Miracle-dz/UniFAR-FTUs huggingface dataset:
Hemodialysis system privatization and patient survival: a report from a large registry Eastern Europe cohort

Abstract Background: There has been a rapid increase in incident and prevalent rates of hemodialysis (HD) patients in Romania following the 2004 system privatization, but little is known about the impact of privatization on patient outcomes. Methods: We retrospectively examined the outcome during 1 year of 8161 prevalent HD patients registered in the Romanian Renal Registry at 31 December 2011. Standardized mortality ratio (SMR) was calculated for each for-profit (FP) and non-profit (NP) HD provider. Results: The 12-month SMR across all HD chain providers was 1.27. FP Chain 1 and the “other” group had SMR similar to the reference level. The mortality rate was two times higher in public NP dialysis centers than the national reference. A stepwise Cox regression analysis identified older age, male gender, DN as primary renal disease and the HD chain provider to be independently associated with a higher mortality. Excepting patients treated by FP Chain 4, patients treated by all the other dialysis providers had a better outcome than those treated in NP facilities. Conclusion: In conclusion, the increase in number of patients treated was not doubled by an increase in their survival. In the context of an expanding dialysis marketplace that tends to consolidate around large for-profit (FP) providers, further exploration of indicators associated with mortality may guide future healthcare policy to improve patient outcomes.
The intensivist in a spiritual care training program adapted for clinicians*

Background:Critical illness is a crisis for the total person, not just for the physical body. Patients and their loved ones often reflect on spiritual, religious, and existential questions when seriously ill. Surveys have demonstrated that most patients wish physicians would concern themselves with their patients’ spiritual and religious needs, thus indicating that this part of their care has been neglected or avoided. With the well-documented desire of patients to have their caregivers include the patient’s spiritual values in their health care, and the well-documented reality that caregivers are often hesitant to do so because of lack of training and comfort in this realm, clinical pastoral education for health care providers fills a significant gap in continuing education for caregivers. Objectives:To report on the first 6 yrs of a unique training program in clinical pastoral education adapted for clinicians and its effect on the experience of the health care worker in the intensive care unit. We describe the didactic and reflective process whereby skills of relating to the ultimate concerns of patients and families are acquired and refined. Design and Setting:Clinical pastoral education designed for clergy was adapted for the health care worker committed to developing skills in the diagnosis and management of spiritual distress. Clinician participants (approximately 10–12) meet weekly for 5 months (400 hrs of supervised clinical pastoral care training). The program is designed to incorporate essential elements of pastoral care training, namely experience, reflection, insight, action, and integration. Results:This accredited program has been in continuous operation training clinicians for the past 6 yrs. Fifty-three clinicians have since graduated from the program. Graduates have incorporated clinical pastoral education training into clinical medical practice, research, and/or further training in clinical pastoral education. Outcomes reported by graduates include the following: Clinical practice became infused with new awareness, sensitivity, and language; graduates learned to relate more meaningfully to patients/families of patients and discover a richer relationship with them; spiritual distress was (newly) recognizable in patients, caregivers, and self. Conclusions:This unique clinical pastoral education program provides the clinician with knowledge, language, and understanding to explore and support spiritual and religious issues confronting critically ill patients and their families. We propose that incorporating spiritual care of the patient and family into clinical practice is an important step in addressing the goal of caring for the whole person.
A double‐blind, placebo‐controlled study of intranasal apomorphine spray as a rescue agent for off‐states in Parkinson's disease

Nine patients with advanced levodopa‐responsive Parkinson's disease were enrolled in a double‐blind, placebocontrolled crossover trial of intranasal apomorphine as rescue therapy for parkinsonian off‐states. Patients were assigned in random order to each of four possible combinations of apomorphine, trimethobenzamide antiemetic, and their matched placebos and received detailed in‐office motor scoring during each of the four study periods. Patients also completed diaries describing the effectiveness of the nasal spray for reversing off‐states. A statistically significant reduction in the Unified Parkinson's Disease Rating Scale (UPDRS) motor score was seen following active apomorphine during in‐office evaluation visits but not following placebo nasal spray. Patient diaries revealed that active apomorphine had a latency to onset of 11 minutes and a duration of 50 minutes. Significant nausea from apomorphine spray was seen in only one patient whereas nasal irritation was disabling in three and mild in two. We conclude that intranasal apomorphine is an effective rescue agent for parkinsonian off‐states although nasal irritation is a limiting factor.
Oxytocin receptors in the primate ovary: molecular identity and link to apoptosis in human granulosa cells.

BACKGROUND Oxytocin (OT) is produced by granulosa cells (GCs) of pre-ovulatory ovarian follicles and the corpus luteum (CL) in some mammalian species. Actions of OT in the ovary have been linked to luteinization, steroidogenesis and luteolysis. Human IVF-derived (h)GCs possess a functional OT receptor (OTR), linked to elevation of intracellular Ca(2+), but molecular identity of the receptor for OT in human granulosa cells (hGCs) and down-stream consequences are not known. METHODS AND RESULTS RT-PCR, sequencing and immunocytochemistry identified the genuine OTR in hGCs. OT (10 nM-10 microM) induced elevations of intracellular Ca(2+) levels (Fluo-4 measurements), which were blocked by tocinoic acid (TA; 50 microM, a selective OTR-antagonist). Down-stream effects of OTR-activation include a concentration dependent decrease in cell viability/metabolism, manifested by reduced ATP-levels, increased caspase3/7-activity (P < 0.05) and electron microscopical signs of cellular regression. TA blocked all of these changes. Immunoreactive OTR was found in the CL and GCs of large and, surprisingly, also small pre-antral follicles of the human ovary. Immunoreactive OTR in the rhesus monkey ovary was detected in primordial and growing primary follicles in the infantile ovary and in follicles at all stages of development in the adult ovary, as well as the CL: these results were corroborated by RT-PCR analysis of GCs excised by laser capture microdissection. CONCLUSIONS Our study identifies genuine OTRs in human and rhesus monkey GCs. Activation by high levels of OT leads to cellular regression in hGCs. As GCs of small follicles also express OTRs, OT may have as yet unknown functions in follicular development.
A peer auditing scheme for cheat elimination in MMOGs

Although much of the research into massively multiplayer online games (MMOGs) focuses on scalability concerns, other issues such as the existence of cheating have an equally large practical impact on game success. Cheat prevention itself is usually addressed through the use of proprietary, ad-hoc or manual methods, combined with a strong centralized authority as found in a straightforward client/server network model. To improve scalability, however, the use of more extensible, yet less secure, peer-to-peer (P2P) models has become an attractive game design option. Here we present the IRS hybrid game model that efficiently incorporates a centralized authority into a P2P setting for purposes of controlling and eliminating game cheaters. Analysis of our design shows that with any reasonable parametrization malicious clients are purged extremely quickly and with minimal impact on non-cheating clients, while still ensuring continued benefit and scalability from distributed computations. Cheating has a serious impact on the viability of multiplayer games, and our results illustrate the possibility of a system in which scalability and security coexist.
Spinach-associated Escherichia coli O157:H7 Outbreak, Utah and New Mexico, 2006

In 2006, Utah and New Mexico health departments investigated a multistate cluster of Escherichia coli O157:H7. A case–control study of 22 case-patients found that consuming bagged spinach was significantly associated with illness (p<0.01). The outbreak strain was isolated from 3 bags of 1 brand of spinach. Nationally, 205 persons were ill with the outbreak strain.
Using eye-tracking to model attribute non-attendance in choice experiments

ABSTRACT We investigate revealed attribute attendance in discrete choice experiments using eye-tracking. A simple theoretical framework is proposed in which choices are a function of visual attention. Consistent with the existing literature, the assumption that participants use all the available information to make their decisions does not hold. The results also illustrate that model fit and predictive power are greatly increased by using visual attendance measures as regressors. The use of eye-tracking technology has value for measuring revealed attention and to benchmark with existing choice models.
Preoperative systemic chemotherapy followed by adjuvant postoperative intraperitoneal therapy for gastric cancer: a University of Southern California pilot program.

PURPOSE A clinical trial for patients with gastric cancer amenable to curative resection was undertaken to determine feasibility and response to preoperative systemic chemotherapy followed by postoperative intraperitoneal (IP) chemotherapy. METHODS AND MATERIALS Thirty-eight patients with resectable gastric tumor received two cycles of protracted intravenous (IV)-infusion fluorouracil (5FU), 200 mg/m2/d, for 3 weeks with weekly IV leucovorin 20 mg/m2 and IV cisplatin 100 mg/m2 days 1 and 29. Resection of the gastric tumor followed within 3 weeks of completion of systemic chemotherapy. Those who had all visible tumor removed with clear margins received two cycles of IP floxuridine 3,000 mg (total dose) per day for 3 days and IP cisplatin 200 mg/m2 with IV sodium thiosulfate on the fourth day of IP therapy. RESULTS Thirty-seven of 38 patients (97%) received two cycles of systemic chemotherapy. Thirty-five of 38 patients (92%) underwent laparotomy for gastric tumor resection. Thirty-three patients (87%) had gastric resections performed; 29 (76%) had all visible tumor removed with microscopically negative margins. No operative mortality was encountered. Twenty-six patients (68%) received IP treatment. IV neoadjuvant treatment was well tolerated and resulted in 68% of the patients reporting improvement in abdominal pain, 45% objective remissions by computed tomography (CT), 38% objective remissions by gastroscopy and biopsy, and 8% had complete surgical pathologic response. Neutropenic sepsis during the IP treatment phase contributed to the only treatment-related death. Four of 29 completely resected patients (14%) have had tumor recurrence. The median follow-up time of patients remaining alive is now 19 months. The median survival for 38 patients entered onto this protocol has not been reached at 17+ months. CONCLUSION This novel approach to the treatment of adenocarcinoma of the stomach is feasible. The neoadjuvant systemic therapy results in significant primary tumor regression. The determination of whether systemic or IP components of the program contribute to decreased recurrence or increased survival awaits a prospectively randomized clinical trial.
Treatment of single brain metastasis: Radiotherapy alone or combined with neurosurgery

Most patients treated for single or multiple brain metastases die from progression of extracranial tumor activity. This makes it uncertain whether the combination of neurosurgery and radiontherapy for treatment of single brain metastasis will lead to better results than less invasive treatment with radiotherapy alone. The effect of neurosurgical excision plus radiotherapy was compared with radiotherapy alone in a prospectively randomized trial with 63 evaluable patients with systemic cancer and a radiological diagnosis of single brain metastasis. Radiotherapy was given to the whole brain by a novel scheme of 2 faractions per day of each 2 Gy for a total of 40 Gy. Before randomization, patients were stratified by site (lung cancer vs nonlung cancer) and status of extracranial disease (progressive vs. stable). Survival as such and functionally independent survival (FIS; defined as world Health Organization performance status ≤ 1 and neurological funcition ≤ 1) were compared between both treatment arms. The combined treatment compared with radiotherapy alone led to a longer survival (p =0.04) and a longer FIS (p=0.06). This was most pronounced in patients with stable extracranial disease (median survival, 12vs 7 mo; median FIS 9 vs 4 Mo). Patients with progressive extracranial cancer had a median overall survival of 5 months and a FIS of 2.5 months irrespective of given treatment. Improvement in functional status occurred more rapidly and for longer periods of time after neurosurgial excision and radiotherapy than after radiotherpy alone. Patients older than 60 years had a hazard ratio of dying of 2.74(p=0.001) compared with younger patients, but in both age groups the combined treatment did better then radiotherapy alone. We coclude that patients with single brain metastasis and stable extracranial tumor activity should be treated with surgical excision and radiotherapy. For patients with progressive extracranial disease during the previous 3 months, radiotherapy alone appears to be sufficient. After treatment of single brain metastasis, parients remain functionally independent until a few months before death.
Use of ELISAs in field studies of rabbit haemorrhagic disease (RHD) in Australia

ELISA techniques developed for the veterinary diagnosis of Rabbit Haemorrhagic Disease (RHD) in domestic rabbits were used for studying the epidemiology of RHD in Australian wild rabbits. The combination of ELISA techniques that distinguished IgA, IgG and IgM antibody responses and a longitudinal data set, mainly based on capture-mark-recapture of rabbits, provided a reliable basis for interpreting serology and set the criteria used to classify rabbits' immunological status. Importantly, young with maternal antibodies, immune rabbits and rabbits apparently re-exposed to RHD were readily separated. Three outbreaks of RHD occurred in 1996–7. The timing of RHD outbreaks was mainly driven by recruitment of young rabbits that generally contracted RHD after they lost their maternally derived immunity. Young that lost maternal antibodies in summer were not immediately infected, apparently because transmission of RHDV slows at that time, but contracted RHD in the autumn when conditions were again suitable for disease spread.
Job Burnout Rate and Related Demographic Factors in Nursing Personnel Employed in Emergency Departments of Chosen Educational Hospitals by Kermanshah University of Medical Science in 2012

Job burnout is a very common phenomenon in the helping professions including nursing. Since this syndrome can cause physical and psychological damage, reduces the job efficiency and motivation of the individual which leads to a sharp drop in the quantity and quality of caring services, current research was performed in order to better understand of burnout dimensions and its related factors in employed nurses in emergency, who are faced with a variety of occupational stress. This study was an analytical cross-sectional and its study population was from all nurses working in the emergency section of the 4 hospitals of Kermanshah University of Medical Science. The study sample included 120 nurses and nursing assistants who were studied using available sampling method. To collect data, a demographic information questionnaire and a job burnout questionnaire of “Maslach” were used. After data extraction, it was statistically evaluated using SPSS 22 software. 103 individuals completed the questionnaire and their data were analyzed. Based on the findings, all nurses had some degree of job burnout. 40.8% had experienced a frequency of emotional exhaustion, 41.7% had intensively faced depersonalization and 40.8% had experienced a high level of personal incompetence and there were significant statistical correlations between Job Satisfaction and Emotional Exhaustion (P <0.001), Rotational Shifts and Intensity of Depersonalization (p=0.045), Contract Employment and Emotional Exhaustion (p=0.015), Job Description and Individual Incompetence (p=0.016), Job Environment Satisfaction and Emotional Exhaustion (p=0.01), Satisfaction of Physicians and Number of Depersonalization (p=0.044) and the Sense of Personal Incompetence and Training Courses related to the hospital care section (p=0.012). The results of this research showed that the job burnout is a major problem and it is at the top level in emotional exhaustion and personal incompetence among most of the employed nurses in the emergency and it is at the average level in depersonalization dimension. So the authorities and managers are advised to provide necessary facilities in order to reduce job burnout and its deleterious effects.
Bake induced charge gain in NOR flash cells

Charge gain, caused by localized defects in the tunnel oxide of floating gate devices, is one of the central reliability concerns of flash memory. In this work, we show that charge motion in the poly sidewall spacers of flash cells can also result in substantial charge gain, for nonoptimized processes. Data showing the time, temperature, and field dependencies of this charge gain mechanism are presented. It is shown that the threshold voltage shift caused by charge motion in the poly sidewall spacers follows the simple factorial expression: /spl Delta/V/sub th/=C/spl middot/V/sub fg//spl middot/t/sup /spl alpha///spl middot/e/sup -/spl epsiv/(a)/kT/.
UAG readthrough during TMV RNA translation: isolation and sequence of two tRNAsTyr with suppressor activity from tobacco plants

The hypothetical replicase or replicase subunit cistron in the 5′‐proximal part of tobacco mosaic virus (TMV) RNA yields a major 126‐K protein and a minor 183‐K ‘readthrough’ protein in vivo and in vitro. Two natural suppressor tRNAs were purified from uninfected tobacco plants on the basis of their ability to promote readthrough over the corresponding UAG termination codon in vitro. In a reticulocyte lysate the yield of 183‐K readthrough protein increases from ˜10% in the absence of added tobacco plant tRNA up to ˜35% in the case of pure tRNATyr added. Their amino acid acceptance and anticodon sequence (GψA) identifies the two natural suppressor tRNAs as the two normal major cytoplasmic tyrosine‐specific tRNAs. tRNATyr1 has an A:U pair at the base of the TψC stem and an unmodified G10, whereas tRNATyr2 contains a G:C pair in the corresponding location and m2G in position 10. This is the first case that, in a higher eukaryote, the complete structure is known of both the natural suppressor tRNAs and the corresponding viral RNA on which they exert their function. The corresponding codon‐anticodon interaction, which is not in accordance with the wobble hypothesis, and the possible biological significance of the readthrough phenomenon is discussed.
Activation of latent myostatin by the BMP-1/tolloid family of metalloproteinases

Myostatin is a transforming growth factor β family member that acts as a negative regulator of skeletal muscle growth. Myostatin circulates in the blood of adult mice in a noncovalently held complex with other proteins, including its propeptide, which maintain the C-terminal dimer in a latent, inactive state. This latent form of myostatin can be activated in vitro by treatment with acid; however, the mechanisms by which latent myostatin is activated in vivo are unknown. Here, we show that members of the bone morphogenetic protein-1/tolloid (BMP-1/TLD) family of metalloproteinases can cleave the myostatin propeptide in this complex and can thereby activate latent myostatin. Furthermore, we show that a mutant form of the propeptide resistant to cleavage by BMP-1/TLD proteinases can cause significant increases in muscle mass when injected into adult mice. These findings raise the possibility that members of the BMP-1/TLD family may be involved in activating latent myostatin in vivo and that molecules capable of inhibiting these proteinases may be effective agents for increasing muscle mass for both human therapeutic and agricultural applications.
Serum S-100B Protein Levels during and after Successful Carotid Artery Stenting or Carotid Endarterectomy

Purpose: To characterize the course of S-100B serum levels, a reliable marker for cellular brain damage, in patients undergoing carotid artery stenting (CAS) or endarterectomy (CEA) for carotid artery stenosis compared to control groups undergoing hemithyroidectomy (HT) or coronary angiography (CA). Methods: Forty-six consecutive patients scheduled for revascularization of internal carotid artery (ICA) stenosis were included in the study. Fourteen patients (11 men; median age 70 years, interquartile range [IQR] 63–74) were selected for treatment with CAS, while CEA was performed in 31 patients (24 men; median age 68 years, IQR 54–78) during the same time period. Fourteen consecutive patients (8 men; median age 60 years, IQR 48–70) undergoing CA for suspected coronary heart disease and 14 patients (10 women; median age 36 years, IQR 26–54) undergoing HT for a single thyroid nodule served as controls. Results: All procedures were completed successfully. During ICA clamping in CEA patients without postoperative neurological deficits, median S-100B serum levels transiently increased from 0.04 to 0.26 ng/mL (p<0.01) and returned to baseline levels after declamping. Median S-100B serum levels of CAS patients without neurological impairment remained at baseline values. No increase in S-100B levels occurred in either control group. Three CEA patients who suffered from neurological deficits (1 transient ischemic attack and 1 major stroke) showed sustained elevation of S-100B serum levels 6 hours after extubation. Conclusion: In patients without neurological complications, CEA but not CAS was associated with a transient increase in the S-100B serum levels. Results indicate that the increase in S-100B does not originate from extracerebral sources, but rather appears to represent an impairment of the blood-brain barrier integrity or subtle brain cell damage probably due to hypoperfusion during clamping. Sustained elevation of S-100B serum levels corresponded to the development of postoperative neurological deficits.