Miracle-dz/UniFAR-FTUs huggingface dataset:
Clinical Predictors of Mortality in Prehospital Distress Calls by Emergency Medical Service Subscribers

(1) Introduction: Most studies rely on in-hospital data to predict cardiovascular risk and do not include prehospital information that is substantially important for early decision making. The aim of the study was to define clinical parameters in the prehospital setting, which may affect clinical outcomes. (2) Methods: In this population-based study, we performed a retrospective analysis of emergency calls that were made by patients to the largest private emergency medical services (EMS) in Israel, SHL Telemedicine Ltd., who were treated on-site by the EMS team. Demographics, clinical characteristics, and clinical outcomes were analyzed. Mortality was evaluated at three time points: 1, 3, and 12 months’ follow-up. The first EMS prehospital measurements of the systolic blood pressure (SBP) were recorded and analyzed. Logistic regression analyses were performed. (3) Results: A total of 64,320 emergency calls were included with a follow-up of 12 months post index EMS call. Fifty-five percent of patients were men and the mean age was 70.2 ± 13.1 years. During follow-up of 12 months, 7.6% of patients died. Age above 80 years (OR 3.34; 95% CI 3.03–3.69, p < 0.005), first EMS SBP ≤ 130 mm Hg (OR 2.61; 95% CI 2.36–2.88, p < 0.005), dyspnea at presentation (OR 2.55; 95% CI 2.29–2.83, p < 0001), and chest pain with ischemic ECG changes (OR 1.95; 95% CI 1.71–2.23, p < 0.001) were the highest predictors of 1 month mortality and remained so for mortality at 3 and 12 months. In contrast, history of hypertension and first EMS prehospital SBP ≥ 160 mm Hg were significantly associated with decreased mortality at 1, 3 and 12 months. (4) Conclusions: We identified risk predictors for all-cause mortality in a large cohort of patients during prehospital EMS calls. Age over 80 years, first EMS-documented prehospital SBP < 130 mm Hg, and dyspnea at presentation were the most profound risk predictors for short- and long-term mortality. The current study demonstrates that in prehospital EMS call settings, several parameters can be used to improve prioritization and management of high-risk patients.
Addressing Sustainable Apparel Design Challenges With Problem-Based Learning

As consumers' social and environmental concerns have grown in the last decade, so has interest in eco-fashion. Behind fast-changing fashion trends, the apparel industry generates substantial environmental and resource depletion problems throughout the textile lifecycle. To respond to these trends, fashion designers and merchandisers have been motivated to practice sustainability in design and production. Some sustainable options are available, such as organic fibers and environmentally safe dyes. Still, there are challenges for apparel designers and merchandisers when trying to realize sustainability. To help undergraduate apparel students learn problem-solving approaches to sustainable garment design, a problem-based learning project was created and implemented in an undergraduate design course. In the course, students designed and produced an original sustainable garment. Student feedback following the project was largely positive, with most students indicating they would continue using sustainable practices in future work.
How much time is enough? Sentinel lymph node mapping time depends on the radiotracer agent

In 2014, technetium‐99m tilmanocept (TcTM) replaced technetium‐99m sulfur colloid (TcSC) as the standard lymphoscintigraphy (LS) mapping agent in melanoma patients undergoing sentinel lymph node biopsy (SLNB). The aim of this study was to examine differences in mapping time, intra‐operative identification of sentinel lymph node (SLN), and false negative rate (FNR) between patients who underwent SLNB with TcTM compared to TcSC.
Direct molecular evidence for both multicentric and monoclonal carcinogenesis followed by transdifferentiation from hepatocellular carcinoma to cholangiocarcinoma in a case of metachronous liver cancer

Frequent recurrence is a major issue in liver cancer and histological heterogeneity frequently occurs in this cancer type. However, it has remained elusive whether such cancers are multicentric or monoclonal. To elucidate the clonal evolution of hepatocellular carcinoma (HCC) recurrence and combined hepatocellular-cholangiocarcinoma (cHCC-CCA) development, the somatic mutation frequency and signatures in a patient with triple occurrence of liver cancer every three years were examined, with samples designated as #1HCC, #2HCC and #3cHCC-CCA, respectively. A total of four tumor regions, including HCC (#3HCC) and intrahepatic CCA (#3iCCA) components of #3cHCC-CCA, and three nontumor regions (#1N, #2N and #3N) were precisely dissected from formalin-fixed paraffin-embedded tissues of each surgical specimen. DNA was extracted and subjected to tumor-specific somatic mutation determination. Of note, five nonsynonymous single-nucleotide variants (SNVs), namely those of KMT2D, TP53, DNMT3A, PKHD1 and TLR4, were identified in #3cHCC-CCA. All five SNVs were detected in both #3HCC and #3iCCA and #2HCC but not in #1HCC. The telomerase reverse transcriptase (TERT) promoter mutation C228T, but not C250T, was observed in all tumors. Digital PCR of C228T also indicated the presence of the TERT promoter mutation C228T in nontumorous liver tissues (#1N, #2N and #3N) at a frequency of 0.11–0.83% compared with normal liver and blood samples. These results suggest the following phylogenetic evolution of three metachronous liver cancers: #1HCC was not related to #2HCC, #3HCC and #3iCCA; both #3HCC and #3iCCA arose from #2HCC. From the above, three novel findings were deduced: i) Both multicentric occurrence and intrahepatic metastasis may be involved in liver cancer in a three-year interval; ii) transdifferentiation from HCC to iCCA is a possible pathogenic mechanism of cHCC-CCA; and iii) a nontumorous, noncirrhotic liver may contain a preneoplastic region with a cancer driver mutation in the TERT promoter.
A high performance pneumatic braking system for heavy vehicles

Current research into reducing actuator delays in pneumatic brake systems is opening the door for advanced anti-lock braking algorithms to be used on heavy goods vehicles. However, these algorithms require the knowledge of variables that are impractical to measure directly. This paper introduces a sliding mode braking force observer to support a sliding mode controller for air-braked heavy vehicles. The performance of the observer is examined through simulations and field testing of an articulated heavy vehicle. The observer operated robustly during single-wheel vehicle simulations, and provided reasonable estimates of surface friction from test data. The effect of brake gain errors on the controller and observer are illustrated, and a recursive least squares estimator is derived for the brake gain. The estimator converged within 0.3 s in simulations and vehicle trials.
Examining depression care outcomes at community health centers serving larger lesbian, gay, and bisexual patient populations: Do rural vs. urban disparities exist?

Abstract Introduction: Little is understood about the quality of services at community health centers (CHCs) serving larger lesbian, gay, and bisexual (LGB) patient populations. This study examined process of care outcomes for depression care among CHCs serving larger LGB patient populations, comparing rural and urban CHCs. Methods: Multivariate regression models were estimated on a propensity score matched analytic sample of 518 CHCs spanning 2016-2018. Results: CHCs serving larger LGB patient populations were more likely to have better process of care outcomes for depression care. However, among CHCs serving larger LGB patient populations, rural and urban CHCs provided functionally equivalent outcomes for depression screening and follow-up care. Conclusion: Among CHCs serving comparatively large LGB patient populations, traditional behavioral health care disparities based on patient population rurality may not exist for depression care.
Akt Plays Differential Roles during the Life Cycles of Acute and Persistent Murine Norovirus Strains in Macrophages

Human noroviruses (HNoV) are a leading cause of viral gastroenteritis, resulting in high annual economic burden and morbidity, yet there are no small-animal models supporting productive HNoV infection or robust culture systems producing cell culture-derived virus stocks. As a result, research on drug discovery and vaccine development against norovirus infection has been challenging, and no targeted antivirals or vaccines against HNoV are approved. ABSTRACT Akt (protein kinase B) is a key signaling protein in eukaryotic cells that controls many cellular processes, such as glucose metabolism and cell proliferation, for survival. As obligate intracellular pathogens, viruses modulate host cellular processes, including Akt signaling, for optimal replication. The mechanisms by which viruses modulate Akt and the resulting effects on the infectious cycle differ widely depending on the virus. In this study, we explored the effect of Akt serine 473 phosphorylation (p-Akt) during murine norovirus (MNV) infection. p-Akt increased during infection of murine macrophages with acute MNV-1 and persistent CR3 and CR6 strains. Inhibition of Akt with MK2206, an inhibitor of all three isoforms of Akt (Akt1/2/3), reduced infectious virus progeny of all three virus strains. This reduction was due to decreased viral genome replication (CR3), defective virus assembly (MNV-1), or altered cellular egress (CR3 and CR6) in a virus strain-dependent manner. Collectively, our data demonstrate that Akt activation increases in macrophages during the later stages of the MNV infectious cycle, which may enhance viral infection in unique ways for different virus strains. The data, for the first time, indicate a role for Akt signaling in viral assembly and highlight additional phenotypic differences between closely related MNV strains. IMPORTANCE Human noroviruses (HNoV) are a leading cause of viral gastroenteritis, resulting in high annual economic burden and morbidity, yet there are no small-animal models supporting productive HNoV infection or robust culture systems producing cell culture-derived virus stocks. As a result, research on drug discovery and vaccine development against norovirus infection has been challenging, and no targeted antivirals or vaccines against HNoV are approved. On the other hand, murine norovirus (MNV) replicates to high titers in cell culture and is a convenient and widespread model in norovirus research. Our data demonstrate the importance of Akt signaling during the late stage of the MNV life cycle. Notably, the effect of Akt signaling on genome replication, virus assembly, and cellular egress is virus strain specific, highlighting the diversity of biological phenotypes despite small genetic variability among norovirus strains. This study is the first to demonstrate a role for Akt in viral assembly.
Attitudes of Israeli Youth Toward the Middle East Conflict

This article examines and analyzes the results of a 1976 survey of Israeli high school students. Special attention is given to their views on Middle East conflict issues and overall attitudes toward, beliefs about, and perceptions of that conflict. A number of relationships are found between respondents' conflict attitudes, beliefs, and perceptions and their socio- economic, contextual, and political characteristics. Several comparisons are drawn with other, related studies and research. Some implications for the present and future direction of the Middle East conflict and peace processes are discussed. Last, a few areas and topics for additional research and analysis are outlined.
Hospital Variation in Non-Invasive Ventilation Use for Acute Respiratory Failure Due to COPD Exacerbation

Background Non-invasive mechanical ventilation (NIV) use in patients admitted with acute respiratory failure due to COPD exacerbations (AECOPDs) varies significantly between hospitals. However, previous literature did not account for patients’ illness severity. Our objective was to examine the variation in risk-standardized NIV use after adjusting for illness severity. Methods We retrospectively analyzed AECOPD hospitalizations from 2011 to 2017 at 106 acute-care Veterans Health Administration (VA) hospitals in the USA. We stratified hospitals based on the percentage of NIV use among patients who received ventilation support within the first 24 hours of admission into quartiles, and compared patient characteristics. We calculated the risk-standardized NIV % using hierarchical models adjusting for comorbidities and severity of illness. We then stratified the hospitals by risk-standardized NIV % into quartiles and compared hospital characteristics between quartiles. We also compared the risk-standardized NIV % between rural and urban hospitals. Results In 42,048 admissions for AECOPD over 6 years, the median risk-standardized initial NIV % was 57.3% (interquartile interval [IQI]=41.9–64.4%). Hospitals in the highest risk-standardized NIV % quartiles cared for more rural patients, used invasive ventilators less frequently, and had longer length of hospital stay, but had no difference in mortality relative to the hospitals in the lowest quartiles. The risk-standardized NIV % was 65.3% (IQI=34.2–84.2%) in rural and 55.1% (IQI=10.8–86.6%) in urban hospitals (p=0.047), but hospital mortality did not differ between the two groups. Conclusion NIV use varied significantly across hospitals, with rural hospitals having higher risk-standardized NIV % rates than urban hospitals. Further research should investigate the exact mechanism of variation in NIV use between rural and urban hospitals.
Vibration of Bridges under the Passage of Vehicles Simulated as Moving Loads

The dynamic behavior of bridges under the effect of moving loads simulating the vehicle moving along the bridge structure idealized by an Euler beam is analyzed. We will present the dynamic behavior of beams under the stress of moving loads (or masses) by the analytical and semi-analytical approaches. When the mass of the bridge structure is comparable to that of the vehicle, the mobile source requesting the bridge is simulated by a mass. In most practical cases, the mobile force used is due to the effects of the gravitational moving masses: . When the moving mass is small compared to the beam mass, the obtained solution under the effect of moving force is approximately correct for the solution obtained with the moving mass. Otherwise, the problem of the moving mass is imperative. To do this, we wrote a program in Matlab language which reflects the dynamic behavior of beams under the effect of moving charges, which gives the following results "The frequencies and modes of vibration, the dynamics deflection of the beam requested by moving force, the dynamic response (DAF: dynamic amplification factor) of the beam requested by a moving force, over the whole length of the beam, for all times and for different speeds. The numerical example that we look to see for study the dynamic behavior of this type of bridge under moving loads is that of a thin beam unamortised on simple support and length of 50m, under the solicitation of moving force and mass at a constant speed and varies from 0 to 100 m / s (M. A. Foda, 1997), depending on the relationship between the vehicle mass and the mass of the bridge that will allow us to see the contribution of the choice of modelling type on the total response and then the vibration of bridge, also we will study the effect of type of simulation of the load by moving force or mass on the dynamic amplification factor and comparing our results with those from the literature.
Pre- and Post-Birth Components of Intergenerational Persistence in Health and Longevity: Lessons from a Large Sample of Adoptees

ABSTRACT:We use a large sample of Swedish-born adoptees and their biological and adopting parents to decompose the persistence in health inequality across generations into pre-birth and post-birth components. We use three sets of measures for health outcomes in the second generation: mortality, measures based on data on hospitalization, and measures using birth outcomes for the third generation. The results show that all of the persistence in mortality is transmitted solely via pre-birth factors, while the results for the hospitalization measures suggest that at least three-quarters of the intergenerational persistence in health is attributable to the biological parents.
The electroosmosis mechanism for fluid delivery in PDMS multi-layer microchannel

Here we reported on fabrication of multi-layer microstructures that takes the advantage of electroosmosisto mix fluids. Microlaboratories for biochemical applications often require rapid mixing of different fluid streams. At the microscale, flow is usually highly ordered laminar flow and the lack of turbulence makes diffusion the primary mechanism for mixing. While diffusional mixing of small molecules can occur in a matter of seconds over distances of tens of micrometers, mixing of larger molecules such as peptides, proteins, and high molecularweight nucleic acids can require equilibration times from minutes to hours over comparable distances. Such delays are impractically long for many chemical analyses. These problems have led to an intense search for more efficient mixers for microfluidic systems most microscale mixing devices are either passive mixers that use geometrical stirring or active mixers that use moving parts or external forces, such as pressure or electric field. In a passive mixer, one way of increasing the mixing is by "shredding" two or several fluids into very thin alternating layers, which decreases the average diffusion length for the molecules between the different fluids. Another way of improving mixing efficiency is to use active mixers with moving parts that stir the fluids. At the microscale level moving parts in an active mixer are very fragile. One alternative solution which we explored is to use electroosmotic effects to achieve a mixing effect that is perpendicular to the main direction of the flow.
A proposed high-frequency, negative-resistance diode

This paper describes and analyzes a proposed semiconductor diode designed to operate as an oscillator when mounted in a suitable microwave cavity. The frequency would be in the range extending from 1 to 50 kmc. The negative Q may be as low as 10 and the efficiency as high as 30 per cent. The diode is biased in reverse so as to establish a depletion, or space-charge, layer of fixed width in a relatively high resistance region, bounded by very low resistance end regions. The electric field has a maximum at one edge of the space-charge region, where hole-electron pairs are generated by internal secondary emission, or avalanche. The holes (or electrons) travel across the space-charge layer with constant velocity, thus producing a current through the diode. Because of the build-up time of the avalanche, and the transit time of the holes across the depletion layer, the alternating current is delayed by approximately one-half cycle relative to the ac voltage. Thus, power is delivered to the ac signal. When the diode is mounted in an inductive microwave cavity tuned to the capacity of the diode, an oscillation will build up. It appears possible to obtain over 20 watts of ac power in continuous operation at 5 kmc.
Mechanical integrity of vias in a thin-film package during manufacture, assembly, and stress-test

The reliability of vias used in thin film packages was estimated through analytical and numerical models. Several processes that produce thermally induced strains in the vias during manufacture, assembly (e.g., card and heat sink attach, and encapsulation of the chip), and stress-tests (e.g., T&H, ship shock, and accelerated thermal cycling) were evaluated to determine the steps which induced potentially high strains in the vias. The study consisted of two parts. In the first part, a preliminary analysis was made in which analytical estimates of via strains during the various processes were obtained under the assumptions of linear elasticity. In the second part of the study, detailed elastic-plastic finite element analyses were carried out to determine the via strains during the various processes. The models were two-dimensional, axi-symmetric in nature. In addition to uniformly plated vias, the study also included analysis of non-uniformly plated vias. In both parts of the study, via strain during a single cycle of ATC (accelerated thermal cycle) was combined with the Coffin-Manson equation for plated copper to determine the number of ATC cycles to failure. Via plating thicknesses analyzed were in the range of 0.5 to 1.4 mils. It was concluded from the study that if the via was manufacturable, then it would survive the accelerated thermal cycling test and hence the field use. This conclusion was in agreement with the results of an ATC test conducted on products with uniformly plated vias. Another conclusion from the study was that vias with non-uniform plating were unlikely to survive the rigors of the manufacturing processes. <<ETX>>
The Design Code

The deputy director of the Research Institute of Building Earthquake Engineering here explains the main features of the current aseismic design Sode for civil and industrial building in China. It includes provisions on the selection of sites, the choice of foundations, the evaluation of earthquake Ooading and protective measures for different types of structure. Based on research and design practice feedback, the code takes account of economic considerations.
Geotechnical Considerations for the Installation of Gravity Base Structures

The installation of Gravity Base structure involves interaction between the disciplines of naval architecture, structural and mechanical engineering and geotechniques. The paper draws attention to key factors that can affect the performance of the foundation system in service. Careful examination of the installation process by the geotechnical engineer and integration with other elements of the platform design and construction is necessary.
Factors affecting multiple climate change adaptation practices of smallholder farmers in lower Eastern Kenya

The study investigated the socioeconomic and institutional factors influencing uptake of multiple climate change adaptation practices among smallholder farmers in lower Eastern Kenya. Multistage sampling procedure was used to select 384 small-scale farmers. Percentage and regression were used in the analysis. Among the socio-economic factors, gender positively and significantly influenced adoption of conservation agriculture and water harvesting at 5%, respectively. Among the institutional factors, distance to markets positively or negatively influenced uptake of all the technologies at 1% and 5%, respectively. Due to complementarity in adoption of all the seven adaptation practices, age and distance to nearest markets should be considered during technology dissemination. The study, therefore, calls for agricultural policy reforms that aim at designing incentive programmes which adequately address most of the socioeconomic and institutional issues related to uptake of adaptation practices as well as encouraging off-farm diversification.