Miracle-dz/UniFAR-FTUs huggingface dataset:
Predictors of inappropriate hospital days in a department of internal medicine.

BACKGROUND This study aimed to identify predictors of inappropriate hospital days in a department of internal medicine, as a basis for quality improvement interventions. METHODS The appropriateness of 5665 hospital days contributed by 500 patients admitted to the Department of Internal Medicine, Geneva University Hospitals, Switzerland, was assessed by means of the Appropriateness Evaluation Protocol. Predictor variables included patient's age and sex, manner of admission and discharge, and characteristics of hospital days (weekend, holiday, sequence). RESULTS Overall, 15% of hospital admissions and 28% of hospital days were rated as inappropriate. In multivariate models, inappropriate hospital days were more frequent among patients whose admission was inappropriate (odds ratio [OR] = 5.3, 95% CI: 3.1-8.4) and among older patients (80-95 years: OR = 3.6, 95% CI: 1.7-7.0, versus <50 years). The likelihood of inappropriateness also increased with each subsequent hospital day, culminating on the day of discharge, regardless of the total length of stay. CONCLUSIONS This study identified both the admission and the discharge processes as important sources of inappropriate hospital use in a department of internal medicine. The oldest patients were also at high risk of remaining in the hospital inappropriately. Surprisingly, long hospital stays did not generate a higher proportion of inappropriate days than short hospital stays. This information proved useful in developing interventions to improve the hospitalization process.
Reducing PICU Central Line–Associated Bloodstream Infections: 3-Year Results

OBJECTIVES: To evaluate the long-term impact of pediatric central line care practices in reducing PICU central line–associated bloodstream infection (CLA-BSI) rates and to evaluate the added impact of chlorhexidine scrub and chlorhexidine-impregnated sponges. METHODS: A 3-year, multi-institutional, interrupted time-series design (October 2006 to September 2009), with historical control data, was used. A nested, 18-month, nonrandomized, factorial design was used to evaluate 2 additional interventions. Twenty-nine PICUs were included. Two central line care bundles (insertion and maintenance bundles) and 2 additional interventions (chlorhexidine scrub and chlorhexidine-impregnated sponges) were used. CLA-BSI rates (January 2004 to September 2009), insertion and maintenance bundle compliance rates (October 2006 to September 2009), and chlorhexidine scrub and chlorhexidine-impregnated sponge compliance rates (January 2008 to June 2009) were assessed. RESULTS: The average aggregate baseline PICU CLA-BSI rate decreased 56% over 36 months from 5.2 CLA-BSIs per 1000 line-days (95% confidence interval [CI]: 4.4–6.2 CLA-BSIs per 1000 line-days) to 2.3 CLA-BSIs per 1000 line-days (95% CI: 1.9–2.9 CLA-BSIs per 1000 line-days) (rate ratio: 0.44 [95% CI: 0.37–0.53]; P < .0001). No statistically significant differences in CLA-BSI rate decreases between PICUs using or not using either of the 2 additional interventions were found. CONCLUSIONS: Focused attention on consistent adherence to the use of pediatrics-specific central line insertion and maintenance bundles produced sustained, continually decreasing PICU CLA-BSI rates. Additional use of either chlorhexidine for central line entry scrub or chlorhexidine-impregnated sponges did not produce any statistically significant additional reduction in PICU CLA-BSI rates.
Financial Determinants of Cash Holding Levels: An Analysis of Indian Agricultural Enterprises

A significant number of studies have been conducted on the determinants of cash holding levels for different corporates. However, no such study has been witnessed so far on the agricultural enterprises. In this study, we examine the determinants of the cash-holding levels for the Indian agrarian enterprises during 1995–2016 period. With the help of weighted least-squares (WLS) regression analysis, we find evidence that the Indian agro-enterprises with greater lucrative opportunities tend to hold less cash. On the other side, we found that large agro-enterprises tend to hold some other mode of liquid assets rather than cash. The firms with higher capital expenditure and distributing profits as a dividend were shown to hold more cash. In our analysis, we find supportive evidence of the static trade-off theory of cash holding. In general, transaction motives and precautionary motives also play an important role in explaining the determinants of cash holding levels for Indian agrarian enterprises.
A 12-Year Experience With Chimney and Periscope Grafts for Treatment of Type I Endoleaks

Purpose: To evaluate the midterm outcomes of chimney and/or periscope grafts (CPGs) in patients presenting type I endoleak after a previous endovascular aneurysm repair (EVAR). Methods: Between June 2002 and April 2014, 24 consecutive patients (mean age 73.9±9.2 years; 23 men) presenting a type I endoleak were addressed with CPGs to extend the proximal and/or distal landing zone and to maintain side branch perfusion. Indication for treatment was a type Ia endoleak in 23 (96%) patients and a type Ib endoleak in one. Median interval from the previous EVAR to endoleak treatment with CPGs was 52.2±48.9 months (range 0.2–179). All patients had proximal/distal landing zones precluding any standard endovascular reintervention. Measured outcomes included technical success and perioperative mortality and morbidity. Technical success was defined as a procedure completed as intended, with no secondary procedures within 30 days. Midterm outcomes included survival, CPG patency, endoleaks, and freedom from reintervention. Results: Technical success was 96%; a single patient required an additional procedure to seal a recurrent type Ia endoleak. Intraoperative revascularization of all 55 target vessels (2.3/patient) with CPGs was successful. One (4%) patient died within 30 days. Estimated survival at 12, 24, and 36 months was 83%; estimated CPG patency at the same intervals was 94%. Over a mean follow-up of 23.4±29 months, 6 (25%) reinterventions were performed; of these, 4 were secondary to type I endoleak. Aneurysm diameters reduced from 88.3±26 to 85.5±33 mm (p=0.49) over the mean follow-up. Conclusion: The CPG technique is a safe and effective tool for treatment of type I endoleak after previous EVAR. The CPG technique is feasible even in nonelective patients, with excellent outcomes in terms of patency. Close imaging follow-up is warranted to rule out recurrent or de novo endoleaks.
Spherical outdoor to indoor power spectrum model at the mobile terminal

Mobile terminals are often used indoor with the base station outdoors. At the mobile terminal the major part of the signal energy comes through openings in the building such as windows. Typically, only one of the sides in a room has windows, and seldom does a room have windows on all sides. Hence, the dominating signal can be expected to arrive at the mobile terminal from a narrow range of angles. Mobile terminal antennas used next to the head in the speaking position will be directional due to the fact that part of the radiation pattern facing the head will be attenuated and reflected. Having a directive antenna in a directive environment, the performance will depend on the orientation of the antenna in the radio environment. A new statistical spherical outdoor to indoor power spectrum model has been proposed to be able to calculate the directional performance of mobile terminals with a single or multiple antennas. The model consists of a major scattering area in one direction and more uniformly distributed minor scatterers in the other directions. A verification of the proposed model was performed and 60 data sets of spherical power spectrum measurements were collected in a typical urban environment. Using the new model, the directional performance of mobile terminal antennas including a human operator has been investigated through directional mean effective gain, branch power ratio, and correlation calculations using spherical radiation pattern measurements of a mobile terminal including the effect of 42 different persons. The accuracy of the calculated values was verified by directly measured values using 200 persons walking with the mobile terminal in the same office-like environments as where the spherical power spectrum measurements were performed.
Haemophilia; Pattern of Clinical Presentation and Disease Severity

Objective: To observe pattern of clinical presentation in patients of Hemophilia A and B. Materials and Methods: Fifty one patients of Haemophilia A and B were evaluated on the basis of Pa- tients demographic data, history (family, medication, past) and parameters like age, clinical features (pallor, number of joint involved, ankylosis and pain). Blood complete picture, Coagulation screening tests, bleeding time, PT, APTT, mixing studies and factor assays were documented. Results: In total of fifty one patients, twenty two (43.13%) had severe degree of disease (<1% factor concentrate), while 19(37.2%) patients were diagnosed to have moderate degree of disease (factor con- centrate 1-5%) and 10 (19.6%) had mild disease (factor concentrate 5-50%). Patients having severe dis- ease were diagnosed earlier than those having moderate and mild disease, and had frequent episodes of bleeding in soft tissues, joints, muscles etc. Conclusion: Pattern of clinical presentation helps to categories the haemophilia patients as having mild, moderate or severe degree of disease
Polyphosphate in Trichodesmium from the low‐phosphorus Sargasso Sea

Polyphosphate (polyP) is often considered to be the product of luxury uptake in areas of excess phosphorus (P), but can also accumulate in P‐depleted cells in response to P resupply. To test the hypothesis that polyP is present in phytoplankton from oligotrophic systems, the marine diazotroph Trichodesmium was collected from the low‐P surface waters of the Sargasso Sea and assayed with solid‐state 31P nuclear magnetic resonance spectroscopy. Up to 25% of Trichodesmium cellular P was characterized as polyP, despite physiological data that indicated the colonies were P deplete. This was consistent with culture studies where there were high percentages of polyP under P‐deplete conditions. All Trichodesmium species examined had the genetic machinery to produce and degrade polyP. Trends in the amount of Trichodesmium polyP along the cruise transect showed that allocation of P to polyP was consistently high, and that the ratio of polyP : carbon varied with changes in temperature and mixed‐layer depth. It may be that Trichodesmium was taking advantage of pulses in P supply, and that polyP is a physiological fingerprint of this variability. Additionally, if polyP formation is a common trait in phytoplankton, polyP released from cells could be an additional bioavailable component of the dissolved organic P pool. Taken together, this study highlights the importance of polyP to P cycling and cellular P allocation even in oligotrophic regions.
Definition of retrosternal thyroid growth

The diagnosis of a retrosternal thyroid growth (RTG) causes extended surgical exploration and a different surgical treatment planning (partial sternotomy, thoracotomy) and is usually made by the help of thyroid scintigraphy and ultrasonography. But both examinations have problems in determining the retrosternal thyroid extend in the complex anatomy of sternal bone and often pathologically altered manubrioclavicular joints (MCJ). This study evaluates the variation of anatomical structures in the upper sternal region, the position of the sternal markers during scintigraphy, and the frequency of enhanced bone metabolism of the MCJs. For this aim, the positions of the upper edges of the MCJs were measured by X-ray fluoroscopy in 50 consecutive patients. To prove the exactness of an external marker as used in thyroid scintigraphy, the variation of the marker position was also determined. The activity in the MCJs was measured semiquantitatively with bone scintigraphy in further 100 patients (mean age: 62.3 yrs, SD: 14.2 yrs). As results, the upper edges of the medial clavicular edges exceed the upper margin of the sternal edge up to 2.7 cm. The distance between the medial clavicular edges ranged from 2.3 - 5.6 cm. The position of the sternal marker was correct in the horizontal deviation (mean: 0.1 cm, SD: 0.48 cm) but too high in the vertical position (mean: 2.2 cm, SD: 0.67 cm). During bone scintigraphy, the MCJs showed no enhanced activitity in 75/200 joints, medium activity in 96/200 joints, and strong enhanced activity in 29/200 joints. In consequence, a high variability in the position of the anatomical structures has to be considered together with a high amount of degenerative alterations. The position of the sternal marker was inappropriate in the vertical direction and overestimated a possible retrosternal growth.
Chlorpromazine‐induced anticardiolipin antibodies and lupus anticoagulant: Absence of thrombosis

Anticardiolipin antibodies were determined in 96 psychiatric patients treated chronically with chlorpromazine by an enzyme‐linked Immunosorbent assay using anti‐IgM and anti‐IgG (fab'2 fragment) as the second antibody. Fifty‐four of these patients had an IgM‐lupus anticoagulant, and the remaining 42 were followed as controls. Elevated IgM‐anticardiolipin antibodies (ACA) levels were detected in 31 patients with the lupus anticoagulant and in 5 controls (p<0.001). During a median followup of 5 years, single episodes of deep vein thrombosis or pulmonary embolism occurred in three patients; one had the lupus anticoagulant and the other two had low‐level ACA. Contrary to the reported experience in systemic lupus erythematosus and related autoimmune disorders, chlorpromazine‐induced lupus anticoagulant and anticardiolipin antibodies levels appear not to be associated with an increased incidence of thrombosis.
ECOLOGY AND MANAGEMENT OF ARUNDO DONAX , AND APPROACHES TO RIPARIAN HABITAT RESTORATION IN SOUTHERN CALIFORNIA

By far the greatest threat to the dwindling riparian resources of coastal southern California is the alien grass species known as Arundo donax. Over the last 25 years the riparian forests of coastal southern California have become infested with A. donax which has spread by flood-fragmentation and dispersal of vegetative propagules. Arundo donax dramatically alters the ecological/successional processes in riparian systems and ultimately moves most riparian habitats towards pure stands of this alien grass. By current estimates there are tens of thousands of acres of A. donax along the major coastal drainage systems of southern California, including the Santa Ana, Santa Margarita, Ventura, Santa Clara, San Diego, and San Luis Rey rivers. The removal of A. donax from these systems provides numerous downstream benefits in terms of native species habitat, wildfire protection, water quantity and water quality.
Le phénomène campaniforme : structures biologiques et intégration historique

On propose une synthese globale de l'anthropologie physique du complexe campaniforme, basee sur une approche utilisant des methodes multivariees. On s'occupe essentiellement du probleme controverse d'une eventuelle concomitance entre des faits culturels et l'existence d'un type humain particulier. On aboutit aux conclusions suivantes: 1) Il existe effectivement une humanite «campaniforme» largement associee aux manifestations culturelles. 2) Elle n'est rattachable a aucun substrat local rencontre dans l'aire de repartition examinee. 3) Son origine est tres probablement a chercher en Europe du Sud-Est, en liaison avec l'expansion des civilisations des Kourganes. 4) Dans une zone qualifiee de nucleaire (Europe centrale), elle forme des populations (sensu stricto) homogenes qui ne se melangent pas avec le substrat. 5) Dans la peripherie son impact biologique est presque partout decelable, mais il s'opere selon diverses modalites, avec ou sans metissage. 6) Au Bronze ancien, l'humanite campaniforme s'eclipse totalement dans presque toutes les regions.
A Randomized Trial of Palliative Care Discussions Linked to an Automated Early Warning System Alert

Objective: To determine whether an Early Warning System could identify patients wishing to focus on palliative care measures. Design: Prospective, randomized, pilot study. Setting: Barnes-Jewish Hospital, Saint Louis, MO (January 15, 2015, to December 12, 2015). Patients: A total of 206 patients; 89 intervention (43.2%) and 117 controls (56.8%). Interventions: Palliative care in high-risk patients targeted by an Early Warning System. Measurements and Main Results: Advanced directive documentation was significantly greater prior to discharge in the intervention group (37.1% vs 15.4%; p < 0.001) as were first-time requests for advanced directive documentation (14.6% vs 0.0%; p < 0.001). Documentation of resuscitation status was also greater prior to discharge in the intervention group (36.0% vs 23.1%; p = 0.043). There was no difference in the number of patients requesting a change in resuscitation status between groups (11.2% vs 9.4%; p = 0.666). However, changes in resuscitation status occurred earlier and on the general medicine units for the intervention group compared to the control group. The number of patients transferred to an ICU was significantly lower for intervention patients (12.4% vs 27.4%; p = 0.009). The median (interquartile range) ICU length of stay was significantly less for the intervention group (0 [0–0] vs 0 [0–1] d; p = 0.014). Hospital mortality was similar (12.4% vs 10.3%; p = 0.635). Conclusions: This study suggests that automated Early Warning System alerts can identify patients potentially benefitting from directed palliative care discussions and reduce the number of ICU transfers.
The Outcome of Training Community Psychiatric Nurses to Deliver Psychosocial Intervention

Background. A prospective quasi-experimental design was used to evaluate the effect of training CPNs to undertake psychosocial intervention with families caring for a relative with schizophrenia. Method. Patients meeting predetermined criteria were allocated to either an initial waiting-list control group or a delayed intervention group. The CPNs were trained to offer family interventions to a total target group of 48. Treatment was eventually accepted by 85%, of whom 81 % (n = 34) were followed-up for 12 months. Families received a weekly mean session of 47 minutes (compared with 33 minutes in the controls). The main outcome measures are frequency and severity of symptoms (KGV), social functioning (SFS) and days in hospital. Carers' minor psychiatric morbidity (GHQ) and knowledge (KASI) are also reported. Results. In the patient group both the positive and negative symptoms of schizophrenia improved significantly (P ≤ 0.001 and P ≤ 0.01 respectively) to 12-month follow-up, as did a global measure of social functioning (P ≤ 0.001). Tentative evidence was also collected that family intervention reduced in-patient episodes. Benefits for relatives included a decrease in minor psychiatric morbidity (P ≤ 0.05) and an increase in knowledge about neuroleptic drugs (P ≤ 0.001). Conclusions. The study offers some evidence that CPNs can be taught to improve the outcome for families who care for a relative with schizophrenia.
The BEM-FDM model of thermal processes proceeding in the domain of the human finger.

PURPOSE The problem of the numerical modeling of thermal processes proceeding in the non-homogeneous domain of the human finger is discussed. The domain considered constitutes the assembling of soft and bone tissues and the system of supplying blood vessels (arteries and veins). The mathematical description of the process analyzed corresponds to the so-called vascular models. METHODS At the stage of numerical modeling the algorithm being the composition of the boundary element method (BEM) and the finite difference method (FDM) is applied. RESULTS The algorithm presented allows one to determine the steady state temperature field in the finger domain in natural convection conditions. To verify the effectiveness and exactness of the method of the problem solution, the thermal imaging measurements of the finger surface temperature have been done. CONCLUSIONS The compatibility of numerical and experimental results (the natural convection conditions) has proved to be quite satisfactory. It is possible to use the algorithm proposed for the modeling of thermal processes proceeding in the conditions of low or high ambient temperatures and the big values of heat transfer coefficients. The impact of protective clothing on the temperature field in the domain of the finger can also be analyzed.
Therapeutic Role of 5‐HT1A Receptors in The Treatment of Schizophrenia and Parkinson's Disease

5‐HT1A receptors have long been implicated in the pathogenesis and treatment of anxiety and depressive disorders. Recently, several lines of studies have revealed new insights into the therapeutic role of 5‐HT1A receptors in treating schizophrenia and Parkinson's disease. Specifically, 5‐HT1A receptors seem to be a promising target for alleviating antipsychotic‐induced extrapyramidal side effects (EPS) and cognitive/affective disorders in schizophrenia. In the treatment of patients with Parkinson's disease, 5‐HT1A agonists are expected to improve not only affective symptoms (e.g., anxiety and depression), but also the core parkinsonian symptoms as well as antiparkinsonian agents‐induced side effects (e.g., L‐DOPA‐induced dyskinesia). Here, the therapeutic mechanisms mediated by 5‐HT1A receptors in schizophrenia and Parkinson's disease are reviewed. This evidence should encourage discovery of new 5‐HT1A ligands, which can resolve the unmet clinical needs in the current therapy.
Support vector learning

Foreword The Support Vector Machine has recently been introduced as a new technique for solving various function estimation problems, including the pattern recognition problem. To develop such a technique, it was necessary to rst extract factors responsible for future generalization, to obtain bounds on generalization that depend on these factors, and lastly to develop a technique that constructively minimizes these bounds. The subject of this book are methods based on combining advanced branches of statistics and functional analysis, developing these theories into practical algorithms that perform better than existing heuristic approaches. The book provides a comprehensive analysis of what can be done using Support Vector Machines, achieving record results in real-life pattern recognition problems. In addition, it proposes a new form of nonlinear Principal Component Analysis using Support Vector kernel techniques, which I consider as the most natural and elegant way for generalization of classical Principal Component Analysis. In many ways the Support Vector machine became so popular thanks to works of Bernhard Schh olkopf. The work, submitted for the title of Doktor der Naturwis-senschaften, appears as excellent. It is a substantial contribution to Machine Learning technology.
Ecological associations of alcohol outlets with underage and young adult injuries.

OBJECTIVE This paper argues that associations between rates of 3 specific problems related to alcohol (i.e., accidents, traffic crashes, and assaults) should be differentially related to densities of alcohol outlets among underage youth and young adults based upon age-related patterns of alcohol outlet use. METHODS Zip code-level population models assessed local and distal effects of alcohol outlets upon rates of hospital discharges for these outcomes. RESULTS Densities of off-premise alcohol outlets were significantly related to injuries from accidents, assaults, and traffic crashes for both underage youth and young adults. Densities of bars were associated with more assaults and densities of restaurants were associated with more traffic crash injuries for young adults. CONCLUSIONS The distribution of alcohol-related injuries relative to alcohol outlets reflect patterns of alcohol outlet use.