Miracle-dz/UniFAR-FTUs huggingface dataset:
Epidemiology of Vertigo

Objective. To investigate the epidemiology of vertigo among the general adult population in Taiwan using the National Health Insurance claims database. Study Design. Cross-sectional study. Setting. Data were retrieved from the 2006 National Health Insurance claims database. Subjects and Methods. Claims data were retrieved for patients 18 years or older with a diagnosis of vertigo (International Classification of Diseases, Ninth Revision, Clinical Modification codes 078.81, 386.XX, or 780.4) from January to December 2006. The authors describe the prevalence and recurrence of vertigo and the medical resource utilization associated with its treatment. Logistic regression models are used to assess the independent effects of age, sex, seasonal variation, institutional level of care, and specialty of care on the risk of vertigo recurrence. Results. A total of 527,807 adult patients (mean ± SD age, 55.1 ± 17.3 years; 1:1.96 ratio of men to women) experienced vertigo in 2006. The prevalence of vertigo was 3.13 cases per 100 adults. Within 1 year of their index vertigo attack, 199,210 patients (37.7%) experienced recurrence. The prevalence and recurrence of vertigo increased significantly with age (P < .001 for both, χ2 test). Age, sex, seasonal variation, institutional level of care, and specialty of care had various effects on the risk of vertigo recurrence. Conclusion. Vertigo is a major health burden among the general adult population and tends to recur, particularly among older women.
The Otology Data Collection Project

Objective. To describe and communicate data collected in the CHEER (Creating Healthcare Excellence through Education and Research) infrastructure proof-of-concept study to facilitate understanding of the potential capabilities of practice-based research networks and to present pilot data for development of future research initiatives. Study Design. Prospective observational study of CHEER infrastructure operational capacity using a convenience sample of all patients presenting to the practices with tinnitus, dizziness, or a combination of these symptoms. Setting. The CHEER network of community and academic practice sites. Subjects and Methods. The data collection exercise collected demographic, clinical, treatment, and health-related quality-of-life surveys on tinnitus, dizziness, and migraine disorders. Descriptive analysis of the data is presented. Results. Of the sites in the CHEER network, 73% (16/22) successfully enrolled subjects; a total of 1532 patients were enrolled in 8 months. Tinnitus alone, dizziness alone, and both occurred in 28%, 34%, and 29%, respectively. Patients complaining of tinnitus and dizziness had lower quality of life than those sufferers with 1 disorder. Migraine was associated with 27% of patients. The most frequent diagnoses for patients with tinnitus and dizziness were Ménière disease (34%), vertiginous migraine (18%), and benign paroxysmal positional vertigo (16%). Conclusion. Descriptive data on patients with common disorders can be rapidly collected within the framework of a practice-based research network. The data in this study provide valuable pilot information on the targeted disorders, providing a baseline for development of future epidemiological data and clinical trials.
Effect of Presence/Absence of a Nasogastric Tube in the Same Person on Incidence of Aspiration

Objective. To determine what effect, if any, the presence or absence of a nasogastric (NG) tube in the same person had on the incidence of anterograde aspiration. Design. Case series with planned data collection. Setting. Large, urban, tertiary care teaching hospital. Subjects and Methods. Referred sample of 62 consecutively enrolled adult inpatients for fiber-optic endoscopic evaluation of swallowing (FEES). Group 1 (n = 21) had either small-bore (n = 13) or large-bore (n = 8) NG tubes already in place and had a FEES first with the NG tube in place and a second FEES after NG tube removal. Group 2 (n = 41) did not have an NG tube and had a FEES first without an NG tube and a second FEES after placement of a small-bore NG tube. Time between FEES was approximately 5 minutes. Patients were tested with thin liquid and puree food consistencies. Occurrence of aspiration for each consistency dependent on the presence or absence of an NG tube was recorded. Results. There were no significant differences (P > .05) in aspiration status for both liquid and puree consistencies in the same person dependent on presence or absence of either a small-bore or large-bore NG tube. Conclusions. Since objective swallowing evaluation (eg, FEES) can be performed with an NG tube in place, it is not necessary to remove an NG tube to evaluate for aspiration. Similarly, there is no contraindication to leaving an NG tube in place to supplement oral alimentation until nutritional requirements are achieved.
An Innovative Solution to Pharmacy Department Information Sharing

The Director's Forum series is written and edited by Michael Sanborn and Robert Weber and is designed for guiding pharmacy leaders in establishing patient-centered services in hospitals and health systems. Another specific goal of this column is addressing many of the key challenges that pharmacy directors currently face, while also providing information that will foster growth in pharmacy leadership and patient safety. Previous articles in this series have discussed the many different aspects of pharmacy management and leadership challenges. This feature addresses an innovative solution to pharmacy department information sharing.
Assessment of TCR‐β clonality in a diverse group of cutaneous T‐Cell infiltrates

While some unequivocally benign infiltrates are easy to distinguish from cutaneous T‐cell lymphoma (CTCL), drug‐associated lymphomatoid hypersensitivity reaction and cutaneous lesions of collagen vascular disease can show cytologic atypia, clonality and an immunophenotypic profile that closely simulates CTCL and cause diagnostics difficulties. Similar immunophenotypic and molecular abnormalities to those of malignant lymphoma can also be observed in pityriasis lichenoides chronica (PLC), large plaque parapsoriasis (LPP), pigmented purpuric dermatosis (PPD) and atypical lymphocytic lobular panniculitis leading one to consider these entities as forms of cutaneous lymphoid dyscrasia. The purpose of our study was to evaluate the distinction of these various subcategories of cutaneous T‐cell infiltrates by assessment of T‐cell receptor (TCR)‐β gene rearrangement. Formalin‐fixed paraffin‐embedded skin biopsies from 80 patients containing a T‐cell dominant lymphocytic infiltrate were analyzed for TCR‐β gene rearrangement. Our findings indicate that monoclonality is a reliable characteristic of CTCL with polyclonality being very infrequent. However, some cases of drug associated lymphomatoid hypersensitivity, collagen vascular disease and the various cutaneous lymphoid dyscrasias (i.e. PLC, PPD and atypical lymphocytic lobular panniculitis) could manifest restricted molecular profiles in the context of an oligoclonal process or frank monoclonality.
Analysis of MUSIC and ESPRIT frequency estimates for sinusoidal signals with lowpass envelopes

In this correspondence, the MUSIC and ESPRIT frequency estimates of sinusoidal signals with lowpass envelopes are analyzed. To achieve computational simplicity, the frequency estimation is conducted as if the signal had a constant amplitude. The aim of the correspondence is to analyze the degradation of performance induced by the aforementioned mismodeling. Unified expressions for the bias and variances of the MUSIC and ESPRIT frequency estimators are derived under the hypothesis of small bandwidth of the signal envelope. Numerical simulations illustrate the agreement between theoretical and empirical results and study the influence of the envelope bandwidth on the frequency estimation performance.
Factors Correlating with Burnout in Practicing Otolaryngologists

Objective. This study sought to determine which demographic and practice characteristics were predictive of professional burnout in otolaryngologists. Study Design. Cross-sectional survey. Setting. Tertiary care hospital. Subjects and Methods. Postal mailings, including the Maslach Burnout Inventory (MBI), were sent to alumni of the University of Iowa Hospitals and Clinics otolaryngology program. Participants completed the MBI according to the enclosed instructions. In addition, they answered a brief questionnaire comprising 8 items designed to collect demographic information. The MBI was then scored and subjects were classified according to their degree of burnout. Statistical analysis was then performed, and correlations were used to summarize associations between continuous variables. Results. This study had a response rate of 49% to the survey. Of the respondents, 3.5% met criteria for burnout syndrome, and 16% were classified as having high levels of burnout according to the MBI. Young age, number of hours worked per week, and length of time in practice were found to be statistically significant predictors of burnout. In addition, the length of time married and the presence of children in the home were also significant predictors of burnout. Conclusion. The authors report an investigation of burnout in practicing otolaryngologists using a validated instrument with correlation to potentially modifiable risk factors. The experience of burnout was found to correlate significantly with both personal and professional factors, each of which can potentially be addressed to curb the incidence of burnout. Further understanding of the potential risk factors for burnout is necessary to minimize and prevent burnout among practicing otolaryngologists.
Silica-Assisted Nucleation of Polymer Foam Cells with Nanoscopic Dimensions: Impact of Particle Size, Line Tension, and Surface Functionality

Core–shell nanoparticles consisting of silica as core and surface-grafted poly(dimethylsiloxane) (PDMS) as shell with different diameters were prepared and used as heterogeneous nucleation agents to obtain CO2-blown poly(methyl methacrylate) (PMMA) nanocomposite foams. PDMS was selected as the shell material as it possesses a low surface energy and high CO2-philicity. The successful synthesis of core–shell nanoparticles was confirmed by Fourier transform infrared spectroscopy, thermogravimetric analysis, and transmission electron microscopy. The cell size and cell density of the PMMA micro- and nanocellular materials were determined by scanning electron microscopy. The cell nucleation efficiency using core–shell nanoparticles was significantly enhanced when compared to that of unmodified silica. The highest nucleation efficiency observed had a value of ∼0.5 for nanoparticles with a core diameter of 80 nm. The particle size dependence of cell nucleation efficiency is discussed taking into account line tension effects. Complete engulfment by the polymer matrix of particles with a core diameter below 40 nm at the cell wall interface was observed corresponding to line tension values of approximately 0.42 nN. This line tension significantly increases the energy barrier of heterogeneous nucleation and thus reduces the nucleation efficiency. The increase of the CO2 saturation pressure to 300 bar prior to batch foaming resulted in an increased line tension length. We observed a decrease of the heterogeneous nucleation efficiency for foaming after saturation with CO2 at 300 bar, which we attribute to homogenous nucleation becoming more favorable at the expense of heterogeneous nucleation in this case. Overall, it is shown that the contribution of line tension to the free energy barrier of heterogeneous foam cell nucleation must be considered to understand foaming of viscoelastic materials. This finding emphasizes the need for new strategies including the use of designer nucleating particles to enhance the foam cell nucleation efficiency.
Hospitalizações por diabetes em adultos e idosos no Ceará, 2001-2012

OBJETIVO:investigar as tendencias das hospitalizacoes por diabetes mellitus entre adultos e idosos residentes no estado do Ceara, Brasil, no periodo 2001-2012.METODOS:estudo ecologico de series temporais, utilizando dados do Sistema de Informacoes Hospitalares do Sistema Unico de Saude (SIH/SUS) referentes as taxas de hospitalizacoes anuais por diabetes, segundo sexo e idade, entre individuos com 20 ou mais anos de idade; para a analise de tendencia temporal, foram utilizados modelos de regressao polinomial.RESULTADOS:no periodo estudado, foram registradas 51.317 hospitalizacoes por diabetes, a maioria do sexo feminino (58,4%); as hospitalizacoes gerais por diabetes mostraram tendencia crescente (p=0,013; r2=0,560) e, quando estratificadas por sexo, apresentaram tendencia crescente para homens (p=0,002; r2=0,734) e decrescente para mulheres (p<0,001; r2=0,957). CONCLUSAO:a tendencia geral da hospitalizacao por diabetes no periodo estudado apresentou crescimento, mesmo resultado encontrado no sexo masculino; no sexo feminino, todavia, observou-se tendencia decrescente.
Functional Connectivity Networks in Nonbothersome Tinnitus

Objective To assess functional connectivity in cortical networks in patients with nonbothersome tinnitus compared with a normal healthy nontinnitus control group by measuring low-frequency (<0.1 Hz) spontaneous blood oxygenation level–dependent (BOLD) signals at rest. Design Case-control. Setting Academic medical center. Participants Nonbothersome, idiopathic subjective tinnitus for at least 6 months (n = 18) and a normal healthy nontinnitus control group (n = 23). Main Outcome Measure Functional connectivity differences in 58 a priori selected seed regions of interest encompassing cortical loci in the default mode, attention, auditory, visual, somatosensory, and cognitive networks. Results The median age of the 18 subjects was 54 years (interquartile range [IQR], 52-57), 66% were male, 90% were white, median Tinnitus Handicap Inventory (THI) score was 8 (IQR, 4-14), and a median Beck Depression Index score was 1 (IQR, 0-5). The median age for the control group was 46 years (IQR, 39-54), and 52% were male. Of the 58 seeds analyzed, no regions had significantly different functional connectivity among the nonbothersome tinnitus group when compared with the control group. Conclusion Among nonbothersome tinnitus patients, the tinnitus percept does not appear to alter the functional connectivity of the auditory cortex or other key cortical regions. Trial Registration ClinicalTrials.gov Identifier: NCT01049828
Ciphertext-policy attribute-based encryption with partially hidden access structure and its application to privacy-preserving electronic medical record system in cloud environment

With the development of cloud computing, more and more sensitive data are uploaded to cloud by companies or individuals, which brings forth new challenges for outsourced data security and privacy. Ciphertext-policy attribute-based encryption (CP-ABE) provides fine-grained access control of encrypted data in the cloud; in a CP-ABE scheme, an access structure, also referred to as ciphertext-policy, is sent along with a ciphertext explicitly, and anyone who obtains a ciphertext can know the access structure associated with the ciphertext. In certain applications, access structures contain very sensitive information and must be protected from everyone except the users whose private key attributes satisfy the access structures. In this paper, we propose a new model for CP-ABE with partially hidden access structure (See Figure 2). In our model, each attribute consists of two parts: an attribute name and its value; if the private key attributes of a user do not satisfy the access structure associated with a ciphertext, the specific attribute values of the access structure are hidden, while other information about the access structure is public. Based on the CP-ABE scheme proposed by Lewko and Waters [1] recently, we then present a concrete construction of CP-ABE with partially hidden access structure and prove that it is fully secure in the standard model. In addition, we discuss how our new model can be employed to construct a privacy-preserving electronic medical record system in the cloud environment. Copyright © 2016 John Wiley & Sons, Ltd.
Effectiveness of Responsible Beverage Service: The Norwegian Experiences

This article summarizes the findings from three evaluation studies of the Responsible Beverage Service (RBS) program in Norway. Effect evaluations in these studies demonstrated no effectiveness in that the program failed to reach its objectives of reducing on-premise sales to intoxicated and to underaged patrons. Process evaluations found that the content of the Norwegian RBS program was limited and represented a “light” version and program implementation varied significantly. In one project the program was hardly implemented, in another project program participation was made a prerequisite for extended opening hours, whereby the coverage of the target group became very high. A significant challenge in this area would be to improve program content and ways of implementation.
Real and virtual wireless radio network emulator

In this paper, we discuss the use of the RF Wireless Network Environment emulator. Its architecture and capabilities are investigated. Four case studies of the RF network emulator are presented in this paper. The first case study simulates the slow-hopping anti-jamming waveform. The second case study is the application of spectrum masking, the third is the use of power difference of arrival localization algorithm to triangulate the location of a local unknown emitter and the fourth utilizes the emulator for testing and verification of a Multiple Link Common Data Link System. The network architecture and setup of the environment emulator for each case is discussed in detail.
Better security enforcement in trusted computing enabled heterogeneous wireless sensor networks

A wireless sensor network (WSN) is an ad hoc wireless network composed of a large number of small sensor nodes. Sensor nodes are usually severely resource limited and power constrained, and as such security enforcement in WSNs is a challenging task. To facilitate security enforcement, we propose a heterogeneous architecture for WSNs, where a WSN is partitioned into clusters, each having a high-end cluster head. The cluster heads are further equipped with trusted computing technology (TC), such that they act as online trusted parties, thereby expected to help enforce security in a more effective manner. To show this, we discuss various examples on both content security and context security. Copyright © 2010 John Wiley & Sons, Ltd.
OP0066 Targeting the Lowest Efficacious Dose for Rheumatoid Arthritis Patients in Remission: Clinical and Structural Impact of a Step-Down Strategy Trial Based on Progressive Spacing of TNF-Blocker Injections (Strass Trial)

Background Biologic tapering has been associated to relapse or structural damage progression in rheumatoid arthritis (RA). Objectives To compare the impact of a DAS28-driven step-down strategy based on TNF-blocker injection spacing (S arm) to a maintenance strategy (M arm) in an equivalence RCT conducted in established RA patients in DAS28 remission with etanercept (ETA) or adalimumab (ADA). Methods Inclusion criteria were: ETA or ADA > 1 year, DAS28 remission > 6 months, stable damage on X-rays. Patients were randomized and followed 3-monthly for 18 months. In the S arm, the inter-injection interval was increased every 3 months up to full stop at 4th step. If DAS28 remission was lost, tapering was reversed to the previous step. Hand and foot X-rays at baseline and 18 months. Study endpoints were disease activity (DAS28), relapse (ΔDAS28>0.6 + DAS28>2.6), and X-ray damage assessed by vdH-SHS (2 independent readers, blinded of patient characteristics and treatment arm). Progression was defined as ΔvdH-SHS>1. Results 137 patients were included, 64 and 73 in the S and M arm (mean/%: age 55 yrs, female 78%, RA duration 9.5 yrs, RF+ 68%, ACPA+ 78%, erosive 88%, DAS28 1.8, DAS44 1.0, ETA 54 %, ADA 46 %). At 18 months, 47 (73.4%) patients of the S-arm tapered TNF-blockers, of whom 24 (37.5%) stopped. Mean DAS28 and mean HAQ were not significantly different between arms. Relapse occurred at least once more frequently in the S than in the M arm (81% vs. 56%, p=0.0009) (Figure). Structural damage progression was not significantly different between arms (p=0.3) (Figure). Only 4 (6.7%) and 3 (4.5%) patients progressed in the S and M arms. Image/graph Conclusions Although relapses were more frequent, the Spacing strategy results in non-significant increase of disease activity and functional impairment, with no significant structural progression. Target the lowest efficacious dose in RA in remission may be considered as the new paradigm for such patients (ClinicalTrials.gov n°: NCT00780793). Disclosure of Interest None Declared
Effect of sildenafil on arterial stiffness and wave reflection

While sildenafil (Viagra) is widely prescribed for erectile dysfunction, its effect on arterial function is not established. The elastic properties of the aorta, as well as the magnitude and timing of wave reflection, are important factors for efficient performance of the cardiovascular system and have been identified as prognosticators of cardiovascular risk. A total of 24 subjects with coronary artery disease, of whom 14 were hypertensives, aged 69 8 years, were studied in a randomized, placebo-controlled, double-blind, cross-over design. Measurements lasted for 3 h after the sildenafil intake (50 mg, p.o.) or placebo. Aortic elastic properties were evaluated with carotid-femoral pulse wave velocity; wave reflection was evaluated with augmentation index and augmented pressure of the aortic pressure waveform. Pulse wave velocity decreased significantly (by 0.65 m/s, p = 0.005), denoting a decrease in aortic stiffness. Augmentation index and augmented pressure decreased significantly (by 4.47% absolute and by 4.01 mmHg; p < 0.001 and p = 0.001, respectively), denoting a decreased effect of wave reflection from the periphery. Aortic pulse pressure decreased significantly (by 6.74 mmHg, p < 0.05). An active effect of the drug on aortic wall appears to contribute to the decrease in pulse wave velocity, although other mechanisms such as a decrease of blood pressure and autonomic reflexes could also have contributed. The effect of sildenafil lasted throughout the study (3 h), being evident 30 min after drug intake. In conclusion, this study shows, for the first time, that sildenafil has a favorable effect on aortic stiffness and wave reflection in patients with coronary artery disease. This finding may have important implications for cardiovascular performance and exercise capacity during intercourse.