Miracle-dz/UniFAR-FTUs huggingface dataset:
An Intervention to Improve Pain Management in the Pediatric Emergency Department

Objective The objective of this study was to measure the impact of a structured intervention on pain management in a pediatric emergency department (ED). Methods Data were prospectively collected from children presenting to an urban tertiary care pediatric ED before and after intervention. Data were collected on the rate and timeliness of analgesic administration, the assessment and reassessment of pain, periprocedural anesthesia, and patient satisfaction. The intervention was developed by a multidisciplinary committee composed of physicians, nurses, and child life specialists and was focused on correcting deficiencies identified before intervention data collection. It consisted of a policy defining pain, pain-appropriate analgesia, age-appropriate pain assessment, and adequate preprocedural and periprocedural analgesia. Implementation occurred through provider education, organizational changes, and patient empowerment. Results One hundred two patients were enrolled during the preintervention period, and 109 were enrolled in the postintervention period. The percentage of patients in pain receiving any analgesic increased from 34% to 50%, an increase of 16% (95% confidence interval [CI], 1%–30%). The median time to medication administration decreased from 97 minutes to 57 minutes, a decrease of 40 minutes (95% CI, −84 to 4 minutes). The percentage of children receiving preprocedural analgesia increased from 10% to 62%, an increase of 52% (95% CI, 12%–74%). Reassessment of pain by physicians increased from 6% to 76%, an increase of 70% (95% CI, 59%–78%). Conclusions A structured intervention, tailored to pain management shortcomings commonly found in the pediatric ED, can lead to improvements in the treatment and prevention of pain in childhood emergencies.
The Preclinical Pharmacology and Therapeutic Activity of the Novel CHK1 Inhibitor SAR-020106

Genotoxic antitumor agents continue to be the mainstay of current cancer chemotherapy. These drugs cause DNA damage and activate numerous cell cycle checkpoints facilitating DNA repair and the maintenance of genomic integrity. Most human tumors lack functional p53 and consequently have compromised G1-S checkpoint control. This has led to the hypothesis that S and G2-M checkpoint abrogation may selectively enhance genotoxic cell killing in a p53-deficient background, as normal cells would be rescued at the G1-S checkpoint. CHK1 is a serine/threonine kinase associated with DNA damage–linked S and G2-M checkpoint control. SAR-020106 is an ATP-competitive, potent, and selective CHK1 inhibitor with an IC50 of 13.3 nmol/L on the isolated human enzyme. This compound abrogates an etoposide-induced G2 arrest with an IC50 of 55 nmol/L in HT29 cells, and significantly enhances the cell killing of gemcitabine and SN38 by 3.0- to 29-fold in several colon tumor lines in vitro and in a p53-dependent fashion. Biomarker studies have shown that SAR-020106 inhibits cytotoxic drug–induced autophosphorylation of CHK1 at S296 and blocks the phosphorylation of CDK1 at Y15 in a dose-dependent fashion both in vitro and in vivo. Cytotoxic drug combinations were associated with increased γH2AX and poly ADP ribose polymerase cleavage consistent with the SAR-020106–enhanced DNA damage and tumor cell death. Irinotecan and gemcitabine antitumor activity was enhanced by SAR-020106 in vivo with minimal toxicity. SAR-020106 represents a novel class of CHK1 inhibitors that can enhance antitumor activity with selected anticancer drugs in vivo and may therefore have clinical utility. Mol Cancer Ther; 9(1); 89–100
A Kainate Receptor Linked to Nitric Oxide Synthesis from Arginine

Abstract: In slices of young rat cerebellum, the glutamate analogue kainate induced a large accumulation of cyclic GMP, which was inhibited by non‐TV‐methyl‐D‐aspartate antagonists. Quisqualate and a‐amino‐3‐hydroxy‐5‐methyl‐4‐isoxazoIepropionate evoked only small cyclic GMP responses and inhibited the effect of kainate. When tested in cerebellar cell suspensions, glutamate was also a potent antagonist of the cyclic GMP response to kainate. Superoxide dismutase enhanced the response in the isolated cells, whereas haemoglobin and methylene blue were inhibitory. The response in slices was Ca2+ dependent, augmented by arginine, and inhibited by l‐NG‐mono‐methylarginine in a manner that could be reversed by additional arginine. It is concluded that stimulation of kainate receptors leads to activation of the enzyme that synthesises nitric oxide from arginine and that activation of soluble guanylate cyclase by the released nitric oxide accounts for the cyclic GMP generation.
Optimal Scheduling of Compute-Intensive Tasks on a Network of Workstations

In a network of high performance workstations, many workstations are underutilized by their owners. The problem of using these idle cycles for solving computationally intensive tasks by executing a large task on many workstations has been addressed before and algorithms with O(N/sup 2/) time and O(N) space for choosing the optimal subset of workstations out of N workstations were presented. We improve these algorithms to reduce the running time to O(N log N), while keeping the space requirement the same. The proposed algorithms are particularly useful for SPMD parallelism where computation is the same for all workstations and the data space is partitioned between the workstations. >
Model Driven Testing with Time Augmented Markov Chain Usage Models - Computations and Test Case Generation Algorithms for Time Augmented Markov Chain Usage Models

In statistical testing Markov Chain Usage Models (MCUM) are employed to describe the possible usage of the System-under-test (SUT) and to automatically derive test cases. However, MCUMs, as they are applied today, do not provide a universal concept for the integration of time. The estimated or known delay time of usage states and execution time of actions can only be considered by auxiliary means. But the importance of this aspect grows continously with the integration of increasingly complex and time sensitive systems in the automotive environment, such as hybrid vehicles. To overcome this drawback we present an intuitive extension of MCUMs that allows the consistent integration of time in MCUMs. We discuss how computations for MCUMs can be easily adapted to Time Augmented MCUMs and present algorithms for automatic test case generation from Time Augmented MCUMs together with a case study that has been conducted in the automotive domain.
Effects of the Global Financial Crisis on Health in High-Income Oecd Countries

A growing body of evidence documents how economic crises impact aspects of health across countries and over time. We performed a systematic narrative review of the health effects of the latest economic crisis based on studies of high-income countries. Papers published between January 2009 and July 2015 were selected based on review of titles and abstracts, followed by a full text review conducted by two independent reviewers. Ultimately, 122 studies were selected and their findings summarized. The review finds that the 2008 financial crisis had negative effects on mental health, including suicide, and to a varying extent on some non-communicable and communicable diseases and access to care. Although unhealthy behaviors such as hazardous drinking and tobacco use appeared to decline during the crisis, there have been increases in some groups, typically those already at greatest risk. The health impact was greatest in countries that suffered the largest economic impact of the crisis or prolonged austerity. The Great Recessions in high-income countries have had mixed impacts on health. They tend to be worse when economic impacts are more severe, prolonged austerity measures are implemented, and there are pre-existing problems of substance use among vulnerable groups.
Handbook of Financial Data and Risk Information II: US residential-mortgage transfer systems: a data-management crisis

This paper reviews the current state of residential-mortgage data structures from origination through the securitization supply chain. We discuss the various uses of these data, their limitations in mortgage-risk management, and the current lack of transparency in important segments of the mortgage market. We conclude that despite the size and importance of the mortgage market in the overall U.S. economy, current data-management practices make it difficult or impossible for borrowers, lenders, investors and government regulators to perform the oversight and analysis functions necessary to maintain an orderly market and to ensure fair pricing of securities backed by those mortgages. ∗The authors gratefully acknowledge helpful contributions from Rob Freund, Patrick Greenfield, and Dwight Jaffee. †U.C. Davis School of Law, U.C. Davis, jphunt@ucdavis.edu. ‡Haas School of Business, U.C. Berkeley, stanton@haas.berkeley. edu. §Haas School of Business, U.C. Berkeley, wallace@haas.berkeley. edu.
Diffusion in a nonhomogeneous medium: quasi-random walk on a lattice

Abstract We are interested in Monte Carlo (MC) methods for solving the diffusion equation: in the case of a constant diffusion coefficient, the solution is approximated by using particles and in every time step, a constant stepsize is added to or subtracted from the coordinates of each particle with equal probability. For a spatially dependent diffusion coefficient, the naive extension of the previous method using a spatially variable stepsize introduces a systematic error: particles migrate in the directions of decreasing diffusivity. A correction of stepsizes and stepping probabilities has recently been proposed and the numerical tests have given satisfactory results. In this paper, we describe a quasi-Monte Carlo (QMC) method for solving the diffusion equation in a spatially nonhomogeneous medium: we replace the random samples in the corrected MC scheme by low-discrepancy point sets. In order to make a proper use of the better uniformity of these point sets, the particles are reordered according to their successive coordinates at each time step. We illustrate the method with numerical examples: in dimensions 1 and 2, we show that the QMC approach leads to improved accuracy when compared with the original MC method using the same number of particles.
Dark progression reveals slow timescales for radiation damage between T = 180 and 240 K.

Can radiation damage to protein crystals be `outrun' by collecting a structural data set before damage is manifested? Recent experiments using ultra-intense pulses from a free-electron laser show that the answer is yes. Here, evidence is presented that significant reductions in global damage at temperatures above 200 K may be possible using conventional X-ray sources and current or soon-to-be available detectors. Specifically, `dark progression' (an increase in damage with time after the X-rays have been turned off) was observed at temperatures between 180 and 240 K and on timescales from 200 to 1200 s. This allowed estimation of the temperature-dependent timescale for damage. The rate of dark progression is consistent with an Arrhenius law with an activation energy of 14 kJ mol(-1). This is comparable to the activation energy for the solvent-coupled diffusive damage processes responsible for the rapid increase in radiation sensitivity as crystals are warmed above the glass transition near 200 K. Analysis suggests that at T = 300 K data-collection times of the order of 1 s (and longer at lower temperatures) may allow significant reductions in global radiation damage, facilitating structure solution on crystals with liquid solvent. No dark progression was observed below T = 180 K, indicating that no important damage process is slowed through this timescale window in this temperature range.
Promoting Local Tourism through Local Government Web Site: An E-Government Application

This chapter is an attempt to investigate the current issues and development of the application of e-government in promoting local tourism industry for small and local cities and counties throughout the United States. The primary data for this study are collected through a comprehensive Web site evaluation. The objectives of this chapter are: (1) to examine the use of online tourism promotion implemented in local city and county Web sites across the United States, (2) to identify major issues and challenges for local governments in promoting local tourism online, and (3) to discuss the managerial implications for future research. The data collected from this study show that there is an emerging need for improvement in promoting local tourism through e-government application.
Photoacoustic imaging enhanced by indocyanine green-conjugated single-wall carbon nanotubes

Abstract. A photoacoustic contrast agent that is based on bis-carboxylic acid derivative of indocyanine green (ICG) covalently conjugated to single-wall carbon nanotubes (ICG/SWCNT) is presented. Covalently attaching ICG to the functionalized SWCNT provides a more robust system that delivers much more ICG to the tumor site. The detection sensitivity of the new contrast agent in a mouse tumor model is demonstrated in vivo by our custom-built photoacoustic imaging system. The summation of the photoacoustic tomography (PAT) beam envelope, referred to as the “PAT summation,” is used to demonstrate the postinjection light absorption of tumor areas in ICG- and ICG/SWCNT-injected mice. It is shown that ICG is able to provide 33% enhancement at approximately 20 min peak response time with reference to the preinjection PAT level, while ICG/SWCNT provides 128% enhancement at 80 min and even higher enhancement of 196% at the end point of experiments (120 min on average). Additionally, the ICG/SWCNT enhancement was mainly observed at the tumor periphery, which was confirmed by fluorescence images of the tumor samples. This feature is highly valuable in guiding surgeons to assess tumor boundaries and dimensions in vivo and to achieve clean tumor margins to improve surgical resection of tumors.
Evolution of inflammation in nonalcoholic fatty liver disease: The multiple parallel hits hypothesis

Whereas in most cases a fatty liver remains free of inflammation, 10%‐20% of patients who have fatty liver develop inflammation and fibrosis (nonalcoholic steatohepatitis [NASH]). Inflammation may precede steatosis in certain instances. Therefore, NASH could reflect a disease where inflammation is followed by steatosis. In contrast, NASH subsequent to simple steatosis may be the consequence of a failure of antilipotoxic protection. In both situations, many parallel hits derived from the gut and/or the adipose tissue may promote liver inflammation. Endoplasmic reticulum stress and related signaling networks, (adipo)cytokines, and innate immunity are emerging as central pathways that regulate key features of NASH. (HEPATOLOGY 2010;52:1836‐1846)
Oocyte quality in small antral follicles in the presence or absence of a large dominant follicle in cattle.

The aim of these experiments was to determine whether the presence of a dominant follicle affects the developmental competence of oocytes from small antral follicles of cattle. In Expt 1, oocytes or follicular fluid samples were collected from follicles 2-7 mm in diameter before (day 3 of the oestrous cycle; n = 4) or after (days 6 and 7 of the oestrous cycle; n = 6) emergence of the first wave dominant follicle (verified by rectal ultrasonography). Five to ten follicles were aspirated for the determination of individual follicular fluid concentrations of oestradiol, progesterone, testosterone and dimeric inhibin; oocytes from the remaining follicles from each cow were pooled and developmental capacity assessed by in vitro fertilization and maturation. In Expt 2, ovaries containing a young corpus luteum and with or without a large oestrogen-active follicle were collected from the abattoir. Follicular aspirates from small follicles in each pair of ovaries were pooled, and oocyte quality and steroid concentrations were determined. In Expt 1, small follicles obtained before emergence of the dominant follicle contained significantly more oestradiol than they did after emergence (19.5 +/- 1.5 versus 0.7 +/- 1.1 ng ml-1, respectively; P < 0.05), but there were no significant differences in concentrations of progesterone, testosterone or dimeric inhibin. The percentage of blastocysts obtained from oocytes collected before (12.1 +/- 9.0) or after emergence (11.8 +/- 7.0) of the dominant follicle did not differ significantly (P > 0.05). In Expt 2, follicular steroid concentrations did not differ in small follicles taken in the presence versus the absence of a large oestrogen-active follicle, and there were no differences in the developmental capacity of the oocytes. There were significant negative correlations between follicular oestradiol concentration and the percentage of blastocysts formed from two-cell (r = -0.90; P < 0.01) and eight-cell embryos (r = -0.65; P < 0.05). These data suggest that in cattle the developmental competence of oocytes from small antral follicles is not adversely affected by the presence of a dominant follicle.
Discrete element modeling and fibre optical measurements for fluidized bed spray granulation

Spout fluidized beds are frequently used for the production of granules or particles through granulation. The products find application in a large variety of applications, for example detergents, fertilizers, pharmaceuticals and food. Spout fluidized beds have a number of advantageous properties, such as a high mobility of the particles, which prevents undesired agglomeration and yields excellent heat transfer properties. The particle growth mechanism in a spout fluidized bed as function of particle-droplet interaction has a profound influence on the particle morphology and thus on the product quality. Nevertheless, little is known about the details of the granulation process. This is mainly due to the fact that the granulation process is not visually accessible. In this work we use fundamental, deterministic models to enable the detailed investigation of granulation behaviour in a spout fluidized bed. A discrete element model is used describing the dynamics of the continuous gas-phase and the discrete droplets and particles. For each element momentum balances are solved. The momentum transfer among each of the three phases is described in detail at the level of individual elements. The results from the discrete element model simulations are compared with local measurements of particle volume fractions as well as particle velocities by using a novel fibre optical probe in a fluidized bed of 400 mm I.D. Simulations and experiments were carried out for two different cases using Geldart B type aluminium oxide particles: a freely bubbling fluidized bed and a spout fluidized bed with the presence of droplets. It is demonstrated how the discrete element model can be used to obtain information about the interaction of the discrete phases, i.e. the growth zone in a spout fluidized bed. Eventually this kind of information can be used to obtain closure information required in more coarse grained models
Reporting of medical errors: An intensive care unit experience

ObjectiveTo determine the occurrence and type of medical errors in an intensive care setting using a voluntary reporting method. DesignProspective, single-center, observational study. SettingThe medical intensive care unit (19 beds) at an urban teaching hospital. PatientsAdult patients requiring at least 48 hrs of intensive care. InterventionsProspective reporting of medical errors. Measurements and Main ResultsDuring a 6-month period, 232 medical events were reported involving 147 patients. A total of 2598 patient days were surveyed yielding 89.3 medical events reported per 1000 intensive care unit days. The source of the reports included nurses, who reported most of the medical events (59.1%), followed by physicians-in-training (27.2%) and intensive care unit attending physicians (2.6%). One hundred thirty (56.2%) medical events occurred within the intensive care unit and were judged to involve patient careproviders who were working directly in the intensive care unit area. One hundred and two (43.8%) medical events were commissions or omissions that occurred outside of the intensive care unit during patient transports or in the emergency department and hospital floors. Twenty-three (9.9%) medical events leading to a medical error resulted in the need for additional life-sustaining treatment, and seven (3.0%) medical errors may have contributed to patient deaths. ConclusionMedical errors appear to be common among patients requiring intensive care. Medical events resulting in an error can result in the need for additional life-sustaining treatments and, in some circumstances, can contribute to patient death. Patient healthcare providers appear to be in a unique position to identify medical errors. Institutions should develop formalized methods for the reporting and analysis of medical errors to improve patient care.
Quantum-mechanical generation of gravitational waves in a braneworld

We study the quantum-mechanical generation of gravitational waves during inflation on a brane embedded in a five-dimensional anti de Sitter bulk. To make the problem well posed, we consider the setup in which both initial and final phases are given by a de Sitter brane with different values of the Hubble expansion rate. Assuming that the quantum state is in a de Sitter invariant vacuum in the initial de Sitter phase, we numerically evaluate the amplitude of quantum fluctuations of the growing solution of the zero mode in the final de Sitter phase. We find that the vacuum fluctuations of the initial Kaluza-Klein gravitons as well as of the zero mode gravitons contribute to the final amplitude of the zero mode on small scales, and the power spectrum is quite well approximated by what we call the rescaled spectrum, which is obtained by rescaling the standard four-dimensional calculation following a simple mapping rule. Our results confirm the speculation raised in Ref. [T. Kobayashi, H. Kudoh, and T. Tanaka, Phys. Rev. D 68, 044025 (2003). ] before.
Outcomes of Turkish Ankylosing Spondylitis Patients

Ankylosing spondylitis (AS) is chronic, progressive, systemic inflammatory rheumatic diseases that lead to serious disability. The objective of this study was to determine the demographic, clinic characteristics and CYP2D6*4 gene mutation profiles of the AS patients in Tokat, Turkey. In this retrospective study, we evaluated 103 patients that were diagnosed and followed up as AS in Tokat, Turkey between 2008-2011. Demographical properties (age, sex, education level, age at diagnosis, disease duration), clinical characteristics (HLA27, peripheral/extraarticular involvoment, chest expansion, enthesopathy, modified schouber) and genetic analysis results (CYP2D6*4 gene mutation frequency) of AS patients were assessed. The mean age of AS patients was 36.80p9. 25 years. The mean age of female and male 39.10p7. 89, 35.40p 9.79 respectively. The female to male ratio was 1:1.6. Major histocompatibility complex, class I, B 27 (HLAB27) was investigated and the rate of positivity was 73.78 %. There was a statistically significant difference between CYP2D6 gene mutation and peripheral /extraarticular involvement (p