Miracle-dz/UniFAR-FTUs huggingface dataset:
Performance Indicators in Spine Surgery

Study Design. Systematic review. Objective. To elucidate how performance indicators are currently used in spine surgery. Summary of Background Data. The Patient Protection and Affordable Care Act has given significant traction to the idea that healthcare must provide value to the patient through the introduction of hospital value-based purchasing. The key to implementing this new paradigm is to measure this value notably through performance indicators. Methods. MEDLINE, CINAHL Plus, EMBASE, and Google Scholar were searched for studies reporting the use of performance indicators specific to spine surgery. We followed the Prisma-P methodology for a systematic review for entries from January 1980 to July 2016. All full text articles were then reviewed to identify any measure of performance published within the article. This measure was then examined as per the three criteria of established standard, exclusion/risk adjustment, and benchmarking to determine if it constituted a performance indicator. Results. The initial search yielded 85 results among which two relevant studies were identified. The extended search gave a total of 865 citations across databases among which 15 new articles were identified. The grey literature search provided five additional reports which in turn led to six additional articles. A total of 27 full text articles and reports were retrieved and reviewed. We were unable to identify performance indicators. The articles presenting a measure of performance were organized based on how many criteria they lacked. We further examined the next steps to be taken to craft the first performance indicator in spine surgery. Conclusion. The science of performance measurement applied to spine surgery is still in its infancy. Current outcome metrics used in clinical settings require refinement to become performance indicators. Current registry work is providing the necessary foundation, but requires benchmarking to truly measure performance. Level of Evidence: 1
Perceived non-shared environment, personality traits, family factors and developmental experiences in bulimia nervosa.

OBJECTIVE The role of perceived non-shared environmental influences and personality traits in the risk of developing bulimia nervosa (BN) was compared in 40 women with BN and their non-eating disordered sisters. METHODS The two sisters were compared for (a) eating pathology, (b) perceived non-shared environmental factors (differential family relationships, developmental teasing, traumatic experiences), (c) personality traits (impulsivity, affective instability, narcissism), and (d) psychopathology (anxiety, depression). RESULTS Specific perceived non-shared risk factors (e.g. perceptions of teasing), nonspecific non-shared risk factors (e.g. insecure paternal attachment) and personality traits (e.g. narcissism) distinguished women with BN from sisters. In the final logistic regression, insecure paternal attachment predicted the risk for BN, while trends were apparent for narcissism and developmental teasing after controlling for psychopathology. CONCLUSIONS Our correlational cross-sectional design does not allow for investigation of direction of effects. However, it is an important first step in identifying possible perceived non-shared environmental influences and personality traits that may constitute vulnerability factors predisposing individuals to the development of BN. Findings are discussed in the light of existing models of risk factors for the etiology of BN.
Coping strategies adopted by international students in an Australian tertiary context

Due to geographic and cultural transition, most international students experience difficulty in adapting to an unfamiliar environment. These adjustment difficulties are commonly regarded as the primary cause of acculturative stress. In order to relieve their acculturative stress, various effective coping strategies are used to improve their adaptation. Effectively using coping strategies enhances their psychological well-being, whereas ineffective coping exacerbates the effects of stress on adjustment. This study, based on both quantitative and qualitative data, investigates coping strategies used by international students in an Australian tertiary context. The findings indicate that "acceptance", "positive reappraisal", "active coping", and "suppression" are the top four coping strategies most widely used by international students, while "denial" is the least used. In addition, participants’ demographics such as gender, degree pursued, length of stay in Australia, and English proficiency are significantly associated with their use of coping strategies.
Planning Games

We introduce planning games, a study of interactions of self-motivated agents in automated planning settings. Planning games extend STRIPS-like models of single-agent planning to systems of multiple self-interested agents, providing a rich class of structured games that capture subtle forms of local interactions. We consider two basic models of planning games and adapt game-theoretic solution concepts to these models. In both models, agents may need to cooperate in order to achieve their goals, but are assumed to do so only in order to increase their net benefit. For each model we study the computational problem of finding a stable solution and provide efficient algorithms for systems exhibiting acyclic interaction structure.
Plasma complement 3d levels in the early phase after pancreas transplantation.

BACKGROUND Rejection and graft thrombosis are the main reasons leading to early graft loss after pancreas transplantation. Identifying parameters that forecast these complications would be helpful. Complement activation might occur during rejection and thrombosis leading to elevated complement split products. This prospective study analyses the plasma complement 3d (C3d) levels in the early post-pancreas transplant (PTx) period to test its predictive value to determine rejection and thrombosis. MATERIAL/METHODS Plasma C3d levels were measured after isolated PTx (n=2), simultaneous pancreas and kidney transplantation (SPKT, n=20) and pancreas re-transplantation (n=3). RESULTS Pancreas rejection was observed in 3, pancreas thrombosis in 4, and kidney rejection in 7 patients. Patients after isolated kidney transplantation (IKT) served as controls. Within 40 days after PTx and IKT C3d levels were significantly elevated compared to volunteers and long-term kidney transplant recipients (p<0.001). C3d levels increased during 40 days after PTx, but dropped after IKT. During pancreas rejection episodes mean C3d levels were elevated (14.0+/-3.5 mg/l) compared to those obtained during graft thrombosis (9.1+/-1.6 mg/l; p=0.012) or periods of normal graft function (10.6+/-1.9 mg/l; p=0.046). A slight elevation of C3d was observed during kidney rejection episodes in SPKT (12.7+/-2.0 mg/l; p=0.074) but not during kidney rejection after IKT. CONCLUSIONS C3d plasma levels increase during episodes of pancreas rejection and decrease in pancreas transplant thrombosis. However, single C3d values have no predictive diagnostic value after SPKT.
The prevalence of dust on the exoplanet HD 189733b from Hubble and Spitzer observations

The hot Jupiter HD 189733b is the most extensively observed exoplanet. Its atmosphere has been detected and characterized in transmission and eclipse spectroscopy, and its phase curve measured at several wavelengths. This paper brings together the results of our campaign to obtain the complete transmission spectrum of the atmosphere of this planet from UV to infrared with the Hubble Space Telescope, using the STIS, ACS and WFC3 instruments. We provide a new tabulation of the transmission spectrum across the entire visible and infrared range. The radius ratio in each wavelength band was re-derived, where necessary, to ensure a consistent treatment of the bulk transit parameters and stellar limb darkening. Special care was taken to correct for, and derive realistic estimates of the uncertainties due to, both occulted and unocculted star spots. The combined spectrum is very different from the predictions of cloud-free models for hot Jupiters: it is dominated by Rayleigh scattering over the whole visible and near-infrared range, the only detected features being narrow sodium and potassium lines. We interpret this as the signature of a haze of condensate grains extending over at least five scaleheights. We show that a dust-dominated atmosphere could also explain several puzzling features of the emission spectrum and phase curves, including the large amplitude of the phase curve at 3.6 μm, the small hotspot longitude shift and the hot mid-infrared emission spectrum. We discuss possible compositions and derive some first-order estimates for the properties of the putative condensate haze/clouds. We finish by speculating that the dichotomy between the two observationally defined classes of hot Jupiter atmospheres, of which HD 189733b and HD 209458b are the prototypes, might not be whether they possess a temperature inversion, but whether they are clear or dusty. We also consider the possibility of a continuum of cloud properties between hot Jupiters, young Jupiters and L-type brown dwarfs.
Water Surface Electromyography

Registration of electrical muscle activity with the use of surface electromyography (SEMG) is today already a routine neuro-physiological method. Over the course of a few decades it has moved from the field of the purely experimental to the area of rehabilitation medicine, kinesiology, and sports issues. Together with this trend, interest has begun to deepen in the study of all types of movement patterns stereotypes conducted in a water environment and in a dry environment. This has also opened a new area of electromyographic diagnostics that represents a modification of the basic methodology of surface EMG in a water environment, so-called Water Surface Electromyography -WaS-EMG (Panek et al., 2010). Although current modern technology allows a huge number of computer post-processing of an acquired native recording, a key phase of the actual recording of electrical activity remains in the hands of the experimenter. For these reasons significant attention is paid to the methodology and issue of correct placement and fixing of electrodes in all neurophysiological methods. In general approach, recording an EMG signal in a water environment is no different from the common methodology of surface EMG, but there are certain specifics in that case. Currently, great attention is paid in the literature to the issue of the different effect of water and dry environments on the nature of the EMG recording itself (Kelly et al., 2000; Masumoto et al., 2004, 2008; Rainoldi et al., 2004; Veneziano et al., 2006), and thus on the course of a defined movement stereotype (Kelly et al., 2000; Masumoto et al., 2004, 2005, 2008; Pavlů & Panek, 2008; Hollanderova, 2011; Sladka, 2011). In this work we take up the issue of Water Surface Electromyography (WaS-EMG), both in terms of research and the practical, including a summary of the results of several of our experiments.
Quantification of lipoprotein subclasses by proton nuclear magnetic resonance-based partial least-squares regression models.

BACKGROUND Cardiovascular disease risk can be estimated in part on the basis of the plasma lipoprotein profile. Analysis of lipoprotein subclasses improves the risk evaluation, but the traditional methods are very time-consuming. Novel, rapid, and productive methods are therefore needed. METHODS We obtained plasma samples from 103 fasting people and determined the plasma lipoprotein subclass profiles by an established ultracentrifugation-based method. Proton nuclear magnetic resonance (NMR) spectra were obtained from replicate samples on a 600 MHz NMR spectrometer. From the ultracentrifugation-based reference data and the NMR spectra, we developed partial least-squares (PLS) regression models to predict cholesterol and triglyceride (TG) concentrations in plasma as well as in VLDL, intermediate-density lipoprotein (IDL), LDL, 3 LDL fractions, HDL, and 3 HDL subclasses. RESULTS The correlation coefficients (r) between the plasma TG and cholesterol concentrations measured by the 2 methods were 0.98 and 0.91, respectively. For LDL- and HDL-cholesterol concentrations, r = 0.90 and 0.94, respectively. For cholesterol concentrations in the LDL-1, LDL-2, and LDL-3 fractions, r = 0.74, 0.78, and 0.69, respectively, and for HDL subclasses HDL(2b), HDL(2a), and HDL(3), cholesterol concentrations were predicted with r = 0.92, 0.94, and 0.75, respectively. TG concentrations in VLDL, IDL, LDL, and HDL were predicted with correlations of 0.98, 0.85, 0.77, and 0.74, respectively. The cholesterol and TG concentrations in the main lipoprotein fractions and in LDL fractions and HDL subclasses predicted by the PLS models were 94%-100% of the concentrations obtained by ultracentrifugation. CONCLUSION NMR-based PLS regression models are appropriate for use in research in which analyses of the plasma lipoprotein profile, including LDL and HDL subclasses, are required in large numbers of samples.
Subspace alignment chains and the degrees of freedom of the three-user MIMO interference channel

We show that the 3 user M<sub>T</sub> × M<sub>R</sub> MIMO interference channel where each transmitter is equipped with M<sub>T</sub> and each receiver is equipped with M<sub>R</sub> antennas has min (M/2-1/k, N/2+1/k) degrees of freedom (DoF) per user normalized by time, frequency, and space dimensions, where N = max(M<sub>T</sub>, M<sub>R</sub>), M = min(M<sub>T</sub>, M<sub>R</sub>), k = [M/N-M]. While the information theoretic DoF outer bound is established for every M, N value, the achievability, relying only on linear interference alignment, is established in general subject to a normalization with respect to spatial-extensions, i.e., the scaling of the number of antennas at all nodes. In the absence of spatial extensions, we can also show through examples how essentially the same alignment scheme may be applied over time or frequency extensions. The central new insight to emerge from this work is the notion of subspace alignment chains as DoF bottlenecks. The subspace alignment chains are instrumental both in identifying the extra dimensions provided by a genie to a receiver for the DoF outer bound, as well as constructing the optimal interference alignment schemes. In addition, our results also settle the question of feasibility of linear interference alignment for the 3 user M<sub>T</sub> × M<sub>R</sub> MIMO interference channel, for all values of M<sub>T</sub>, M<sub>R</sub>.
Head Rotation During Internal Jugular Vein Cannulation and the Risk of Carotid Artery Puncture

We undertook a prospective laboratory study to examine the effect of head position on the relative positions of the carotid artery and the internal jugular vein (IJV). Volunteers (n = 12) from departmental staff, 18-60 yr of age, who had never undergone cannulation of the IJV underwent imaging of their IJV and carotid artery. With the subject in a 15 degrees Trendelenburg position, two-dimensional ultrasound images of the IJV and the carotid artery were obtained on the left and right sides of the neck at 2 and 4 cm from the clavicle along the lateral border of the sternal head of the sternocleidomastoid muscle at 0 degrees, 40 degrees, and 80 degrees of head rotation from the midline. The percent overlap of the carotid artery and IJV increased significantly at 40 degrees and 80 degrees head rotation to both the right and left (P < 0.05). Data from 2 and 4 cm above the clavicle did not differ and were pooled. The percent overlap was larger on the left than the right only with 80 degrees of head rotation (P < 0.05). The increased overlap of carotid artery and IJV with head rotation >40 degrees increases the risk of inadvertent puncture of the carotid artery associated with the common occurrence of transfixion of the IJV before it is identified during needle withdrawal. The IJV frequently collapses with needle insertion. This may result in puncture of the posterior wall of the vessel, and thus of the carotid artery when the two vessels overlap. To decrease this risk, the head should be kept in as neutral a position as possible, that is <40 degrees rotation, during IJV cannulation. (Anesth Analg 1996;82:125-8)
Differences of the Fecal Microflora With Clostridium difficile Therapies.

BACKGROUND During treatment of Clostridium difficile infection (CDI), patterns of pathogen reduction in relationship to changes in components of the normal microbiota are hypothesized to be predictive of response to treatment and subsequent sustained cure. METHODS At a single center, subjects enrolled into phase 2 and 3 C. difficile treatment clinical trials (2003-2008) provided fecal samples to assess killing of C. difficile and changes to components of the microbiome. Quantitative bacterial cultures, measurement of C. difficile toxin titers, quantitative polymerase chain reaction of fecal samples for Bacteroidetes, Clostridium clusters XIVa and IV, and C. difficile were performed. RESULTS Quantitative bacterial cultures showed a mean log10 C. difficile count (colony-forming units [CFU]) of 6.7 ± 2.0 at study entry; vancomycin treatment consistently reduced C. difficile counts to the limit of detection (2.0 log10 CFU/g), whereas metronidazole was associated with mean C. difficile counts 1.5-2 log10 higher at 10 days of treatment. In patients receiving tolevamer, C. difficile persisted in high counts during treatment; response to treatment was correlated with neutralization of toxin along with persistence of normal microbiota components. However, this was achieved in approximately half of subjects. Both vancomycin and metronidazole further suppressed microbiome components during treatment of CDI. Lactobacilli were observed to be a microbiome component that persisted during treatment of CDI. CONCLUSIONS Differences of pathogen clearance and microbiome perturbation during treatment of CDI appear to explain treatment outcomes. The hypothesis that probiotic microbes could help prevent onset of CDI is supported by the observation of persistence of lactobacilli during and after treatment of CDI.
Emotional Value: Creating Strong Bonds with Your Customers

Part 1 Building an emotion-friendly serviced culture: the customer is always emotional emotions matter valuing the emotionality in customer communications managing emotions begins with me positive emotional states add value shifting to positive emotions. Part 2 Choosing emotional competence: emotional labour or emotional competence? the challenges of burnout managing for emotional authenticity fostering positive interdependency the customer isn't always tight.hiring for emotional competence defining the emotional requirements of service jobs the necessity of ongoing education staff autonomy and emotional competence. Part 3 Maximising customer experience with empathy: satisfaction isn't good enough. anymore the challenge in measuring customer emotions the gift of empathy creating a climate for generous empathy broadcasting service successes measuring emotional reactions. Part 4 Viewing complaints as emotional opportunities: complaints - emotional opportunities fundamentals of complaints going from problems to partners empowering staff is more than giving permission creating a craving for feedback focusing on lifetime customer value talking to the emotionality of complaints turning complaints into customer learning opportunities taking complaints seriously eliminating blame! expanding the zone of tolerance when corporate customers complain. Part 5 Using emotional connections to increase customer loyalty: loyalty is behaviour with its roots in emotions emotional drivers of loyalty and value listening to the voices of loyal customers retaining customers by retaining staff going for impact that's where emotions reside communicating a message of fairness.
Leaf δ15N as a physiological indicator of the responsiveness of N2-fixing alfalfa plants to elevated [CO2], temperature and low water availability

The natural 15N/14N isotope composition (δ15N) of a tissue is a consequence of its N source and N physiological mechanisms in response to the environment. It could potentially be used as a tracer of N metabolism in plants under changing environmental conditions, where primary N metabolism may be complex, and losses and gains of N fluctuate over time. In order to test the utility of δ15N as an indicator of plant N status in N2-fixing plants grown under various environmental conditions, alfalfa (Medicago sativa L.) plants were subjected to distinct conditions of [CO2] (400 vs. 700 μmol mol−1), temperature (ambient vs. ambient +4°C) and water availability (fully watered vs. water deficiency—WD). As expected, increased [CO2] and temperature stimulated photosynthetic rates and plant growth, whereas these parameters were negatively affected by WD. The determination of δ15N in leaves, stems, roots, and nodules showed that leaves were the most representative organs of the plant response to increased [CO2] and WD. Depletion of heavier N isotopes in plants grown under higher [CO2] and WD conditions reflected decreased transpiration rates, but could also be related to a higher N demand in leaves, as suggested by the decreased leaf N and total soluble protein (TSP) contents detected at 700 μmol mol−1 [CO2] and WD conditions. In summary, leaf δ15N provides relevant information integrating parameters which condition plant responsiveness (e.g., photosynthesis, TSP, N demand, and water transpiration) to environmental conditions.
Chronic subdural hematoma: comparison of two surgical techniques. Preliminary results of a prospective randomized study.

AIM The optimal treatment for chronic subdural hematoma (CSDH) is not yet well defined and research for efficient surgical solutions continues. Burr hole craniotomy (BHC) is a common treatment and twist drill craniostomy (TDC) is a less invasive alternative. A closed-system drainage with subdural expansion catheter and suction reservoir can be used to enhance the TDC procedure. METHODS We report preliminary results of a prospective study comparing BHC and TDC with suction drainage, in a series of 47 patients randomized into two treatment groups. One group of 22 patients underwent TDC with closed-system drainage and suction reservoir (14 men, 8 women, mean age 78.7 years). Another group of 24 patients underwent BHC with subdural irrigation and closed drainage (16 men, 8 women, mean age 76.3 years). Neurological status was assessed by Markwalder's Grading Scale on admission and at follow-up. All patients underwent computed tomography (CT) before surgery, within 4 days after it, and 1 and 2 months later. RESULTS Preoperative clinical and radiological data were similar in the two groups. Operating times were shorter in the TDC group, while drainage time was shorter in the BHC group (P<0.0001). Length of hospitalization was similar. Recurrence rate, mortality, and neurological recovery were similar, with non significant differences in favor of the TDC group. After 2 months, CT showed complete regression of subdural effusion in 66.6% of cases in the TDC group and in 31.8% in the BHC group (P<0.05). CONCLUSIONS Preliminary results indicate TDC and BHC as at least equally effective, however TDC favors faster regression of residual subdural effusion, is a faster procedure, and seems to be associated with fewer recurrences. If confirmed at the end of the study, these results could indicate TDC with suction as the elective surgical treatment for CSDH.
Confirmation Bias: A Ubiquitous Phenomenon in Many Guises

Confirmation bias, as the term is typically used in the psychological literature, connotes the seeking or interpreting of evidence in ways that are partial to existing beliefs, expectations, or a hypothesis in hand. The author reviews evidence of such a bias in a variety of guises and gives examples of its operation in several practical contexts. Possible explanations are considered, and the question of its utility or disutility is discussed.