Miracle-dz/UniFAR-FTUs huggingface dataset:
Clinical Guidelines : Nutrition Support of Hospitalized Adult Patients With Obesity

As of June 2013, the American Medical Association recognized obesity as a disease that requires medical treatment. Based on the National Health and Nutrition Examination Survey 2009-2010, the prevalence of obesity in the United States is 35.5% in adult men, 35.8% in adult women, including 4.4% and 8.2% respectively with body mass index (BMI) ≥ 40 kg/m. Thus, nutrition support clinicians are likely to care for obese patients, particularly during hospital admissions. While nutrition support clinicians care for patients across a broad range of clinical settings, the bulk of publications available for this clinical guideline have come from hospitalized patients. Furthermore, since the clinical acuity of patients admitted to intensive care units (ICUs) is much higher than those who are not critically ill, for this guideline most recommendations have been made separately for these 2 groups of obese hospitalized patients when data were available. Bariatric surgery is a common treatment for patients who have severe obesity, with estimates of approximately 200,000 adults treated with bariatric surgery annually in the United States. Since these procedures are designed to limit the patient’s nutrient intake as a strategy to promote significant and durable weight loss, patients treated with these procedures may require nutrition care. Thus, the purpose of this clinical guideline is to guide clinicians on the nutrition support care of hospitalized adult patients who have obesity. 499374 PENXXX10.1177/0148607113499374Journal of Parenteral and Enteral Nutrition XX(X)Choban et al research-article2013
Do ejection fraction and other gated stress rest myocardial perfusion parameters differ by age and gender?

BACKGROUND We have studied the end-diastolic volume (EDV), the end-systolic volume (ESV), and the ejection fraction (EF) for patients who had normal results on treadmill exercise tests and perfusion scans. We also studied normal wall motion as diagnosed by gated myocardial perfusion imaging with the quantitative gated single photon emission tomography (QGSPECT) software set to launch a range of normal values. In addition, we evaluated differences based on age and gender. MATERIALS AND METHODS All subjects with normal results on Bruce exercise and myocardial perfusion imaging QGSPECT using the 2-days stress-rest technetium-99m (99mTc) sestamibi protocol were enrolled in the study. The quantitated functional data of EDV, ESV, and EF using the QGSPECT software were assessed in the rest and stress studies. The association of quantitated functional data with age and sex at both stress and rest was studied in 78 subjects with no symptoms from the cardiovascular system and normal QGSPECT imaging, 29 males (mean age: 58.41 ± 9.0 years) and 49 females (mean age: 58.18 ± 9.0 years). Also studied were differences between males and females. RESULTS Our results showed that in women compared with men only stress EF showed a significantly higher value (P = 0.02), whereas all other parameters including REF, SESV, SEDV, RESV, and REDV did not demonstrate a significant difference between men and women (P value > 0.05). CONCLUSION The study showed that EF as determined by the QGSPECT technique should be considered as gender-matched normative parameter.
Elevated Soluble CD163 Plasma Levels Are Associated with Disease Severity in Patients with Hemorrhagic Fever with Renal Syndrome

Background Hantaan virus is a major zoonotic pathogen that causesing hemorrhagic fever with renal syndrome (HFRS). Although HFRS pathogenesis has not been entirely elucidated, the importance of host-related immune responses in HFRS pathogenesis has been widely recognized. CD163, a monocyte and macrophage-specific scavenger receptor that plays a vital function in the hosts can reduce inflammation, is shed during activation as soluble CD163 (sCD163). The aim of this study was to investigate the pathological significance of sCD163 in patients with HFRS. Methods Blood samples were collected from 81 hospitalized patients in Tangdu Hospital from October 2011 to January 2014 and from 15 healthy controls. The sCD163 plasma levels were measured using a sandwich ELISA, and the relationship between sCD163 and disease severity was analyzed. Furthermore, CD163 expression in 3 monocytes subset was analyzed by flow cytometry. Results The results demonstrated that sCD163 plasma levels during the HFRS acute phase were significantly higher in patients than during the convalescent stage and the levels in the healthy controls (P<0.0001). The sCD163 plasma levels in the severe/critical group were higher than those in the mild/moderate group during the acute (P<0.0001). A Spearman correlation analysis indicated that the sCD163 levels were positively correlated with white blood cell, serum creatine, blood urea nitrogen levels, while they were negatively correlated with blood platelet levels in the HFRS patients. The monocyte subsets were significantly altered during the acute stage. Though the CD163 expression levels within the monocyte subsets were increased during the acute stage, the highest CD163 expression level was observed in the CD14++CD16+ monocytes when compared with the other monocyte subsets. Conclusion sCD163 may be correlated with disease severity and the disease progression in HFRS patients; however, the underlying mechanisms should be explored further.
Fabrication of Ceramic-Metal Composites with Percolation of Phases Using GPI

Al2O3/AlSi12CuMgNi composites were fabricated using gas-pressure infiltration (T=700°C, p=4 MPa) of an aluminium alloy into alumina performs. Volume fraction of the ceramic phase was up to 30%, while the pore sizes of the ceramic preforms varied from 300 to 1000 µm. Ceramic preforms were formed by method of copying the cellular structure of the polymer matrix. The results of the X-ray tomography proved very good infiltration of the pores by the aluminium alloy. Residual porosity is approximately 1 vol%. Image analysis has been used to evaluate the specific surface fraction of the interphase boundaries (Sv). The presented results of the studies show the effect of the surface fraction of the interphase boundaries of ceramic-metal on the composite compressive strength, hardness and Young’s modulus. The composites microstructure was studied using scanning electron microscopy (SEM). SEM investigations proved that the pores are almost fully filled by the aluminium alloy. The obtained microstructure with percolation of ceramic and metal phases gives the composites high mechanical properties together with the ability to absorb the strain energy. Compression tests for the obtained composites were carried out and Young’s modulus was measured by the application of the DIC (Digital Image Correlation) method. Moreover, Brinell hardness tests were performed. Gas-pressure infiltration (GPI) allowed to fabricate composites with high compressive strength and stiffness.
A multisensor architecture for the assessment of postural sway in elderly and people with neurological disease

Postural instability is one of the symptoms of Parkinson's disease which can cause falls with possible unpleasant consequences. Two main tests, the Timed Up and Go and the Pull Test, are typically performed by physicians to assess the postural instability of patients. Such tests require on purpose structured laboratory equipped with expensive monitoring systems. Moreover, in the case of Pull test, the validity of the tests can be compromised by the nonstandard backward tug provided to the patient. The solution proposed in this paper consists of a low cost multisensor system and a methodology which allows to implement an objective estimation of the input solicitation as well as the assessment and classification of the user response. Different parameters (10) presented in the literature for the sake of the postural instability evaluation were investigated, in case of Pull Test, with a large set of experiments (59) in order to extract a set of features useful for the classification between stable and unstable behavior. Results obtained demonstrated the feasibility of the methodology proposed.
Geranylgeraniol Regulates Negatively Caspase-1 Autoprocessing: Implication in the Th1 Response against Mycobacterium tuberculosis1

Caspase-1 is a cysteine protease composed by two 20-kDa and two 10-kDa subunits that processes pro-IL-1β and pro-IL-18 to their mature forms. This enzyme is present in cells as a latent zymogen that becomes active through a tightly regulated proteolytic cascade. Activation is initiated by the oligomerization of an adaptor molecule, or by the formation of a multiprotein complex named inflammasome. Negative regulation of caspase-1 activation is exerted by proteins that compete with the adaptor molecule or with the inflammasome formation. We previously reported that fluvastatin, an inhibitor of 3-hydroxy-3-methylglutaryl coenzyme A reductase, increases caspase-1 activity in PBMC. This effect was strengthened by Mycobacterium tuberculosis, rending an exacerbated IL-1β, IL-18, and IFN-γ production. Mevalonate, the product of 3-hydroxy-3-methylglutaryl coenzyme A reductase, is a precursor for both nonsterol isoprenoid and sterol formation. In this study, we studied the involvement of mevalonate derivatives in the regulation of caspase-1 activation. Inhibition of sterol formation by SKF-104976 or haloperidol had no effect on IL-1β release. However, the isoprenoid geranylgeraniol prevented both caspase-1 activation and the exacerbated IL production induced by fluvastatin. This isoprenoid significantly reduced the release of IL-18 and IFN-γ by PBMC treated with mycobacteria, even in the absence of fluvastatin. In correlation with the increased caspase-1 activity, fluvastatin stimulated the proforms cleavage, enhancing the formation of active subunit p10. Geranylgeraniol not only prevented this effect, but induced proforms accumulation. Present results suggest that, once the proteolytic cascade is initiated, geranylgeraniol may exert an additional negative regulation on caspase-1 cleavage process.
Constitutive Modeling of Geomaterials: Principles and Applications

Introduction PART 1: MODELING OF GEOMATERIALS Fundamentals of Conventional Elastoplasticity Introduction One-dimensional modeling of elastoplastic materials Multidimensional modeling of elastoplastic materials Modeling of One-Dimensional Soil Behavior Introduction Modeling of normally consolidated soils-conventional elastoplastic modeling Modeling of overconsolidated soils-advanced elastoplastic modeling at stage I Modeling of structured soils (naturally deposited soils)-advanced elastoplastic modeling at stage II Modeling of other features of soils-advanced elastoplastic modeling at stage III Loading condition using increment of total change of void ratio and explicit expression in advanced elastoplastic modeling Application of the advanced model (stage III) to time-dependent behavior of soil Meaning of present time-dependent model-common and different points to Sekiguchi model Simulation of time-dependent behavior of soil in one-dimensional conditions Application of advanced methods to modeling of some other features Ordinary Modeling of Three-Dimensional Soil Behavior Introduction Outline of ordinary elastoplastic models such as the Cam clay model Discussion on applicability of Cam clay type model in three-dimensional conditions based on test results Unified Modeling of Three-Dimensional Soil Behavior Based on the tij Concept Introduction Concept of modified stress tij Three-dimensional modeling of normally consolidated soils based on the tij concept Three-Dimensional Modeling of Various Soil Features Based on the tij Concept Introduction Three-dimensional modeling of overconsolidated soils-advanced elastoplastic modeling at stage I Three-dimensional modeling of structured soils-advanced elastoplastic modeling at stage II Three-dimensional modeling of other features of soils-advanced elastoplastic modeling at stage III Conclusions of Part 1 PART 2: NUMERICAL AND PHYSICAL MODELING OF GEOTECHNICAL PROBLEMS Introduction to Numerical and Physical Modeling Introduction Modeling the interface behavior between soil and structure Geomaterials used in 2D and 3D model tests and their material parameters Tunneling Two-dimensional trapdoor problems Three-dimensional trapdoor problems Circular tunneling Earth Pressure of Retaining Walls and Bearing Capacity of Foundations Active and passive earth pressure behind retaining walls Braced open excavation Strip foundation and piled raft foundation Reinforced Soils Reinforced foundation under uplift loading Reinforcing for increasing bearing capacity Localization and Shear Band Development in Element Tests Introduction Outline of analyses Results and discussion Conclusions of Part 2 References Index
Anal Incontinence After Vaginal Delivery: A Five-Year Prospective Cohort Study

OBJECTIVE: The long-term prevalence of anal incontinence after vaginal delivery is unknown. The aim of the present study was to evaluate the prevalence of anal incontinence in primiparous women 5 years after their first delivery and to evaluate the influence of subsequent childbirth. METHODS: A total of 349 nulliparous women were prospectively followed up with questionnaires before pregnancy, at 5 and 9 months, and 5 years after delivery. A total of 242 women completed all questionnaires. Women with sphincter tear at their first delivery were compared with women without such injury. Risk factors for development of anal incontinence were also analyzed. RESULTS: Anal incontinence increased significantly during the study period. Among women with sphincter tears, 44% reported anal incontinence at 9 months and 53% at 5 years (P = .002). Twenty-five percent of women without a sphincter tear reported anal incontinence at 9 months and 32% had symptoms at 5 years (P < .001). Risk factors for anal incontinence at 5 years were age (odds ratio [OR] 1.1; 95% confidence interval [CI] 1.0–1.2), sphincter tear (OR 2.3; 95% CI 1.1–5.0), and subsequent childbirth (OR 2.4; 95% CI 1.1–5.6). As a predictor of anal incontinence at 5 years after the first delivery, anal incontinence at both 5 months (OR 3.8; 95% CI 2.0–7.3) and 9 months (OR 4.3; 95% CI 2.2–8.2) was identified. Among women with symptoms, the majority had infrequent incontinence to flatus, whereas fecal incontinence was rare. CONCLUSION: Anal incontinence among primiparous women increases over time and is affected by further childbirth. Anal incontinence at 9 months postpartum is an important predictor of persisting symptoms.
Organizational strategies for promoting patient and provider uptake of personal health records

OBJECTIVE To investigate organizational strategies to promote personal health records (PHRs) adoption with a focus on patients with chronic disease. METHODS Using semi-structured interviews and a web-based survey, we sampled US health delivery organizations which had implemented PHRs for at least 12 months, were recognized as PHR innovators, and had scored highly in national patient satisfaction surveys. Respondents had lead positions for clinical information systems or high-risk population management. Using grounded theory approach, thematic categories were derived from interviews and coupled with data from the survey. RESULTS Interviews were conducted with 30 informants from 16 identified organizations. Organizational strategies were directed towards raising patient awareness via multimedia communications, and provider acceptance and uptake. Strategies for providers were grouped into six main themes: organizational vision, governance and policies, work process redesign, staff training, information technology (IT) support, and monitoring and incentives. Successful organizations actively communicated their vision, engaged leaders at all levels, had clear governance, planning, and protocols, set targets, and celebrated achievement. The most effective strategy for patient uptake was through health professional encouragement. No specific outreach efforts targeted patients with chronic disease. Registration and PHR activity was routinely measured but without reference to a denominator population or high risk subpopulations. DISCUSSION AND CONCLUSION Successful PHR implementation represents a social change and operational project catalyzed by a technical solution. The key to clinician acceptance is making their work easier. However, organizations will likely not achieve the value they want from PHRs unless they target specific populations and monitor their uptake.
OLTP-Bench: An Extensible Testbed for Benchmarking Relational Databases

Benchmarking is an essential aspect of any database management system (DBMS) effort. Despite several recent advancements, such as pre-configured cloud database images and database-as-a-service (DBaaS) offerings, the deployment of a comprehensive testing platform with a diverse set of datasets and workloads is still far from being trivial. In many cases, researchers and developers are limited to a small number of workloads to evaluate the performance characteristics of their work. This is due to the lack of a universal benchmarking infrastructure, and to the difficulty of gaining access to real data and workloads. This results in lots of unnecessary engineering efforts and makes the performance evaluation results difficult to compare. To remedy these problems, we present OLTP-Bench, an extensible "batteries included" DBMS benchmarking testbed. The key contributions of OLTP-Bench are its ease of use and extensibility, support for tight control of transaction mixtures, request rates, and access distributions over time, as well as the ability to support all major DBMSs and DBaaS platforms. Moreover, it is bundled with fifteen workloads that all differ in complexity and system demands, including four synthetic workloads, eight workloads from popular benchmarks, and three workloads that are derived from real-world applications. We demonstrate through a comprehensive set of experiments conducted on popular DBMS and DBaaS offerings the different features provided by OLTP-Bench and the effectiveness of our testbed in characterizing the performance of database services.
Changes in cancer incidence and mortality in England and Wales and a comparison of cancer deaths in the major developed countries by age and sex 1979–2002 in context of GDP expenditure on health

Background: The successful treatment of cancer is a major health and political issue for England and Wales and the major developed countries (MDCs). All malignancy deaths by age and sex are analysed to determine how successful the MDCs were in reducing cancer mortality between the end points of 1979–81 and 2000–2, and whether there was any association between each nations ‘gross domestic product expenditure on health’ (GDPEH) and the reduction in their cancer deaths. Method: Incidence of cancer in England and Wales was examined for 1979–80 to 2003–4 to highlight the extent of the problem. The cancer mortality rates for England and Wales were compared with each MDC by age and sex, using ‘WHO all malignancies mortality rates’ for the periods of 1979–81 and 2000–2, and tests of significance were made. The GDPEH for each MDC was examined for 1980–2002, and Spearman rank-order correlations calculated to explore any association between declining cancer deaths and the GDPEH of each MDC. Results: Men’s All Age malignancy incidence in England and Wales rose 48% and women’s 51%, with notable rises for females aged 15–34 and 55–74 years. Every MDC increased its GDPEH substantially; it rose to 9.3% in the United Kingdom, but the United Kingdom still remains eighth of the ten MDCs and below the MDC average (9.85%). The average number of cancer related deaths for men in England and Wales (15–74 years) was third highest in 1979–81, but fell to eighth by 2000–2. This decline was significantly greater than in seven other MDCs. Average female death rates in England and Wales were highest both in 1979–81 and in 2000–2, but declined significantly more than most MDCs in every age band from 35 to 74 years. There was a significant correlation between reduced deaths and the level of GDPEH of each nation. Male death rates declined significantly more than that of female in each MDC, with the exception of Japan and Spain. Conclusions: The rising incidence in cancer-related deaths poses a problem for every MDC, and the poorer women’s results should be a matter of concern for most MDCs. The reduction in cancer deaths reflects well on frontline services, and the significant association between reduced cancer mortality and increased GDPEH is encouraging, but still a challenge for governments, especially if the incidence continues to rise.
The Experience of Presence Among Telehealth Nurses

Background: Telehealth technology allows for the provision of nursing care even when the patient and nurse are physically separated from each other. Telehealth has shown positive effects on healthcare costs and healthcare access. Although it can increase healthcare access and decrease healthcare costs, the use of telehealth has altered the typical pattern of nurse–patient proximity. It is unknown how the physical separation related to telehealth use may affect the experience of presence among nurses during nurse–patient interactions. Purpose: The purpose of the research was to gain knowledge about the ways that nurses experience presence during interactions with patients using telehealth technology. Methods: A qualitative descriptive design with convenience sampling was used for this study. Sample inclusion criteria included being a registered nurse with at least 1 year of experience using telehealth technology and working in telehealth at the time of the study. Institutional review board approval was received before beginning data collection. Participants (n = 6) provided informed consent. Qualitative data were obtained by individual, audiotaped, semistructured interviews. The data were transcribed and analyzed deductively for the existence of presence. Ethnograph version 6.0 software was used to assist in organizing and analyzing the data. Results: Two examples of presence during telehealth nurse–patient interactions were described by participants. Conclusion: This study documented for the first time the experience of presence among nurses who interact with their patients using only nonvideo telehealth technology.
Post-irradiation hardening of dual-cured and light-cured resin cements through machinable ceramics.

PURPOSE To evaluate the surface hardness (Knoop Hardness Number) of the thin layer in three light-cured and dual-cured resin cements irradiated through or not through 2.0 mm thick machinable ceramics. METHODS A piece of adhesive polyethylene tape with a circular hole was positioned on the surface of the ceramic plate to control the cement layer (approximately 50 microm). The cement paste was placed on the ceramic surface within the circle. The ceramic plate with resin cement paste was placed on a clear micro cover glass over a zirconia ceramic block to obtain a flat surface, and the material was polymerized using a visible-light-curing unit. The surface hardness was recorded at a series of time intervals up to 5 days, starting from the end of a light-irradiation period. RESULTS The hardness steadily increased with post-irradiation time and tended towards a maximum, usually reached after 1 or 2 days. In all cases, the increase in hardness was relatively rapid over the first 30 minutes and continued at a lower rate thereafter. The dual-cured resin cement for each material showed a significantly higher hardness value than the light-cured resin cement irradiated either through or not through ceramics at all post-irradiation times. The resin cements cured through ceramic for each material were significantly less hard compared with those cured not through ceramics at all post-irradiation times.