Miracle-dz/UniFAR-FTUs huggingface dataset:
Case Presentations of the Harvard Affiliated Emergency Medicine Residencies RASH AND SHOCK

Dr. Lulu Wang: Today’s case is that of a 76-year-old gentleman who presented to the emergency department (ED) with left groin rash. The patient first noticed symptoms 5 days before presentation, when a small painless nodule appeared in his left inguinal fold, which he presumed to be a lymph node. Over the following week, the skin surrounding the nodule became erythematous and tender, expanding to cover a large area of his left groin. The rash was not bothersome and did not impede the patient’s range of motion. He had not suffered any known trauma, or chemical or allergen exposure to the region. He denied any accompanying fever or chills and did not notice any spontaneous drainage. He was seen by his primary care physician earlier on the day of ED presentation. In clinic, his blood pressure was 70/40 mm Hg and he was diaphoretic. A 12-lead electrocardiogram showed new-onset atrial fibrillation with occasional premature ventricular contractions. He was referred to the ED for further evaluation. Dr. Eric Nadel: Can you describe his physical examination upon presentation to the ED? Dr. Wang: His vital signs were: temperature 36.6 C, blood pressure 78/42 mmHg, heart rate 97 beats/min, respiratory rate 20 breaths/min, and oxygen saturation 95% on room air. On examination, he was obese, alert, wellappearing, in no acute distress, and speaking in full sentences. The respiratory examination was notable for normal respiratory effort, with lungs clear to auscultation bilaterally. The heart was tachycardic with an irregularly
Pathology of the Future: Molecular Profiling for Targeted Therapy

Recent evidence suggests that each patient's cancer has a unique subset of molecular pathogenetic derangements. These derangements may both genetic and proteomic alterations. Genomic and proteomic research tools enable genome-wide assessment of gene expression as well as kinase driven cell signaling events. These tools are illuminating the molecular derangements of individual tumors, even if these tumors have similar morphological characteristics. A combination of laser capture microdissection with multiplexed phosphoproteomic analysis using reverse phase protein microarray technology is being used to identify protein molecular signatures of individual tumors. The in vivo state of multiple kinase driven signal pathways may be evaluated by reverse phase protein microarray with a panel of specific antibodies developed based upon our knowledge of biological processes. Molecular profiling of individual patient's tumors is currently being evaluated in clinical trials at the National Institutes of Health, National Cancer Institute for monitoring Epidermal Growth Factor (EGF) cell signaling events for patients with breast and ovarian cancer.
FTY720/Cyclosporine Regimens in De Novo Renal Transplantation: A 1‐Year Dose‐Finding Study

FTY720 is a novel immunomodulator being investigated for rejection prophylaxis in renal transplantation when combined with full‐dose cyclosporine (CsA; FDC). This 1‐year phase II study compared FTY720 plus FDC (Neoral®) with FTY720 plus reduced‐dose CsA (RDC) and mycophenolate mofetil (MMF) plus FDC in de novo renal transplant patients. Patients were randomized 2:2:2:1 to FTY720 5 mg plus RDC (n = 72); FTY720 2.5 mg plus RDC (n = 74); FTY720 2.5 mg plus FDC (n = 76); or MMF plus FDC (n = 39) for 12 months. CsA exposure in the RDC group was reduced on average by 50% as assessed by C2 monitoring. The primary efficacy endpoint was the composite incidence of biopsy‐proven acute rejection (BPAR), graft loss, death or premature study discontinuation. The incidences for this composite endpoint were 24% and 22%, respectively, for FTY720 5 mg plus RDC and FTY720 2.5 mg plus FDC versus 39% for MMF plus FDC. Patients receiving FTY720 2.5 mg plus RDC were discontinued from treatment due to risk of under‐immunosuppression. FTY720 2.5 mg plus FDC and FTY720 5 mg plus RDC were safe and effective in de novo renal transplant patients over 12 months.
Impact of Geometric Variability on Axial Compressor Performance

A probabilistic methodology to quantify the impact of geometric variability on compressor aerodynamic performance is presented. High-fidelity probabilistic models of geometric variability are derived using a principal-component analysis of blade surface measurements. This probabilistic blade geometry model is then combined with a compressible, viscous blade-passage analysis to estimate the impact on the passage loss and turning using a Monte Carlo simulation. Finally, a mean-line multistage compressor model, with probabilistic loss and turning models from the blade-passage analysis, is developed to quantify the impact of the blade variability on overall compressor efficiency and pressure ratio. The methodology is applied to a flank-milled integrally bladed rotor. Results demonstrate that overall compressor efficiency can be reduced by approximately 1% due to blade-passage effects arising from representative manufacturing variability.
BM patent evolution map for tracking the development of E-service

Given that the study on the creation and operation of e-service is an important research field, the challenges of developing systematic and scientific methodology for the analysis of e-service operation and creation still carry on. This research attempts to suggest a systematic approach to identify the evolution of e-service based on the BM patent database as a quantitative database. Despite the considerable contribution that BM patents can bring to the service world as a valuable database, only a few studies have been conducted on them. This research proposes an algorithm for constructing a BM patent evolution map by selecting major arcs in the patent citation network. Furthermore, the algorithm is applied to the e-finance field to construct and evolution map. The results of this research can be used to understand the process of evolution of e-service, extracting fruitful new service ideas from existing e-service processes or methods, and identifying the legal rights and limitations of created e-service concepts and operation methods.
Percutaneous microwave hepatic tumor coagulation with segmental hepatic blood flow occlusion in seven patients.

OBJECTIVE We assess the usefulness of microwave hepatic tumor coagulation therapy with balloon occlusion of segmental hepatic blood flow for eight recurrent metastatic hepatic tumors in seven patients. CONCLUSION Limited early experience with microwave hepatic tumor coagulation therapy and segmental hepatic blood flow occlusion has been positive, suggesting that further clinical evaluation is warranted.
Tetanic stimulation of Schaffer collaterals induces rhythmic bursts via NMDA receptor activation in rat CA1 pyramidal neurons

Exploring the principles that regulate rhythmic membrane potential (Vm) oscillations and bursts in hippocampal CA1 pyramidal neurons is essential to understanding the θ rhythm (θ). Recordings were performed in vitro in hippocampal slices from young rats, and a group of the recorded CA1 pyramidal cells were dye‐filled with carboxifluorescein and immunolabeled for the R1 subunit of the NMDA receptor. Tetanic stimulation of Schaffer collaterals (SCs) and iontophoresis of glutamate evoked rhythmic Vm oscillations and bursts (≈10 mV, ≈7 Hz, 2–5 spikes per burst) in cells (31%) placed close to the midline (“medial cells”). Rhythmic bursts remained under picrotoxin (10 μM) and Vm oscillations persisted with tetrodotoxin (1.5 μM), but bursts were blocked by AP5 (25 μM) and Mg2+‐free solutions. Depolarization and AMPA never induced rhythmic bursts. The rest of the neurons (69%), recorded closer to the CA3 region (“lateral cells”), discharged rhythmically single repetitive spikes under SC stimulation and glutamate in control conditions, but fired rhythmic bursts under similar stimulation, both when NMDA was applied and when non‐NMDA receptors were blocked with CNQX (20 μM). Medial cells exhibited a larger NMDA current component and a higher NMDAR1 density at the apical dendritic shafts than lateral cells, suggesting that these differences underlie the dissimilar responses of both cell groups. We conclude that the “θ‐like” rhythmic oscillations and bursts induced by glutamate and SC stimulation relied on the activation of NMDA receptors at the apical dendrites of medial cells. These results suggest a role of CA3 pyramidal neurons in the generation of CA1 θ via the activation of NMDA receptors of CA1 pyramidal neurons. Hippocampus 2002;12:434–446. © 2002 Wiley‐Liss, Inc.
A SURVEY ON ONTOLOGY BASED WEB PERSONALIZATION

Over the last decade the data on World Wide Web has been growing in an exponential manner. According t o Google the data is accelerating with a speed of billion pages per day [24]. Internet has around 2 million users accessing the World Wide Web for various information [25]. These numbers certainly ra ise a severe concern over information over load cha llenges for the users. Many researchers have been working to overcome the chall enge with web personalization, many researchers are looking at ontology based web personalization as an answer to the information overload, as each individual is unique. In this pa per we present an overview of ontology based web personalization, Challenges and a survey of the work. This paper also points future work in web personalization.
Selective room-temperature sensing of NO2 by WO3 film/graphene layers

This is one of the first attempts of making WO3 thick film selective at low operating temperature by placing graphene sheets directly on the film surface. The WO3 film was prepared by DC magnetron reactive sputtering of a pure tungsten target and annealing in air. The thickness of the film averaged 507 nm from FIB cross-sectioning and STEM measurement. The film was characterized with XRD, XPS and Raman spectroscopy. Graphene was synthesized on copper foil using plasma enhanced chemical vapor deposition of methane gas, which was found to produce three monolayers of graphene sheets according to Raman spectroscopic analysis. The graphene was transferred onto the WO3 film and annealed. It was found that the pure WO3 sensed low concentrations of nitrogen dioxide at 30°C and 100°C operating temperature. The selectivity towards nitrogen dioxide over ammonia and carbon monoxide was achieved with graphene on the tungsten trioxide film at the compromise of sensitivity at both operating temperatures. The analysis of the graphene/WO3 composite orientation may lead to improved sensor capabilities as well as better understanding of the sensing mechanism.
Uplink Interference Management for HSPA+ and 1xEVDO Femtocells

Femtocells are low power cellular base stations typically deployed indoors in residential and enterprise environments as well as hotspots in order to improve voice and high rate data coverage and provide excellent user experience. The cellular operator benefits from reduced infrastructure deployment costs for capacity upgrades and coverage improvements. While improving performance, femtocells may cause some interference to other users in the network. However, with the use of proper interference management techniques, this interference may be well controlled. This paper focuses on uplink (UL) interference management techniques for 3G femtocell deployments. On the UL, the challenge is the presence of large uncontrolled interference from nearby users not associated by the femtocell that result in high noise rise (rise-over-thermal, RoT), that may lead to poor femto user experience. Femtocell users that can not be power controlled due to their very close proximity to femtocells may also cause high noise rise levels. An algorithm is proposed for both HSPA+ and 1xEVDO femtocells to desensitize the receiver when uncontrolled interference is detected, ensuring robust UL performance with minimal impact on the macro network. It is demonstrated through system level simulations that in addition to superior performance experienced by femtocell users, the macro users also benefit significantly from offloading traffic load to the femto network.
The Effects of Dietary Turkish Propolis and Vitamin C on Performance, Digestibility, Egg Production and Egg Quality in Laying Hens under Different Environmental Temperatures

In this study, the effects of propolis and vitamin C (L-ascorbic acid) supplementation in diets were investigated on feed intake (FI), body weight (BW), body weight gain (BWG), feed conversion rate (FCR) and digestibility and on egg production and qualities (weight, mortality, shell thickness) in laying hens exposed to heat stress. A total of 150 Hyline White Leghorn, aged 42 weeks, hens was divided into five groups of 30 hens. Chicks were randomly divided into 1 positive control, 1 control and 3 treatment groups. The chicks were kept in cages in temperature-controlled rooms at 22°C for 24 h/d (positive control, Thermoneutral, TN group) or 34°C for 9 h/d from 08.00-17.00 h followed by 22°C for 15 h (control, heat stress, HS group) and fed a basal diet or basal diet supplemented with vitamin C (250 mg/kg of L- ascorbic acid/kg of diet) or two levels of propolis (2 and 5 g of ethanol extracted propolis/kg of diet). Increased FI (p 0.05). However, the egg shell thickness and egg shell weight appeared to be increased in Vitamin C and propolis groups in comparison to HS group birds (p<0.05). In conclusion, dietary supplementation of laying hens with anti-oxidants (vitamin C and propolis) can attenuate heat stress-induced oxidative damage. These positive effects were evidenced by increased growth performance and digestibility, improvement of egg shell thickness and egg weight in comparison to non-supplemented birds. Moreover, supplementation with propolis (5 g/kg diet) was the most efficient treatment.
Perinatal Care and Outcome of Fetuses with Trisomies 13 and 18 following a Parental Decision Not to Terminate the Pregnancy

Objective: To describe pregnancy outcomes of fetuses affected by trisomies 13 and 18 following prenatal diagnosis and a decision to continue the pregnancy. Material and Methods: A single-center, retrospective study of 34 cases with a diagnosis or strong suspicion of trisomy 13 or 18. Results: Fourteen of 34 (41%) families chose to continue the pregnancy after a diagnosis of trisomy 13 or 18 was made. Nine fetuses subsequently died in utero (IUD). No prenatal signs were predictive of IUD. There were no intrapartum deaths. All 4 live-born babies were delivered vaginally; 2 died immediately after birth in the labor ward whilst 2 were transferred to the neonatal unit, dying at 10 and 11 days, respectively. Discussion: Couples should be counseled that the precise outcome of trisomy 13 or 18 is unpredictable, and they should receive multidisciplinary support.
Anti‐epidermal growth factor receptor monoclonal antibodies in cancer therapy

The epidermal growth factor receptor (EGFR) is a transmembrane tyrosine kinase receptor involved in the proliferation and survival of cancer cells. EGFR is the first molecular target against which monoclonal antibodies (mAb) have been developed for cancer therapy. Here we review the mechanisms underlying the effects of EGFR‐specific mAb in cancer therapy. The efficacy of EGFR‐specific mAb in cancer occurs thanks to inhibition of EGFR‐generated signalling; furthermore, the effects of antibodies on the immune system seem to play an important role in determining the overall anti‐tumour response. In this review, attention is focused on cetuximab and panitumumab, two mAb introduced recently into clinical practice for treatment of metastatic colorectal and head and neck cancer which target the external part of EGFR.
Is China Abolishing the Hukou System?*

Abstract In recent years, China has instituted a variety of reforms to its hukou system, an institution with the power to restrict population mobility and access to state-sponsored benefits for the majority of China's rural population. A wave of newspaper stories published in late 2005 understood the latest round of reform initiatives to suggest that the hukou is set to be abolished, and that rural residents will soon be “granted urban rights. ” This article clarifies the basic operations of the hukou system in light of recent reforms to examine the validity of these claims. We point out that confusion over the functional operations of the hukou system and the nuances of the hukou lexicon have contributed to the overstated interpretation of the initiative. The cumulative effect of these reforms is not abolition of the hukou, but devolution of responsibility for hukou policies to local governments, which in many cases actually makes permanent migration of peasants to cities harder than before. At the broader level, the hukou system, as a major divide between the rural and urban population, remains potent and intact.
Antifungal evaluation of pseudolaric acid B, a major constituent of Pseudolarix kaempferi.

Pseudolaric acid B [1] was isolated and identified as the main antifungal constituent of Pseudolarix kaempferi using bioassay-directed fractionation. Pseudolaric acid B was active against Trichophyton mentagrophytes, Torulopsis petrophilum, Microsporum gypseum, and Candida spp. , while its methylated or hydrolyzed derivatives were not active against these same organisms. The minimum inhibitory concentrations and minimum fungicidal concentrations of pseudolaric acid B [1] against Candida and Torulopsis species were comparable with those of amphotericin B. The in vivo activity of pseudolaric acid B was evaluated in a murine model of disseminated candidiasis. Pseudolaric acid B [1] reduced the number of recovered colony-forming units significantly at different dosages. Infected mice treated intravenously with pseudolaric acid B [1] also had a longer survival time than those treated with vehicle alone.
NGL‐3‐induced presynaptic differentiation of hippocampal neurons in an afadin‐dependent, nectin‐1‐independent manner

A hippocampal mossy fiber synapse, which is implicated in learning and memory, has a complex structure. We have previously shown using afadin‐deficient mice that afadin plays multiple roles in the structural and functional differentiations of this synapse. We investigated here using a co‐culture system with cultured hippocampal neurons and non‐neuronal COS‐7 cells expressing synaptogenic cell adhesion molecules (CAMs) whether afadin is involved in the presynaptic differentiation of hippocampal synapses. Postsynaptic CAMs NGL‐3 (alias, a Lrrc4b gene product) and neuroligin induced presynaptic differentiation by trans‐interacting with their respective presynaptic binding CAMs LAR (alias, a Ptprf gene product) and neurexin. This activity of NGL‐3, but not neuroligin, was dependent on afadin, but not the afadin‐binding presynaptic CAM nectin‐1. The afadin‐binding postsynaptic CAM nectin‐3 did not induce presynaptic differentiation. Immunofluorescence and immunoelectron microscopy analyses showed that afadin was localized mainly at puncta adherentia junctions, but partly at synaptic junctions, of the mossy fiber synapse. β‐Catenin and γ‐catenin known to bind to LAR were co‐immunoprecipitated with afadin from the lysate of mouse brain. These results suggest that afadin is involved in the NGL‐3‐LAR system‐induced presynaptic differentiation of hippocampal neurons cooperatively with β‐catenin and γ‐catenin in a nectin‐1‐independent manner.
PPD antigens and the diagnosis of mycobacterial diseases. A study of atypical mycobacterial disease in Oklahoma.

Atypical mycobacteria were isolated from 240 of the 3,211 persons in Oklahoma's tuberculosis (TB) register. Fifty-one of the patients excreting atypical mycobacteria had disease caused by these organisms. Nonchromogens were the organisms in 26 (51%), photochromogens in 20 (39%), and scotochromogens in 5 (10%). A battery of mycobacterial purified protein derivative antigens (PPD-S, -Y, -G, -B, and -F) was applied to 34 patients with atypical mycobacterial disease, and to 34 patients with tuberculosis. Reactions to more than one antigen were observed in 30 (88%) of the former, and in 33 (97%) of the latter group. The largest reaction corresponded to the homologous antigen in 14 of 20 patients with nonchromogen organisms, 6 of 11 with photochromogen organisms, 1 of 3 with scotochromogen organisms, and in 28 of 34 patients with TB. Skin test reactions verified the laboratory diagnosis in the majority of cases. Multiple uniform-sized reactions were common however, and
A rapid survey to determine the prevalence of smear-positive tuberculosis in Addis Ababa.

SETTING Four kebeles (lowest administrative units) in a typical district of Addis Ababa, Ethiopia. OBJECTIVE To determine the prevalence of smear-positive pulmonary tuberculosis (TB) in an adult population by using a screening questionnaire and sputum examination. DESIGN A house-to-house visit was conducted. All those 14 years of age and above were screened for the presence of symptoms. Three sputum samples were collected from persons who had symptoms for acid-fast bacilli (AFB) examination. RESULTS A total of 12,149 individuals were screened, of whom 173 had symptoms suggestive of TB. Twenty-three were positive for AFB (189/100,000, 95% CI 112-267). No association was observed between smear positivity and socio-demographic factors. Only two of the 23 patients were on anti-tuberculosis treatment (8.7%, 95% CI 1.5-29.5). CONCLUSION This simple and cost-effective method provides a fairly realistic estimate of the prevalence of TB. Thus with further development of the method it can be used to monitor the progress of TB programmes in resource-poor settings.
Thermodynamics of hydrogen adsorption in MOF-177 at low temperatures: measurements and modelling

Hydrogen adsorption measurements and modelling for the Zn-based microporous metal–organic framework (MOF) Zn4O(1,3,5-benzenetribenzoate)2, MOF-177, were performed over the 50–77 K and 0–40 bar ranges. The maximum excess adsorption measured under these conditions varies over about 105–70 mg g−1. An analysis of the isotherms near saturation shows that hydrogen is ultimately adsorbed in an incompressible phase whose density is comparable to that of the bulk liquid. These liquid state properties observed under supercritical conditions reveal a remarkable effect of nanoscale confinement. The entire set of adsorption isotherms can be well described using a micropore filling model. The latter is used, in particular, to determine the absolute amounts adsorbed and the adsorption enthalpy. When expressed in terms of absolute adsorption, the isotherms show considerable hydrogen storage capacities, reaching up to 125 mg g−1 at 50 K and 25 bar. The adsorption enthalpies are calculated as a function of fractional filling and range from 3 to 5 kJ mol−1 in magnitude, in accordance with physisorption. These results are discussed with respect to a similar analysis performed on another Zn-based MOF, Zn4O(1,4-benzenedicarboxylate)3, IRMOF-1, presented recently. It is found that both materials adsorb hydrogen by similar mechanisms.
Describing the clinical reasoning process: Application of a model of enablement to a pediatric case

Background and purpose: Clinical reasoning is a core tenet of physical therapy practice leading to optimal patient care. The purpose of this case was to describe the outcomes, subjective experience, and reflective clinical reasoning process for a child with cerebral palsy using the International Classification of Functioning, Disability, and Health (ICF) model. Case description: Application of the ICF framework to a 9-year-old boy with spastic triplegic cerebral palsy was utilized to capture the interwoven factors present in this case. Interventions in the pool occurred twice weekly for 1 h over a 10-week period. Outcomes: Immediately post and 4 months post-intervention, the child made functional and meaningful gains. The family unit also developed an enjoyment of exercising together. Each individual family member described psychological, emotional, or physical health improvements. Discussion: Reflection using the ICF model as a framework to discuss clinical reasoning can highlight important factors contributing to effective patient management.