Miracle-dz/UniFAR-FTUs huggingface dataset:
Incorporating recent advances to make the TRISS approach universally available.

BACKGROUND The Trauma and Injury Severity Score (TRISS), used to garner predictions of survival from the Injury Severity Score (ISS), the Revised Trauma Score (RTS, for physiologic reserve), and age is difficult for many trauma facilities to compute because it requires 8 to 10 variables and ISS depends on the specialized Abbreviated Injury Scale (AIS) scale rather than the International Classification of Diseases scale (ICD-9). It has been shown that metrics describing a patient's worst injury (WORSTSRR) are a powerful predictor of survival (regardless of coding type, AIS versus ICD-9) and that the Glasgow Coma Scale (GCS) motor component contains the majority of the information found in the full GCS score. This study hypothesized that the TRISS approach could be made more predictive and efficient with fewer variables by incorporating these advances. METHODS A total of 310,958 patients with nonmissing TRISS variables were subset from the National Trauma Data Bank (NTDB). Logistic regression was used to model mortality as a function of anatomic, physiologic and age variables. A traditional TRISS model was computed (with NTDB-derived coefficients) that uses ISS, RTS, age index, and mechanism to predict survival. Four smaller three- or four-variable models employed the ICD-9 WORSTSRR, the GCS motor component, and age (both continuously and dichotomously). Two of the four models also use mechanism. These models were compared using the concordance index (c-index, a measure of model discrimination) and the pseudo-R statistic (estimates proportion of variance explained). RESULTS Each experimental model (two models with 3 variables and two models with 4 variables) have superior discrimination and explain more variance than the traditional TRISS model that employs 8-10 variables. CONCLUSIONS Recent advances in anatomic and physiologic scoring markedly simplify TRISS-type models at no cost to prediction. This approach uses routinely available data, requires up to seven fewer terms, and predicts at least as well as the original TRISS. These findings could increase the availability of accurate trauma scoring tools to smaller trauma facilities.
Membrane Viability in the Long Term Peritoneal Dialysis Patient

A s both the number of peritoneal dialysis (PD) patients and the overall longevity of patients on PD increase worldwide, ongoing questions centering on the durability of the peritoneal membrane continue to generate significant discussion. These questions are pertinent not only to the clinical success of the modality, but constitute a research framework for federally funded and corporatesponsored research and product development activities. Over the last decade, the medical community has addressed a number of concerns in hemodialysis (HD), some ofwhich include: the importance ofmembrane biocompatibility, dialyzer reuse, and optimal dialysis targets. The focus is now on PD as we begin to examine those issues most pertinent to its continued growth. Since the peritoneal membrane is central to the success ofPD, alterations in its structural and functional durability can negatively affect patient outcome. Examining the basic structure of the peritoneal membrane and how membrane integrity is affected by PD will help establish a framework for future research initiatives.
PET OEF Reactivity for Hemodynamic Compromise in Occlusive Vascular Disease

Background and Purpose. Hemodynamic compromise in symptomatic patients with occlusive vascular disease (OVD) identified by cerebrovascular reserve (CVR) and oxygen extraction fraction (OEF) is an independent predictor of high stroke risk. However, up to 60% of patients compromised by CVR have normal OEF indicating a high rate of discordance. CVR is measured with an acetazolamide challenge, and OEF reactivity (OEFR) to acetazolamide, ie, a hemodynamic challenge, may reveal hemodynamic compromise and less discordance with measurements of CVR. Methods. Nine symptomatic patients with OVD were studied by positron emission tomography before and 15 minutes after 15 mg/kg intravenous acetazolamide in the middle cerebral artery territories of each hemisphere. Results. A close correlation between hemispheric CVR and OEFR was observed. Two hemispheres from two different patients showed an increase in OEF to acetazolamide challenge despite a normal baseline OEF. The two hemispheres showing an increase in OEF in response to acetazolamide were also associated with the lowest CVR and severest white matter hyperintensities. Conclusions. These observations suggest that positive OEFR may distinguish hemispheres in hemodynamic compromise despite normal OEF and show less discordance with CVR. However, these preliminary observations require confirmation in a larger study.
Benefit assessment in Germany.

To the Editor: In his Perspective article, Sawicki (Nov. 12 issue)1 portrays Germany as a land of milk and honey, thanks to the efforts and actions of the Institute for Quality and Efficiency in Health Care (Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen, or IQWiG). However, current politics tries with questionable success to prevent a class-divided medicine, in which access to innovations is restricted to high earners. Similarly biased and unfounded are his remarks concerning the purely Samaritan work of the IQWiG. The institute was founded to cut down costs and is financed solely through the statutory health insurance. Serious conflict of interest and heavily biased assessments are the results. The bias in assessing innovative drug regimens and the determination to come to preassigned conclusions can be illustrated by a number of examples in which sound methodologic standards have repeatedly been ignored. For example, in evaluating the randomized, double-blind trial of Clopidogrel versus Aspirin in Patients at Risk of Ischemic Events (CAPRIE), the IQWiG attributed a clinical benefit to clopidogrel only for the subgroup of patients with peripheral arterial disease, negating the proof of superiority in the predefined intention-to-treat analysis.2 The IQWiG also reported a suspicion of an increased risk of cancers with insulin analogues from a database analysis with a median follow-up of 1.3 years. Pocock and Smeeth, however, noted that “two serious errors make the article’s findings uninterpretable. ”3 Not surprisingly, very few assessments so far completed have shown a positive result for the drug under evaluation. A recent critical appraisal documented that the overall assessment and decision making are guided by a hidden agenda.4 There is no doubt that we need comparativeeffectiveness agencies, but they definitely should be more independent, unbiased, and impeccable.
Levels of cognitive and linguistic development in Angelman syndrome: a study of 20 children

Angelman syndrome (AS) is a genetic disorder associated with severe developmental delay. The purpose of this study was to investigate cognitive and linguistic development in AS. Piaget's developmental model was used to evaluate the test results. The participants comprised 20 children (14 boys and 6 girls) aged 2-14 years (median age 7.4 years). AS was diagnosed either according to typical clinical criteria or confirmatory genetic testing. Cognitive functioning was evaluated with Griffiths' Mental Development Scale. Language development was also evaluated with Receptive-Expressive Emergent Language Scale 2 (REEL-2). Cognitive functioning, based on results on the Performance Scale, never exceeded Piaget's sensorimotor stage, 0-2 years. The median mental age for language development was 9 months. Expressive verbal vocabulary consisted of less than 2 words (n = 11), 2-3 words (n = 7) and 4-5 words (n = 2). Analyses according to REEL-2 did not indicate a consistent discrepancy between impressive and expressive language.
Photovoltaic supply chain coordination under polysilicon capacity constraints

This paper studies the photovoltaic supply chain coordination under polysilicon capacity constraints, and separately builds revenue sharing contract model under polysilicon capacity constraints and cooperative R&D contract model break polysilicon capacity constraints, the research shows that i) Under the revenue sharing contract for Photovoltaic supply chain under Polysilicon capacity constraints, the coordinated wholesale price decreases with the rate of revenue sharing increasing, and Polysilicon chips manufacturer (PCM)'s profit increases while the Photovoltaic system manufacturer (PSM)'s profit decreases with rate of revenue sharing increasing. ii) Under the cooperative R&D contract for Photovoltaic supply chain under Polysilicon capacity constraints, the coordinated wholesale price decreases with the rate of R&D fund provided by PSM increasing, and PCM's profit decreases while the PSM's profit increases with R&D fund provided by PSM increasing.
A New Stable and Accurate Algorithm of Large Image Mosaic

Due to the overlapped region and image size of the input image pair is unpredictable, it makes the matching procedure more difficult and unstable. For the purpose of finding out the stable and accurate matching algorithm of large images, we give an analysis of different kinds of characters, such as, scale invariant feature transform (SIFT), local maximum gradient descriptor, Harris corners, and the maximum curvature points of the image edges, etc. Based on the experiments of different images, a new stable matching algorithm is proposed in this paper. In our model, the matching procedure is divided into two stages, the rough and accurate matching procedures. To evaluate the matching result, the edge information is combined with the local maximum gradient of the input images as the constraint of our matching algorithm. After the extraction of the local maximum gradient character points, we use the edge information to divide these points into different classes. Then, the searching of the stable and accurate matching problem becomes to find out the best matching results which agree to the edge constraints. The experimental results show that the proposed algorithm is more efficient and stable than the other kinds of matching algorithms especially in the proposing of large size images.
Equatorial range limits of an intertidal ectotherm are more linked to water than air temperature

As climate change is expected to impose increasing thermal stress on intertidal organisms, understanding the mechanisms by which body temperatures translate into major biogeographic patterns is of paramount importance. We exposed individuals of the limpet Patella vulgata Linnaeus, 1758, to realistic experimental treatments aimed at disentangling the contribution of water and air temperature for the buildup of thermal stress. Treatments were designed based on temperature data collected at the microhabitat level, from 15 shores along the Atlantic European coast spanning nearly 20° of latitude. Cardiac activity data indicated that thermal stress levels in P. vulgata are directly linked to elevated water temperature, while high air temperature is only stressful if water temperature is also high. In addition, the analysis of the link between population densities and thermal regimes at the studied locations suggests that the occurrence of elevated water temperature may represent a threshold P. vulgata is unable to tolerate. By combining projected temperatures with the temperature threshold identified, we show that climate change will likely result in the westward expansion of the historical distribution gap in the Bay of Biscay (southwest France), and northward contraction of the southern range limit in south Portugal. These findings suggest that even a minor relaxing of the upwelling off northwest Iberia could lead to a dramatic increase in thermal stress, with major consequences for the structure and functioning of the intertidal communities along Iberian rocky shores.
The role of basicranial synchondroses in flexure processes and ontogenetic development of the skull base.

The contribution of the basicranial synchondroses in the growth of neurocranial length and ontogenetic development of the cranial base were investigated. The study concentrated on the midsphenoidal synchondrosis and its delayed fusion in nonhuman primates when compared to man, and on the spheno-occipital synchondrosis. The mode and time of fusion of both growth centers were observed, and their role in the ontogenetic growth changes (flattening processes) of the cranial base were established. The chondrogenic ossification of midsphenoidal and spheno-occipital synchondroses was studied on 20 skulls of Macaca mulatta females, ranging in age from newborn specimens to those 24 months old. The technique of in vivo tetracycline bone labeling was used for histologic evaluation of the material. Different chondrogenic growth patterns were observed in both synchondroses. The endochondral activity of the spheno-occipital synchondrosis increased with age, from a nonactive narrow cartilaginous column in the neonatal specimen to a broad band with high chondrogenic ossification in the 24-month-old specimens. This growth center contributes to elongation of the posterior portion of the cranial base and is a secondary factor in its flexion. The midsphenoidal synchondrosis seems to be the primary factor in the mode of flexure of the cranial base in Macaques. This growth center is very active in the first ten months of life but later exhibits cessation of chondrogenic activity and long remains unfused. The first signs of fusion were observed as late as 72 months of age. At the same time, the continuous process of cranial base flattening showed the first signs of tapering off.
CD 40 Deficiency in Mice Exacerbates Obesity-induced Adipose 2 Tissue Inflammation , Hepatic Steatosis and Insulin Resistance

40 41 The pathophysiology of obesity and type 2 diabetes in rodents and humans is characterized by 42 low-grade inflammation in adipose tissue and liver. The CD40 receptor and its ligand, CD40L, 43 initiate immune cell signaling promoting inflammation, but conflicting data on CD40L null mice 44 confound its role in obesity-associated insulin resistance. Here we demonstrate that CD40 45 receptor deficient mice on a high fat diet display the expected decrease in hepatic cytokine levels, 46 but paradoxically exhibit liver steatosis, insulin resistance and glucose intolerance compared to 47 their age-matched wild type controls. Hyperinsulinemic-euglycemic clamp studies also 48 demonstrated insulin resistance in glucose utilization by the CD40 null mice compared to wild 49 type mice. In contrast to liver, adipose tissue in CD40 deficient animals harbors elevated cytokine 50 levels and infiltration of inflammatory cells, particularly macrophages and CD8 effector T-cells. 51 In addition, ex vivo explants of epididymal adipose tissue from CD40 mice display elevated 52 basal and isoproterenol-stimulated lipolysis, suggesting a potential increase of lipid efflux from 53 visceral fat to the liver. These findings reveal that, 1) CD40 null mice represent an unusual model 54 of hepatic steatosis with reduced hepatic inflammation, and 2) CD40 unexpectedly functions in 55 adipose tissue to attenuate its inflammation in obesity, thereby protecting against hepatic steatosis. 56 57 58 59
Fuzzy MCDM for evaluating the e-commerce strategy

This study aimed to provide a theoretically and empirically based model for evaluating and selecting an e-commerce strategy. In practical environments, mangers face a variety of information types that are vague. Traditional decision making methods cannot fulfill the e-commerce managers' needs. Therefore, a Fuzzy Multiple Criteria Decision-Making (MCDM) method is adopted in this research. In order to show the practicality and usefulness of this model, an empirical study of the Taiwan ISP industry is demonstrated. The results show that the first to market strategy is the most applicable.
GROWTH OF PSYCHROPHILIC BACTERIA

On the basis of the temperature range in which growth can occur, bacteria are usually divided into 3 groups, namely: thermophiles, mesophiles, and psychrophiles (sometimes called cryophiles or rhigophiles). Thermophiles have temperature optima (generally quite close to temperature maxima) 10 to 25 degrees above the temperature optima of mesophiles. Thermophiles and mesophiles are easily distinguished on this basis. Possibly by analogy to the distinction between thermophiles and mesophiles, most textbook definitions of psychrophiles are also based on temperature optima or maxima. Psychrophiles are usually defined as organisms that "grow best" below a certain temperature, usually 20 C (Lamanna and Mallette, 1953) or 12 to 18 C (Oginsky and Umbreit, 1954), and sometimes as low as 5 to 10 C (Kelly and Hite, 1949). Actually, however, there are very few reports of organisms with temperature optima below 20 C. Only three such organisms are listed in Bergey's Manual (Breed et al., 1948) and these are questionable, since the temperature maxima were 30 to 40 C. One would not expect optimum and maximum temperature to differ so greatly. ZoBell and Conn (1940) state that they have never encountered "true psychrophiles" or organisms which grow best at relatively low temperatures. Hess (1934) reports three organisms with optima below 20 C, but his criterion of optimum growth is maximum total cell yield rather than maximum growth rate. From a study of the literature, one must conclude that there are very few or possibly no bacteria that fit the textbook definitions of psychrophiles. Irrespective of temperature optima, there is an important and large group of bacteria which grows relatively rapidly at low temperatures, i. e. , produces visible colonies in approximately one week at 0 C. Some are capable of growth at temperatures as low as -7.5 C (Bedford, 1933). The ability of bacteria to grow at 0 C has been
Induction Chemotherapy with Docetaxel/Cisplatin/5-Fluorouracil for Patients with Node-Positive Esophageal Cancer

Background: Despite improvements in the surgical management of esophageal cancer, the prognosis of patients with lymph node metastases is still unsatisfactory. Recently, survival benefit of neoadjuvant or induction chemotherapy for patients with esophageal cancer has been highlighted. Methods: Efficacy and toxicity of induction chemotherapy for esophageal cancer were reviewed. In addition, our experience on modified docetaxel/cisplatin/5-FU (DCF) as induction chemotherapy was also demonstrated. The modified DCF consisted of 60 mg/m2 of docetaxel on day 1, and 350 mg/m2 of 5-FU and 6 mg/m2 of cisplatin on days 1–5. Two courses have been administered as induction chemotherapy in 51 patients with node-positive esophageal cancer. Response was evaluated by RECIST v1.0 and changes in standardized uptake value by 18F-fluorodeoxyglucose positron emission tomography. Results: Induction chemotherapy may be beneficial for node-positive esophageal cancer, although the consensus has not yet been established. A regimen of induction chemotherapy should have a high response rate and cisplatin/5-FU may be underpowered as an induction setting. DCF can be a candidate for the regimen of induction chemotherapy for esophageal cancer, although severe adverse events have been reported. Several modified regimens to reduce the toxicity have been reported. The response rate of our series was 61% and a significant decrease in standardized uptake values was observed after the induction chemotherapy. Although high-grade neutropenia was still observed with this regimen, neither treatment-related death nor delay in the following treatment was observed. Conclusions: Modified DCF can be a regimen of induction chemotherapy for node-positive esophageal cancer because of its high efficacy, although an adequate care for severe neutropenia is needed.
Estimación del Coste de la Calidad del Software a través de la Simulación del Proceso de Desarrollo

Some of the main objectives of quality assurance practices are to detect and correct the errors that arise during the development of a software product, as well as to guarantee that the final product conforms to the client’s requirements. Quality initiatives suppose an added cost to the software development projects, cost that is totally justified but which, in most of the cases, is the first one that is cut when the pressure of the budget and/or the time unexpectedly increases. In many occasions, the cost estimation of the quality initiatives consists of a percentage of part of the total budget considered for project development. This way, it is impossible to determine which the efficiency of those activities has been and how the quality problems arisen during the development could have been improved, if not solved. In this work we contribute a new approach to measure the efficiency, in the scope of cost and yield, of the software assurance activities. 1 Dpto. de Lenguajes y Sistemas Informaticos. Universidad de Cadiz. Escuela Superior de Ingenieria. C/ Chile, no1 11003 – Cadiz (Spain) e-mail: mercedes.ruiz@uca.es 2 Dpto. de Lenguajes y Sistemas Informaticos. Universidad de Sevilla Facultad de Informatica y Estadistica. Avda. Reina Mercedes, s/n 41012 – Sevilla (Spain) e-mail: isabel.ramos@lsi.us. es 2 Mercedes Ruiz Carreira / Isabel Ramos Roman r i rr ir / I l Tabla 1: Definicion de las categorias de costes de la calidad Mientras que los costes de las actividades de aseguramiento de calidad y de la mejora del proceso han sido objeto de mucha investigacion durante mas de 20 anos [Alberts 1976], no hay una progresion similar en la determinacion del coste de la calidad del software (CoSQ) [Hersh 1993] y [Knox 1993]. El modelo de Knox y los estudios de Raytheon [Dion 1993] constituyen notables excepciones ya que si emplean de forma explicita el coste de la calidad del software. Los trabajos de Knox We propose to combine the simulation of dynamic models, as an alternative to the expensive, and in most of the occasions impossible, experimentation in the project management field, with the CoSQ method.
The study of fixing field curvature by flexible image sensor array

Field curvature is one of the most common aberrations in an optical system. The phenomenon of field curvature occurs when the resulting image is curved at the projective plane after light propagates through spherical lenses. Therefore, if the projective plane can be a curved surface that fits the curvature of the image, we can obtain a non-distorted projective image. In this study, a curved image sensor is employed to verify the effect of image modification on field curvature as well as to capture a better result. The curved image sensor is fabricated using surface-mount technology (SMT) to package image sensors on flexible printed circuit. The image sensor arrays are fixed on three kinds of curved substrates, 120 mm, 60 mm and 40 mm respectively. The image signals are captured by image sensor arrays with different curvatures through a plano-convex lens (R1: 133 mm, R2: — ∞) with diameter of 101 mm. The signals are then sent to the computer for analysis using the IEEE standard facsimile test chart — IEEE Std 167A–1987 as the testing object. The sharpness of the captured images from the sensors at the same position of different substrates is compared. According to the analysis of captured images, the use of the curved substrate with curvature of 60 mm yields the best result which can obtain a clear and uniform image. In addition, the illuminance on different projective planes are analyzed by an optical simulation software. The variation coefficients of the illuminance on a plane surface and three kinds of curved surfaces are calculated to map the light intensity on the sensors. Based on the simulated results, the smallest variation of illuminance coefficient on projective plane shows a uniform illumination at the curvature of 60 mm, which matches the experimental results.