region fuhrte zu dem in der vorliegenden Arbeit vorgeschlagenen Modell zur Korrektur der Umwelteinflusse, das bei der Entwicklung einer Routine-Zuchtwertschatzung fur die Rassen Fleckvieh und Braunvieh in Suddeutschland berucksichtigt werden soll.
Comment dépister et prendre en charge le rebond précoce d’adiposité chez les enfants à Montreuil ?

CONTEXTE : L’obesite infantile favorise le developpement de maladies des l’enfance. Le depistage du rebond precoce d’adiposite permet d’intervenir le plus precocement possible. QUESTION : Comment depister et prendre en charge le rebond d’adiposite precoce chez les enfants a Montreuil ? METHODE : Recherche de consensus par groupe nominal pour le protocole de depistage du rebond d’adiposite precoce et elaboration du protocole de prise en charge des enfants depistes selon la methode du groupe RAND/UCLA Appropriateness Method (RAM). RESULTATS : Le depistage ne pourra pas se faire par des actions collectives, mais par la multiplication des mesures d’IMC individuelles par l’ensemble des professionnels de la sante des enfants mais aussi par les parents. Le renforcement de l'utilisation du carnet de sante est indispensable. Une large campagne d’information des professionnels et du grand public est necessaire. La litterature ne contient aucune etude evaluant specifiquement les interventions a proposer en cas de rebond d’adiposite precoce. Le vote du groupe RAM aboutit a un protocole inedit associant neuf interventions. Il combine des ateliers pour les parents, des activites pour les enfants, une formation des professionnels de la petite enfance et un guide des lieux ou sortir en famille. CONCLUSION : Le depistage du rebond d’adiposite a Montreuil devra etre realise de maniere individuelle, par l’ensemble des professionnels de la sante des enfants mais aussi par les parents. Le protocole de prise en charge proposera aux familles des enfants depistes un programme de neuf interventions sur une annee. Une evaluation de l’efficience de ce protocole sera necessaire.