Miracle-dz/UniFAR-FTUs huggingface dataset:
Effect of kinetic therapy on pulmonary complications.

BACKGROUND Optimal turning of critically ill patients is not well established. Kinetic therapy (systematic mechanical rotation of patients with 40 degree turns) may improve pulmonary function more than the improvement in function achieved via the standard of care (turning patients every 2 hours). OBJECTIVE To determine (1) if patients receiving mechanical ventilation who tolerate kinetic therapy have better pulmonary function than do patients treated with standard turning and (2) the cost-effectiveness of kinetic therapy. METHODS A prospective, randomized, multicenter study including 234 medical, surgical, and trauma patients (137 control patients, 97 patients receiving kinetic therapy). RESULTS Kinetic therapy significantly decreased the occurrence of ventilator-associated pneumonia and lobar atelectasis. The risk of pneumonia developing was lower (P = .002) in patients receiving kinetic therapy than in the control patients. The risk of lobar atelectasis developing was decreased (P = .02) for the patients receiving kinetic therapy. Lengths of stay in the intensive care unit and in the hospital did not differ between the groups. Charges for intensive care were less in the kinetic therapy group (81,700 dollars) than in the control group (84,958 dollars), but not significantly less. Twenty-one patients did not tolerate kinetic therapy and were not included in the analysis. CONCLUSION Kinetic therapy helps prevent ventilator-associated pneumonia and lobar atelectasis in critically ill patients. Costs to rent the bed may be offset by the potential cost reduction associated with kinetic therapy.
How infants die in the neonatal intensive care unit: trends from 1999 through 2008.

OBJECTIVE To determine whether trends toward decreasing use of cardiopulmonary resuscitation at the time of death and increasing frequency of forgoing life-sustaining treatment had continued, as few studies quantifying mode of death for hospitalized infants have been conducted in the last 10 years. DESIGN Retrospective descriptive study. SETTING Regional referral neonatal intensive care unit. PARTICIPANTS Infants who died from January 1, 1999, to December 31, 2008. Infants were categorized into following categories: (1) very preterm (≤32 weeks' gestation); (2) congenital anomaly; and (3) other. MAIN OUTCOME MEASURES The primary outcome was level of clinical service provided at the end of life (care withheld, care withdrawn, or full resuscitation). RESULTS For 10 years, 414 neonatal patients died. Of these, 61.6% had care withdrawn, 20.8% had care withheld, and 17.6% received cardiopulmonary resuscitation. The percentage of deaths that followed withholding of treatment rose by 1% per year (P = .01). Most of this change was accounted for by withholding of therapy in the very premature group. CONCLUSION During the 10-year period, the primary mode of death in this regional referral neonatal intensive care unit was withdrawal of life-sustaining support. When death is imminent or medical care is considered futile, the approach is thought to provide a peaceful, controlled setting. Significant increase in withholding of care suggests improved recognition of medical futility and desire to provide a peaceful death.
Revising motion planning under Linear Temporal Logic specifications in partially known workspaces

In this paper we propose a generic framework for real-time motion planning based on model-checking and revision. The task specification is given as a Linear Temporal Logic formula over a finite abstraction of the robot motion. A preliminary motion plan is first generated based on the initial knowledge of the system model. Then real-time information obtained during the runtime is used to update the system model, verify and further revise the motion plan. The implementation and revision of the motion plan are performed in real-time. This framework can be applied to partially-known workspaces and workspaces with large uncertainties. Computer simulations are presented to demonstrate the efficiency of the framework.
Inorganic Nitrogen Deposition and Its Impacts on N:P-Ratios and Lake Productivity

The pronounced increase in the cycling and deposition of biologically reactive dissolved inorganic nitrogen (DIN) over large areas globally not only cause increased concentrations of DIN in surface waters, but it will also affect nutrient ratios in rivers, lakes and coastal areas. This review addresses the flux and fate of DIN, focusing NO3 in lakes of boreal and alpine catchments. Not only DIN-deposition, but also catchment properties strongly affect the concentrations of NO3 in lakes, as well as NO3:total P (TP) ratios. This ratio displays an extreme variability, and does also serve as an indicator of shift between N and P-limitation of aquatic autotrophs. A high share of forests and bogs in the catchment generally decreases NO3:total P ratios, while alpine and subalpine catchments with sparse vegetation cover may have high NO3:total P ratios, especially in regions with high DIN-deposition. Several empirical and experimental studies indicate a shift from an initial N to P-limitation, but for N-limited lakes, an increased growth of phytoplankton, periphytes and macrophytes may be accredited to elevated inputs of DIN. An intensified P-limitation may also be a consequence of elevated DIN-deposition. This P-limitation may again yield higher C:P-ratios in autotrophs with negative impacts on grazers and higher trophic levels.
Individuals and the Variation Needed for High Species Diversity in Forest Trees

Difference, Not Diversity In tropical forests, as in the ocean plankton, thousands of species may compete for the same resources. How they succeed in coexisting remains one of the central paradoxes in the study of biodiversity. Theory shows that coexisting species must partition the environment, but such partitioning is not obvious. Using data from coexisting forest trees in the southeastern United States, Clark (p. 1129) show that individual variation between members of the same species allows them to avoid direct competition: One plant may differ significantly from another in its requirements for light, nutrients, or moisture, yet remain within the general spectrum of features displayed by its conspecifics. Within-species variation in response to environmental conditions may explain the coexistence of forest tree species. In the past, explanations for high species diversity have been sought at the species level. Theory shows that coexistence requires substantial differences between species, but species-level data rarely provide evidence for such differences. Using data from forests in the southeastern United States, I show here that variation evident at the individual level provides for coexistence of large numbers of competitors. Variation among individuals within populations allows species to differ in their distributions of responses to the environment, despite the fact that the populations to which they belong do not differ, on average. Results are consistent with theory predicting that coexistence depends on competition being stronger within than between species, shown here by analysis of individual-level responses to environmental fluctuation.
MicroRNA-330-5p as a Putative Modulator of Neoadjuvant Chemoradiotherapy Sensitivity in Oesophageal Adenocarcinoma

Oesophageal adenocarcinoma (OAC) is the sixth most common cause of cancer deaths worldwide, and the 5-year survival rate for patients diagnosed with the disease is approximately 17%. The standard of care for locally advanced disease is neoadjuvant chemotherapy or, more commonly, combined neoadjuvant chemoradiation therapy (neo-CRT) prior to surgery. Unfortunately, ~60-70% of patients will fail to respond to neo-CRT. Therefore, the identification of biomarkers indicative of patient response to treatment has significant clinical implications in the stratification of patient treatment. Furthermore, understanding the molecular mechanisms underpinning tumour response and resistance to neo-CRT will contribute towards the identification of novel therapeutic targets for enhancing OAC sensitivity to CRT. MicroRNAs (miRNA/miR) function to regulate gene and protein expression and play a causal role in cancer development and progression. MiRNAs have also been identified as modulators of key cellular pathways associated with resistance to CRT. Here, to identify miRNAs associated with resistance to CRT, pre-treatment diagnostic biopsy specimens from patients with OAC were analysed using miRNA-profiling arrays. In pre-treatment biopsies miR-330-5p was the most downregulated miRNA in patients who subsequently failed to respond to neo-CRT. The role of miR-330 as a potential modulator of tumour response and sensitivity to CRT in OAC was further investigated in vitro. Through vector-based overexpression the E2F1/p-AKT survival pathway, as previously described, was confirmed as a target of miR-330 regulation. However, miR-330-mediated alterations to the E2F1/p-AKT pathway were insufficient to significantly alter cellular sensitivity to chemotherapy (cisplatin and 5-flurouracil). In contrast, silencing of miR-330-5p enhanced, albeit subtly, cellular resistance to clinically relevant doses of radiation. This study highlights the need for further investigation into the potential of miR-330-5p as a predictive biomarker of patient sensitivity to neo-CRT and as a novel therapeutic target for manipulating cellular sensitivity to neo-CRT in patients with OAC.
Performance of Nb3Sn quadrupole magnets under localized thermal load

This paper describes the results of design and analyses performed on 120-mm Nb{sub 3}Sn and NbTi quadrupole magnets with parameters relevant for the LHC IR upgrade. A realistic radiation heat load is evaluated in a wide luminosity range and translated into the magnet quench performance. The simulation results are supported by thermal measurements on a 90-mm Nb{sub 3}Sn quadrupole coil.
Selection Process of ERP Systems

Abstract Background: The application and introduction of ERP systems have become a central issue for management and operation of enterprises. The competition on market enforces the improvement and optimization of business processes of enterprises to increase their efficiency, effectiveness, and to manage better the resources outside the company. The primary task of ERP systems is to achieve the before-mentioned objectives. Objective: The selection of a particular ERP system has a decisive effect on the future operation and profitability of the enterprise. The qualitative correlation between the size of enterprises, market position, etc. and the applied selection criteria for ERP systems should be analysed as to whether which criteria are used at multinational enterprises or at SMEs. Methods/Approach: Our research is grounded in a literature review and case studies of everyday practice related to the introduction, implementation and roll-out of ERP systems. Results: The dominant critical success factor of ERP introduction seems to be “ERP software suitability”, “Information quality”, “ERP vendor quality”. Conclusion: The set of criteria on one hand shows strong correlation with non-functional requirements codified in standards, and on the other hand with usual functional requirements for ERP systems.
Outdoor ultraviolet exposure of children and adolescents

The weekday and weekend outdoor ultraviolet exposure‐ of young people from primary and secondary schools in three geographically distinct regions of England was determined over a 3‐month period in summer. Ultraviolet exposure was measured using personal Him badges worn by each young person, and time spent outdoors, in hourly intervals, assessed using exposure records. In each area a class of 9‐10‐year‐old children from a primary school and a class of 14‐1 5‐year‐old adolescents from a secondary school took part, giving a total of 180 subjects. We found that primary school children received higher outdoor ultraviolet exposure than young people in secondary schools, and geographical differences in exposure could not be accounted for solely by differences in ambient ultraviolet. There was little difference between the exposure of males and females. Children and adolescents did not behave as homogeneous groups with regard to exposure.
Aggressive assembly of pyrosequencing reads with mates

Motivation: DNA sequence reads from Sanger and pyrosequencing platforms differ in cost, accuracy, typical coverage, average read length and the variety of available paired-end protocols. Both read types can complement one another in a ‘hybrid’ approach to whole-genome shotgun sequencing projects, but assembly software must be modified to accommodate their different characteristics. This is true even of pyrosequencing mated and unmated read combinations. Without special modifications, assemblers tuned for homogeneous sequence data may perform poorly on hybrid data. Results: Celera Assembler was modified for combinations of ABI 3730 and 454 FLX reads. The revised pipeline called CABOG (Celera Assembler with the Best Overlap Graph) is robust to homopolymer run length uncertainty, high read coverage and heterogeneous read lengths. In tests on four genomes, it generated the longest contigs among all assemblers tested. It exploited the mate constraints provided by paired-end reads from either platform to build larger contigs and scaffolds, which were validated by comparison to a finished reference sequence. A low rate of contig mis-assembly was detected in some CABOG assemblies, but this was reduced in the presence of sufficient mate pair data. Availability: The software is freely available as open-source from http://wgs-assembler.sf. net under the GNU Public License. Contact: jmiller@jcvi.org Supplementary information: Supplementary data are available at Bioinformatics online.
Microballoon Wall Thickness Effects on Properties of Syntactic Foams

A novel approach for changing the density of syntactic foams, while keeping the microballoon (hollow particles) volume fraction constant, is adopted in this work. This is achieved by selecting microballoons of the same size but with different wall thickness. Five types of microballoons are selected to fabricate syntactic foams. All the types of microballoons have about 40 mm mean particle sizes, but different wall thicknesses. This approach allows to maintain the same volume fractions of constituents and interfacial area while changing the density of syntactic foams. The fabricated syntactic foams are tested for their compressive properties in accordance to the ASTM D 695-96 standard. The results of the experimental investigation show a strong dependence of the compressive properties and the fracture characteristics of syntactic foams on the microballoon wall thickness. Shear cracking followed by cracking under secondary tensile stresses has been observed as the fracture mode. The present approach is found to be more effective than changing the microballoon volume fraction to change the syntactic foam density as it considerably increases the strength to the weight ratio.
MR guidance in radiotherapy

Magnetic resonance imaging (MRI) has become, over the last 30 years, one of the main pillars of modern diagnostic imaging, which is widely used for many clinical problems. One of the reasons for its success is the high level of technical innovation which has turned modernday MRI into a versatile medical imaging modality (Haacke et al 1999). MRI stands out in terms of soft tissue visualization. MRI does not require ionizing radiation. In addition, it provides several functional imaging modalities for measuring biological function and physiology. Throughout its relatively short history the strive for higher magnetic field strength has been a constant factor from 0.5 T MR scanners in the eighties to 1.5 and 3 T MR scanners in current clinics. A higher magnetic field strength is favourable as it leads to higher signal-to-noise Topical Review
Functional defecation disorder as a clinical subgroup of chronic constipation: Analysis of symptoms and physiological parameters

Objective. Patients with functional constipation can be classified according to symptoms and physiological parameters as either having a disorder of defecation or having normal defecation. It is hypothesized that the disordered defecation, where it exists, is a causative factor of the constipation. However, the utility of this classification has yet to be proven in terms of predicting response to therapy. The definitions are non-specific and based on tests that are done in an artificial setting and with derived normal ranges. It is therefore possible that the symptoms and physiological parameters of a defecatory disorder may occur as a continuous spectrum in these patients, rather than defining a discrete entity or subtype. The aim of this study was to use cluster analysis and factor analysis of defecatory symptoms and physiological parameters to look for evidence of subgroups in patients with functional constipation. Material and methods. Consecutive patients presenting to a specialist constipation clinic and satisfying the inclusion criteria were assessed to determine the severity of defecatory symptoms, and underwent isotope defecating proctography and the Sitzmark transit study. Assessments were made contemporaneously and results of any test not performed within 6 weeks of the initial assessment were excluded. Principle components analysis and cluster analysis were performed to look for evidence of subgroups. Relationships between evacuatory symptoms, index parameters, and test results were explored. The detailed and unselected nature of the analyses produced hundreds of test results, and statistically significant results were critically evaluated in this context. Results. A total of 116 patients were studied (age range 18–73 years, mean 40.5 years). Based on the results of the transit study and proctography, 38% of patients showed evidence of slow transit constipation, 20% FDD (functional defecation disorder), 29% both, and 12% neither. Principle components analysis did not demonstrate an obvious dimension reduction for the variables tested. Cluster analysis (over 150 solutions tested) failed to show evidence of clustering. There were no useful predictive relationships between evacuatory symptoms, index parameters and test results. Conclusions. We used multiple statistical analyses to look for clustering and predictive relationships between clinical and physiological parameters in consecutive patients with functional constipation and found no evidence of the existence of a subgroup of patients with a defecatory disorder. This may be due to weaknesses in the study design, poor validity of the assessments performed, or that defecatory features do not identify a distinct pathophysiological entity, but rather are manifested variably as a continuous spectrum.
Comparison of Lateral-Flow Immunoassay and Enzyme Immunoassay with Viral Culture for Rapid Detection of Influenza Virus in Nasal Wash Specimens from Children

ABSTRACT The performance of two commercially available rapid test kits for influenza virus detection was compared to that of viral culture by using 356 nasal wash specimens collected during the 2001 to 2002 influenza season. Overall, the two rapid tests were easy to perform and showed comparable sensitivities (70.4 and 72.2%) and specificities (97.7 and 98.3%); for both test kit groups, most of the specimens that yielded false-negative results were found to be growing influenza B virus.
Variations in Abdominal Aortic Aneurysm Care: A Report From the International Consortium of Vascular Registries

Background: This project by the ICVR (International Consortium of Vascular Registries), a collaboration of 11 vascular surgical quality registries, was designed to evaluate international variation in the contemporary management of abdominal aortic aneurysm (AAA) with relation to recommended treatment guidelines from the Society for Vascular Surgery and the European Society for Vascular Surgery. Methods: Registry data for open and endovascular AAA repair (EVAR) during 2010 to 2013 were collected from 11 countries. Variations in patient selection and treatment were compared across countries and across centers within countries. Results: Among 51 153 patients, 86% were treated for intact AAA (iAAA) and 14% for ruptured AAA. Women constituted 18% of the entire cohort (range, 12% in Switzerland–21% in the United States; P<0.01). Intact AAAs were repaired at diameters smaller than recommended by guidelines in 31% of men (<5.5 cm; range, 6% in Iceland–41% in Germany; P<0.01) and 12% of women with iAAA (<5 cm; range, 0% in Iceland–16% in the United States; P<0.01). Overall, use of EVAR for iAAA varied from 28% in Hungary to 79% in the United States (P<0.01) and for ruptured AAA from 5% in Denmark to 52% in the United States (P<0.01). In addition to the between-country variations, significant variations were present between centers in each country in terms of EVAR use and rate of small AAA repair. Countries that more frequently treated small AAAs tended to use EVAR more frequently (trend: correlation coefficient, 0.51; P=0.14). Octogenarians made up 23% of all patients, ranging from 12% in Hungary to 29% in Australia (P<0.01). In countries with a fee-for-service reimbursement system (Australia, Germany, Switzerland, and the United States), the proportions of small AAA (33%) and octogenarians undergoing iAAA repair (25%) were higher compared with countries with a population-based reimbursement model (small AAA repair, 16%; octogenarians, 18%; P<0.01). In general, center-level variation within countries in the management of AAA was as important as variation between countries. Conclusions: Despite homogeneous guidelines from professional societies, significant variation exists in the management of AAA, most notably for iAAA diameter at repair, use of EVAR, and the treatment of elderly patients. ICVR provides an opportunity to study treatment variation across countries and to encourage optimal practice by sharing these results.
Colonic obstruction secondary to sigmoid fecaloma endoscopically resolved with Coca-Cola®.

BACKGROUND Colonic obstruction is a relatively common condition in emergency care, with a mortality rate of up to 20%. In 90% of cases it results from colonic or rectal adenocarcinoma, volvulus, or stenosis secondary to diverticular disease. When fecal impaction is the underlying cause, the condition is usually managed conservatively, but may on occasion become complicated and even require surgical intervention. Based on the proven efficacy of Coca-Cola® to dissolve gastric phytobezoars, we report a case of colonic obstruction secondary to sigmoid fecaloma. CASE REPORT A 58 years old woman arrived at the Emergency Room (ER) with persistent constipation for the last six days. An abdominal CT scan showed a large fecal mass at the sigmoid colon with retrograde dilated colonic loops. Cleansing enemas and oral lactulose were administered, which failed to resolve the clinical presentation, so we then proceeded to inject Coca-Cola® within the fecaloma using a sclerosing needle, and then washed the fecaloma surface also with Coca-Cola®. After a few minutes we started to fragment the fecalith, the consistency of which had been notably decreased. DISCUSSION The use of Coca-Cola® for gastric washes in the management of phytobezoars is well established. Since fecaliths are partly composed of these same substances than phytobezoars, the use of Coca-Cola® might well be warranted against them as in our patient, without surgery. Our case report is the second one published in the literature, in which Coca-Cola® helped solve colonic obstruction secondary to fecaloma.