Miracle-dz/UniFAR-FTUs huggingface dataset:
Is the quality of data in an electronic medical record sufficient for assessing the quality of primary care?

OBJECTIVE Quality indicators for the treatment of type 2 diabetes are often retrieved from a chronic disease registry (CDR). This study investigates the quality of recording in a general practitioner's (GP) electronic medical record (EMR) compared to a simple, web-based CDR. METHODS The GPs entered data directly in the CDR and in their own EMR during the study period (2011). We extracted data from 58 general practices (8235 patients) with type 2 diabetes and compared the occurrence and value of seven process indicators and 12 outcome indicators in both systems. The CDR, specifically designed for monitoring type 2 diabetes and reporting to health insurers, was used as the reference standard. For process indicators we examined the presence or absence of recordings on the patient level in both systems, for outcome indicators we examined the number of compliant or non-compliant values of recordings present in both systems. The diagnostic OR (DOR) was calculated for all indicators. RESULTS We found less concordance for process indicators than for outcome indicators. HbA1c testing was the process indicator with the highest DOR. Blood pressure measurement, urine albumin test, BMI recorded and eye assessment showed low DOR. For outcome indicators, the highest DOR was creatinine clearance <30 mL/min or mL/min/1.73 m(2) and the lowest DOR was systolic blood pressure <140 mm Hg. CONCLUSIONS Clinical items are not always adequately recorded in an EMR for retrieving indicators, but there is good concordance for the values of these items. If the quality of recording improves, indicators can be reported from the EMR, which will reduce the workload of GPs and enable GPs to maintain a good patient overview.
Effectiveness of knowledge of result and knowledge of performance in the learning of a skilled motor activity by healthy young adults

[Purpose] The acquisition of motor skills are fundamental to human life. There is a lack of research on whether knowledge of performance or knowledge of result as augmented feedback is more effective. The objective of this study was to compare the effectiveness of knowledge of result and knowledge of performance in the learning of a skilled motor activity by healthy young adults. [Subjects and Methods] A total of thirty healthy young adult males and females without any neurological or musculoskeletal impairment, between the age of 18–30 years were the subjects of the study. They were randomly allocated to 2 groups: group 1 was given knowledge of result as feedback, and knowledge of performance was given as feedback to group 2. Both the groups practiced the task of throwing a soft spongy ball for 6 days per week for 4 weeks, with 40 trials each day. The outcome measure used was the distance of the throw. [Results] The results were analyzed using the t-test. The mean distances thrown by both the groups showed highly significant improvements and throwing distance of group 2 showed better improvement than that of group 1. [Conclusion] Both types of augmented feedback were effective at improving skilled motor activity, but the knowledge of performance group showed better improvement than the knowledge of result group.
Integrating Affective Responses and Gamification into Early Reading Acquisition Software Applications

Sisu is a gamified learning application designed to assist school-aged children who are struggling to read. Sisu utilizes readily-available technology to promote learning at home, with unique elements tied to the learning experience: (1) a spelling game with (2) an empathic agent, and (3) a mini-game. The empathic agent utilizes a facial action coding system (FACS) to recognize core expressions of the child user and respond to the child's affect in-game. We anticipate that Sisu's accessible and affective nature will not only support children's emotional needs, but the addition of gamified elements will motivate them to practice reading and assist them in their learning objectives.
Cancer risks associated with germline mutations in MLH1, MSH2, and MSH6 genes in Lynch syndrome.

CONTEXT Providing accurate estimates of cancer risks is a major challenge in the clinical management of Lynch syndrome. OBJECTIVE To estimate the age-specific cumulative risks of developing various tumors using a large series of families with mutations of the MLH1, MSH2, and MSH6 genes. DESIGN, SETTING, AND PARTICIPANTS Families with Lynch syndrome enrolled between January 1, 2006, and December 31, 2009, from 40 French cancer genetics clinics participating in the ERISCAM (Estimation des Risques de Cancer chez les porteurs de mutation des gènes MMR) study; 537 families with segregating mutated genes (248 with MLH1; 256 with MSH2; and 33 with MSH6) were analyzed. MAIN OUTCOME MEASURE Age-specific cumulative cancer risks estimated using the genotype restricted likelihood (GRL) method accounting for ascertainment bias. RESULTS Significant differences in estimated cumulative cancer risk were found between the 3 mutated genes (P = .01). The estimated cumulative risks of colorectal cancer by age 70 years were 41% (95% confidence intervals [CI], 25%-70%) for MLH1 mutation carriers, 48% (95% CI, 30%-77%) for MSH2, and 12% (95% CI, 8%-22%) for MSH6. For endometrial cancer, corresponding risks were 54% (95% CI, 20%-80%), 21% (95% CI, 8%-77%), and 16% (95% CI, 8%-32%). For ovarian cancer, they were 20% (95% CI, 1%-65%), 24% (95% CI, 3%-52%), and 1% (95% CI, 0%-3%). The estimated cumulative risks by age 40 years did not exceed 2% (95% CI, 0%-7%) for endometrial cancer nor 1% (95% CI, 0%-3%) for ovarian cancer, irrespective of the gene. The estimated lifetime risks for other tumor types did not exceed 3% with any of the gene mutations. CONCLUSIONS MSH6 mutations are associated with markedly lower cancer risks than MLH1 or MSH2 mutations. Lifetime ovarian and endometrial cancer risks associated with MLH1 or MSH2 mutations were high but do not increase appreciably until after the age of 40 years.
Brazilian Journal of Microbiology (2012):

Agro-industrial wastes such as sugarcane bagasse, wheat bran, rice bran, corn cob and wheat straw are cheapest and abundantly available natural carbon sources. The present study was aimed to production of amylase and xylanase simultaneously using agro-industrial waste as the sole carbon source. Seven thermophilic strains of actinomycete were isolated from the mushroom compost. Among of these, strain designated MSC702 having high potential to utilize agro-industrial wastes for the production of amylase and xylanase. Strain MSC702 was identified as novel species of Streptomyces through morphological characterization and 16S rRNA gene sequence. Enzyme production was determined using 1% (w/v) of various agro-industrial waste in production medium containing (g/100mL): K2HPO4 (0.1), (NH4)2SO4 (0.1), NaCl (0.1), MgSO4 (0.1) at pH 7.0 after incubation of 48 h at 50°C. The amylase activity (373.89 IU/mL) and xylanase activity (30.15 IU/mL) was maximum in rice bran. The decreasing order of amylase and xylanase activity in different type of agro-industrial wastes were found rice bran (RB) > corn cob (CC) > wheat bran (WB) > wheat straw (WS) > sugarcane bagasse (SB) and rice bran (RB) > wheat bran (WB) > wheat straw (WS) > sugarcane bagasse (SB) > corn cob (CC), respectively. Mixed effect of different agroindustrial wastes was examined in different ratios. Enzyme yield of amylase and xylanase was ~1.3 and ~2.0 fold higher with RB: WB in 1:2 ratio.
Identifying the Study Process Dimensions of Australian University Students

This investigation of 540 first year university students using the ‘approaches to studying’ inventory casts doubt on the validity of the meaning/reproducing/achieving model of the study process domain espoused by Entwistle and Biggs. Rather it suggests that the reproducing dimension can be broken down into surface/confusion and operation learning components. Little evidence was found of the role of achievement motivation in the study methods adopted by these students. The surface/confusion factor was the only factor consistently significantly correlated with tertiary grades. This study supports earlier findings with students at another Australian university that arts students and mature students are more likely to adopt deep-level approaches to study. However there was no agreement as to whether males or females were more inclined to adopt such an approach.
Intramuscular Administration of Lidocaine or Bupivacaine Alters the Effect of Midazolam from Sedation to Hypnosis in a Dose-Dependent Manner

We examined the sedative/hypnotic interaction between the administration of intravenous (i.v.) midazolam and intramuscular (i.m.) lidocaine or bupivacaine. Women undergoing gynecological surgery (n = 150) were randomly assigned to 15 dose groups of 10 patients each. Fifty patients received one of five predetermined doses of midazolam for the calculation of its median effective dose (ED50). The remaining patients (n = 100) received i.v. midazolam 0.1 mg/kg following an i.m. injection of either bupivacaine, lidocaine, or saline (control). Three minutes after the i.v. dose, the loss of response to verbal command was evaluated. The ED50 of midazolam was 0.226 mg/kg (95% confidence interval [CI] 18-027; p = 0.03). Both bupivacaine and lidocaine enhanced the effect of midazolam in a dose-dependent fashion. The hypnotic ED50 for bupivacaine and lidocaine was 0.7 mg/kg (95% CI 0.5-1.0) and 3.32 mg/kg (95% CI 2.2-11.7), respectively. The slopes of the dose-response curves were significantly different (p < 0.01). Local anesthetics that are well within the range of clinical use for regional blocks or local infiltration can bring the effect of midazolam from the sedative into the hypnotic range.
Helix formation via conformation diffusion search

The helix-coil transition kinetics of an α-helical peptide were investigated by time-resolved infrared spectroscopy coupled with laser-induced temperature-jump initiation method. Specific isotope labeling of the amide carbonyl groups with 13C at selected residues was used to obtain site-specific information. The relaxation kinetics following a temperature jump, obtained by probing the amide I′ band of the peptide backbone, exhibit nonexponential behavior and are sensitive to both initial and final temperatures. These data are consistent with a conformation diffusion process on the folding energy landscape, in accord with a recent molecular dynamics simulation study.
Knowledge, attitudes, and breast feeding practices of postnatal mothers: A cross sectional survey.

BACKGROUND Breast feeding has several benefits for both the infants and mothers. However, despite strong evidences in support of breast feeding its prevalence has remained low worldwide. The objective of the present study was to examine the knowledge and attitude towards breast feeding and infant feeding practices among Indian postnatal mothers. METHODOLOGY A cross sectional descriptive study was carried out among randomly selected postnatal mothers at Pediatric outpatient department at a tertiary care center. Data was collected through face-to-face interview using a structured questionnaire. RESULTS Our findings revealed that a majority (88.5%) of the mothers were breast feeders. However, merely 27% of the mothers were exclusive breast feeders and only 36.9% initiated breast feeding within an hour. While mothers have good knowledge on breast feeding (12.05±1.74, M±SD), the average score of the Iowa Infant Feeding Scale (IIFAS) (58.77±4.74, M ±SD) indicate neutral attitudes toward breast feeding. Mothers those who were currently breast feeding (58.83 ± 4.74) had more positive attitudes than non- breastfeed mothers (45.21±5.22). CONCLUSION Our findings also show that the level of exclusive breast-feeding was low. Thus, it is important to provide prenatal education to mothers and fathers on breast-feeding. We also recommend strengthening the public health education campaigns to promote breast-feeding.
Effects of Pitavastatin on the Intima-Media Thickness of the Carotid Artery in Patients with Ischemic Stroke: The Pitavastatin Efficacy Study on Surrogate Markers and Imaging for Stroke (PESSMIST)

Pitavastatin is a strong statin that was developed in Japan. The clinical impact of pitavastatin treatment in patients with ischemic stroke has not been reported. We conducted a prospective, open label, clinical case-control study to determine the secondary preventive effects of pitavastatin for patients with cerebral infarction and hyperlipidemia. The pitavastatin group included 20 Japanese patients diagnosed with cerebral infarction and hyperlipidemia without previous statin intake. The control group included 22 patients diagnosed with cerebral infarction without hyperlipidemia. The pitavastatin group of patients received 2 mg of pitavastatin once a day after dinner. The mean age of the patients was 69.3 and 75.5 years for the pitavastatin and control groups, respectively, and the age of the pitavastatin group was significantly younger than that of the control group (P
On economical timing-error detectors for QAM receivers

This paper deals with timing jitter reduction in the timing recovery loop of a digital QAM receiver. The main contribution, which is derived analytically, is an economical prefilter to reduce the timing jitter in timing recovery loops containing either the early-late or the Gardner timing-error detector (TED). The proposed prefilter has the advantage of being an infinite impulse response filter that is placed inside the TED and runs at the symbol rate. For small roll off factors, it is shown with a computer simulation that a single-pole filter placed inside either the early-late or the Gardner detector is quite effective in reducing the timing jitter.
On the Definition of Resilience in Systems

In the current era of world-wide terrorism, the terms “vulnerability” and “resilience” have become common in the parlance of risk analysis, and various attempts have been made to define and to quantify them. In an article published in Risk Analysis, “On the Definition of Vulnerabilities in Measuring Risks to Infrastructures,”(1) I offered the following definitions: Vulnerability refers to the inherent states of a given system (e.g., physical, technical, organizational, and cultural) that can be exploited by an adversary to adversely affect (cause harm or damage to) that system. Intent is the desire or motivation of an adversary to attack a target and to cause adverse effects. Capability is the ability and capacity to attack a target and to cause adverse effects. Threat denotes the intent and capability to adversely affect (cause harm or damage to) the system by adversely changing its states. A threat with adverse effects to a vulnerable system may lead to risk. (Throughout the rest of this article, the term threat will connote a threat with adverse effects.) Resilience, however, has been defined in the literature in many different ways. Consider, for example, the following definitions. (1) Resilience is the ability of a system to absorb external stresses. (2) (2) Resilience is a system capability to create foresight, to recognize, to anticipate, and to defend against the changing shape of risk before adverse consequences occur. (3,4) (3) Resilience refers to the inherent ability and adaptive responses of systems that enable them to avoid potential losses. (5) (4) Resilience is the re-
Estrous cycle dependent changes in steroid secretion by pig ovarian cells in vitro to polychlorinated biphenyl (PCB 153).

OBJECTIVE To characterize PCB 153 action on the ovary, the direct effect of PCB153 was investigated in vitro using a co-culture of pig granulosa and theca cells collected during different stages of follicular development. METHODS The cells were cultured in the absence or presence of 5, 10, 50 or 100 ng/ml of PCB 153. Media were changed after 48, 96 and 144 h and frozen until further estradiol (E2), progesterone (P4) and testosterone (T) analysis. RESULTS 48 hrs exposure of follicular cells collected from small-size follicles to all the investigated doses of PCB 153 caused statistically significant decrease in progesterone (P4) secretion and at doses of 50 ng and 100 ng/ml in testosterone (T) secretion. No effect on estradiol (E2) secretion was observed. After 96h and 144h exposure to PCB an increase in P4 secretion with concomitant drastic decrease in T secretion and a tendency to decrease in E2 secretion was observed. Similarly as in the case of small follicles, the action of PCB on steroid secretion by cells collected from medium follicles depended on time of exposure. The increase in T secretion and no influence on P4 and E2 secretion was observed after 2 days of exposure to PCB. Antiestrogenic action of PCB was noted after 4 and 6 days of exposure to PCB. In large, preovulatory follicles 2 days exposure to PCB had no effect on steroids secretion while longer exposition to this congener caused statistically significant antiestrogenic action. CONCLUSION The presented paper suggests various actions of PCB 153 as an endocrine disrupter on estradiol, progesterone and testosterone secretion from ovarian cells in vitro which were dependent on both exposure length and stage of the follicular development.
Context-aware and content-based dynamic Voronoi page segmentation

This paper presents a dynamic approach to document page segmentation based on inter-component relationships, local patterns and context features. State-of-the art page segmentation algorithms segment zones based on local properties of neighboring connected components such as distance and orientation, and do not typically consider additional properties other than size. Our proposed approach uses a contextually aware and dynamically adaptive page segmentation scheme. The page is first over-segmented using a dynamically adaptive scheme of separation features based on [2] and adapted from [13]. A decision to form zones is then based on the context built from these local separation features and high-level content features. Zone-based evaluation was performed on sets of printed and handwritten documents in English and Arabic scripts with multiple font types, sizes and we achieved an increase of 15% over the accuracy reported in [2].
Fetal endoderm primarily holds the temporal and positional information required for mammalian intestinal development

In rodents, the intestinal tract progressively acquires a functional regionalization during postnatal development. Using lactase-phlorizin hydrolase as a marker, we have analyzed in a xenograft model the ontogenic potencies of fetal rat intestinal segments taken prior to endoderm cytodifferentiation. Segments from the presumptive proximal jejunum and distal ileum grafted in nude mice developed correct spatial and temporal patterns of lactase protein and mRNA expression, which reproduced the normal pre- and post-weaning conditions. Segments from the fetal colon showed a faint lactase immunostaining 8-10 d after transplantation in chick embryos but not in mice; it is consistent with the transient expression of this enzyme in the colon of rat neonates. Heterotopic cross-associations comprising endoderm and mesenchyme from the presumptive proximal jejunum and distal ileum developed as xenografts in nude mice, and they exhibited lactase mRNA and protein expression patterns that were typical of the origin of the endodermal moiety. Endoderm from the distal ileum also expressed a normal lactase pattern when it was associated to fetal skin fibroblasts, while the fibroblasts differentiated into muscle layers containing alpha-smooth- muscle actin. Noteworthy, associations comprising colon endoderm and small intestinal mesenchyme showed a typical small intestinal morphology and expressed the digestive enzyme sucrase-isomaltase normally absent in the colon. However, in heterologous associations comprising lung or stomach endoderm and small intestinal mesenchyme, the epithelial compartment expressed markers in accordance to their tissue of origin but neither intestinal lactase nor sucrase-isomaltase. A thick intestinal muscle coat in which cells expressed alpha-smooth- muscle actin surrounded the grafts. The results demonstrate that: (a) the temporal and positional information needed for intestinal ontogeny up to the post-weaning stage results from an intrinsic program that is fixed in mammalian fetuses prior to endoderm cytodifferentiation; (b) this temporal and positional information is primarily carried by the endodermal moiety which is also able to change the fate of heterologous mesodermal cells to form intestinal mesenchyme; and (c) the small intestinal mesenchyme in turn may deliver instructive information as shown in association with colonic endoderm; yet this effect is not obvious with nonintestinal endoderms.
Learn From Your Mistakes

Fired superintendents should resolve to first set their own house in order, admonish colleagues who have lost their jobs. Tve been trying to correct the things I was doing in my 'previous life/ " said Jim Gilligan of Richmond County Country Club in Staten Island, N.Y. Gilligan, who several years ago was fired after 22 years at his former course, said: "My current job is stronger because I've learned from those experiences. That's true when you're able to make the change. Some people can't do it. I've talked to a lot of superintendents who have been fired and did not evaluate themselves. " Books on career changes and outplacement don't address selfevaluation, Gilligan said. "They pointyou toward the future, stress your accomplishments, and put the negatives and failures aside. But they're [failures] still there. " Spot personal weaknesses, acceptyour portion of the blame for losing your job, and work to improve, Gilligan recommended. Although he has a degree in club management as well as in agricultural biology and turfgrass management, Ted Horton said most superintendents have very little personnel training and few management skills. Horton, vice president of resource management at Pebble Beach Co. in Monterey, Calif. , said some schools are working to rectify that by adding personnel courses into their twoand four-year curricula. "Jim McLoughlin [of McLoughlin Group in Pleasantville, N.Y. ] 15 years ago started a club management course at Manhattanville College. All the superintendents in the area rushed to take it But all the club managers avoided it. And because they did not participate in the program, it fell on its face. I think it was a very well-intentioned program that should have gotten support of the whole industry," Horton said. Gilligan said many superintendents feel isolated and that "it's you against the rest of the world. You become protective. " Because of his years at his former course, Gilligan was addressing the course as partly his. But, he said, "I was told it was not It was the members' course. I was veiy protective of it. Too much so. "Now I'm taking more of a business-like perspective of my job. I'm using some business plan models in dealing with personnel and jobs at the course, dealing with members, trying to act more as a middle manager in a corporation. " • • •
A distributed graphics library system

We present a set of library routines that allow easily parallelized graphics rendering routines that require no communication between each parallel task, such as ray‐tracing, to be run efficiently in an environment of distributed workstations. The presentation of the paper focuses on the problems encountered in implementing a distributed system under Unix and proposes solutions to each problem. Specifically, we discuss the challenges involved in overcoming the limits of communicating with a large number of processes in Unix and in providing fault tolerance when using sockets. Technical aspects of the implementation and some additional problems that were encountered are discussed. Finally, we compare the rendering times for a complex image with a renderer using the library and show that the library routines are able to exploit much of the existing parallelism. The library is presented using a graphics application, though the concepts are generic enough to be of use in designing any distributed system under Unix.