Miracle-dz/UniFAR-FTUs huggingface dataset:
Frailty and activation of the inflammation and coagulation systems with and without clinical comorbidities: results from the Cardiovascular Health Study.

BACKGROUND The biological basis of frailty has been difficult to establish owing to the lack of a standard definition, its complexity, and its frequent coexistence with illness. OBJECTIVE To establish the biological correlates of frailty in the presence and absence of concurrent cardiovascular disease and diabetes mellitus. METHODS Participants were 4735 community-dwelling adults 65 years and older. Frail, intermediate, and nonfrail subjects were identified by a validated screening tool and exclusion criteria. Bivariate relationships between frailty level and physiological measures were evaluated by Pearson chi2 tests for categorical variables and analysis of variance F tests for continuous variables. Multinomial logistic regression was performed to evaluate multivariable relationships between frailty status and physiological measures. RESULTS Of 4735 Cardiovascular Health Study participants, 299 (6.3%) were identified as frail, 2147 (45.3%) as intermediate, and 2289 (48.3%) as not frail. Frail vs nonfrail participants had increased mean +/- SD levels of C-reactive protein (5.5 +/- 9.8 vs 2.7 +/- 4.0 mg/L), factor VIII (13 790 +/- 4480 vs 11 860 +/- 3460 mg/dL), and, in a smaller subset, D dimer (647 +/- 1033 vs 224 +/- 258 ng/mL) (P< or =.001 for all, chi2 test for trend). These differences persisted when individuals with cardiovascular disease and diabetes were excluded and after adjustment for age, sex, and race. CONCLUSIONS These findings support the hypothesis that there is a specific physiological basis to the geriatric syndrome of frailty that is characterized in part by increased inflammation and elevated markers of blood clotting and that these physiological differences persist when those with diabetes and cardiovascular disease are excluded.
GASTROENTEROLOGY CLINICS OF NORTH AMERICA Irritable Bowel Syndrome : Current Approach to Symptoms , Evaluation , and Treatment

I rritable bowel syndrome (IBS) is a common functional gastrointestinal (GI) disorder. It has a very high prevalence, estimated to be 10% to 20% in the general population [1]. IBS accounts for significant health care costs with annual direct and indirect costs estimated at $1.35 billion and at least $200 million, respectively [2]. IBS patients use more health care services than the general population, even for non–GI-related concerns [3,4]. This article provides clinicians with a current, concise, and evidence-based review of the symptoms, diagnostic evaluation, and treatment of IBS. A clear understanding of recommended diagnostic and therapeutic approaches leads to greater patient satisfaction and reduced health care costs.
Quality of informed consent for invasive procedures.

OBJECTIVE To assess quality of informed consent among patients undergoing procedures and patient's preferences about decision-making. DESIGN Cross-sectional survey of hospitalized patients about informed consent before surgery or other procedures. Preference for decision-making was elicited in hospitalized and ambulatory patients. SETTING Large academic general hospital and 10 general clinics, over the years 2002-04. INTERVENTION Data of initial survey were presented at staff meetings, recommending asking patients to restate what was explained to them. MAIN OUTCOME MEASURES Rate of patient's recall for explanations on risks and alternative options; rate of patients preferring shared, autonomous and paternalistic modes of decision-making; degree of satisfaction from the decision-making. RESULTS Half of the patients did not recall receiving explanations about risks and two-third did not remember discussion of alternative options. The intervention failed, <10% of patients being asked to re-state what was explained to them. Expectations about decision varied: approximately 60% favored shared decision, nearly 20% preferred autonomous decision and the remainder wanted physicians to make decisions. Satisfaction was rated as good or very good by 80% of patients. CONCLUSIONS Most patients do not remember receiving explanations about risks or alternatives for procedures, and physicians resist attempts to improve informed consent. Tools should be developed to measure the quality of consent. Since patients significantly differ in their preferred mode of decision-making, the informed consent should be patient-specific.
Performance Analysis of Routing Protocol for Low Power and Lossy Networks (RPL) in Large Scale Networks

With growing needs to better understand our environments, the Internet-of-Things (IoT) is gaining importance among information and communication technologies. IoT will enable billions of intelligent devices and networks, such as wireless sensor networks, to be connected and integrated with computer networks. In order to support large scale networks, IETF has defined the routing protocol for low power and lossy networks (RPL) to facilitate the multihop connectivity. In this paper, we provide an in-depth review of current research activities. Specifically, the large scale simulation development and performance evaluation under various objective functions and routing metrics are pioneering works in RPL study. The results are expected to serve as a reference for evaluating the effectiveness of routing solutions in large scale IoT use cases.
Predicting bankruptcy in resort hotels: a survival analysis

Purpose This study aims to examine variables influencing resort hotels’ survival in Spain, which had not previously been analysed. In this country, determining whether the reasons resort hotels close are different from other hotels could be imperative to resort hotels’ survival. Design/methodology/approach The survival analysis used Cox’s semi-parametric proportional hazards regression to determine which variables influence hotel closure and how much each variable increases risk of closure. Findings Resort hotel closure depends on hotel size, location, executive management and the business cycle. Survival is not affected by hotel type or financial structure. Research limitations/implications While this methodology is common in business survival analyses, it has seldom been applied to hotels and has never been used to study the survival of resort hotels. Practical implications Companies need to rethink the location of new hotels. For already-built facilities, good management practices are strategically important for resort hotels’ survival. Originality/value This paper explores the reasons why resort hotels survive. The study’s selection of variables and methodology and its conclusions are unique.
Unpacking the relationship between high-performance work systems and innovation performance in SMEs

Purpose The purpose of this paper is to explore the black box between high-performance work systems (HPWS) and innovation performance in small- and medium-sized enterprises (SMEs). Through application of the ability, motivation and opportunity (AMO) framework, the study examines the mediating roles of innovation-specific ability, motivation and voice behaviors between HPWS and SMEs’ innovation performance. Design/methodology/approach The hypotheses are tested on data collected through a self-administered questionnaire from 237 SMEs in Pakistan. Findings Findings indicate that human capital, motivation and employee voice fully mediate the relationship between HPWS and innovation performance in SMEs. Research limitations/implications The cross-sectional research design and self-reported measures warrant caution for the interpretation of findings. Future research may consider a longitudinal research design and objective measures. Practical implications SMEs need to invest in the adoption and implementation of HPWS that will develop innovation-specific abilities, motivation and voice behaviors simultaneously among employees that will lead to higher innovation performance. Originality/value This is the first study of its kind utilizing an AMO framework to investigate the underlying mechanism through which HPWS affect innovation performance in SMEs.
Root-Gel Interactions and the Root Waving Behavior of Arabidopsis1[w]

Arabidopsis roots grown on inclined agarose gels exhibit a sinusoidal growth pattern known as root waving. While root waving has been attributed to both intrinsic factors (e.g. circumnutation) and growth responses to external signals such as gravity, the potential for physical interactions between the root and its substrate to influence the development of this complex phenotype has been generally ignored. Using a rotating stage microscope and time-lapse digital imaging, we show that (1) root tip mobility is impeded by the gel surface, (2) this impedance causes root tip deflections by amplifying curvature in the elongation zone in a way that is distinctly nontropic, and (3) root tip impedance is augmented by normal gravitropic pressure applied by the root tip against the gel surface. Thus, both lateral corrective bending near the root apex and root tip impedance could be due to different vector components of the same graviresponse. Furthermore, we speculate that coupling between root twisting and bending is a mechanical effect resulting from root tip impedance.
Control of hypertension in children after renal transplantation

Abstract: The aim of this cross‐sectional single‐center study was to investigate the efficacy of hypertension control in children who underwent transplantation using ambulatory blood pressure (BP) monitoring, and to determine the risk factors associated with poor control of hypertension. Thirty‐six children fulfilled the inclusion criteria. The mean age was 13.9±4.4 yr; the mean time after renal transplantation was 2.7±2.4 yr (0.5–10.1). Hypertension was defined as a mean ambulatory BP ≥95th centile for healthy children and/or requiring antihypertensive drugs. Hypertension was regarded as controlled if the mean ambulatory BP was <95th centile in children already on antihypertensive drugs, or uncontrolled if the mean ambulatory BP was ≥95th centile in treated children. Hypertension was present in 89% of children. Seventeen children (47%) had controlled hypertension, and 14 (39%) had uncontrolled hypertension. One child (3%) had untreated hypertension, and only four children (11%) showed normal BP without antihypertensive drugs. The efficacy of hypertensive control was 55% (17 of 31 children on antihypertensive drugs had a BP<95th centile), i.e. 45% of treated children still had hypertension. Children with uncontrolled hypertension had significantly higher cyclosporine doses (6.1 vs. 4.3 mg/kg/day, p=0.01) and tacrolimus levels (9.2 vs. 6.1 μg/L, p<0.05), and there was a tendency toward use of lower number of antihypertensive drugs (2.0 vs. 1.5 drugs/patient, p=0.06) and lower use of angiotensin‐converting enzyme (ACE) inhibitors (7 vs. 35%, p=0.09) and diuretics (29 vs. 59%, p=0.14) than in children with controlled hypertension. In conclusion, nearly 90% of our children after renal transplantation are hypertensive and the control of hypertension is unsatisfactorily low. The control of hypertension could be improved by increasing the number of prescribed antihypertensive drugs, especially ACE inhibitors, and diuretics, or by using higher doses of currently used antihypertensives.
Emotional Intelligence and Employees’ Innovator Role: The Moderating Effect of Service Types

Services vary significantly. Some services require high level of customization while others are focusing on standardization as the main objective. Customized services absolutely require service providers’ creativity in meeting the customers’ expectation. Studies have shown that Emotional Intelligence (EI) can be used to enhance service providers’ innovator role. Therefore, this study aims at investigating the moderating effect of service types on the relationship between EI factors (self emotional appraisal, others’ emotional appraisal, regulation of emotion, and use of emotion) and employees’ innovator role. Analyses of 167 responses revealed that the differential slopes of the moderator-based subgroups for the relationship between self emotional appraisal (SEA) and innovator role were significant. The findings highlight the importance of EI for employees in different service types to enhance their innovator role.
Distribution of radiographic osteoarthritis between the right and left hands, hips, and knees.

OBJECTIVE To investigate whether radiographic osteoarthritis (OA) is asymmetric and greater on the right side than on the left side in the hands, hips, and knees. METHODS Participants were 489 individuals with posteroanterior hand radiographs from a family study of nodal OA, 1,715 community-derived individuals who had undergone intravenous urography with views of both hips, and 1,729 community-derived individuals with weight-bearing fully extended tibiofemoral (TF) joint and skyline patellofemoral (PF) joint radiographs. All radiographs were evaluated for global OA grade, osteophytes, and joint space narrowing (JSN). Minimum joint space width (JSW) was measured at the hip and knee. Odds ratios (ORs) for global OA on the right side versus the left side were calculated. Osteophytes and JSN were compared by Wilcoxon's signed rank test, and the JSW was compared by paired t-test. RESULTS Global OA was more prevalent on the right side at the distal interphalangeal joints (OR 1.57; 95% confidence interval 1.22, 2.02) and the TF joint (OR 1.24; 95% confidence interval 1.01, 1.52). Osteophyte scores for the fingers were greater on the right side, but JSN was symmetric. At the hip, there were no right-left differences in osteophytosis or JSN, but the JSW was smaller on the left. At the TF joint, the medial compartment was narrower and the lateral compartment wider on the right side, and osteophyte scores were greater on the right side. At the PF joint, there were no right-left differences in osteophytes, and for lone PF joint OA, there were no differences in JSN or the JSW. CONCLUSION This discordance in symmetry suggests that the relative importance of biomechanical factors in the pathogenesis of OA is site-specific and may be discordant for cartilage and bone.
Long-term efficacy of triple oral therapy for type 2 diabetes mellitus.

OBJECTIVE To report the status of 35 patients with type 2 diabetes mellitus approximately 3 years after the initiation of triple oral antidiabetic therapy--with a sulfonylurea, metformin, and a thiazolidinedione. METHODS Study patients were assessed for the need for the addition of insulin, and follow-up clinical and laboratory findings were analyzed. RESULTS At a mean follow-up of 37 months (range, 18 to 45), 26 (74%) of 35 patients (group A) had well-controlled blood glucose levels on triple oral therapy, with a mean glycated hemoglobin (HbA1c) value of 6.9 +/- 0.3% (upper limit of normal, 6.5%). In the nine other patients (group B), triple oral therapy failed and the use of insulin was necessary after a mean duration of 30 months (range, 18 to 42); the mean HbA1c in these patients was 8.8 +/- 0.5%. Both group A and B gained similar amounts of weight during the study period (14.2 +/- 2.1 lb versus 11.6 +/- 3.8 lb, respectively; P = 0.54). A search for potential predictors of success or failure revealed that both groups had similar baseline characteristics, including age, duration of diabetes, weight, body mass index, HbA1c, and baseline stimulated C-peptide levels, and none of these factors demonstrated a significant correlation with the response to therapy. The only difference found between the two groups was a significant increase in the stimulated C-peptide levels (from 3.6 +/- 0.9 ng/mL to 5.2 +/- 1.1 ng/mL; P = 0.002) during follow-up in the group that had good glycemic control with triple oral therapy, in comparison with a nonsignificant increase (from 3.7 +/- 0.8 ng/mL to 4.2 +/- 0.4 ng/mL; P = 0.46) in the group that failed to maintain glycemic control on triple oral therapy. CONCLUSION Triple oral antidiabetic therapy is an effective long-term treatment for a substantial proportion of patients with type 2 diabetes who initially achieve glycemic control with triple oral therapy, particularly those in whom production of endogenous insulin is increased when a thiazolidinedione is added.
Drought cuts back regeneration in logged tropical forests

Logged tropical forests represent a major opportunity for preserving biodiversity and sequestering carbon, playing a large role in meeting global forest restoration targets. Left alone, these ecosystems have been expected to undergo natural regeneration and succession towards old growth forests, but extreme drought events may challenge this process. While old growth forests possess a certain level of resilience, we lack understanding as to how logging may affect forest responses to drought. This study examines the drought–logging interaction in seedling dynamics within a landscape of logged and unlogged forests in Sabah Malaysia, based on 73 plots monitored before and after the 2015–16 El Niño drought. Drought increased seedling mortality in all forests, but the magnitude of this impact was modulated by logging intensity, with forests with lower canopy leaf area index and above-ground biomass experiencing greater drought induced mortality. Moreover, community traits in more heavily logged forests shifted towards being more ruderal after drought, suggesting that the trajectory of forest succession had been reversed. These results indicate that with reoccurring strong droughts under a changing climate, logged forests that have had over half of their biomass removed may suffer permanently arrested succession. Targeted management interventions may therefore be necessary to lift the vulnerable forests above the biomass threshold.
The essence of cancer care: the impact of training on nurses' ability to communicate effectively.

BACKGROUND The importance of effective communication between health professionals and patients with cancer is widely recognized. Training programmes aimed at improving key communication skills are becoming increasingly available. PURPOSE To evaluate a communication skills programme delivered to 308 cancer nurses as part of degree/diploma courses. Based on previous work, it was hypothesized that a statistically significant improvement between pre- and postintervention scores would be observed. METHODS Audiotaped nursing assessments with patients were undertaken before and after the course. These were evaluated according to coverage of nine previously identified key areas of communication. RESULTS Mean postcourse scores rose by 5.9 points (P < 0.001) to 16.3 (out of a possible 27). All nine individual areas of the assessment showed statistically significant improvements postintervention (P < 0.001). The areas showing most improvement were those with a high emotional content. CONCLUSIONS This study has demonstrated that an integrated approach to communication skills training has the potential to improve nurses' skills, particularly in emotionally laden areas across the spectrum of roles in cancer care.
Depression after stroke: a review of the evidence base to inform the development of an integrated care pathway. Part 1: Diagnosis, frequency and impact

Background: Depression is a common complication of stroke, leading to increased morbidity and mortality. It can impede the process of rehabilitation, and has been associated with poorer outcomes and increased length of stay in hospital. This systematic review was undertaken as a preliminary step to explore the available evidence on which to base an integrated care pathway (ICP) for the management of post-stroke depression (PSD) in a rehabilitation setting. It is divided into two parts. Aims and objectives: In part 1 we review the frequency of depression in stroke and its impact on functional recovery. Also the different methods for diagnosis and measurement. Methods: Data sources comprised a computer-aided search of published studies on depression in stroke and references to literature used in reviews. Main findings: PSD is common and is associated with cognitive, functional and social deficits which potentially limit the outcome from rehabilitation. However, diversity of assessment tools and diagnostic criteria confound assimilation of the available literature. The Beck Depression Inventory (BDI), Hamilton Depression Rating Scale and Zung Self-rating Depression Scale were most commonly used and have demonstrable validity in stroke patients but tend to exclude those with aphasia. Instruments developed specifically to include aphasic patients, such as the Stroke Aphasic Depression Scale, are promising but have yet to be fully evaluated. Conclusions: Further work is required to adapt and evaluate instruments to measure depression in the context of stroke. Development of an integrated care pathway may help to establish a more consistent approach to assessment and diagnosis of PSD.
Function of Bovine CD46 as a Cellular Receptor for Bovine Viral Diarrhea Virus Is Determined by Complement Control Protein 1

ABSTRACT The pestivirus bovine viral diarrhea virus (BVDV) was shown to bind to the bovine CD46 molecule, which subsequently promotes entry of the virus. To assess the receptor usage of BVDV type 1 (BVDV-1) and BVDV-2, 30 BVDV isolates including clinical samples were assayed for their sensitivity to anti-CD46 antibodies. With a single exception the infectivity of all tested strains of BVDV-1 and BVDV-2 was inhibited by anti-CD46 antibodies, which indicates the general usage of CD46 as a BVDV receptor. Molecular analysis of the interaction between CD46 and the BVD virion was performed by mapping the virus binding site on the CD46 molecule. Single complement control protein modules (CCPs) within the bovine CD46 were either deleted or replaced by analogous CCPs of porcine CD46, which does not bind BVDV. While the epitopes recognized by anti-CD46 monoclonal antibodies which block BVDV infection were attributed to CCP1 and CCP2, in functional assays only CCP1 turned out to be essential for BVDV binding and infection. Within CCP1 two short peptides on antiparallel beta strands were identified as crucial for the binding of BVDV. Exchanges of these two peptide sequences were sufficient for a loss of function in bovine CD46 as well as a gain of function in porcine CD46. Determination of the size constraints of CD46 revealed that a minimum length of four CCPs is essential for receptor function. An increase of the distance between the virus binding domain and the plasma membrane by insertion of one to six CCPs of bovine C4 binding protein exhibited only a minor influence on susceptibility to BVDV.
A Test of the Efficiency of a Given Portfolio

A test for the ex ante efficiency of a given portfolio of assets is analyzed. The relevant statistic has a tractable small sample distribution. Its power function is derived and used to study the sensitivity of the test to the portfolio choice and to the number of assets used to determine the ex post mean-variance efficient frontier. Several intuitive interpretations of the test are provided, including a simple mean-standard deviation geometric explanation. A univariate test, equivalent to our multivariate-based method, is derived, and it suggests some useful diagnostic tools which may explain why the null hypothesis is rejected. Empirical examples suggest that the multivariate approach can lead to more appropriate conclusions than those based on traditional inference which relies on a set of dependent univariate statistics. Copyright 1989 by The Econometric Society.