Miracle-dz/UniFAR-FTUs huggingface dataset:
Nursing Care of Older Patients in Hospital: Implications for Clinical Leadership

Objective: This study investigated how nurses managed the care of acutely ill older patients in acute hospital settings. Design: Constructivist inquiry has been used that included multiple methods of data collection: interviews, observations and documentation of care. Setting: Participants were recruited from five acute medical and surgical units across two public hospitals. Participants: Twenty seven registered nurses caring for patients who were aged 65 years and older. Results: Three themes were identified from the data analysis: being informed about care; limiting care; and rationalising actions. Nurses articulated they understood that quality care was important, but care was limited and interventions were prioritised. The participants blamed health services, lack of clinical leadership, patients, other nurses, and themselves. Conclusion: These findings have implications for issues of professional agency and clinical leadership. While there is a need for good clinical leadership which is aligned with empowerment to exercise professional agency, speculation about how the dynamics within the units in this study developed and were maintained needs further consideration.
Association of interferon regulatory factor ‐7 gene polymorphism with liver cirrhosis in chronic hepatitis C patients

Background and aims: Interferon (IFN) regulatory factor 7 (IRF‐7) has been shown to play an essential role in the transcriptional activation of virus‐inducible cellular genes, especially IFN genes. Polymorphisms of the IRF‐7 gene may probably affect both the quality and the quantity of IRF‐7. We investigated the role of IRF‐7 polymorphisms in Japanese patients with chronic hepatitis C virus (HCV) infection.
Entropic barriers, transition states, funnels, and exponential protein folding kinetics: A simple model

This paper presents an analytically tractable model that captures the most elementary aspect of the protein folding problem, namely that both the energy and the entropy decrease as a protein folds. In this model, the system diffuses within a sphere in the presence of an attractive spherically symmetric potential. The native state is represented by a small sphere in the center, and the remaining space is identified with unfolded states. The folding temperature, the time‐dependence of the populations, and the relaxation rate are calculated, and the folding dynamics is analyzed for both golf‐course and funnel‐like energy landscapes. This simple model allows us to illustrate a surprising number of concepts including entropic barriers, transition states, funnels, and the origin of single exponential relaxation kinetics.
Urban Mining Service Design: Roadmap for Recycling Industry Transformation

Current recycling industry must facing emerging challenges especially for rapid growth of public-welfare and environmental protection concepts. Although various participants have different ideas for improving our living environment, but these participants from society could become the most useful collaborator for improving the recycling industry. In this paper, an innovative recycling service application is proposed that highlights sharing the value for better utilization within the recycling industry. The new recycling service model is grounded from the service innovation ideas that emphasis on the prosocial behaviors and the massive participations of the entire society member. We introduce the service as well as its design concepts, followed by analyzing the challenges for promotion public-welfare service. In this paper, we concentrate on discovering what is the internal key factors that influence their decision and how the psychologically factors from the recycling service participants could encourage all urban participants to share their love and passion to improve their living environment and their spiritual satisfaction. Several critical service development issues are generated from multiple case studies, which provide the cues for future urban mining service design and supporting information system development.
Ulnar forearm free flaps in head and neck reconstruction: Systematic review of the literature and a case report

Objective: Under the assumption that the ulnar artery is the predominant blood supply to the hand, radial forearm free flaps (RFFF) generally have been preferred over ulnar forearm free flaps (UFFF) in head and neck reconstruction. The objective of this study is to create the first and only systematic review of the literature regarding UFFF in head and neck reconstruction, assessing the usage, morbidity, complications, and rationale of its use. Methods: A systematic review of the literature was conducted using PubMed, including Mesh terms and manual searches. Articles not in English were excluded. Results: Seventeen articles of the 80 articles identified by our search criteria met inclusion criteria; a total of 682 cases of UFFF were identified, including our patient case. Fifty‐five percent of the cases involved use of the Allen's test. Mean flap size was 6.1 × 10.5 cm. Of the 432 cases reporting flap survival, 14 (3.2%) flap losses were reported, 13 total (3.0%), and one partial (0.2%). The UFFF was preferred to the RFFF due to decreased hirsutism (61%), better cosmetic outcomes (91%), and better post‐operative hand function with reduced donor site morbidity (73%). For the case report, an UFFF was used successfully for lid reconstruction and resurfacing in a 72‐year‐old man who presented with late ectropion and exposure keratopathy following maxillary resection for leiomyosarcoma. Conclusions: This is the first and only systematic review of the literature to date of UFFF in head and neck reconstruction. Our review demonstrates that the UFFF rarely results in flap loss, donor site morbidity, or hand ischemia, instead providing enhanced outcomes. With its many surgeon‐perceived advantages and minimal morbidity, the UFFF may become a preferred forearm flap for head and neck reconstruction. © 2013 Wiley Periodicals, Inc. Microsurgery 34:68–75, 2014.
Scene Change Detection using Edge Direction based on Intra Prediction Mode in H.264/AVC Compression Domain

This paper presents a novel scene change detection method using edge direction based on intra prediction mode in H.264/AVC. When scene change occurs, there is less temporal correlation between frames. Therefore, most of macro-blocks are encoded in intra mode. Using this property, the proposed method calculates the percentage of intra mode blocks in each predictive frame in order to get candidates of scene change frames. To find accurate scene changes, we generate an edge histogram of each candidate with eight prediction directions of intra prediction mode in H.264/AVC. We detect scene change frames with l1 -norm of edge histograms. The experimental results show that the proposal method is efficient and robust
Comparison between the effect of non-immersive virtual reality training and conventional rehabilitation on balance in patients after ACL reconstruction – A Randomized Control Trial. : A Hypothesis

Background: Anterior cruciate ligament (ACL) injury is the most commonly seen knee ligament injury during sporting or recreational activities causing severe functional problems. Injury to ACL causes balance disorders due to proprioceptive dysfunction and mechanical instability at the knee. Altered neuromuscular control of the hip and knee joints and deficits in postural stability increases the risk of re-injury after ACL reconstruction. Therefore, enhancement of the neuromuscular control of the knee after ACL reconstruction is suggested by the prescription of balance and proprioceptive exercises which will reduce the risk of re-injury and lead to better results in terms of return to the functional activities.Different techniques for improving balance in these patients include the conventional balance training using devices like therabolt, wobble board etc. However, development of a more effective rehabilitation program which will help to address these deficiencies is required. New technology based technique such as non-immersive virtual reality using Microsoft Xbox Kinect has been proved as a reliable tool in improving balance in neurological cases such as stroke, cerebral palsy, etc.Hence, the objective of this study is to compare the effect of non-immersive virtual reality training and conventional rehabilitation on balance in patients after Anterior Cruciate Ligament(ACL)Reconstruction. Hypothesis : Non-immersive virtual reality training would be more effective than the conventional rehabilitation for improving balance in patients after anterior cruciate ligament reconstruction Clinical Importance : Training with Microsoft Kinect Xbox (XbK) will lead to better improvements in balance of the patients after ACL reconstruction. It will help in an early return to the functional activities or sports and will also reduce the risk of reinjury. Future Research : Nonimmersive virtual reality training can be given to the patients with other sport injuries for improving their balance.
The repellant and antifeedant properties of Cyperus articulatus against Tribolium casteneum Hbst.

Cyperus articulatus is an insect repellant plant commonly found in Northern Nigeria and used traditionally in pest control. The light petroleum and methanol extracts of the plant's rhizome were evaluated against Tribolium casteneum Hbst (the red flour beetle) using standard techniques. The methanol extract showed more antifeedant property than the light petroleum extract, while both the extracts were observed to have similar repellant actions.
Relative orientation of quadrupole tensors from two-dimensional multiple-quantum MAS NMR.

The Multiple-Quantum Magic Angle Spinning (MQMAS) technique enables the resolution of crystallographically inequivalent nuclei and also yield the quadrupolar coupling constant C-Q, quadrupolar asymmetry eta, and isotropic chemical shift delta(CS) of each crystallographic site. However, no information is obtained that relates one quadrupole tensor to another, such as internuclear distances or relative orientations. Here, we discuss a recently developed modification of the MQMAS NMR experiment that utilizes two-dimensional correlation of second-order (rank I = 4) broadened MAS line shapes to obtain the relative orientation of quadrupole tensors. This new method involves the insertion of a "mixing time", tau(m), into the MQMAS experiment such that magnetization transfer between two distinct nuclei within a crystallite during this period will result in a two-dimensional "cross-peak" correlating the two line shapes. The shapes of these cross-peaks are characteristic of the three Euler angles, alpha', beta', and gamma', that describe the relative orientation of the two quadrupole tensors.
Standardizing Diagnostic Markers to Evaluate and Compare Their Performance

Background: Markers that purport to distinguish subjects with a condition from those without a condition must be evaluated rigorously for their classification accuracy. A single approach for statistical evaluation and comparison of markers is not yet established. Methods: We suggest a standardization that uses the marker distribution in unaffected subjects as a reference. For an affected subject with marker value Y, the standardized placement value is the proportion of unaffected subjects with marker values that exceed Y. Results: We applied the standardization to 2 illustrative datasets. As a marker for pancreatic cancer, the CA-19-9 marker had smaller placement values than the CA-125 marker, indicating that CA-19-9 was the better marker. For detecting hearing impairment, the placement values for the test output (the marker) were smaller when the input sound stimulus was of lower intensity, which indicates that the test better distinguishes hearing-impaired from unimpaired ears when a lower intensity sound stimulus is used. Explicit connections are drawn between the distribution of standardized marker values and the receiver operating characteristic curve, one established statistical technique for evaluating classifiers. Conclusion: The standardization is an intuitive procedure for evaluating markers. It facilitates direct and meaningful comparisons between markers. It also provides a new view of receiver operating characteristic analysis that may render it more accessible to those as yet unfamiliar with it. The general approach provides a statistical tool to address important questions that are typically not addressed in current marker research, such as quantifying and controlling for covariate effects.
Modeling and Control PV-Wind Hybrid System Based On Fuzzy Logic Control Technique

As energy demands around the world increase, the need for a renewable energy sources that will not harm the environment is increased. The overall objective of renewable energy systems is to obtain electricity with competitive cost and even benefit with respect to other energy sources. The optimal design of renewable energy system can significantly improve the economical and technical performance of power supply. This paper presents the power management control using fuzzy logic control technique. Also, a complete mathematical modeling and MATLAB/Simulink model for the proposed the electrical part of an aquaculture system is implemented to track the system performance. The simulation results show the feasibility of control technique.
Controlled phase gate for solid-state charge-qubit architectures

We describe a mechanism for realizing a controlled phase gate for solid-state charge qubits. By augmenting the positionally defined qubit with an auxiliary state, and changing the charge distribution in the three-dot system, we are able to effectively switch the Coulombic interaction, effecting an entangling gate. We consider two architectures, and numerically investigate their robustness to gate noise.
A non-foster circuit design for antenna miniaturization

In this paper, a non-Foster circuit for achieving a negative small capacitance based on Linvill floating-type Negative Impedance Convertor (NIC) is realized. The effect of the parasitic elements and the transmission lines on the circuit performance is discussed. The experimental results show that the circuit presents a negative capacitor of 0.87pF in the UHF band. The circuit linearity test reveals a high output 1dB gain compression point at 7.8dBm and an output saturation point at 15.6dBm. Furthermore, the circuit has relatively high inter-modulation Output Intercept Points (OIPs).
The association of Nef with a cellular serine/threonine kinase and its enhancement of infectivity are viral isolate dependent

The nef genes of human immunodeficiency virus type 1 (HIV-1) and simian immunodeficiency virus (SIV) encode a 27- to 34-kDa myristoylated protein which induces downregulation of CD4 surface levels and enhances virus infectivity. In adult macaques, Nef has been implicated in pathogenesis and disease progression. Both HIV-1 SF2 Nef and SIVmac239 Nef have been shown to associate with a cellular serine/threonine kinase. We tested five functional Nef isolates to examine whether this kinase association is a property conserved among different isolates. HIV-1 SF2 and 248 and SIVmac239 Nef proteins were found associated with the kinase. HIV-1 NL4-3 and 233 Nef proteins were found weakly associated or not associated with the kinase. All five Nef isolates efficiently downregulated CD4 cell surface expression, suggesting that the association with this cellular kinase is not required for Nef to downregulate CD4. Comparison of the SF2 and NL4-3 isolates shows a differential ability of Nef to enhance infectivity that suggests a possible correlation between kinase association and enhancement of infectivity.
Hierarchical Second-Order Sliding-Mode Observer for Linear Systems with Unknown Inputs

The problem of observability for systems with unknown inputs is revised. The sufficient and necessary conditions are used for the design an observer for linear systems with bounded unknown inputs. To realize the observation of the state, a second order sliding mode observer is suggested. Such observer provides a robust estimate of the state vector in a finite time. The design is based on the concept of the hierarchical output injection maintaining a value of zero for output tracking error at each level of the hierarchy. The equivalent control is used to identify the unknown inputs, which can be used as a contribution concerning the problem of fault detection. A numerical example illustrates the effectiveness of the suggested technique
The twin policy challenges of Medicare physician payment and Medicaid.

T h e t w o m o s t i m p o rta n t c h a l l e n g e s during my tenure as Health Care Financing Administration (HCFA) administrator (1990–92) were implementing physician payment reform and thwarting the “creative” financing schemes being adopted by states to finance a portion of their Medicaid programs. “Fixing” physician payment and reforming Medicaid continue to be two of the most serious challenges facing the Centers for Medicare and Medicaid Services (CMS) today. Physician payment reform. In 1990–91, the challenge regarding physician payment was to implement the first phase of the resource-based relative value scale (RBRVS) and the volume performance standards (VPS). Making sure that the agency was able to implement the administrative changes and issuing the necessary rules in a timely way were major challenges to the agency, although probably far less difficult to meet than the challenges posed by the Balanced Budget Act (BBA) of 1997 or implementation of the new Part D drug benefit. Although most policy analysts and policymakers believed that the RBRVS represented an improvement over the traditional fee schedule and that the VPS would limit spending, concerns were already being raised about the “perverse” incentives associated with the system Medicare was adopting. Those incentives continue to plague Medicare. None of the reimbursements used by Medicare currently reward quality or good clinical outcomes, but the bundled payment systems like diagnosis-related groups (DRGs) at least reward the more efficient institutions. The RBRVS, because it is so disaggregated, used along with the VPS penalizes rather than rewards efficient physicians. Congress and the administration recognize that Medicare needs to find a way to reward physicians who achieve good clinical outcomes, follow practice guidelines, and practice in an efficient way, and Congress has been pressing the CMS to begin implementing pay-for-performance measures. C M S R e f l e c t i o n s
Correlates of Caregiver Burden After Coronary Artery Bypass Surgery

Background: Coronary artery bypass (CAB) patients often rely on spouses for care and assistance during recovery after surgery. Caregiving can be stressful and meaningful depending upon the interplay of many factors not completely understood. These factors may affect the spouse caregiver's health-related quality of life (HRQL), which may impact ability to care for the CAB patient. Objective: To investigate patient-spouse caregiver relationship and role variables associated with caregiver burden during the first year after CAB surgery. Methods: Using a cross-sectional design, a convenience sample of CAB spouses was recruited at 3, 6, or 12 months. Spouses (n = 166) completed a survey that included perceptions of patient health status, caregiver burden and other caregiving variables, and caregiver HRQL. Results: Higher burden scores were associated with patient's gender (female), poorer patient health status, lower caregiver mental HRQL, increased personal gain, and increased caregiver competence. These correlates explained 38% of the variance in caregiver burden. Discussion: Only poorer patient health status and lower caregiver mental HRQL were supported by previous research in this population. Positive relationships between burden and caregiver competence and personal gain may be a reflection that spouse caregivers were invested and working hard. They felt satisfied from enhancement of self but were burdened from their caregiving role, providing support for a previously described two-domain caregiving model. Caregiver screening is essential to identify spouses at high risk for negative outcomes. Longitudinal research is needed to identify the correlates and predictors most likely to influence burden and caregiver gain over time, and to more fully understand caregiving in the CAB population.
Mild Plasmodium falciparum Malaria following an Episode of Severe Malaria Is Associated with Induction of the Interferon Pathway in Malawian Children

Infection with Plasmodium falciparum can lead to a range of severe to minimal symptoms, occasionally resulting in death in young children or nonimmune adults. In areas of high transmission, older children and adults generally suffer only mild or asymptomatic malaria infections and rarely develop severe disease. The immune features underlying this apparent immunity to severe disease remain elusive. To gain insight into host responses associated with severe and mild malaria, we conducted a longitudinal study of five children who first presented with severe malaria and, 1 month later, with mild malaria. Employing peripheral blood whole-genome profiling, we identified 68 genes that were associated with mild malaria compared to their expression in the severe malaria episode (paired Students t test, P < 0.05). These genes reflect the interferon (IFN) pathway and T cell biology and include IFN-induced protein transcripts 1 to 3, oligoadenylate synthetases 1 and 3, and the T cell markers cathepsin W and perforin. Gene set enrichment analysis identified Gene Ontology (GO) pathways associated with mild malaria to include the type I interferon-mediated signaling pathway (GO 0060337), T cell activation (GO 0042110), and other GO pathways representing many aspects of immune activation. In contrast, only six genes were associated with severe malaria, including thymidine kinase 1, which was recently found to be a biomarker of cerebral malaria susceptibility in the murine model, and carbonic anhydrase, reflecting the blood's abnormal acid base environment during severe disease. These data may provide potential insights to inform pathogenesis models and the development of therapeutics to reduce severe disease outcomes due to P. falciparum infection.
BSTETRICS he diagnostic dilemma of thrombotic thrombocytopenic urpura / hemolytic uremic syndrome in the obstetric triage nd emergency department : lessons from 4 tertiary hospitals

p t w k e p W c W t g t d W p l m l t f s t s t a l found neurologic sy oi: 10.1016/j.ajog. 2008.10. 037 rome/preeclampsia, whereas patients who were seen in the ED had a iagnosis that is commonplace in the ED (panic attack, domestic vioence, gastroenteritis). Latency from the onset of symptoms to diagnois ranged from 1-7 days. Plasmapheresis treatments in early gestation esulted in favorable maternal-neonatal outcome. Maternal and perinaal mortality rates were 25% each.