Miracle-dz/UniFAR-FTUs huggingface dataset:
Review Paper: The Impact of Electronic Health Records on Time Efficiency of Physicians and Nurses: A Systematic Review

A systematic review of the literature was performed to examine the impact of electronic health records (EHRs) on documentation time of physicians and nurses and to identify factors that may explain efficiency differences across studies. In total, 23 papers met our inclusion criteria; five were randomized controlled trials, six were posttest control studies, and 12 were one-group pretest-posttest designs. Most studies (58%) collected data using a time and motion methodology in comparison to work sampling (33%) and self-report/survey methods (8%). A weighted average approach was used to combine results from the studies. The use of bedside terminals and central station desktops saved nurses, respectively, 24.5% and 23.5% of their overall time spent documenting during a shift. Using bedside or point-of-care systems increased documentation time of physicians by 17.5%. In comparison, the use of central station desktops for computerized provider order entry (CPOE) was found to be inefficient, increasing the work time from 98.1% to 328.6% of physician's time per working shift (weighted average of CPOE-oriented studies, 238.4%). Studies that conducted their evaluation process relatively soon after implementation of the EHR tended to demonstrate a reduction in documentation time in comparison to the increases observed with those that had a longer time period between implementation and the evaluation process. This review highlighted that a goal of decreased documentation time in an EHR project is not likely to be realized. It also identified how the selection of bedside or central station desktop EHRs may influence documentation time for the two main user groups, physicians and nurses.
Multi-Antibiotic Resistance of Some Gram Negative Bacterial Isolates from Poultry Litters of Selected Farms in Benue State

This study was aimed at isolating and identifying Shigella, Salmonella and Escherichia coli bacteria associated with poultry litter obtained from the University of Mkar Community, Adekaa, Gboko central and GRA Gboko. The study also determines the antibiotic sensitivity patterns of the associated bacteria. The bacteria were isolated and identified phenotipically following standard microbiological methods. The antibiotic sensitivity patterns of the isolated bacteria tested against Septrin, Chloranphenicol, Sparfloxacin, Ciprofloxacin, Amoxacillin, Augmentin, Gentamycin, Pefloxacin, Tarivid and Streptomycin. Shigella and Salmonella were completely resistant to chloranphenicol, augmentin, pefloxacin, amoxicillin. Shigella were also resistant to all the antibiotics excepts Septrin and ciprofloxacin showed they are intermediate to the drugs. Percentage antibiotics susceptibility pattern of gram negative bacteria isolated from poultry litter showed all bacterial isolates (100%) were resistant to Chloranphenicol while most of the isolates were susceptible to Amoxacillin. All the bacterial isolates showed high level (10.2 MAR index) antibiotic resistance. The study found that there was close (R= .516) association between the isolates and antibiotics. There was also significant relationship (X 2 = 5.871) between isolates and occurrence at different sample sites. The study therefore recommends proper information dissemination to farmers and poultry feeds producers on dangers of antibiotic resistant strains, use of Probiotics in animal feeds to prevent gastro-intestinal infections and use of regulations to control poultry litter disposal.
Hepatitis B virus S gene escape mutants

Hepatitis B virus (HBV) can be classified into nine immunological subtypes or eight genotypes. The most prevalent genotypes in Asia are genotypes B and C. HBV is transmitted parenteraly and can produce either asymptomatic or symptomatic disease. Although the consequences of acute hepatitis B can be severe, serious sequelae are associated with chronic infections. HBV seroprevalence ranges from intermediate (2%-7%) to high (≥8%) levels in Asia. Several strategies for the control and prevention of HBV infection have been found to be efficacious. They include vaccination and the administration of HBIG, interferon-a and nucleoside/nucleotide analogues. However, these procedures also apply selective pressures on HBV in infected individuals leading to the generation and accumulation of mutations in the S gene. Most of these mutations occur in the major hydrophilic region (MHR) of the S gene. These mutations create public health concerns as they can be responsible for reactivation of hepatitis B and occult hepatitis B infection. The inability to detect occult infections means that these individuals may become blood donors. This suggests that new strategies for donor evaluation and selection may need to be developed to protect the blood supply.
Geometric Swimming on a Granular Surface

—Snake robots can contact their environments along their whole bodies. This distributed contact makes them versatile and robust locomotors, but also makes controlling them a challenging problem involving high-dimensional conﬁguration spaces, with no direct way to break their motion down into “driving” and “steering” actions. In this paper, we use concepts from geometric mechanics—e.g., expanded Lie bracket analysis—to simplify the problem of controlling a snake robot moving across a granular surface. Without needing force laws that model the interaction of the snake robot with the granular surface, the relationship between shape and body velocities can be experimentally derived by perturbing the robot’s shape from a sampling of initial conﬁgurations, which allows us to: 1. Generate an intuitive and visualizable relationship between gait cycles and the motion they induce; 2. Make accurate predictions about the most efﬁcient gaits available to the robot; and 3. Identify an effective turning gait for the robot that to the best of our knowledge has not previously appeared in the snake robot literature. This geometric analysis of snake robot locomotion serves as a demonstration of how differential-geometric tools can provide insight into the motion of systems that do not have the analytic models often associated with such approaches.
Nucleocytoplasmic Distribution Is Required for Activation of Resistance by the Potato NB-LRR Receptor Rx1 and Is Balanced by Its Functional Domains[W]

The resistance protein Rx1 exists in cytoplasmic and nuclear pools in the cell. Both subcellular pools are necessary for full PVX resistance, and the cytoplasmic compartment could be linked to PVX recognition. A functional phosphate binding loop and the presence of SGT1 are required to sustain the nuclear pool. Functional domains of Rx1 were shown to have opposing roles in Rx1 localization. The Rx1 protein, as many resistance proteins of the nucleotide binding–leucine-rich repeat (NB-LRR) class, is predicted to be cytoplasmic because it lacks discernable nuclear targeting signals. Here, we demonstrate that Rx1, which confers extreme resistance to Potato virus X, is located both in the nucleus and cytoplasm. Manipulating the nucleocytoplasmic distribution of Rx1 or its elicitor revealed that Rx1 is activated in the cytoplasm and cannot be activated in the nucleus. The coiled coil (CC) domain was found to be required for accumulation of Rx1 in the nucleus, whereas the LRR domain promoted the localization in the cytoplasm. Analyses of structural subdomains of the CC domain revealed no autonomous signals responsible for active nuclear import. Fluorescence recovery after photobleaching and nuclear fractionation indicated that the CC domain binds transiently to large complexes in the nucleus. Disruption of the Rx1 resistance function and protein conformation by mutating the ATP binding phosphate binding loop in the NB domain, or by silencing the cochaperone SGT1, impaired the accumulation of Rx1 protein in the nucleus, while Rx1 versions lacking the LRR domain were not affected in this respect. Our results support a model in which interdomain interactions and folding states determine the nucleocytoplasmic distribution of Rx1.
An Adaptive Markov Chain Monte Carlo Approach to Time Series Clustering of Processes with Regime Transition Behavior

A numerical framework for clustering of time series via a Markov chain Monte Carlo (MCMC) method is presented. It combines concepts from recently introduced variational time series analysis and regularized clustering functional minimization [I. Horenko, SIAM J. Sci. Comput. , 32 (2010), pp. 62--83] with MCMC. A conceptual advantage of the presented combined framework is that it allows us to address the two main problems of the existent clustering methods, e.g., the nonconvexity and the ill-posedness of the respective functionals, in a unified way. Clustering of the time series and minimization of the regularized clustering functional are based on the generation of samples from an appropriately chosen Boltzmann distribution in the space of cluster affiliation paths using simulated annealing and the Metropolis algorithm. The presented method is applied to sets of generic ill-posed clustering problems, and the results are compared to those obtained by the standard methods. As demonstrated in numerical example.
Intriguing Results Regarding the Prevalence and Distribution of Hpv Types in Women with Cervical Cancer in a Romanian Population

Cancer of the uterine cervix is the 5th most deadly type of female cancer [1]. It is clearly demonstrated that HPV infection is the necessary, but not the sufficient cause of most cervical cancers [2]. The association between cancer of the uterine cervix and HPV is unique because no other human cancer is dependent on a single infectious factor for its development [3]. Worldwide, HPV types 16 and 18 accounts for approximately 70% of cervical cancer cases with other high-risk types, such as HPV-45, HPV-31, HPV-33, and HPV-52, being responsible for the remaining cases [4,5].
TURBULENCE IN THE SUB-ALFVÉNIC SOLAR WIND DRIVEN BY REFLECTION OF LOW-FREQUENCY ALFVÉN WAVES

We study the formation and evolution of a turbulent spectrum of Alfvén waves driven by reflection off the solar wind density gradients, starting from the coronal base up to 17 solar radii, well beyond the Alfvénic critical point. The background solar wind is assigned and two-dimensional shell models are used to describe nonlinear interactions. We find that the turbulent spectra are influenced by the nature of the reflected waves. Close to the base, these give rise to a flatter and steeper spectrum for the outgoing and reflected waves, respectively. At higher heliocentric distance both spectra evolve toward an asymptotic Kolmogorov spectrum. The turbulent dissipation is found to account for at least half of the heating required to sustain the background imposed solar wind and its shape is found to be determined by the reflection-determined turbulent heating below 1.5 solar radii. Therefore, reflection and reflection-driven turbulence are shown to play a key role in the acceleration of the fast solar wind and origin of the turbulent spectrum found at 0.3 AU in the heliosphere.
Effect of Longitudinal and Radial Position on Creep for Bamboo

Change of relaxation properties of bamboo in the longitudinal and radial direction were examined on the basis of results of creep measurement and the micro-structure observation in cross section using the stereoscopic microscope. Creep compliance J(t) was greater in the bottom and inner side than in the top and outer side. J(t) versus ln(t) was represented by the Nutting equation. The number of vascular bundle per mm2, that is its dispersion, increases with locating to the top and outer side of bamboo. Various values of relaxation properties, J(t), J(t)-J(0), and dJ(t)/dlnt, was characterized by just density of bamboo which was linear to the number of vascular bundle per mm2. Our results show that bamboo changes relaxation properties in the longitudinal and radial direction by controlling the dispersion of vascular bundles.
Prioritizing Rare Diseases: Psychological Effects Influencing Medical Decision Making

Background. Measuring societal preferences for rarity has been proposed to determine whether paying premium prices for orphan drugs is acceptable. Objective. To investigate societal preferences for rarity and how psychological factors affect such preferences. Method. A postal survey containing resource allocation dilemmas involving patients with a rare disease and patients with a common disease, equal in severity, was sent out to a randomly selected sample of the population in Sweden (return rate 42.3%, n = 1270). Results. Overall, we found no evidence of a general preference for prioritizing treatment of patients with rare disease patients over those with common diseases. When treatment costs were equal, most respondents (42.7%) were indifferent between the choice options. Preferences for prioritizing patients with common diseases over those with rare diseases were more frequently displayed (33.3% v. 23.9%). This tendency was, as expected, amplified when the rare disease was costlier to treat. The share of respondents choosing to treat patients with rare diseases increased when presenting the patients in need of treatment in relative rather than absolute terms (proportion dominance). Surprisingly, identifiability did not increase preferences for rarity. Instead, identifying the patient with a rare disease made respondents more willing to prioritize the patients with common diseases. Respondents’ levels of education were significantly associated with choice—the lower the level of education, the more likely they were to choose the rare option. Conclusions. We find no support for the existence of a general preference for rarity when setting health care priorities. Psychological effects, especially proportion dominance, are likely to play an important role when preferences for rarity are expressed.
Randomized Controlled Trial Comparing Primary and Staged Basilic Vein Transposition

Objective It is unclear if brachio-basilic vein fistula should be performed as a primary or staged procedure, particularly for smaller basilic veins. Our aim was to report on a randomized controlled trial comparing these two techniques. Methods Sixteen patients with a basilic vein ≥2.5 mm were randomized into primary transposed brachio-basilic vein (TBBV) fistula (n = 9) and staged TBBV fistula (n = 7). Patients with basilic veins enlarged by previous arteriovenous fistulas were excluded. Baseline characteristics of the two study groups, including vein size, were comparable (median basilic vein diameter 3.5 mm, range 2.8–4.1 mm). The staged group had a brachio-basilic vein fistula performed first followed by the transposition procedure performed at least 6 weeks later to allow the basilic vein to enlarge. TBBV fistula maturation at 10 weeks, primary, assisted-primary, and secondary patency were the primary outcome measures. Early failures were included in the calculation of patency rates. Results Transposed brachio-basilic vein fistula maturation rate after primary procedures (3/9, 33%) was lower compared to maturation rate after staged procedures (7/7, 100%, P = 0.011, Fisher’s exact test), which led to premature termination of the trial. Time to hemodialysis [median (interquartile range)] of primary and staged procedures was 54 (51.5–113.5) days and 97 (93–126) days, respectively (P = 0.16). One-year primary and assisted-primary patency rates of primary and staged procedures were equivalent (44 vs 57%, P = 0.76 and 44 vs 71%, P = 0.29, respectively); however, there was a trend toward a better 1-year secondary patency after staged procedures (86 vs 44% for primary procedures, P = 0.09). Conclusions Among candidates for TBBV fistula with a small basilic vein, staged transposition achieves higher maturation rates compared to primary procedures, a difference reflected in long-term secondary patency. Trial registration www.ClinicalTrials. gov, identifier NCT01274117.
Maturation-dependent response of the piglet brain to scaled cortical impact.

OBJECT The goal of this study was to investigate the relationship between maturational stage and the brain's response to mechanical trauma in a gyrencephalic model of focal brain injury. Age-dependent differences in injury response might explain certain unique clinical syndromes seen in infants and young children and would determine whether specific therapies might be particularly effective or even counterproductive at different ages. METHODS To deliver proportionally identical injury inputs to animals of different ages, the authors have developed a piglet model of focal contusion injury by using specific volumes of rapid cortical displacement that are precisely scaled to changes in size and dimensions of the growing brain. Using this model, the histological response to a scaled focal cortical impact was compared at 7 days after injury in piglets that were 5 days, 1 month, and 4 months of age at the time of trauma. Despite comparable injury inputs and stable physiological parameters, the percentage of hemisphere injured differed significantly among ages, with the youngest animals sustaining the smallest lesions (0.8%, 8.4%, and 21.5%, for 5-day-, 1-month-, and 4-month-old animals, respectively, p = 0.0018). CONCLUSIONS These results demonstrate that, for this particular focal injury type and severity, vulnerability to mechanical trauma increases progressively during maturation. Because of its developmental and morphological similarity to the human brain, the piglet brain provides distinct advantages in modeling age-specific responses to mechanical trauma. Differences in pathways leading to cell death or repair may be relevant to designing therapies appropriate for patients of different ages.
Unruptured Intracranial Aneurysms: Screening and Management

Purpose of Review: Unruptured intracranial aneurysms are found commonly in the general public, and more frequently in certain populations. This article focuses on the epidemiology, screening strategies, and management options for patients with unruptured aneurysms. Recent Findings: Recent epidemiologic studies show the overall prevalence of intracranial aneurysms to be approximately 3%, with higher rates seen in familial aneurysm syndromes and in certain medical conditions, such as autosomal dominant polycystic kidney syndrome. Aneurysm treatment may include surgical or endovascular techniques, with increasing utilization of endovascular strategies over time. Increased aneurysm diameter, certain locations, and other anatomical considerations may be associated with higher risks of aneurysm rupture. Summary: Given the high morbidity and mortality associated with aneurysm rupture, screening for unruptured aneurysms is generally recommended for high-risk patients (patients who have at least two first-degree relatives with aneurysms, and patients with autosomal dominant polycystic kidney disease). Screening may be considered for other patients (eg, one first-degree relative with aneurysm) after discussion of the risks and benefits of imaging. Following identification of an aneurysm, decisions regarding observation or treatment should be based on patient characteristics, features of the aneurysm, and provider expertise.
The Role of Social Support in Elder Financial Exploitation Using a Community Sample

Abstract Background and Objective Social support is known to be an important protective factor against elder financial exploitation (FE), yet few empirical studies have examined the relationship between FE and distinct components of social support. Perceived social support, social network size, and interactions with close network members (positive and negative) were measured separately and tested as potential predictors of FE. Research Design and Methods Three hundred and ninety-five community-dwelling adults aged 60 and older were recruited to complete a 90-minute survey and interview. We used OLS regression to examine the role of social support in FE. Other risk factors associated with FE including dependency, poor physical health, depression, cognition, and demographic characteristics were included as potential predictors. Results Negative interactions with close network members predicted FE, and remained predictive when all other variables and social support factors were included in the model. Other social support factors were not unique predictors of FE. Discussion and Implications Negative social interactions with close network members are important to assess and consider in FE prevention and intervention programs; relationships between social interactions and other risk factors warrant further attention.
Evaluating Automatic Model Selection

We outline a range of criteria for evaluating model selection approaches that have been used in the literature. Focusing on three key criteria, we evaluate automatically selecting the relevant variables in an econometric model from a large candidate set. General-to-specific selection is outlined for a regression model in orthogonal variables, where only one decision is required to select, irrespective of the number of regressors. Comparisons with an automated model selection algorithm, Autometrics (Doornik, 2009), show similar properties, but not restricted to orthogonal cases. Monte Carlo experiments examine the roles of post-selection bias corrections and diagnostic testing as well as evaluate selection in dynamic models by costs of search versus costs of inference.
Human Pose Forecasting via Deep Markov Models

Human pose forecasting is an important problem in computer vision with applications to human-robot interaction, visual surveillance, and autonomous driving. Usually, forecasting algorithms use 3D skeleton sequences and are trained to forecast for a few milliseconds into the future. Long-range forecasting is challenging due to the difficulty of estimating how long a person continues an activity. To this end, our contributions are threefold: (i) we propose a generative framework for poses using variational autoencoders based on Deep Markov Models (DMMs); (ii) we evaluate our pose forecasts using a pose-based action classifier, which we argue better reflects the subjective quality of pose forecasts than distance in coordinate space; (iii) last, for evaluation of the new model, we introduce a 480,000-frame video dataset called Ikea Furniture Assembly (Ikea FA), which depicts humans repeatedly assembling and disassembling furniture. We demonstrate promising results for our approach on both Ikea FA and the existing NTU RGB+D dataset.
On Using Very Large Target Vocabulary for Neural Machine Translation

Neural machine translation, a recently proposed approach to machine translation based purely on neural networks, has shown promising results compared to the existing approaches such as phrase-based statistical machine translation. Despite its recent success, neural machine translation has its limitation in handling a larger vocabulary, as training complexity as well as decoding complexity increase proportionally to the number of target words. In this paper, we propose a method based on importance sampling that allows us to use a very large target vocabulary without increasing training complexity. We show that decoding can be efficiently done even with the model having a very large target vocabulary by selecting only a small subset of the whole target vocabulary. The models trained by the proposed approach are empirically found to outperform the baseline models with a small vocabulary as well as the LSTM-based neural machine translation models. Furthermore, when we use the ensemble of a few models with very large target vocabularies, we achieve the state-of-the-art translation performance (measured by BLEU) on the English! German translation and almost as high performance as state-of-the-art English! French translation system.