Miracle-dz/UniFAR-FTUs huggingface dataset:
Specificity of computerized physician order entry has a significant effect on the efficiency of workflow for critically ill patients

Background:Critically ill patients require rapid care, yet they are also at risk for morbidity from the potential complications of that care. Computerized physician order entry (CPOE) is advocated as a tool to reduce medical errors, improve the efficiency of healthcare delivery, and improve outcomes. Little is known regarding the essential attributes of CPOE in the intensive care unit (ICU). Objective:To assess the effect of CPOE on ICU patient care. Design:Retrospective before and after cohort study. Setting:An academic ICU. Patients:Patients admitted to the ICU during use of the initial CPOE application and those admitted after its modification. Interventions:Comprehensive order interface redesign improving clarity, specificity, and efficiency. Measurements:Orders for complex ICU care were compared between the two groups. In addition, the use of higher-efficiency CPOE order paths was tracked. Results:Patients treated with both the initial and modified CPOE system were similar for all measured characteristics. With the modified CPOE system, there were significant reductions in orders for vasoactive infusions, sedative infusions, and ventilator management. There was also a significant increase in orders executed through ICU-specific order sets after system modifications. Limitations:This retrospective study cannot assess issues related to learner expertise and is meant to only suggest the importance of developing CPOE systems that are appropriate for specialty care environments. Conclusion:Appropriate CPOE applications can improve the efficiency of care for critically ill patients. The workflow requirements of individual units must be analyzed before technologies like CPOE can be properly developed and implemented.
Analysis of the prognostic factors for liver metastasis of gastric cancer after hepatic resection: a multi-institutional study of the indications for resection.

BACKGROUND/AIMS The number of reports of hepatic resection for metastatic gastric cancer is very small. The outcome and indications of hepatic resection for metastatic gastric cancer remains unknown. METHODOLOGY A multi-institutional study was made. Thirty-six patients who underwent a hepatic resection for liver metastasis of gastric cancer with no residual tumor were included in this study. The clinicopathological factors were examined as prognostic factors by multivariate analyses. Thirty patients had recurrence and the recurrence pattern and risk factors for extrahepatic recurrence was examined. RESULTS The overall survival rate was 64% at 1 year, 43% at 2 years, 26% at 3 years 26% at 5 years, and 26% at 10 years after hepatectomy. Multivariate analysis showed that lymphatic invasion, venous invasion of cancer cells of primary gastric cancer and the number of the liver metastasis (> 3) were independent poor prognostic factors after hepatic resection. The most common recurrence pattern was intrahepatic recurrence in 22 patients (73%). The risk factors for extrahepatic recurrence was serosal invasion, lymph node metastasis of primary gastric cancer, stage, and curability of operation. CONCLUSIONS Hepatic resection for liver metastasis should be attempted in case primary gastric cancer has neither lymphatic invasion nor venous invasion. The most common recurrent site was the liver. In patients with advanced gastric cancer, having neither serosal invasion nor lymph node metastasis, who underwent a less curative operation, the intra-hepatic recurrence would be expected. Thus, aggressive adjuvant chemotherapy through the hepatic artery may improve the survival after hepatectomy in these patients.
A data structure for circuit net lists

A data structure for storing and processing electrical circuit net lists is described. The basic data structure is not new, but the version described here is novel in three specific ways. It adds separate structure (arrays) for cell type and I/O-pad-specific information, stores net lists defined in terms of primitive elements or cells as two superimposed symmetric incidence list form directed graphs, and separates primitive element input and output lists to follow signal flow traversal. The focus is on computer-program-level implementation details and on various practical problems arising in circuit net-list processing. The structure's construction cost and algorithmic efficiency are discussed. <<ETX>>
Haptic and Visual Influences on Grasp Point Selection

ABSTRACT When using precision grip to pick up objects, there are many possible pairs of grasp points that permit the thumb and index finger to exert opposed forces for secure grip. Previously, it was shown that individuals select grasp points so that the line between them (grasp axis) passes through or near the center of mass (CoM), thus minimizing the torque around the grasp axis during lifting. The accuracy of grasp axis selection depended on object spatial symmetry, indicating the importance of vision. The authors investigated how grasp point selection is influenced by haptic as well as visual information. Ten participants lifted cuboids whose CoM was located either symmetrically in the geometric center or asymmetrically toward one end. Results for the asymmetric cuboid revealed that grasp points migrated toward the asymmetric CoM from the geometric center. This was more pronounced in the presence of visual cues that reliably indicated the location of CoM. The results suggest that grasp point selection is influenced by a multimodal representation of CoM.
The Diabetes Management Education Program in South Texas: An Economic and Clinical Impact Analysis

Introduction Diabetes is a major chronic disease that can lead to serious health problems and high healthcare costs without appropriate disease management and treatment. In the United States, the number of people diagnosed with diabetes and the cost for diabetes treatment has dramatically increased over time. To improve patients’ self-management skills and clinical outcomes, diabetes management education (DME) programs have been developed and operated in various regions. Objective This community case study explores and calculates the economic and clinical impacts of expanding a model DME program into 26 counties located in South Texas. Methods The study sample includes 355 patients with type 2 diabetes and a follow-up hemoglobin A1c level measurement among 1,275 individuals who participated in the DME program between September 2012 and August 2013. We used the Gilmer’s cost differentials model and the United Kingdom Prospective Diabetes Study (UKPDS) Risk Engine methodology to predict 3-year healthcare cost savings and 10-year clinical benefits of implementing a DME program in the selected 26 Texas counties. Results Changes in estimated 3-year cost and the estimated treatment effect were based on baseline hemoglobin A1c level. An average 3-year reduction in medical treatment costs per program participant was $2,033 (in 2016 dollars). The total healthcare cost savings for the 26 targeted counties increases as the program participation rate increases. The total projected cost saving ranges from $12 million with 5% participation rate to $185 million with 75% participation rate. A 10-year outlook on additional clinical benefits associated with the implementation and expansion of the DME program at 60% participation is estimated to result in approximately 4,838 avoided coronary heart disease cases and another 392 cases of avoided strokes. Conclusion The implementation of this model DME program in the selected 26 counties would contribute to substantial healthcare cost savings and clinical benefits. Organizations that provide DME services may benefit from reduction in medical treatment costs and improvement in clinical outcomes for populations with diabetes.
Long-term follow-up of simultaneous guided bone regeneration using native and cross-linked collagen membranes over 6 years.

OBJECTIVES To investigate the impact of a cross-linked- (VN) collagen membrane on the long-term stability of peri-implant health over 6 years. MATERIAL AND METHODS Vestibular dehiscence-type defects at titanium implants (19 patients, 19 implants) were augmented using a natural bone mineral and randomly allocated to either VN or a native collagen membrane (CM) and left to heal in a submerged position for 4 months. Clinical parameters (i.e. Bleeding on Probing-BOP, probing pocket depth-PD, mucosal recession-MR) were recorded at 4 and 6 years after prosthesis installation. RESULTS At 4 and 6 years, both VN and CM revealed comparable mean BOP, PD and MR values at both vestibular and oral aspects. Changes in these parameters from 4 to 6 years were minimal (vestibular aspect-VN: -3.3 ± 48.2%, -0.1 ± 0.5 mm, -0.1 ± 0.3 mm; CM: -1.8 ± 33.7%, 0.0 ± 0.4 mm, -0.1 ± 0.7 mm) and not significantly different between groups. At 6 years, the incidence of mucositis and peri-implantitis was comparable in both groups (VN: 60.0% and 20.0%; CM: 33.3% and 33.3%). CONCLUSION In conclusion, the present follow-up observation failed to identify any beneficial impact of VN over CM on peri-implant health at 4 and 6 years.
Plasmid-mediated 16S rRNA methylases among extended-spectrum-beta-lactamase-producing Salmonella enterica Senftenberg isolates from Algeria.

blaCTX-M-15, 9 isolates representative of individual PFPs (comprising 78 isolates) had peak profiles corresponding to blaCTX-M-14, 2 isolates representative of individual PFPs (comprising 3 isolates) had peak profiles corresponding to blaCTX-M-9 and 1 isolate had a peak profile corresponding to blaCTX-M-1. The rapid dissemination of CTX-M-producing Enterobacteriaceae reported in a number of countries is a significant public health concern. In this study, members of CTX-Mgroup-1and CTX-M-group-9-producing isolates were both common, accounting for 60% and 40% of isolates, respectively. This is in keeping with what has previously been observed in other European countries. CTX-M-14 accounts for most CTX-M-group-9 enzymes in Ireland. This is similar to the situation reported from Spain, where CTX-M-14 is the predominant group-9 CTX-M enzyme, but contrasts with the neighbouring UK where CTX-M-14 appears to be less common. CTX-M-15 is the predominant group 1 genotype, again in concordance with what has been observed in other European countries. The dissemination of specific clones or clonal groups has been central to the dramatic increase in the prevalence of CTX-M b-lactamases in Europe and worldwide. In this study, six major clusters of related isolates comprising 50% of all CTX-M-producing E. coli were defined by PFGE. Few healthcare institutions in Ireland have reported outbreaks of ESBL-PE transmission. These data show evidence of interand intrahospital dissemination of clonal groups. We also identified the presence of the UK epidemic ‘strain A’, which has recently been confirmed as belonging to the internationally disseminated clone O25:H4-ST131. The widespread dissemination of Enterobacteriaceae producing CTX-M-15 and CTX-M-14 in Ireland may reflect introduction via foreign travel, originally from areas where these genotypes are common, and subsequent significant local spread. Spread may be facilitated by levels of antimicrobial consumption. According to a recent European Surveillance of Antimicrobial Consumption report, the total outpatient use of antimicrobials in Ireland was 21.23 defined daily doses per 1000 inhabitants in 2006, representing midto high-range use compared with other European countries. Although there is recent evidence of increasing public policy emphasis on and public interest in the control of antimicrobial resistance, there is little evidence that measures taken to date have lead to improved control of the dissemination of ESBL-PE in the community and the principal routes of transmission in this setting have not been defined.
LDPC coding for interference mitigation at the transmitter

We consider a Gaussian additive-noise channel with interference known to the transmitter but unknown to the receiver. A precoding technique based on lattice quantization is able to achieve Costa’s “dirty-paper” limit for arbitrary interference signal, when this is known non-causally. When interference is known causally, the same technique yields asymptotically optimal achievable rates for high-SNR. We provide explicit code constructions based on low-density parity-check codes and on -PAM modulation able to closely approach the rates achievable by the lattice precoding scheme for causal known-interference.
Effects of major dietary antioxidants on inflammatory markers of RAW 264.7 macrophages

Oxidative stresses are involoved in the process of chronic inflammatory diseases. The objective of this study was to evaluate and compare the anti‐inflammatory activity of major dietary antioxidants. Murine RAW264.7 macrophages (4 × 106 cells) were incubated in DMEM containing 10% FBS supplemented with 5 to 20 μM of α‐tocopherol, β‐carotene or quercetin for 24 hrs, and then treated with LPS for 16hrs. The medium was collected to measure TNF‐α, IL‐6, PGE2 and nitrite. Expressions of cyclooxygenase‐2(COX‐2) and inducible nitric oxide synthase(iNOS) were determined using the harvested cells. Results indicate that TNF‐α and IL‐6 accumulations were significantly reduced by 5 to 20 μM quercetin treatment, and 20 μM of α‐tocopherol treatment. Nitrite release was significantly reduced by 5 μM quercetin treatment. However, PGE2accumulation was not affected by any of the antioxidants used. Expressions of COX‐2 and iNOS were effectively reduced by 5 μM quercetin treatment. These findings indicate that dietary antioxidants possess significant anti‐inflammatory activities, and quercetin is the most potent antioxidant.
Delta-sigma modulator with μ-synthesis and switching loop filter based on the linear gain

A delta-sigma modulator is one of systems used for an analog-to-digital converter. It is known that high signal-to-noise ratio will be obtained by making a high-order loop filter of the delta-sigma modulator. However, when input amplitude becomes large, a problem that the system becomes unstable occurs. This paper proposes a delta-sigma modulator combining the method of switching the loop filter by the change of the linear gain with the loop filters designed through a μ-synthesis. A stable range will spread out for large input amplitude by using the method of switching the loop filter. The effectiveness of the proposed method is confirmed by computer simulations.
Association of Catechol-O-Methyltransferase Polymorphism (Val108/158Met) With Parkinson's Disease: A Meta-Analysis

ABSTRACT Parkinson's disease (PD) is a common neurodegenerative disease, the risk factors of which are gaining more attentions. Among all these risk factors, catechol-o-methyltransferase (COMT) has been widely studied, and believed to be associated with PD. However, the relationship between COMT polymorphism and PD has not been confirmed hitherto. Therefore, a meta-analysis was performed to evaluate the effect of COMT polymorphism on PD patients. A total of 24 study subjects comprising 3,807 patients with PD and 3,942 unrelated healthy controls were recruited in this meta-analysis. Heterogeneity testing and sensitivity analysis were conducted with Review Manager 5.0 software (The Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen, Denmark) and Stata software (StataCorp, College Station, TX), together with publication bias by funnel plot method and modified Egger's linear regression test. No evidences of publication bias and heterogeneity were detected. In the 24 studies, the estimated odds ratios (OR) in PD patients are 0.98 for the Met allele (95% confidence interval [0.92, 1.05]) under a fixed-effects model. The authors also conducted a stratified analysis according to geographic region among Europe, Asia, and North America, the ORs for the Met allele are 0.92, 1.02, and 1.10, respectively. According to the results of the meta-analysis, a conclusion could be drawn that polymorphism of Val108/158Met are not associated with the risk of PD. However, more convincing studies are warranted to have a solid conclusion supported.
Caractérisation d'une modification éventuelle de la relation pluie-débit autour des années 1970 en Afrique de l'Ouest et centrale non sahélienne

Des conditions prolongees de deficits pluviometrique et hydrometrique constituent une realite observee en Afrique de l'ouest et centrale depuis la fin des annees 1960 et le debut des annees 1970. Parmi les interrogations que suscite cette importante variation, l'une d'elles concerne l'eventuelle modification de la relation pluie-debit. On s'est attache a mettre en evidence et a caracteriser des modifications eventuelles des facteurs d'ecoulement suite a cette fluctuation climatique. Pour mener cette etude, on a eu recours a la modelisation de la relation pluie-debit. Le principe a consiste essentiellement a ajuster les memes modeles sur les deux periodes humide et seche, puis a tester si les parametres obtenus sur les deux periodes variaient significativement.
Comparisons of Robustness and Sensitivity between Cancer and Normal Cells by Microarray Data

Robustness is defined as the ability to uphold performance in face of perturbations and uncertainties, and sensitivity is a measure of the system deviations generated by perturbations to the system. While cancer appears as a robust but fragile system, few computational and quantitative evidences demonstrate robustness tradeoffs in cancer. Microarrays have been widely applied to decipher gene expression signatures in human cancer research, and quantification of global gene expression profiles facilitates precise prediction and modeling of cancer in systems biology. We provide several efficient computational methods based on system and control theory to compare robustness and sensitivity between cancer and normal cells by microarray data. Measurement of robustness and sensitivity by linear stochastic model is introduced in this study, which shows oscillations in feedback loops of p53 and demonstrates robustness tradeoffs that cancer is a robust system with some extreme fragilities. In addition, we measure sensitivity of gene expression to perturbations in other gene expression and kinetic parameters, discuss nonlinear effects in feedback loops of p53 and extend our method to robustness-based cancer drug design.
Understanding e-Waste Management in Developing Countries: Strategies, Determinants, and Policy Implications in the Indian ICT Sector

Management of e-waste is a growing problem for developing countries; one that may undermine the sustainability of information and communication technology (ICT) use if not addressed. In this paper, we focus on a somewhat under-emphasized group that contributes significantly to developing country e-waste: local organizational consumers of ICT. Although this group creates the majority of e-waste, the factors shaping their e-waste decisions are not well understood. Our purpose in the paper is to provide such an understanding. This paper, therefore, builds conceptual models of e-waste strategies and e-waste strategy determinants from the environmental management literature. It applies these models to a key e-waste producer – the ICT services sector in India – drawing qualitative data from a mix of very large and small/medium firms. While the former have been proactive in their e-waste strategy, the small/medium firms are characterized as indifferent to e-waste; a divergence explained by the very different strengths of determining factors to which they are subject. In turn, those factors relate to the size of these ICT consumers and the nature of value chains into which they are placed. Understanding these determinants can help us plan better e-waste interventions; a point illustrated through critique of recently introduced legislation.
The Arabidopsis Flavin-Dependent Monooxygenase FMO1 Is an Essential Component of Biologically Induced Systemic Acquired Resistance1[OA]

Upon localized attack by necrotizing pathogens, plants gradually develop increased resistance against subsequent infections at the whole-plant level, a phenomenon known as systemic acquired resistance (SAR). To identify genes involved in the establishment of SAR, we pursued a strategy that combined gene expression information from microarray data with pathological characterization of selected Arabidopsis (Arabidopsis thaliana) T-DNA insertion lines. A gene that is up-regulated in Arabidopsis leaves inoculated with avirulent or virulent strains of the bacterial pathogen Pseudomonas syringae pv maculicola (Psm) showed homology to flavin-dependent monooxygenases (FMO) and was designated as FMO1. An Arabidopsis knockout line of FMO1 proved to be fully impaired in the establishment of SAR triggered by avirulent (Psm avrRpm1) or virulent (Psm) bacteria. Loss of SAR in the fmo1 mutants was accompanied by the inability to initiate systemic accumulation of salicylic acid (SA) and systemic expression of diverse defense-related genes. In contrast, responses at the site of pathogen attack, including increases in the levels of the defense signals SA and jasmonic acid, camalexin accumulation, and expression of various defense genes, were induced in a similar manner in both fmo1 mutant and wild-type plants. Consistently, the fmo1 mutation did not significantly affect local disease resistance toward virulent or avirulent bacteria in naive plants. Induction of FMO1 expression at the site of pathogen inoculation is independent of SA signaling, but attenuated in the Arabidopsis eds1 and pad4 defense mutants. Importantly, FMO1 expression is also systemically induced upon localized P. syringae infection. This systemic up-regulation is missing in the SAR-defective SA pathway mutants sid2 and npr1, as well as in the defense mutant ndr1, indicating a close correlation between systemic FMO1 expression and SAR establishment. Our findings suggest that the presence of the FMO1 gene product in systemic tissue is critical for the development of SAR, possibly by synthesis of a metabolite required for the transduction or amplification of a signal during the early phases of SAR establishment in systemic leaves.
Liquid exfoliated pristine WS2 nanosheets for ultrasensitive and highly stable chemiresistive humidity sensors

WS2 nanosheets have been synthesized by ultrasonication in a binary mixture of acetone and 2-propanol, with a volume ratio of 80:20. Hansen solubility parameters were taken into consideration as part of the process. These nanosheets have been characterized by electron microscopy, atomic force microscopy, and x-ray diffraction, along with spectroscopy such as ultraviolet-visible spectroscopy, Raman spectroscopy, and x-ray photoelectron spectroscopy. The nanosheets were further used as a sensing material to fabricate a humidity sensor on interdigitated aluminum electrodes, realized over Si/SiO2 substrate using a conventional photolithography technique. The response for our sensor varied from 11.9 for 40% RH to as high as 37.5 for 80% RH. Response and recovery time were found to be 13 ± 2 s and 17 ± 2 s respectively. The suspended nanosheets were also treated with UV light in a nitrogen environment. The response for UV treated nanosheets shows better linearity, however its response decreases in the presence of humidity. This is due to a decrease in oxygen content of the UV treated sample. Furthermore, the effect of sonication time has been investigated, and it was found that samples with 10 h sonication are better than others due to their high surface-to-volume ratio. The repeatability and stability of the sensor have been investigated and found to be excellent. The hysteresis in the sensors was also explored. The mechanism of humidity sensing has been discussed in detail.