Miracle-dz/UniFAR-FTUs huggingface dataset:
Conversations About Goals and Values Are Feasible and Acceptable in Long-Term Acute Care Hospitals: A Pilot Study.

RATIONALE The chronically critically ill have survived acute critical illness but require prolonged mechanical ventilation. These patients are frequently transferred from acute care to long-term acute care hospitals (LTACHs) for prolonged recovery, yet many suffer setbacks requiring readmission to acute care. The patient's relatively improved condition while at the LTACH might be an opportunity for communication regarding care goals; however, there have been no prior studies of the feasibility of such conversations in the LTACH. OBJECTIVES To determine the feasibility, acceptability, and potential usefulness of conversations about serious illness with chronic critical illness patients or their surrogate decision makers after LTACH admission. METHODS We adapted an existing conversation guide for use in chronically critically ill (defined by tracheotomy for prolonged ventilation) LTACH patients or their surrogates to explore views about quality of life, understanding of medical conditions, expectations, and planning for setbacks. These conversations were conducted by one interviewer and summarized for the patients' clinicians. We surveyed patients, surrogates, and clinicians to assess acceptability. MEASUREMENT AND MAIN RESULTS A total of 70 subjects were approached and 50 (71%) were enrolled, including 30 patients and 20 surrogates. The median duration of the conversation was 14 minutes 45 seconds [IQR 12:46, 19]. The presence of ongoing mechanical ventilation did not lead to longer conversations; in fact, conversations with patients were shorter than those with surrogates. The majority of subjects (81%) described the conversation as worthwhile. The majority of clinicians (73%) reported that the conversation offered a new and significant understanding of the patient's preferences if a setback were to occur. CONCLUSIONS Conversations about serious illness care goals can be accomplished in a relatively short period of time, are acceptable to chronically critically ill patients and their surrogate decision makers in the LTACH, and are perceived as worthwhile by patients, surrogates, and clinicians.
BIOLOGICAL ORGANIZATION AND ANTI-ENTROPY

This paper proposes a systemic perspective for some aspects of both phylogenesis and ontogenesis by expressing biological organization in terms of "anti-entropy", a notion to be defined below and which conceptually differs from the common use of "negative entropy". To this purpose, we introduce two principles, in addition to the thermodynamic ones, which are (mathematically) compatible with traditional principles but which have no meaning with regard to inert matter. A traditional balance equation for the metabolism will then be extended to the new notion as specified by these principles. We examine far from equilibrium systems and we focus in particular on the production of global entropy associated to the irreversible character of the processes. A close analysis of anti-entropy will be performed from the perspective of a diffusion equation of biomass over "complexity" and, as a complementary approach and as a tool for specifying a source term, in connection to Schrodinger's method regarding his equation in the field of Quantum Mechanics. We borrow only the operatorial approach from this equation and do so using a classical framework, since we use real coefficients instead of complex ones, thus falling outside of the mathematical framework of quantum theories. The first application of our proposal is a simple mathematical reconstruction of Gould's complexity curve of biomass over complexity as it applies to evolution. We then present, based on the existence of different time scales, a partition of ontogenetic time, in reference to entropy and anti-entropy variation. On the grounds of this approach, we analyze the metabolism and scaling laws. This allows to compare various relevant coefficients appearing in these scaling laws, which fit empirical data. Finally, a tentative and quantitative evaluation of complexity is proposed, also in relation to some empirical data (Caenorhabditis elegans).
Acquiring a priori knowledge from ground and spaceborne BRDF measurements

Previous work has successfully demonstrated the application of a priori knowledge to bidirectional reflectance distribution function (BRDF) model inversion. The a priori knowledge used in the tests is the general knowledge which can be applied to all land cover types. One of the advantages of general knowledge is that it can be applied independently and doesn't need more information. However, the inversion accuracy may be low, compared to results using correct specific knowledge. This paper mainly focuses on the accumulation of a priori knowledge for the linear BRDF model in both general and specific realms. The authors first provide some specific knowledge based on ground and spaceborne BRDF measurements for BRDF model parameters.
Post neoadjuvant residual breast tumor size; clinical, radiological and pathological correlation

Methods: 25 patients (age range, 25-62 years; mean age, 42.7 years) with breast cancer who had been treated by neoadjuvant chemotherapy were taken retrospectively. We compared the predicted residual tumour size and the predicted response on imaging and clinical examination with residual tumour size and response on surgical pathology. Statistical analysis was performed using Spearman Analysis and weighted Kappa values.
Prevalence of Metabolic Syndrome Among People Living with HIV in Developing Countries: A Systematic Review

Abstract Metabolic syndrome (MS) is a group of components associated with cardiovascular disease and type 2 diabetes mellitus. The prevalence of MS in the HIV population is increasing in epidemic proportions globally. However, the magnitude and characteristics of MS are not fully elucidated in developing countries. The aim of this systematic review was to assess the prevalence of MS and its components among people living with HIV (PLWH) in developing countries. Searches were carried out in MEDLINE, Embase, Web of Science, CINAHL, Cochrane Central Register of Controlled Trials, Scopus, other web sources, and by hand search. Articles were restricted to English language studies reporting on the prevalence of MS among PLWH in developing countries. Eighteen articles were included in the review. The studies were divided into Africa, South America, and Asia regions. The most frequent criterion used in the review was the National Cholesterol Education Program: Adult Treatment Program III 2001 definition. The prevalence of MS among PLWH ranged from 8.4% to 47% across the developing regions and comparable to the overall prevalence across the developed regions (7.8‐52.2%). The mean prevalence was 30.5%, 21.5%, and 21.4% in Africa, Asia, and South America, respectively. The most frequent component observed was low high‐density lipoprotein cholesterol (50.1%). This systematic review provides an essential overview on the distribution of MS in the HIV population across the developing regions. As these prevalences were comparably high in the developed regions, this review highlights the need for more robust research in developing countries.
Secret-Key Agreement Over Unauthenticated Public Channels—Part III: Privacy Amplification

This is the third part of a three-part paper on se- cret-key agreement secure against active adversaries. Here, we con- sider the special case where the legitimate partners already share a mutual string which might, however, be partially known to the adversary. The problem of generating a secret key in this case has been well studied in the passive-adversary model—for instance, in the context of quantum key agreement—under the name of privacy amplification. We consider the same problem with respect to an ac- tive adversary and propose two protocols, one based on universal hashing and one based on extractors, allowing for privacy ampli- fication secure against an adversary whose knowledge about the initial partially secret string is limited to one third of the length of this string. Our results are based on novel techniques for au- thentication secure even against adversaries knowing a substantial amount of the "secret" key. information about . From Eve's point of view, the length of can in this case be roughly equal to the Renyi entropy of . In this paper, we investigate the same problem under the as- sumption that the communication between Alice and Bob is not authenticated. Note that, in contrast to the model where many independent repetitions of the involved random variables are given (15), the same piece of information must be used here both for authentication and as the input for privacy amplifica- tion. Two problems that arise in this context are authentication with an only partially secret key, and the fact that this authenti- cation leaks information about , hence potentially also about , to the adversary. We show that for our purpose, a new, inter- active, authentication method is better than one-way authentica- tion by strongly universal hashing, and that so-called extractors, requiring fewer random bits (i.e., shorter messages to be com- municated), are a better technique for privacy amplification than
Ultrasound-Guided Interscalene Nerve Block: An Alternative Technique to Anatomical Landmark-Guided Approaches

Background: The use of ultrasonography in interscalene brachial plexus block (ISBPB) has rapidly evolved over the past few years. It has been speculated that ultrasound guidance might increase success rates and reduce complications. Objective: The aim of our study is to compare the success rate and safety of ISBPB performed either with ultrasound visualization or with anatomical landmark to guide needle placement. Methods: A total of 44 patients scheduled for shoulder and upper arm surgeries in Zagazig University hospital, Zagazig, Egypt, were included in this prospective study and randomized into two equal groups according to the guidance method for ISBPB. In the ultrasound group (group A), the brachial plexus was visualized with a linear 38-mm, high frequency 7 MHz probe and the spread of the local anesthetic was assessed. In anatomical landmark group (group B), the roots of the brachial plexus were located by eliciting parasthesias when the target nerves were touched by the needle. Results: Surgical anesthesia was achieved in 91% of patients in group A vs. 73 % of patients in group B (p= 0.01). The dose of anesthesia was significantly lower in group A compared to group B. Also, duration of anesthesia was increased and the need for analgesia was reduced in group A. The incidence of complications was significantly higher in group B (45%) than in group A (18%) (p= 0.01). Conclusion: The use of ultrasonography helps to improve the efficacy and to reduce the complications associated with ISBPB.
Human Hepatitis E Virus among Apparently Healthy Individuals in Ogbomoso, South-Western Nigeria

Hepatitis E virus (HEV) is a small non-enveloped positive sense single stranded RNA icosahedral virus with a 7.7 kilobase genome that belongs to the genus Herpevirus [1]. Hepatitis E virus infections occur world-wide. The virus is endemic in regions of the world characterized with poor sanitation (such as Africa, Asia and Central America) as epidemiologic studies have shown the route of transmission to be by faecal-oral route with contaminated food and water being the primary source of infection [2,3]. However, blood borne transmission of HEV has been investigated as one of the possible risk factors for acquiring hepatitis E virus [1]. This transmission can be from any apparently healthy individual who can be potential blood donor to healthy/unhealthy individuals during blood transfusion. Other possible risk factors are not limited to previous history of surgery or alcohol intake [4]. Even though hepatitis E infections are self-limiting among immunocompetent individuals, persistency can result into fulminant hepatitis [3,5].
Baixa qualidade da dieta de idosos: estudo de base populacional no sul do Brasil

Resumo O objetivo deste estudo foi identificar os fatores associados a baixa qualidade da dieta de idosos da cidade de Pelotas, RS. As informacoes de consumo alimentar foram coletadas atraves de um questionario de frequencia alimentar resumido e a qualidade da dieta foi avaliada atraves do Indice de Qualidade da Dieta de Idosos (IQD-I), desenvolvido pelos autores. Foram atribuidos pontos a cada alimento avaliado, conforme sua frequencia de consumo. As maiores frequencias de consumo receberam maior pontuacao quando alimentos saudaveis e menor quando nao saudaveis. A pontuacao total foi dividida em tercis, classificados em: baixa, intermediaria e boa qualidade. A associacao entre a qualidade da dieta e as variaveis independentes foi investigada atraves de regressao logistica multinomial. Os fatores associados a dieta de baixa qualidade foram: sexo masculino, idade inferior a 80 anos, baixa escolaridade, dificuldade financeira para compra de alimentos, baixo peso, problemas na boca ou nos dentes e realizar menos de quatro refeicoes por dia. Importantes barreiras para o consumo de uma dieta de boa qualidade foram identificadas neste estudo, ficando evidente a importância de se considerar esses aspectos na promocao da alimentacao saudavel em idosos.
The new TNM classification of lung cancer in practice

Educational aims To describe the changes in the 7th edition of the TNM classification of lung cancer To discuss the clinical implications of the incorporation of the new TNM classification in everyday practice To emphasise the key points for a proper pathologic classification Summary The 7th edition of the TNM (tumour, node, metastases) classification of lung cancer incorporates the proposals of the International Association for the Study of Lung Cancer, whose database included more than 100,000 patients from Asia, Australia, Europe, and North America. The changes affect the T and the M components of the classification, and the stage grouping. The N component remained unaltered, although the present descriptors were validated both in the clinical and pathologic settings. This new TNM classification applies to non-small cell lung cancer, small cell lung cancer and, for the first time, to broncho-pulmonary carcinoids. The innovations allow for a better separation of tumours with significantly different prognosis, and imply a more careful determination of tumour size.
Obesity and circadian system

Obesity, an epidemic health concern that related with high levels of worldwide morbidity and mortality levels, showed marked increase to last years. Studies focus on the factors leading such rise to make effective and long lasting intervensions intended for obesity. Decreased nightly sleep duration,compared to the past century,is considered as one of these factors and studies emphasize the relation between changing sleep patterns and obesity and accompanying health disorders as impaired glucose metabolism, cardiovascular diseases,type 2 diabetes mellitus, hypertension those also have high prevelances. Current thesis was created in the form of literature review with the articles those taken from Pubmed and Science Direct especially were published after 2010 to comply with the aim of demonstrating the association of sleep with obesity and mentioned health disorders, basic mechanisms undelying this association and factors affecting the functioning of these mechanism.
Serum Vitamin D Level in Iranian Multiple Sclerosis patients and their Siblings: A Case-Control Study

1.1. Objectives: To measure serum vitamin D level in multiple sclerosis patients (MS) patients and their healthy siblings. 1.2. Methods: During the 12 month period (May 2014 - May 2015) in a case-control study, relapsing-remitting MS patients (based on McDonald 2005 criteria) and their healthy siblings were recruited. All participants were residents of Tehran city. Exclusion criteria were: 1. consumption of drugs with known interaction with vitamin D metabolism during past two months 2. Current consumption of vitamin D and calcium supplements 3. Smoking 4. Medical disease which interferes with vitamin D metabolism. 5. Residents of other cities due to different latitude and sunshine expousure. Vitamin D levels (25 Hydroxy vitamin D3) were measured by ELISA (Enzyme Linked Immune Sorbent Assay) method. To reduce variability, all samples were analysed in batched assays. Differences in vitamin D levels between patients and controls were analysed. 1.3. Results: We evaluated 31 MS patients and 31 healthy siblings. The mean vitamin D level in the cases and controls was 12.7±5.5 ng/ml and 20.9±8.1 ng/ml, respectively. There was a significant difference in serum vitamin D levels between cases and controls (P< 0.001). Conclusion: In the present study Serum vitamin D levels were significantly lower in MS patients compared to that of healthy siblings. Nevertheless further research is needed to recommend routine vitamin D supplementation in MS patients.
Instrumentos desenvolvidos para o gerenciamento e cuidado de idosos em instituições de longa permanência: uma revisão sistemática

The demand for long-stay care institutions for the elderly (ILPIs) is increasing and it is relevant for public health systems to discuss the process of assessing the health status of its residents. The study aimed to identify measurement tools built specifically for the management and care of elderly residents in long-stay care facilities. A systematic review was conducted following PRISMA recommendations in Medline and CINAHL databases since their creation to May 2013 using the Medical Subject Headings terms suitable for the search. A total of 1858 articles were located, of which 30 were selected and 28 instruments were identified in the studies. The United States was the country that created most instruments geared to this population and the Minimum Data Set/Resident Assessment Instrument (MDS/RAI) was the one most used in the studies of this review. The variables most frequently evaluated by the instruments were depression, cognition and functional capacity. The reformulation of public policies that ensure a standardized assessment system for residents in ILPIs in Brazil is urgently needed and the challenge is to ensure that the instruments developed are disseminated and effectively implemented in the daily tasks of the professionals working in these institutions.
Retrospective Review of Bloodless Liver Transplant Recipients at a Single Center

Introduction: Jehovah’s Witness (JW) patients are known to refuse blood transfusions, but may accept solid organ transplants. Liver transplantation (LT), with the possibility of substantive blood loss, is more challenging in patients who refuse blood transfusion. In this report, we present a case series of JW patients who underwent LT at our center over the past two decades and discuss their management and outcomes. Methods: We retrospectively reviewed the medical records of JW patients who underwent LT at our institution from 1994 through 2015. Results: Nine JW patients underwent LT and were included in the study. The median age of the group is 42.38 years old (range 35- 56), with seven females and two males. No patient received blood products during or after LT. During the first three post-operative months, five patients suffered acute rejection episodes, three developed systemic sepsis, two developed acute kidney injury, and seven survived the first year post-LT. Conclusion: LT is feasible without blood transfusion. The one-year mortality rate in JW patients is comparable to LT recipients who received blood transfusion at our center. With a multidisciplinary protocol and better surgical techniques, it is possible to perform LT without the use of blood products, which can result in favorable postoperative outcomes.
Adherence to Antiretroviral Therapy among Patients Attending an Inner-City HIV Primary Care Clinic: Non-obvious Factors are Most Important

Patient adherence is arguably the most important factor determining both individual and public health benefits of antiretroviral therapy (ART). Adherence issues also appear to be central in understanding the large disparities between African Americans and Whites in terms of lower rates of ART utilization and adherence. In an attempt to understand factors which constitute barriers or facilitators of adherence, particularly in African American populations, seven studies are reviewed which focus on the largely disadvantaged and African American patients receiving HIV care through the University of Maryland Medical System in Baltimore. Analysis of these studies reveals that ART adherence is better understood and predicted by “non-obvious,” complex, and often underlying factors, including the adverse circumstances which describe the HIV-infected individual who ends up receiving care in an emergency room and inpatient setting rather than from the same clinician in an outpatient clinic, patients’ subjective perceptions of their health care providers, mistrustful beliefs about HIV and its treatment, and dimensions of forgiveness and how these affect attitudes and behaviors about being HIV-infected and relating to others, medical systems, and God or spiritual being. More “obvious” factors such as knowledge of HIV and its treatment, “pill burden,” or providing external incentives or methods intended to help patients take their prescribed medicines do not play a significant role in adherence, and moreover, may have counter-intuitive effects, as discussed in two studies. We present a model of biodisparity, as the biological entrenchment of socioeconomic and healthcare access disparities, resulting from the conjoint influence of suboptimal adherence and the transmission of drug resistant virus within isolated social networks and disadvantaged sub-populations.
Effect of fading correlation on adaptive arrays in digital mobile radio

In this paper, we investigate the effect of correlations among the fading signals at the antenna elements of an adaptive array in a digital wireless communication system. With an adaptive array, the signals received by multiple antennas are optimally weighted and combined to suppress interference and combat desired signal fading. Previous results for flat and frequency-selective fading assumed independent fading at each antenna. Here, we present a model of local scattering around a mobile where the received multipath signals arrive at the base station within a given beamwidth, and derive a closed-form expression for the correlation as a function of antenna spacing. Results show that the degradation in performance with correlation in an adaptive array that combats fading and suppresses interference is only slightly larger than that for combating fading alone, i.e., with maximal ratio combining. This degradation is small even with correlation as high as 0.5. >
Pain Management in Weight Loss Surgery: Aiming for Multimodal Approach

Weight loss surgery (WLS) is an effective group of procedures with a low rate of complications, preventing or treating several cardiovascular co morbidities associated with morbid obesity. Pain management in the preoperative needs special consideration in this population because of different aspects, specially the theoretical need for opioid avoidance, generally used in the postoperative of major surgeries. This literature review assesses the available information on analgesic strategies for WLS, with a special approach on multimodal settings and possible alternatives. Well-controlled studies are needed to determine the level of recommendation for individual therapies and multimodal regimens.