Miracle-dz/UniFAR-FTUs huggingface dataset:
Electronic Health Record Challenges, Workarounds, and Solutions Observed in Practices Integrating Behavioral Health and Primary Care

Purpose: This article describes the electronic health record (EHR)-related experiences of practices striving to integrate behavioral health and primary care using tailored, evidenced-based strategies from 2012 to 2014; and the challenges, workarounds and initial health information technology (HIT) solutions that emerged during implementation. Methods: This was an observational, cross-case comparative study of 11 diverse practices, including 8 primary care clinics and 3 community mental health centers focused on the implementation of integrated care. Practice characteristics (eg, practice ownership, federal designation, geographic area, provider composition, EHR system, and patient panel characteristics) were collected using a practice information survey and analyzed to report descriptive information. A multidisciplinary team used a grounded theory approach to analyze program documents, field notes from practice observation visits, online diaries, and semistructured interviews. Results: Eight primary care practices used a single EHR and 3 practices used 2 different EHRs, 1 to document behavioral health and 1 to document primary care information. Practices experienced common challenges with their EHRs' capabilities to 1) document and track relevant behavioral health and physical health information, 2) support communication and coordination of care among integrated teams, and 3) exchange information with tablet devices and other EHRs. Practices developed workarounds in response to these challenges: double documentation and duplicate data entry, scanning and transporting documents, reliance on patient or clinician recall for inaccessible EHR information, and use of freestanding tracking systems. As practices gained experience with integration, they began to move beyond workarounds to more permanent HIT solutions ranging in complexity from customized EHR templates, EHR upgrades, and unified EHRs. Conclusion: Integrating behavioral health and primary care further burdens EHRs. Vendors, in cooperation with clinicians, should intentionally design EHR products that support integrated care delivery functions, such as data documentation and reporting to support tracking patients with emotional and behavioral problems over time and settings, integrated teams working from shared care plans, template-driven documentation for common behavioral health conditions such as depression, and improved registry functionality and interoperability. This work will require financial support and cooperative efforts among clinicians, EHR vendors, practice assistance organizations, regulators, standards setters, and workforce educators.
Effect of a Gurney Flap on the Performance of an Axial Fan

Chen Liu, Haijun Xie, Jun Xu, Chen Jian*, Ren Dai 2 School of Energy and Power Engineering, University of Shanghai for Science and Technology 3 E-mail: 09900589r@connect.polyu. hk 4 Abstract: 5 The Gurney flap (GF) is a miniature lift-enhancement device and is usually mounted at the trailing 6 edge of an airfoil. The GF and has been successfully applied to isolated airfoils, multi-element 7 airfoils, and aircraft wings as well as helicopter rotor due to its attractive features of simplicity, cost8 effective and separation control. The GF also has aroused the attention of researchers in the 9 turbomachinery industry. However, limited studies are currently available on the application of a 10 GF to an axial fan. 11 Hence, in this paper, we conduct a wind tunnel and computational fluid dynamic (CFD) 12 investigation on an axial fan profiled with a NACA 65-(12)10 airfoil to evaluate the effect of the GF 13 on the performance of the fan. We also present the detailed flow features of the fan with and 14 without the GF after validating the simulation results with the experimental results. The 15 experimental results show that as the GF is installed higher on the fan blade, it can produce a higher 16 total pressure rise accompanied with a greater loss of efficiency. The installation of the GF also 17 enlarges the work capacity of the fan. Detailed flow field analysis, including the surface pressure 18 distribution, vorticity distribution at the trailing edge and streamline distribution of the fan, is 19 carried out to understand the mechanisms of the effect of the GF on the performance of the fan. 20
The prevalence of the metabolic syndrome in Greece: The MetS‐Greece Multicentre Study

Background: The Third Report (ATP III) of the National Cholesterol Education Program Expert Panel (NCEP) highlighted the importance of identifying and treating patients with the metabolic syndrome (MetS) to prevent cardiovascular disease (CVD) and progression to diabetes mellitus. Limited information is available about the prevalence of MetS, as defined by the NCEP ATP III, in Europe, especially in Greece.
Comparing risks and benefits of colorectal cancer screening in elderly patients.

BACKGROUND & AIMS In patients with limited life expectancy, the risks of colorectal cancer screening may outweigh the benefits. The aim of this study was to quantify risks and benefits of different screening strategies in elderly patients with varying life expectancies. METHODS We examined risks and benefits of screening in patients aged 70-94 years with differing health status using 3 strategies: annual fecal occult blood tests, flexible sigmoidoscopy every 5 years, or colonoscopy every 10 years. We compared the number needed to screen to prevent one cancer-related death and the number needed to encounter one screening-related complication for different strategies. RESULTS The potential benefit from screening varied widely with age, life expectancy, and screening modality. One cancer-related death would be prevented by screening 42 healthy men aged 70-74 years with colonoscopy, 178 healthy women aged 70-74 years with fecal occult blood tests, 431 women aged 75-79 years in poor health with colonoscopy, or 945 men aged 80-84 years in average health with fecal occult blood tests. Colonoscopy screening had the greatest benefit but the highest risk of complications. The potential for screening-related complications was greater than estimated benefit in some population subgroups aged 70 years and older. At all ages and life expectancies, the potential reduction in mortality from screening outweighed the risk of colonoscopy-related death. CONCLUSIONS The potential benefits and risks of screening vary in elderly patients of different life expectancies. For any individual patient, the potential for harm from screening must be weighed against the likelihood of benefit, especially with shorter life expectancy.
Beyond the Wall

At the steamship company we were again told. it was very regrettable, but not really their fault. There was nothing they could do now. At Cybele's insistence, I left it at that. On the way back to the hotel she gave her one judgement of Mr. Kaffeemann. "He was a very foolish man, but a very good one. He believed in himself. " I left the next day for Zurich to make arrangements for the funeral. Cybe1e did not know yet if she ought to g~ he;self and meet his family. We said we hoped we would meet agam. Thus was the death of Mr. Kaffeemann, builder of monuments.
The Staphylococcal QacR Multidrug Regulator Binds a Correctly Spaced Operator as a Pair of Dimers

ABSTRACT Expression of the Staphylococcus aureusplasmid-encoded QacA multidrug transporter is regulated by the divergently encoded QacR repressor protein. To circumvent the formation of disulfide-bonded degradation products, site-directed mutagenesis to replace the two cysteine residues in wild-type QacR was undertaken. Analysis of a resultant cysteineless QacR derivative indicated that it retained full DNA-binding activities in vivo and in vitro and continued to be fully proficient for the mediation of induction ofqacA expression in response to a range of structurally dissimilar multidrug transporter substrates. The cysteineless QacR protein was used in cross-linking and dynamic light-scattering experiments to show that its native form was a dimer, whereas gel filtration indicated that four QacR molecules bound per DNA operator site. The addition of inducing compounds led to the dissociation of the four operator-bound QacR molecules from the DNA as dimers. Binding of QacR dimers to DNA was found to be dependent on the correct spacing of the operator half-sites. A revised model proposed for the regulation ofqacA expression by QacR features the unusual characteristic of one dimer of the regulatory protein binding to each operator half-site by a process that does not appear to require the prior self-assembly of QacR into tetramers.
Silicon carbide MESFETs performances and application in broadcast power amplifiers

We present DC, small signal and power characterization of recent Thomson silicon carbide MESFETs. We present also performances of SiC power amplifiers designed for use in broadcast digital television. A comparison with a LDMOS amplifier showed that SiC is a very promising material for microwave and RF power amplification.
Cell cycle regulation of PML modification and ND 10 composition

ND10, otherwise known as nuclear dots (NDs), PML nuclear bodies or promyelocytic oncogenic domains (PODs) are punctate structures with a diameter of about 0.5 μm. There are usually between 5 and 20 ND10 per nucleus, each containing several proteins of which the most studied are PML and Sp100 (reviewed by Sternsdorf et al., 1997a). Interest in PML arose because most cases of promyelocytic leukaemia are caused by a chromosomal translocation which results in the expression of a fusion protein linking the normal PML protein to the retinoic acid receptor α (for references, see Sternsdorf et al., 1997a). Both PML and Sp100 have been associated with the repression of gene expression (Mu et al., 1994; Alcalay et al., 1998; Vallian et al., 1998; Lehming et al., 1998; Seeler et al., 1998), while PML has recently been implicated in apoptotic pathways (Quignon et al., 1998). The status of ND10 can be modulated by a number of factors, including stress, virus infection, interferon treatment and cell cycle progression (reviewed by Sternsdorf et al., 1997a). Both PML and Sp100 are covalently modified by the small ubiquitin-like protein SUMO-1, and it has been suggested that this modification is an important factor for the localisation of PML at ND10 (Sternsdorf et al., 1997b; Kamitani et al., 1998a,b; Muller et al., 1998; Duprez et al., 1999). Furthermore, immunofluorescence experiments showed that PML and Sp100 become separated during mitosis and the remaining PML foci are not co-stained with an anti-SUMO-1 reagent (Sternsdorf et al., 1997a,b). The implication was that the SUMO-1 modification status of PML and Sp100 varies during the cell cycle, but this was not verified directly. In this paper we report a systematic investigation of the intracellular distribution and biochemical characteristics of endogenous PML and Sp100 through the cell cycle. We found that interphase SUMO-1-conjugated isoforms of both PML and Sp100 were completely eliminated during mitosis and that a novel modified PML species appears. The mitosis-specific PML isoform was highly labile in vitro, but it was stabilised by inhibition of phosphatases. Treatment of interphase cells with heat shock and the phosphatase inhibitor calyculin A also caused loss of SUMO-1 modified PML isoforms and the appearance of PML species with a distinct gel mobility. We suggest that the disruption of ND10 that occurs at the beginning of mitosis is a consequence of deconjugation of SUMO-1 from both PML and Sp100, and increased phosphorylation of PML. Reversal of this process leads to reestablishment of ND10 in the early stages of G1. These biochemical changes provide a model by which ND10 structure and composition could be changed rapidly by diverse 4581 Journal of Cell Science 112, 4581-4588 (1999) Printed in Great Britain © The Company of Biologists Limited 1999 JCS0794
Features for micro-Doppler based activity classification

Safety and security applications benefit from better situational awareness. Radar micro-Doppler signatures from an observed target carry information about the target's activity, and have potential to improve situational awareness. This article describes, compares, and discusses two methods to classify human activity based on radar micro-Doppler data. The first method extracts physically interpretable features from the time-velocity domain such as the main cycle time and properties of the envelope of the micro-Doppler spectra and use these in the classification. The second method derives its features based on the components with the most energy in the cadence-velocity domain (obtained as the Fourier transform of the time-velocity domain). Measurements from a field trial show that the two methods have similar activity classification performance. It is suggested that target base velocity and main limb cadence frequency are indirect features of both methods, and that they do often alone suffice to discriminate between the studied activities. This is corroborated by experiments with a reduced feature set. This opens up for designing new more compact feature sets. Moreover, weaknesses of the methods and the impact of non-radial motion are discussed.
Homogeneous single-component betaine Ziegler-Natta catalysts derived from (butadiene)zirconocene precursors.

(Butadiene)zirconocene adds B(C(6)F(5))(3) at a terminal diene carbon atom to yield the zirconocene-(mu-hydrocarbyl)-borate betaine Cp(2)Zr[C(4)H(6)-B(C(6)F(5))(3)] (4). The dipolar complex 4 contains a distorted pi-allyl moiety and features an additional stabilizing Zr-F-C(arene) coordination. Under kinetic control, an isomeric betaine system is formed, characterized by an internal Zr(+). CH(2)[B](-) ion-pair interaction, that rearranges to 4 upon heating. A great variety of ansa-metallocene(butadiene) complexes and related systems cleanly form analogous metallocene-(mu-conjugated diene)-borate betaines upon treatment with B(C(6)F(5))(3) and related Lewis acids. Most of these systems represent very active homogeneous single-component Ziegler-Natta catalysts for alpha-olefin polymerization and copolymerization. In addition, these betaine catalysts are ideally suited for carrying out mechanistic studies in active Ziegler-Natta catalyst systems. They allow for an experimental observation of the first alkene insertion step at the active single-component catalyst. This feature has been used for studying the mechanism of transfer of the stereochemical information from the bent metallocene backbone and for an experimental characterization of the energy profile of the alkene addition/alkene insertion reaction sequence in active homogeneous Ziegler-Natta systems. The neutral dipolar single-component catalysts (e.g., 4) produce a polyolefin-modified R'-(CHR-CH(2))-C(4)H(6)-B(C(6)F(5))(3)(-) counterion at the end of the initiation period upon entering into the repetitive active catalytic cycle.
The relationship between the localization of the generalized spike and wave discharge generators and the response to valproate

Up to 30% of patients with idiopathic generalized epilepsy (IGE) have seizures that are refractory to medication despite appropriate therapy that commonly includes valproate (VPA). The aim of this study was to compare patients with VPA‐refractory and VPA‐responsive IGE in order to determine whether there are group differences in generalized spike and wave discharge (GSWD) generators that may be associated with VPA resistance.
Evaluation of the Antinociceptive Activity of Ocimum gratissimum L. (Lamiaceae) Essential Oil and its isolated Active Principles in Mice

Ocimum gratissimum is used in popular medicine to treat painful diseases. The antinociceptive properties of O. gratissimum essential oil (OgEO) and two of its active principles (eugenol and myrcene) were tested in classic models of pain (hot plate test and formalin test). Adult male C57BL/6 J mice acutely received corn oil (control group, p.o.), morphine (positive control group, 5 mg/kg, i.p.), OgEO (10, 20, or 40 mg/kg, p.o.), eugenol or myrcene (both at 1, 5, or 10 mg/kg, p.o.). The highest doses of all tested drugs significantly increased the latency to lick the paw(s) in the hot plate test compared with the control group. OgEO at a dose of 40 mg/kg and eugenol and myrcene at a dose of 10 mg/kg were effective in minimizing animal pain in the first and second phases of the formalin test. The antinociceptive effect shown by all drugs tested in hot plate test was reverted by naloxone administration (1 mg/kg), indicating opiod system participation. These results demonstrate the beneficial effects of OgEO and its active principles against neurogenic and inflammatory pain. Our findings demonstrate that OgEO and its isolated active principles exhibited antinociceptive activity in murine pain models. Copyright © 2012 John Wiley & Sons, Ltd.
Family Caregiving in Heart Failure

Background: Little is known about the experiences of family caregivers of patients with heart failure, despite the fact that these patients have disabling symptoms and diminished functioning that could lead to caregiver stress. Objectives: Based on a caregiver model, the aims of this study were to (a) examine relationships among age, perceived control over managing heart problems, perceived difficulty with tasks, perceived outcomes, and perceived mental and general health among caregivers of persons with heart failure; (b) describe caregivers' perceptions of control over managing heart problems; and (c) describe the tasks and outcomes perceived as being most difficult and negative by caregivers. Methods: A sample of 21 family caregivers of patients with heart failure completed the study questionnaires. Most were women (n = 20), spouses (n = 20), and White (n = 18), with a mean age of 59.6 years. The patients with heart failure were male veterans with New York Heart Association (NYHA) Class II, III, or IV. Descriptive statistics and Spearman's &rgr; correlations were used. Results: Younger caregivers perceived their tasks to be more difficult and their mental health to be poorer. Caregivers' perceived control over managing heart problems was related moderately to poorer perceived mental health. Greater perceived difficulty with tasks was associated with negative perceptions of caregiver outcomes and poorer perceived mental health. Negative perceptions of caregiver outcomes were associated strongly with perceptions of poorer mental health. Performing household tasks and managing patient behaviors were most difficult, and the caregiver's emotional and financial well-being, time for social activities, and general health had deteriorated. Conclusions: The preliminary results support the model. Future longitudinal studies are needed in larger samples to evaluate predictors of caregiver-perceived negative outcomes to identify priority areas for interventions.
A classification efficiency test of spectral karyotyping and multiplex fluorescence in situ hybridization: Identification of chromosome homologies between Homo sapiens and Hylobates leucogenys

Two digital fluorescence microscopy systems, spectral karyotyping (SKY) and multiplex fluorescence in situ hybridisation (M‐FISH), are used with multicolour probe sets to assist in the detection of chromosome aberrations. We have compared the resolution of the two methods in their ability to identify karyotype rearrangements, which have occurred during the divergence of Homo sapiens and Hylobates leucogenys in evolution. A 24‐color human paint kit distinguishes 74 conserved autosomal segments in H. leucogenys, some of which are difficult to resolve. We examined the extent to which the SKY and M‐FISH techniques are able to detect the smallest of these bands. We have found this to be a rigorous test of multicolour chromosome classification systems. We conclude from our results that both systems are able invariably to classify the majority of conserved segments but differ in the efficiency of detection of small inserts. © 2001 Wiley‐Liss, Inc.
Passive scalars in stratified turbulence

Statistics of a passive scalar (or tracer) with a horizontal mean gradient in randomly forced and strongly stratified turbulence are investigated by numerical simulations. We observe that horizontal isotropy of the passive scalar spectrum is satisfied in the inertial range. The spectrum has the form Eθ(kh) = CθɛθɛK−1/3kh−5/3, where ɛθ, ɛK are the dissipation of scalar variance and kinetic energy respectively, and Cθ ≃ 0.5 is a constant. This spectrum is consistent with atmospheric measurements in the mesoscale range with wavelengths 1–500 km. We also calculate the fourth‐order passive scalar structure function and show that intermittency effects are present in stratified turbulence.
Meningococcal serogroup C conjugate vaccine

Meningococcal meningitis and septicaemia are important causes of morbidity and mortality in many parts of the world. More than 90% of the cases are caused by serogroups A, B and C; the remaining 10% are largely caused by the W-135 and Y strains. During the mid-to-late 1990s there was an increase in meningococcal serogroup (MS) C disease in the UK and some parts of Europe. MS C polysaccharide vaccines that were developed in the 1960s are weakly immunogenic and not protective in infants under 2 years of age, but are effective in older recipients. Meningitec™ (Wyeth-Ayerst) is produced by conjugation of serogroup C oligosaccharide with a mutant diphtheria protein (CRM197), with the aim of inducing T-cell dependent immune responses. It has been found to be immunogenic in infants, toddlers, older children and adults. The vaccine has also been shown to induce immunological memory and therefore is likely to give long-term protection against disease. It received a license for use in the UK in October 1999 and was introduced into the UK immunisation schedule in November 1999. Surveillance studies after introduction of this and similar vaccines have demonstrated a dramatic fall in the incidence of MS C disease. Pre-licensure research studies and post-licensure adverse event data have confirmed that the vaccine is safe.
Evaluation of Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry for Identification of Vibrio cholerae

ABSTRACT We evaluated the use of matrix-assisted laser desorption ionization–time of flight mass spectrometry (MS) for the identification of Vibrio cholerae. MS identified all 42 isolates of V. cholerae O1 and O139 and 7 of 9 non-O1/O139 isolates. MS correctly discriminated between all Aeromonas and V. cholerae isolates. Overall, MS performed as well as or better than biochemical methods.
A remark on infinity-harmonic functions.

In this paper, we prove that any nonconstant, C2 solution of the infinity Laplacian equation uxiuxj uxixj = 0 can not have interior critical points. This result was first proved by Aronsson [2] in two dimensions. When the solution is C4, Evans [6] established a Harnack inequality for |Du|, which implies that non-constant C4 solutions have no interior critical points for any dimension. Our method is strongly motivated by the work in [6].
Novel Renal Transplant-Related Surgical Approaches in the 21st Century

The surgical procedures of implanting a kidney graft into the extraperitoneal iliac fossa has not changed much since its inception in 1950s; whereas the other renal transplant-related surgical approaches have been dramatically updated recently, especially with the commencement of urological laparoscopic surgery. The mile-stone advancement is the laparoscopic live donor nephrectomy (LDN). Conventional open LDN technique has been alleged as a hurdle for expanding live donor programs. Minimally invasive surgery approaches, like laparoscopic LDN, have been advocated to overcome this obstacle (Boulware et al., 2002). A variety of laproscopic LDN approaches will be detailed.