Miracle-dz/UniFAR-FTUs huggingface dataset:
Compliance of blood sampling procedures with the CLSI H3-A6 guidelines: An observational study by the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) working group for the preanalytical phase (WG-PRE)

Abstract Background: An observational study was conducted in 12 European countries by the European Federation of Clinical Chemistry and Laboratory Medicine Working Group for the Preanalytical Phase (EFLM WG-PRE) to assess the level of compliance with the CLSI H3-A6 guidelines. Methods: A structured checklist including 29 items was created to assess the compliance of European phlebotomy procedures with the CLSI H3-A6 guideline. A risk occurrence chart of individual phlebotomy steps was created from the observed error frequency and severity of harm of each guideline key issue. The severity of errors occurring during phlebotomy was graded using the risk occurrence chart. Results: Twelve European countries participated with a median of 33 (18–36) audits per country, and a total of 336 audits. The median error rate for the total phlebotomy procedure was 26.9 % (10.6–43.8), indicating a low overall compliance with the recommended CLSI guideline. Patient identification and test tube labelling were identified as the key guideline issues with the highest combination of probability and potential risk of harm. Administrative staff did not adhere to patient identification procedures during phlebotomy, whereas physicians did not adhere to test tube labelling policy. Conclusions: The level of compliance of phlebotomy procedures with the CLSI H3-A6 guidelines in 12 European countries was found to be unacceptably low. The most critical steps in need of immediate attention in the investigated countries are patient identification and tube labelling.
Body size and prostate cancer.

Anthropometry deals with the comparative measurements of the human body and its associated parts which is widely utilized as a method of assessing human body compositions. A number of studies have been done to assess the relation of body size to prostate cancer. Investigations of the relation between body size and prostate cancer used anthropometric measurement focusing mainly on weight and measurements of obesity such as the body mass index (BMI) that is highly correlated with percent body fat. Obesity is associated with numerous endocrine changes which leads to lowered sex hormone-binding globulin that could increase testorene levels. Researchers believed that testosterone is related to prostate cancer risk. Moreover obesity is related to insulin resistance and hyperinsulinemia. Studies have supported the presence of positive association of insulin-like growth factors-1 with prostate cancer risk. However case-control studies have noted inconsistency of results on BMI which is related to both lean body mass and body fat leading to limitation of interpretation of results. In this regard inexpensive and uninvasive methods of assessing adiposity need to be developed as substitute to the commonly used BMI that has apparent shortcomings in estimating obesity.
Les études de coûts-efficacité des traitements pharmacologiques et psychologiques des troubles anxieux : une recension des écrits

Cet article porte sur une recension des ecrits sur l’evaluation economique des traitements eprouves cognitivo-comportementaux et pharmacologiques des troubles anxieux. La recherche des articles pertinents s’echelonne de 1980 a 2008, a partir des bases de donnees electroniques du milieu medical et psychologique. Sept etudes sont recensees et portent sur le trouble panique, le trouble d’anxiete generalisee, la phobie specifique et la phobie sociale. Les traitements pharmacologiques et la psychotherapie cognitive-comportementale presentent un rapport couts-efficacite avantageux, particulierement lorsque compares aux soins usuels. Les auteurs concluent que malgre le besoin de renforcer l’etat des connaissances sur le rapport couts-efficacite des interventions, il semble avantageux pour la societe d’accroitre l’acces aux traitements eprouves des troubles anxieux.
Recent advance in diabetes therapy: pancreatic beta cell regeneration approaches

Diabetes mellitus (DM) is a chronic metabolic disorder characterized by elevated blood glucose. According to WHO, more than 400 million people live with diabetes and the number is expected to rise to 592 million by 2035. Improved glycemic control decreases the risk of development of microvascular and macrovascular complication and disease progression. The currently available treatments options are either associated with an increased incidence of adverse effects or fail to prevent progression of diabetes-associated complication. As core pathologic condition in diabetes is either β-cell destruction or insufficiency, recent research focuses mainly on improving glucose homeostasis by regeneration of this key cell type. These cellular based therapeutic approaches are focused on the transplantation of the islet cells or β-cell, stimulation of human β-cell proliferation, in vivo β-cell regeneration and protect β-cells from apoptosis. However, none of these approaches are in clinical use due to a shortage of donor; the inefficient technique of β-cell generation and β-cell in adult humans does not grow sufficiently. This review focuses on current progress in β-cells regeneration approaches for the treatment of diabetes mellitus.
Estimating liver cancer deaths in Thailand based on verbal autopsy study.

BACKGROUND Liver cancer mortality is high in Thailand but utility of related vital statistics is limited due to national vital registration (VR) data being under reported for specific causes of deaths. Accurate methodologies and reliable supplementary data are needed to provide worthy national vital statistics. This study aimed to model liver cancer deaths based on verbal autopsy (VA) study in 2005 to provide more accurate estimates of liver cancer deaths than those reported. The results were used to estimate number of liver cancer deaths during 2000-2009. METHODS A verbal autopsy (VA) was carried out in 2005 based on a sample of 9,644 deaths from nine provinces and it provided reliable information on causes of deaths by gender, age group, location of deaths in or outside hospital, and causes of deaths of the VR database. Logistic regression was used to model liver cancer deaths and other variables. The estimated probabilities from the model were applied to liver cancer deaths in the VR database, 2000-2009. Thus, the more accurately VA-estimated numbers of liver cancer deaths were obtained. RESULTS The model fits the data quite well with sensitivity 0.64. The confidence intervals from statistical model provide the estimates and their precisions. The VA-estimated numbers of liver cancer deaths were higher than the corresponding VR database with inflation factors 1.56 for males and 1.64 for females. CONCLUSIONS The statistical methods used in this study can be applied to available mortality data in developing countries where their national vital registration data are of low quality and supplementary reliable data are available.
[Cost-efectiveness of Ibersartan in type II diabetic nephropathy with hypertension. A Spanish perspective].

BACKGROUND In the Irbesartan Diabetic Nephropathy Trial (IDNT), treatment with irbesartan demonstrated 23% and 20% reductions in the combined endpoint of doubling of serum creatinine (DSC), end-stage renal disease (ESRD) or death in patients with hypertension, type 2 diabetes and overt nephropathy compared to amlodipine and control respectively. A simulation model was developed to project long-term cost consequences of the IDNT in the Spanish setting. METHODS A Markov model simulated progression from nephropathy to DSC, ESRD and death in patients with hypertension, type 2 diabetes and overt nephropathy. Treatment-specific probabilities were derived from IDNT. Country-specific ESRD-related data were retrieved from published sources. Delay in onset of ESRD, life expectancy and mean lifetime costs were calculated for patients with baseline age 59 years. Future costs were discounted at 6% per annum, and clinical benefits were discounted at 0% and 6% per annum. Extensive sensitivity analyses were performed. RESULTS Onset of ESRD was delayed with irbesartan by 1.41 and 1.35 years versus amlodipine and control respectively. When a 25-year (lifetime) horizon was considered, delay in ESRD onset led to anticipated improvements in life expectancy (discounted at 6% shown in brackets) of 0.46 (0.21) years versus amlodipine and 0.75 (0.37) years versus control. Irbesartan was associated with cost savings of 13,673 Euro and 7,632 Euro patient versus amlodipine and control respectively. The results were robust under a wide range of plausible assumptions. CONCLUSIONS Treating patients with hypertension, type 2 diabetes and overt nephropathy using irbesartan was both cost- and life-saving compared to amlodipine and control in the Spanish setting.
‘SHAKING PUPS’: A DISORDER OF CENTRAL MYELINATION IN THE SPANIEL DOG. III. QUANTITATIVE ASPECTS OF GLIA AND MYELIN IN THE SPINAL CORD AND OPTIC NERVE

Quantification of glial cells, axonal size and myelin thickness and volume were carried out in selected areas of the three funiculi of the cervical spinal cord and the optic nerve of ‘shaking pups’ and normal littermates at 4 and 8 weeks of age. There was a marked reduction of oligodendrocytes in the affected pups with many of these cells having distended rough endoplasmic reticulum. Oligodendrocyte death was not noticeable. Astrocyte numbers were similar in both normal and affected pups. Axonal diameters were not reduced in the affected pups and there was no apparent correlation between myelination and axonal size in these animals. Total myelin volume and thickness were greatly reduced in the ‘shaking pups. ’ Impaired stem cell division together with metabolic disturbance of oligodendrocytes are considered to be the main causes of the hypomyelination in this mutant.
P Acute Aortic Syndromes Pre-Operative N-Terminal Pro-Brain Natriuretic Peptide Predicts Outcome in Type A Aortic Dissection

Methods We prospectively measured pre-operative NT-proBNP in 104 patients (39 female, 35%; median age 61 years) undergoing emergency surgery for AAD during a 6-year study period. European System for Cardiac Operative Risk Evaluation risk scores were recorded and patients were followed for 30-day mortality and major adverse events (MAEs) as defined by the need for rethoracotomy, occurrence of postoperative heart failure, neurologic deficit, lung failure, renal failure, or sepsis.
Analysis of power-ground plane with combination of rectangle and triangle segmentation

A new power-ground analysis method combining rectangle and triangle partition is proposed for the analysis of the ground bounce noise in high-speed digital electronic systems. In this method, most of an irregular plane is firstly covered by rectangles, and then the rest area is partitioned into triangle meshes. Cavity model is used to analyze rectangular segment and lumped model is used to analyze triangle mesh. As power supply planes often contain large connected area, the resultant inner virtual ports and simulation time can be reduced significantly. Multilayered planes with apertures can also be analyzed by using impedance matrix model. The result is accurate over a wide range of frequency.
Training Canada's future clinician–teachers and researchers

Although Mark Baerlocher's review of data from the 2004 CFPC/CMA/RCPSC National Physician Survey[1][1] suggests that medical students have a greater desire to engage in teaching or research than physicians currently in practice, it fails to address the key issue revealed by the data: a noticeable
Activation of acetylcholine receptors on clonal mammalian BC3H‐1 cells by high concentrations of agonist.

1. Currents were recorded through acetylcholine (ACh) receptor channels on clonal BC3H‐1 cells in the presence of high concentrations of ACh (20‐1000 microM) and carbamylcholine (180‐1000 microM). 2. Channel openings at high agonist concentrations occur in clusters separated by long silent periods (seconds). Clusters, in turn, show groups of closely spaced openings separated by relatively long (hundreds of milliseconds) closed periods. The closed periods between clusters and between groups within clusters are thought to reflect two desensitized states (Sakmann, Patlak & Neher, 1980). 3. Openings within groups consist largely of long‐duration openings. An excess of brief‐duration openings is seen at all high agonist concentrations; most brief openings occur as isolated, solitary openings. 4. The distribution of closed periods within groups shows four exponential components with time constants separated by several fold over the range of 50 microseconds to 50 ms. 5. The distribution of closed periods within groups is analysed as a function of agonist concentration, to estimate rate constants for transitions in a hypothetical reaction scheme for receptor activation. One or two of these components (depending on agonist and agonist concentration) appear to reflect agonist binding and channel gating. It is hypothesized that the other closed‐period components within groups at high agonist concentrations result from additional states of doubly liganded receptors which have closed ion channels. 6. With ACh as agonist the data indicate that binding and activation saturate at concentrations above 130 microM. The data are quantitatively consistent with measurements made at low concentrations of ACh (Sine & Steinbach, 1986b), and indicate that a four‐state linear scheme is able to describe major features of ACh‐receptor activation on BC3H‐1 cells. The channel opening rate is estimated to be about 450 s‐1 and the closing rate about 35 s‐1 (‐70 mV, 11 degrees C). The concentration dependence of closed durations suggests that some positive co‐operativity exists in agonist binding. The dissociation constant with one ACh molecule bound is about 50 microM, and that with two bound is about 10 microM (for an ACh receptor with a closed channel). 7. Saturation is not observed with carbamylcholine, even at 1 mM. The data are consistent with data obtained at low concentrations of carbamylcholine, and are in over‐all agreement with the interpretation of data obtained with ACh. The affinity for carbamylcholine is estimated to be about 20‐fold lower than with ACh. (ABSTRACT TRUNCATED AT 400 WORDS)
Fuzzy rule classifiers for multi-label classification

In this paper we investigate the use of fuzzy rule-based classifiers for multi-label classification. This classification task deals with problems where more than one label could be assigned simultaneously to a given instance. We concentrate on problem transformation methods, which use different strategies to transform a multi-label problem into a different single-label classification problems. This transformation make it possible to use almost any single label learner as base-classifiers, thus benefiting from the rich miscellany of algorithms available for this task. Fuzzy rules provide both interpretability and flexibility to model the vagueness among different labels. Empirical results using six datasets, four different problem transformation methods, eight base-classifiers, and five different performance measure shows the suitability of fuzzy rules for this task.
Image Formation Using Fast Factorized Backprojection Based on Sub-Aperture and Sub-Image for General Bistatic Forward-Looking SAR with Arbitrary Motion

In this paper, a fast time domain imaging algorithm called bistatic forward-looking fast factorized backprojection algorithm (BF-FFBPA) based on sub-aperture and sub-image is proposed for general bistatic forward-looking synthetic aperture radar (BFSAR) with arbitrary motion. It can not only accurately dispose the large spatial variant range cell migrations and complicated motion errors, but also achieve high imaging efficiency. First, the imaging geometry and signal model are established, and the implementation of back projection algorithm (BPA) in the BFSAR imaging is given to provide a basis for the proposed BF-FFBPA. Then, considering motion errors, the more accurate requirements of splitting sub-aperture and sub-image in the BF-FFBPA is introduced based on the range error analysis to offer the tradeoff between the imaging quality and efficiency. Finally, the implementation and computational burden of the BF-FFBPA is provided and analyzed. Simulated results and evaluations are given to prove the correctness of the theory analysis and the validity of the proposed approach.
Anterior Trunk Mobility Does Not Predict Disability in Elderly Women With Acute Low Back Pain: Brazilian Back Complaints in the Elders (BACE-Brazil) Study Results

Study Design. Cross-sectional, ancillary study of an international multicenter epidemiological study. Objective. To investigate the relationship of the anterior trunk mobility with self-report and physical performance measures in elderly women with acute low back pain (LBP). Summary of Background Data. LBP is one of the most prevalent pain complaints in the elderly population. It is postulated that the increased range of motion of limited joints of the trunk may improve LBP and functionality of patients. Recent studies have, however, questioned the association between trunk range of motion and the functional status. Methods. The present study included a convenience sample of elderly women from the community aged 60 years and older who presented with a new (acute) episode of LBP. Volunteers with severe diseases and visual, hearing and mobility losses, or cognitive impairment were excluded. Trunk mobility was assessed by the fingertip-to-floor test. Functionality was assessed by the Roland-Morris Questionnaire (RMQ) and gait speed test. Statistical analysis was performed by using hierarchical linear regression model. Results. Data from 459 elderly women, mean age of 69.0 (6.1) years old, were used to describe this report. The additional predictive value for the inclusion of independent variable trunk mobility was only 4.4% in the RMQ score and 1.5% in the gait speed test, respectively. A reduced hierarchical linear regression model showed that the significant predictors for RMQ and gait speed test were body mass index, pain intensity, and trunk mobility. Conclusion. This was the first study to investigate the relationship between trunk mobility and functionality in elderly women with acute LBP. The results suggest that these clinical parameters are independent from each other. Level of Evidence: N/A
Biological and clinical relevance of stem cells in pancreatic adenocarcinoma

Cancer stem cells (CSC) have been identified in a growing number of human malignancies. CSC are functionally defined by their ability to self‐renew and recapitulate tumors in the ectopic setting, and a growing number of studies have shown that they display other functional characteristics, such as invasion and drug resistance. These unique functional properties implicate a role for CSC in clinical consequences, such as initial tumor formation, relapse following treatment, metastasis, and resistance, suggesting they are a major factor in directing clinical outcomes. Pancreatic adenocarcinoma is a highly‐aggressive disease with a propensity for early metastasis and drug resistance. Tumorigenic pancreatic cancer cells have been identified using the cell surface antigens CD44, CD24, and CD133, as well as the high expression of aldehyde dehydrogenase (ALDH). In vitro and in vivo studies have shown that ALDH‐ and CD133‐expressing pancreatic CSC have a greater propensity for metastasis, and ALDH‐expressing CSC have been shown to be resistant to conventional chemotherapy. In clinical samples from patients with resected pancreatic adenocarcinoma, the presence of ALDH‐expressing CSC was associated with worse overall survival. The development of CSC‐targeting therapies might be important in changing the clinical outcomes of patients with this disease, and others and we have begun to identify novel compounds that block CSC function. This review will discuss the biological and clinical relevance of CSC in pancreatic cancer, and will discuss novel therapeutic strategies to target them.
The Emotional Impact of Psychiatric Symptoms in Dementia on Partner Caregivers: Do Caregiver, Patient, and Situation Characteristics Make a Difference?

This study aims to investigate the emotional impact of psychiatric symptoms of patients with dementia on their caregiving partners, and to explore if caregiver, patient, and situation factors predict this emotional impact on caregivers. A cross-sectional design was used. Partners of patients with slight to moderately severe dementia who live in the community (n = 85) were interviewed. In a subgroup (n = 58) potential predictors of emotional impact of psychiatric symptoms on caregivers were studied. Agitation, irritability, apathy, and disinhibition produced the highest mean emotional impact scores in caregivers. Besides the neuropsychiatric symptoms themselves, the emotional impact of these symptoms on caregivers was predicted by sense of competence, degree of care needed by the patient, and financial expenditure due to the caregiving situation. The emotional impact of psychiatric symptoms on caregivers is predicted by several patient, caregiver, and situation factors. Interventions aimed at decreasing the experienced burden of caregivers should therefore not only focus on the psychiatric symptoms of the patient, but also on the sense of competence of the caregiver and the financial burden due to the caregiving situation.
A linear epileptic seizure predictor based on slow waves of scalp EEGs

Seizure prediction could change treatment of epilepsy, which has attracted substantial attention over the past two decades. Nonlinear EEG analysis techniques have made some successes at it, but linear analysis techniques being with the controversial results. We put forward a linear seizure predictor, which tracks the time evolution of the slow wave energy bigger than some preset threshold from scalp EEGs. The results from four generalized epileptic patients demonstrate that pre-seizure transition phases of several minutes can be identified clearly by our linear predictor, which could help us to a deeper understanding of the mechanism of seizure and open the possibility of clinical applications
Climate engineering by artificial ocean upwelling: Channelling the sorcerer's apprentice

Recent suggestions to reduce the accumulation of anthropogenic carbon dioxide in the atmosphere have included ocean fertilization by artificial upwelling. Our coupled carbon‐climate model simulations suggest that artificial upwelling may, under most optimistic assumptions, be able to sequester atmospheric CO2 at a rate of about 0.9 PgC/yr. However, the model predicts that about 80% of the carbon sequestered is stored on land, as a result of reduced respiration at lower air temperatures brought about by upwelling of cold waters. This remote and distributed carbon sequestration would make monitoring and verification particularly challenging. A second caveat predicted by our simulations is that whenever artificial upwelling is stopped, simulated surface temperatures and atmospheric CO2 concentrations rise quickly and for decades to centuries to levels even somewhat higher than experienced in a world that never engaged in artificial upwelling.