Miracle-dz/UniFAR-FTUs huggingface dataset:
The ABCDEF Bundle: Science and Philosophy of How ICU Liberation Serves Patients and Families.

Over the past 20 years, critical care has matured in a myriad of ways resulting in dramatically higher survival rates for our sickest patients. For millions of new survivors comes de novo suffering and disability called "the postintensive care syndrome. " Patients with postintensive care syndrome are robbed of their normal cognitive, emotional, and physical capacity and cannot resume their previous life. The ICU Liberation Collaborative is a real-world quality improvement initiative being implemented across 76 ICUs designed to engage strategically the ABCDEF bundle through team- and evidence-based care. This article explains the science and philosophy of liberating ICU patients and families from harm that is both inherent to critical illness and iatrogenic. ICU liberation is an extensive program designed to facilitate the implementation of the pain, agitation, and delirium guidelines using the evidence-based ABCDEF bundle. Participating ICU teams adapt data from hundreds of peer-reviewed studies to operationalize a systematic and reliable methodology that shifts ICU culture from the harmful inertia of sedation and restraints to an animated ICU filled with patients who are awake, cognitively engaged, and mobile with family members engaged as partners with the ICU team at the bedside. In doing so, patients are "liberated" from iatrogenic aspects of care that threaten his or her sense of self-worth and human dignity. The goal of this 2017 plenary lecture at the 47th Society of Critical Care Medicine Congress is to provide clinical ICU teams a synthesis of the literature that led to the creation of ICU liberation philosophy and to explain how this patient- and family-centered, quality improvement program is novel, generalizable, and practice changing.
Microbial Biofilms

Biofilms are the aggregation of microbial cells, which are associated with the surface in almost an irreversible manner. It exists in variety of forms like dental plaque, pond scum, or the slimy build up in sink. Biofilm formation involves sequence of steps like conditioning, attachment, metabolism, and detachment. Biofilm consists of water channels, EPS (Exopolysaccharide), and eDNA (Environmental DNA), which plays an important role in nutrient circulation, its development, and structure stabilization. Resistance of planktonic bacteria against antimicrobial agents gets increased on the formation of biofilm, which may be the presence of diffusive barrier EPS or neutralizing enzyme, cells undergoing starvation, or due to spore formation. There are numerous factors, which affects biofilm formation such as substratum effects, conditioning film on substratum, hydrodynamics, characteristics of the aqueous medium, cell characteristics, and environmental factors. Biofilm can cause industrial, medical, and household damage and is a reason for loss of billions of dollars every year. Development of biofilm on catheters, medical implants, and devices is a major cause of infections and diseases in humans. Examples include Plaque, Native Valve Endocarditis, Otitis media, Prostatitis, Cystic fibrosis, Periodontitis, Osteomyelitis, and many more.
Adenomatous polyposis coli nucleates actin assembly to drive cell migration and microtubule-induced focal adhesion turnover

Cell motility depends on tight coordination between the microtubule (MT) and actin cytoskeletons, but the mechanisms underlying this MT–actin cross talk have remained poorly understood. Here, we show that the tumor suppressor protein adenomatous polyposis coli (APC), which is a known MT-associated protein, directly nucleates actin assembly to promote directed cell migration. By changing only two residues in APC, we generated a separation-of-function mutant, APC (m4), that abolishes actin nucleation activity without affecting MT interactions. Expression of full-length APC carrying the m4 mutation (APC (m4)) rescued cellular defects in MT organization, MT dynamics, and mitochondrial distribution caused by depletion of endogenous APC but failed to restore cell migration. Wild-type APC and APC (m4) localized to focal adhesions (FAs), and APC (m4) was defective in promoting actin assembly at FAs to facilitate MT-induced FA turnover. These results provide the first direct evidence for APC-mediated actin assembly in vivo and establish a role for APC in coordinating MTs and actin at FAs to direct cell migration.
ADHD and Comorbid Disorders in Childhood Psychiatric Problems, Medical Problems, Learning Disorders and Developmental Coordination Disorder

ADHD is a common disorder for children and is highly comorbid with a number of psychiatric and somatic disorders, which leads to important social impacts. Among common comorbid psychiatric disorders, mood, anxiety and conduct disorders are among the most frequently encountered in clinical practice. Furthermore, there is also some overlap between ADHD and addictive behavior, OCD, tics sleeping disorder and specific learning disorder. Likewise, autistic spectrum disorder and eating disorder are more and more recognized as comorbid entities. Lastly, links with PTSD and attachment disorder have been noted. Other medical issues should also be considered in the assessment of ADHD: brain injury, epilepsy and obesity for example. ADHD children with a co-occurring condition are severely impaired and treatment is more complex. A better comprehension of the high rates of comorbidities with ADHD is necessary to optimize treatment of this condition and prevent some of the negative outcomes associated with comorbid ADHD.
A Ring-Core Optical Fiber Sensor With Asymmetric LPG for Highly Sensitive Temperature Measurement

A compact and highly sensitive temperature sensor based on mode conversion in the ring-core fiber (RCF) incorporating an asymmetric long-period grating (aLPG) is proposed and theoretically simulated. The RCF is composed of a hollow core and a high refractive index ring. The aLPG inscribed in the upper half ring generates mode conversion between modes with different azimuthal orders within the ring. A composite resonant dip containing dual-resonant dips which are generated by mode conversion from HE<inline-formula> <tex-math notation="LaTeX">$_{11x}$ </tex-math></inline-formula> to <inline-formula> <tex-math notation="LaTeX">$\mathrm{T}E_{01}$ </tex-math></inline-formula> and HE<inline-formula> <tex-math notation="LaTeX">$_{21x}$ </tex-math></inline-formula> can be observed in the transmission spectrum. The hollow core is infiltrated with a refractive index liquid whose material refractive index can be modulated via temperature, so the wavelength of the resonant dip can be modulated by temperature, which displays a high sensitivity of 12.92 nm/°C (<inline-formula> <tex-math notation="LaTeX">$32.3~\mu \text{m}$ </tex-math></inline-formula>/RIU). Furthermore, the relationship between 3-dB bandwidth of the resonant dip and temperature is also obtained by polynomial fitting with a high fitting degree of 99.99%.
Projections of primary hip arthroplasty in Germany until 2040

Background and purpose — The number of hip replacements in Germany has increased considerably during the last 2 decades but lately levelled off with no significant increase in operation rates. We analyzed the future trend of hip arthroplasty and projected the number of primary hip replacements that will be performed in Germany until 2040. Patients and methods — We used prevalence data of hip arthroplasty patients from 2010 to 2016 from the nationwide inpatient statistics and population forecasts from the German Federal Bureau of Statistics up to the year 2040. We used Poisson regression to estimate the expected annual number of arthroplasty surgeries with calendar year and patient age as covariates to account for differences among age groups and changes over time. Results — The number of primary hip replacements performed in Germany in 2040 was estimated to grow by 27% to 288 x 103 (95% CI 250 x 103–332 x 103) from 2010. Projected counts were highest for patients aged 60 to 70 years. The estimated incidence rate was projected to 360 (95% CI 312–414) per 100,000 residents. However, incidence rates for individual age classes were found to be constant with a slight decrease over time for individual age classes. Interpretation — Our findings suggest a growth in the total hip arthroplasty count whereas incidence rate remained constant over age classes. We consider the future demographic change to an older population as well as the increasing life expectancy to be the main reasons for the increasing patient numbers rather than a general increase in the operation frequency.
Antenna subset selection for line-of-sight millimeter wave massive MIMO systems

In this paper, antenna subset selection for downlink millimeter wave (mmWave) massive MIMO systems is studied. A low complexity method is proposed to select antenna subset on a uniform planar array (UPA) in base station. The antenna subset selection is reduced to find the optimal positions of the sub-arrays on the UPA. Numerical results show that our proposed antenna subset selections with two or four sub-arrays are superior to transmission using all antennas when the number of users is two in high SNR regime.
A Fuzzy Model Predictive Control Based Upon Adaptive Neural Network Disturbance Observer for a Constrained Hypersonic Vehicle

A fuzzy model predictive control scheme based upon adaptive neural network disturbance observer is proposed for the longitudinal dynamics of a constrained hypersonic vehicle (HV) in the presence of diverse disturbances. First, an equivalent disturbed fuzzy dynamic model with the varying parameters is constructed to approximate the nonlinear dynamics, where the inevitable lumped disturbances, including the fuzzy modeling error, extraneous disturbances, and model uncertainties caused by aerodynamic uncertainties, need to be suppressed. Subsequently, according to the parameter-dependent Lyapunov function, the proposed scheme taking the varying parameters into account is developed to explicitly handle the constraints of fuel equivalence ratio, elevator deflection, and angle of attack. Furthermore, based on the strong nonlinear approximation ability of neural network (NN), an adaptive neural network disturbance observer with the adaptive laws of NN’s weight matrixes is established to estimate lumped disturbances, and then an additional compensator formulated by integrating the estimations of lumped disturbances and the corresponding compensation gain matrix is appended to the proposed method for suppressing the lumped disturbances directly. Finally, the comparative simulation results for tracking the reference commands of velocity and altitude demonstrate that the proposed method provides a satisfactory tracking performance even when HV is in the presence of lumped disturbances and constraints.
Bio-WiTel: A Low-Power Integrated Wireless Telemetry System for Healthcare Applications in 401–406 MHz Band of MedRadio Spectrum

This paper presents a low-power integrated wireless telemetry system (Bio-WiTel) for healthcare applications in 401–406 MHz frequency band of medical device radiocommunication (MedRadio) spectrum. In this paper, necessary design considerations for telemetry system for short-range (upto 3 m) communication of biosignals are presented. These considerations help greatly in making important design decisions, which eventually lead to a simple, low power, robust, and reliable wireless system implementation. Transmitter (TX) and receiver (RX) of Bio-WiTel system have been fabricated in 180 nm mixed mode CMOS technology. While radiating −18 dBm output power to a 50 <inline-formula><tex-math notation="LaTeX">$\Omega$</tex-math></inline-formula> antenna, the packaged TX IC consumes 250 μW power in 100% on state from 1 V supply, whereas the RX IC consumes 990 μW power from 1.8 V supply with a sensitivity of −75 dBm. Measurement results show that TX fulfils the spectral mask requirement at a maximum data rate of 72 kb/s. The measured bit error rate (BER) of RX is less than <inline-formula><tex-math notation="LaTeX">$10^{-4}$</tex-math></inline-formula> for a data rate of 200 kb/s. The proposed Bio-WiTel system is tested successfully in home and hospital environments for the communication of electrocardiogram and photoplethysmogram signals at a data rate of 57.6 kb/s with a measured BER of <10 <inline-formula><tex-math notation="LaTeX">$^{-4}$</tex-math></inline-formula> for a maximum distance of 3 m.
Cutaneous Wound Healing

Overall, burns are smaller than 20 years ago, but even small burns can leave patients with debilitating scars. The management of the burn wound and resultant scarring requires the integration of multiple disciplines. Despite our best efforts, the evaluation and treatment of burn wounds and burn scars has not been completely elucidated. The purpose of this work is to describe the state of knowledge regarding wound healing, both what is known and what is not known, and to recap the priorities set by the breakout sessions of the Burn State of the Science: Research meeting. Wound challenges in 2007 include wound coverage for patients with extensive full-thickness burns, management of donor sites and partial-thickness burns, and reduction of longterm morbidity from burn scars.
Shinrin-Yoku (Forest Bathing) and Nature Therapy: A State-of-the-Art Review

Background: Current literature supports the comprehensive health benefits of exposure to nature and green environments on human systems. The aim of this state-of-the-art review is to elucidate empirical research conducted on the physiological and psychological effects of Shinrin-Yoku (or Forest Bathing) in transcontinental Japan and China. Furthermore, we aim to encourage healthcare professionals to conduct longitudinal research in Western cultures regarding the clinically therapeutic effects of Shinrin-Yoku and, for healthcare providers/students to consider practicing Shinrin-Yoku to decrease undue stress and potential burnout. Methods: A thorough review was conducted to identify research published with an initial open date range and then narrowing the collection to include papers published from 2007 to 2017. Electronic databases (PubMed, PubMed Central, CINAHL, PsycINFO and Scopus) and snowball references were used to cull papers that evaluated the use of Shinrin-Yoku for various populations in diverse settings. Results: From the 127 papers initially culled using the Boolean phrases: “Shinrin-yoku” AND/OR “forest bathing” AND/OR “nature therapy”, 64 studies met the inclusion criteria and were included in this summary review and then divided into “physiological,” “psychological,” “sensory metrics” and “frameworks” sub-groups. Conclusions: Human health benefits associated with the immersion in nature continue to be currently researched. Longitudinal research, conducted worldwide, is needed to produce new evidence of the relationships associated with Shinrin-Yoku and clinical therapeutic effects. Nature therapy as a health-promotion method and potential universal health model is implicated for the reduction of reported modern-day “stress-state” and “technostress. ”.
Bayesian Optimization of Personalized Models for Patient Vital-Sign Monitoring

Gaussian process regression (GPR) provides a means to generate flexible personalized models of time series of patient vital signs. These models can perform useful clinical inference in ways that population-based models cannot. A challenge for the use of personalized models is that they must be amenable to a wide range of parameterizations, to accommodate the plausible physiology of any patient in the population. Additionally, optimal performance is typically achieved when models are regularized in light of the knowledge of the physiology of the individual patient. In this paper, we describe a method to build GP models with varying complexity (via covariance kernels) and regularization (via fixed priors over hyperparameters) on a patient-specific level, for the purpose of robust vital-sign forecasting. To this end, our results present evidence in support of two main hypotheses: 1) the use of patient-specific models can outperform population-based models for useful clinical tasks, such as vital-sign forecasting; and 2) the optimal values of (hyper)parameters of these models are best determined by sophisticated methods of optimization, due to high correlation between dimensions of the search space. The resulting models are sufficiently robust to inform clinicians of a patient's vital-sign trajectory and warn of imminent deterioration.
Model-based recursive partitioning to identify risk clusters for metabolic syndrome and its components: findings from the International Mobility in Aging Study

Objective Conceptual models underpinning much epidemiological research on ageing acknowledge that environmental, social and biological systems interact to influence health outcomes. Recursive partitioning is a data-driven approach that allows for concurrent exploration of distinct mixtures, or clusters, of individuals that have a particular outcome. Our aim is to use recursive partitioning to examine risk clusters for metabolic syndrome (MetS) and its components, in order to identify vulnerable populations. Study design Cross-sectional analysis of baseline data from a prospective longitudinal cohort called the International Mobility in Aging Study (IMIAS). Setting IMIAS includes sites from three middle-income countries—Tirana (Albania), Natal (Brazil) and Manizales (Colombia)—and two from Canada—Kingston (Ontario) and Saint-Hyacinthe (Quebec). Participants Community-dwelling male and female adults, aged 64–75 years (n=2002). Primary and secondary outcome measures We apply recursive partitioning to investigate social and behavioural risk factors for MetS and its components. Model-based recursive partitioning (MOB) was used to cluster participants into age-adjusted risk groups based on variabilities in: study site, sex, education, living arrangements, childhood adversities, adult occupation, current employment status, income, perceived income sufficiency, smoking status and weekly minutes of physical activity. Results 43% of participants had MetS. Using MOB, the primary partitioning variable was participant sex. Among women from middle-incomes sites, the predicted proportion with MetS ranged from 58% to 68%. Canadian women with limited physical activity had elevated predicted proportions of MetS (49%, 95% CI 39% to 58%). Among men, MetS ranged from 26% to 41% depending on childhood social adversity and education. Clustering for MetS components differed from the syndrome and across components. Study site was a primary partitioning variable for all components except HDL cholesterol. Sex was important for most components. Conclusion MOB is a promising technique for identifying disease risk clusters (eg, vulnerable populations) in modestly sized samples.
Dietary fat intake and risk of coronary heart disease : the Strong Heart Study 1 4

Background: The results of previous studies on the association between dietary fat intake and coronary heart disease (CHD) incidence are inconsistent. Objective: The aim of this study was to examine the association between dietary fat intake and CHD incidence in American Indians in the Strong Heart Study. Design: A total of 2938 participants aged 47–79 y and free of CHD at the second examination (1993–1995) were examined and followed for CHD, nonfatal CHD, and fatal CHD events to 31 December 2002. Dietary intake was assessed by using a 24-h diet recall and was calculated as percentages of energy. Results: Participants were followed for a mean ( SD) of 7.2 2.3 y. During follow-up, 436 incident CHD cases (298 nonfatal CHD and 138 fatal CHD events) were ascertained. Participants aged 47–59 y in the highest quartile of intake of total fat, saturated fatty acids, or monounsaturated fatty acids had higher CHD mortality than did those in the lowest quartile [hazard ratio (95% CI): 3.57 (1.21, 10.49), 5.17 (1.64, 16.36), and 3.43 (1.17, 10.04), respectively] after confounders were controlled for. These associations were not observed for those aged 60–79 y. Conclusions: Total fat, saturated fatty acid, and monounsaturated fatty acid intake were strong predictors of CHD mortality in American Indians aged 47–59 y, independent of other established CHD risk factors. It may be prudent for American Indians to reduce their fat intake early in life to reduce the risk of dying from CHD. Am J Clin Nutr 2006;84:894–902.
Factors Influencing Productivity of Agile Software Development Teamwork: A Qualitative System Dynamics Approach

Agile method emphasizes on the people factors and strength of teamwork that simplify the development process. A highly productive team throughout an agile software development process is very instrumental in achieving project success. Consequently, understanding of how individual behaviour and productivity are affected by teamwork within an agile team becomes critical. Identifying factors that impact productivity will result in improvement of teamwork. Hence, a need emerges to recognise the significant ones. Doing so will enable project team management to determine the areas where to concentrate efforts in order to improve productivity. The objective of this research is to identify and analyse agile teamwork productivity influence factors by using system dynamics (SD) approach. Identification of main factors influencing productivity and how they impact agile teamwork are carried out through interviews, survey and literature review. From the perspective of agile team members, the four most perceived factors impacting on their productivity are team effectiveness, team management, motivation and customer satisfaction. Lack of agile team management support is found to be the most mentioned reason for failed agile project. The complex interrelated structure of different factors affecting agile teamwork productivity is modeled using influence diagram and Causal Loop Diagram (CLD) for qualitative analysis.
Compressive sensing based power signal compression in advanced metering infrastructure

In this paper, we consider a compressive sensing (CS) based compression method for aggregated power signals of smart meters in advanced metering infrastructure (AMI). If detailed power signals with high sampling rates are available for energy management systems, advanced services such as demand response and power disaggregation can be provided. However, typical smart meters have limited bandwidth resources and may require aggressive data compression for supporting the intensively sampled data. In order to alleviate the overhead for the detailed power signal, a CS based compression scheme is proposed in this study to take advantage of the sparsity of power signals based on the appliance load superposition modeling. Through simulations, the CS based compression schemes demonstrate improved energy efficiency while maintaining good reconstruction performance, compared to the wavelet based compression.