Miracle-dz/UniFAR-FTUs huggingface dataset:
Efficacy of the ABCDE Bundle in Reducing Delirium in Critically Ill Patients: An Integrative Literature Review

Delirium is an acute dysfunction of the brain that occurs in up to eighty percent of critically ill patients which has been associated with increased morbidity, mortality and long-term cognitive deficits. In an effort to reduce symptoms associated with Intensive Care Unit (ICU) acquired delirium, leading critical care researchers created the Awakening and Breathing Coordination, Delirium Monitoring/Management and Early mobility (ABCDE) bundle (Balas et al, 2012). Through an integrative literature review, the aim of this scholarly inquiry paper is to determine the efficacy of the ABCDE bundle in reducing the incidence of delirium in critically ill patients and provide supporting recommendations for ongoing use of this clinical tool. Using PubMed, CINAHL, and Google Scholar, eight research studies of varying levels of evidence were reviewed and analyzed, including one clinical practice guideline and one systematic review. A conceptual map was created to illustrate the results of the literature review and provide future recommendations. The literature review did not provide definitive results that proved a reduction in episodes of delirium when the ABCDE bundle was implemented but patient outcomes, such as mortality and readmission rates improved, warranting consideration of the ABCDE bundle for clinical practice. Successful implementation of the ABCDE bundle requires a true interdisciplinary approach by the healthcare team and would be best implemented using an evidence-based practice (EBP) framework or model such as the Johns Hopkins Nursing Evidence-Based Practice Model. By utilizing this model, a step-by-step recommendation will be made for pilot implementation of the ABCDE bundle.
Ultra-sonografia da aorta abdominal e de seus ramos em cães

A duplex ultrasound system incorporating a pulsed wave Doppler ultrasound probe with conventional B-mode real-time imaging was used to evaluate the biometric and the hemodynamic of abdominal aorta and external iliac arteries of a hundred and thirty one normal dogs. Results of biometrics of abdominal aorta, presented a mean diameter of 0.80cm in its diaphragmatic segment (AOD); 0.74cm in its segment caudal to the renal arteries (AOR) and 0.69cm in the segment cranial to its termination (AOT). The right-external-iliac artery (AIED) presented a mean diameter of 0.42cm and the left-external iliac artery (AIEE) a mean diameter of 0.39cm. The hemodynamic study of the abdominal aorta presented a medium systolic peak velocity to AOR of 104cm per sec. ; to AOT of 99.61cm per sec. ; to AIED of 85.47cm per sec. and to AIEE of 99.51cm per sec. Correlations of different intensities between the vascular diameters have been verified between the measured points and the corporeal biometric factors (Crown Rump-Lenght). Low correlations have been observed regarding the diameters in relation to the age.
A Survey of Published Attacks on Intel SGX

Intel Software Guard Extensions (\kw{SGX}) provides a trusted execution environment (\kw{TEE}) to run code and operate sensitive data. \kw{SGX} provides runtime hardware protection where both code and data are protected even if other code components are malicious.However, recently many attacks targeting \kw{SGX} have been identified and introduced that can thwart the hardware defence provided by \kw{SGX}. In this paper we present a survey of all attacks specifically targeting Intel \kw{SGX} that are known to the authors, to date.We categorized the attacks based on their implementation details into 7 different categories.We also look into the available defence mechanisms against identified attacks and categorize the available types of mitigations for each presented attack. (Less)
Catering theory and dividend policy: A study of MENA region

Corporate dividend policy has long been an issue of interest in the financial literature, and despite the large body of research on the subject, it remains a subject open to debate. In fact, Miller and Modigliani (1961) argue that dividend policies are equivalent and there is no specific policy that can increase shareholder wealth than the perfect capital market principle. However, several researchers offered alternative explanations for dividends payout under imperfect market conditions. Despite extensive evidence in the US market on the issue, there is no definitive answer as to why investors demand dividends. In addition, businesses have become less likely to pay dividends beyond what might be expected in terms of changes in their characteristics such as size, profitability, and growth opportunities. In fact, Fama and French (2001) found that a decline in the proportion of dividends payout by US companies cannot be explained satisfactorily by changes in their characteristics. Therefore, the decision to distribute dividends is not fully explained by the individual characteristics of each company. On the international front, different authors conducted Abstract
What drives consumers repurchase intention in mobile apps An empirical study from Indonesia

: This study aims to analyze what drives consumers’ repurchase intention in a mobile application. A total of 189 Shopee buyers have participated in this online survey by filling electronic questionnaires link. Structural Equation Model - Partial Least Square (SEM-PLS) method was applied to test the collected primary data. The results proved that electronic word of mouth (e-WOM) significantly influences electronic trust (e-trust) and e-trust has a significant effect on repurchase intention.
Application of SatelliteData for Evaluating theCold Climate Performance of the Canadian Regional Climate Model over Qu ebec, Canada

This study evaluates key aspects of the snow cover, cloud cover, and radiation budget simulated by the Canadian Regional Climate Model, version 4 (CRCM4), coupled with two versions of the Canadian Land Surface Scheme (CLASS). CRCM4 coupled with CLASS version 2.7 has been used operationally at Ouranos since 2006, while, more recently, CRCM4 has been coupled experimentally with CLASS 3.5, which includes a number of improvements to the representation of snow cover processes. The simulations showed evidence of a systematic cold temperature bias. Evaluation of cloud cover and radiation fluxes with satellite data suggests this bias is related to insufficient cloud radiative forcing from a combination of underestimated cloud cover, excessive cloud albedo, and too low cloud emissivity in the model. This cold bias is reinforced by a positive snow albedo feedbackmanifest through earlier snow cover onset in the fall and early winter period. Snow albedowas found to be very sensitive to the treatment of albedo refresh but insignificantly influenced by the partitioning of solid precipitation in CLASS. This study demonstrates that atmospheric forcing can exert a significant impact on the simulation of snow cover and surface albedo. The results highlight the need to evaluate parameterizations in land surface models designed for climate models in fully coupled mode.
Microbial Ecology in Health and Disease

Background/Aims: Mechanisms by which synbiotic treatment improves liver function in patients with cirrhosis are unknown. This study was performed to address this important issue. Patients and methods: Thirty cirrhotic patients were randomized to receive synbiotic or placebo preparations for 7 days. Viable faecal counts of Lactobacillus species, Child-Pugh class, plasma retention rate of indocyanine green (ICGR15), whole blood tumour necrosis factor alpha (TNF-a) mRNA and interleukin-6 (IL-6) mRNA, serum TNF-a, soluble TNF receptor (sTNFR)I, sTNFRII and IL-6 and plasma endotoxin levels were measured preand post-treatment. Results: Synbiotic treatment was associated with significantly increased faecal lactobacilli counts and significant improvements in ICGR15 and Child-Pugh class. Significant increases in whole blood TNF-a mRNA and IL-6 mRNA, along with serum levels of sTNFRI and sTNFRII, also occurred. TNF-a and IL-6 levels correlated significantly, both at baseline and post-synbiotic treatment. Synbiotic-related improvement in ICGR15 was significantly associated with changes in IL-6, both at mRNA and protein levels, and unrelated to plasma endotoxin values. No significant changes in any study parameter followed placebo treatment. Conclusions: Short-term synbiotic treatment proven to modulate gut flora significantly improves liver function in patients with cirrhosis. Benefit is unrelated to reduction in endotoxaemia and may be mediated, at least in part, by treatment-related induction of IL-6 synthesis by TNF-a.
Tocopherol-mediated peroxidation. The prooxidant effect of vitamin E on the radical-initiated oxidation of human low-density lipoprotein

Oxidation of human low-density lipoprotein (LDL) is implicated as an initiator of atherosclerosis. α-Tocopherol (α-TocH) may thus inhibit atherosclerosis beause it is the major and most active chain-breaking antioxidant in extracted LDL lipid. Our studies show, however, that α-TocH can be a strong prooxidant for the LDL itself, i.e., an aqueous dispersion of lipid-bearing particles. Thus, a steady flux (R g ) of alkylperoxyl radicals (ROO . ) generated from a water-soluble azo initiator induced lipid peroxidation in LDL which was faster in the presence of α-TocH than in its absence (for R g <2 NM S -1 ), insensitive to R g and [O 2 ], and inhibited by vitamin C, ubiquinol-10 (normally present in fresh LDL), and small phenolic antioxidants but not inhibited by the aqueous radical scavenger uric acid
Validation of the dynamic wake meander model with focus on tower loads

This paper presents a comparison between measured and simulated tower loads for the Danish offshore wind farm Nysted 2. Previously, only limited full scale experimental data containing tower load measurements have been published, and in many cases the measurements include only a limited range of wind speeds. In general, tower loads in wake conditions are very challenging to predict correctly in simulations. The Nysted project offers an improved insight to this field as six wind turbines located in the Nysted II wind farm have been instrumented to measure tower top and tower bottom moments. All recorded structural data have been organized in a database, which in addition contains relevant wind turbine SCADA data as well as relevant meteorological data – e.g. wind speed and wind direction – from an offshore mast located in the immediate vicinity of the wind farm. The database contains data from a period extending over a time span of more than 3 years. Based on the recorded data basic mechanisms driving the increased loading experienced by wind turbines operating in offshore wind farm conditions have been identified, characterized and modeled. The modeling is based on the Dynamic Wake Meandering (DWM) approach in combination with the state-of-the-art aeroelastic model HAWC2, and has previously as well as in this study shown good agreement with the measurements. The conclusions from the study have several parts. In general the tower bending and yaw loads show a good agreement between measurements and simulations. However, there are situations that are still difficult to match. One is tower loads of single-wake operation near rated ambient wind speed for single wake situations for spacing’s around 7-8D. A specific target of the study was to investigate whether the largest tower fatigue loads are associated with a certain downstream distance. This has been identified in both simulations and measurements, though a rather flat optimum is seen in the measurements.
The effects of a yoga training program with fit ball on the physical fitness and body composition of overweight or obese women

A quasi-experimental study was to determine the effects of a yoga training program with fit ball on the physical fitness and body composition of overweight or obese women. Thirty participants were recruited in this study. The participants were aged between 30 to 45 years, and with 23.0 to 29.9 kg/m2 of BMI. The study was divided into three phases, namely, the pre-training period (the 1st week to the 8th week), training period (the 9th week to the 16th week), and home program period (the 17th week to the 24th week). The outcome measurements were physical fitness (flexibility, balance, muscular strength and muscular endurance) and body composition (weight, height, body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR), fat percentage and muscle mass). A one-way ANOVA with repeated measures and Bonferroni were used. After training period and home program period, outcome measurements showed significant improvement except in the WHR case. It was found that the results of the yoga training program with fit ball increased after the 16th week and the 24th week. The physical fitness increased as follows: flexibility, balance, muscular strength and muscular endurance (p=0.001**). More importantly, the body composition decreased: the weight (p=0.001**); the BMI (p=0.001*); waist circumference (WC) (p=0.001*); waist-hip ratio (WHR) (p= 1.000); fat percentage (p=0.001**); and the muscular muscle mass increased (p=0.001*). Therefore, the eight-week training of yoga with fit ball can improve some parameters of physical fitness and body composition in overweight or obese women.
Cepaea nemoralis (L.) in Göteborg, S.W. Sweden: variation in a recent urban invader

Although present since the mid 19th century, the introduced snail species Cepaea nemoralis has spread extensively in Goteborg, mainly in the last two decades. Early samples show the predominance of yellow-shelled morphs, but in modern populations pink shells predominate. There is great variation in morph frequencies among modern populations with high values of FST, and with no relationships to habitat. The patterns shown resemble those seen in Sheffield (UK), a city also colonised over a similar time period, but differ from those seen in regions where the species has been established for much longer. The combination of early and recent records suggests not only that founder effects play a large part in determining morph frequencies, but that present populations derive from multiple colonisations from different sources. key woRDs: Cepaea nemoralis, polymorphism, invasion, Goteborg
Athletic heart adaptation, pathological hypertrophy and sudden cardiac death

Cardiac hypertrophy has been continuing as the subject of the ‘hottest’ topic in research field for a long time since it creates pathophysiologic and clinical issues by structural and functional alterations of heart. Probably, it is explained by the prevalence of cardiovascular disorders in all-cause mortality. It seems that, on the basis of a contemporary data, the perception of ‘benign’ nature of the cardiac hypertrophy in athletic population is blurred. The improvement of imaging modalities and assessment tools largely contributed to comprehensive integration of scientific and clinical standpoints of athletic hypertrophy. Conventionally pathologic hypertrophy believed to be developed in a case of cardiovascular diseases, while the athlete’s heart resulted by long-standing physical training. According to recent evidence, a gray zone of hypertrophy became emerged between physiological and pathological entities, which require further extensive investigations. The emerging huge challenges in sports cardiology are overtraining and doping abuse of elite athletes by the development of an excessive cardiac hypertrophy with the increased risk of cardiovascular adverse outcomes. Additionally, the higher prevalence of sudden cardiac death in sportsmen compared to sedentary matches, especially in case of athletes with known or suspected cardiovascular diseases necessitated scrupulous investigation of athletic heart syndrome. The development, variety and severity of cardiac hypertrophy fluctuate by sportive branch and training mode. The significance of problem is more emphasized when cohort studies represented survival differences by means of cardiovascular parameters between athletes and sedentary subjects and cardiac patients. In this review, we aimed to represent recent physiological and clinical standpoints regarding to athletic heart syndrome as well as its difference from sedentary heart changes and pathological hypertrophy, its association with sudden cardiac death.
Pain Outcomes with an Elliptical Regimen (POWER) Study: Identifying the Proper Dosage of Exercise for Therapeutic Effect in Persons with Chronic Back Pain

Background context: Exercise therapy for low back pain has long been prescribed as one of the initial remedies for back pain. Traditional therapy is completed under a therapist’s supervision and consists of lumbar stabilization, aerobic exercise and stretching exercises. Recent studies have explored treating back pain with aerobic exercise such as walking which can be done anywhere and without supervision which is lower cost and easily administered. Purpose: To assess a therapeutic dosage of aerobic exercise that is associated with pain reduction in persons experiencing low back pain. Study design: Case series. Participant description: Sixteen patients entered the study and twelve patients completed the study (mean ± SD: age 51 ± 11 years; weight 89.2 ± 16 kg). Subjects were included if they were ages 18–65, had chronic back pain lasting for more than 3 months and a score of greater than 30% on the Oswestry Low Back Disability Questionnaire. Methods: Subjects underwent a six-week exercise program using the elliptical trainer three times each week. Exercise duration was steadily increased each week for the length of the study. The total cumulative amount of work that coincided with significant reductions in chronic low back pain was then identified. Results: At 4 weeks, pain scores were significantly reduced from baseline (3.2 vs 4.7, p<0.0001). This significant pain reduction corresponded to an average of 30.8 Kcal/kg of body mass in cumulative work performed. Pain was significantly reduced by 21% and 32% on the Oswestry Questionnaire and the PROMIS 29 respectively. Conclusions: These pilot findings suggest that approximately 30.8 kcal/Kg of accumulated physiological work is a therapeutic “dosage” of exercise needed for significant reduction in chronic back pain. Clinicians can begin to use this benchmark for their oversight of rehabilitation programs to determine if an exercise program has been sufficiently intense and long enough in duration for managing their patients with chronic low back pain.
Characterizing source fingerprints and ageing processes in Potential Aerosol Mass (PAM) SOA experiments using proton-nuclear m

The study of secondary organic aerosol (SOA) in laboratory settings has greatly increased our knowledge of the diverse chemical processes and environmental conditions responsible for the formation of particulate matter starting from biogenic and anthropogenic volatile compounds. However, characteristics of the different experimental setups and the way they impact the composition and the timescale of formation of SOA are still subject to debate. In this study, SOA samples were generated using a Potential Aerosol Mass 20 (PAM) oxidation flow reactor using -pinene, naphthalene and isoprene as precursors. The PAM reactor facilitated exploration of SOA composition over atmospherically-relevant photochemical aging time scales that are unattainable in environmental chambers. The SOA samples were analyzed using two state-of-the-art analytical techniques for SOA characterization proton nuclear magnetic resonance (H-NMR) spectroscopy and HPLC determination of humic-like substances (HULIS). Results were compared with previous Aerodyne 25 aerosol mass spectrometer (AMS) measurements. The combined H-NMR, HPLC, and AMS datasets show that the composition of the studied SOA systems tend to converge to highly oxidized organic compounds upon prolonged OH exposures. Further, our H-NMR findings show that only -pinene SOA acquire spectroscopic features comparable to those of ambient OA when exposed to at least 1*10 molec OH /cm*s OH exposure, or multiple days of equivalent atmospheric OH oxidation. Over multiple days of equivalent 30 OH exposure, the formation of HULIS is observed in both -pinene SOA and in naphthalene SOA (maximum yields: 16% and 30%, respectively, of total analyzed WSOC), providing evidence of the formation of humiclike polycarboxylic acids in unseeded SOA.
High School Students’ Misbehaviors and the Principal’s Role – A Qualitative Approach

This study investigates the high school principal’s role in the students’ misbehavior. The findings indicated that this role is a central one, as principals in secondary education are called to design, inspire and implement strategies and policies effectively. Furthermore, it was concluded that both the contribution of the state with training, funding, and a well defined legislative context, and the harmonious cooperation between principals and the Teachers’ and Parents’ Associations is crucial, for this principals’ role to be successfully fulfilled.
Anthropogenic effects on winter behavior of ferruginous hawks

Little information is known about the ecology of ferruginous hawks (Buteo regalis) in winter versus the breeding season and less about how the species adapts to fragmented grassland habitats. Accordingly, we studied the behavior of 38 radiotagged ferruginous hawks during 3 winters from 1992 to 1995. We used 2 adjacent sites in Colorado that were characterized by low and high levels of anthropogenic influence and habitat fragmentation: the Rocky Mountain Arsenal National Wildlife Refuge (RMANWR; low-level influence), and several adjacent Denver suburbs (high-level influence). Relative abundance of ferruginous hawks differed by treatment area and year (P 0.05) at RMANWR and suburban sites. Ferruginous hawks appear to modify their behavior in fragmented, largely human-altered habitats, provided some foraging habitats with adequate populations of suitable prey species are present.
Comparison of generalized non-data-driven lake and reservoir routing models for global-scale hydrologic forecasting of reservoir outflow at diurnal time steps

Abstract. Large-scale hydrologic forecasts should account for attenuation through lakes and reservoirs when flow regulation is present. Globally generalized methods for approximating outflow are required but must contend with operational complexity and a dearth of information on dam characteristics at global spatial scales. There is currently no consensus on the best approach for approximating reservoir release rates in large spatial scale hydrologic forecasting, particularly at diurnal time steps. This research compares two parsimonious reservoir routing methods at daily steps: Döll et al. (2003) and Hanasaki et al. (2006). These reservoir routing methods have been previously implemented in large-scale hydrologic modeling applications and have been typically evaluated seasonally. These routing methods are compared across 60 reservoirs operated by the U.S. Army Corps of Engineers. The authors vary empirical coefficients for both reservoir routing methods as part of a sensitivity analysis. The method proposed by Döll et al. (2003) outperformed that presented by Hanasaki et al. (2006) at a daily time step and improved model skill over most run-of-the-river conditions. The temporal resolution of the model influences model performances. The optimal model coefficients varied across the reservoirs in this study and model performance fluctuates between wet years and dry years, and for different configurations such as dams in series. Overall, the method proposed by Döll et al. (2003) could enhance large-scale hydrologic forecasting, but can be subject to instability under certain conditions.