Miracle-dz/UniFAR-FTUs huggingface dataset:
Anesthesia for the elderly: selected topics

Purpose of review With the graying of the Western population, there is a continuous increase in the proportion of elderly patients undergoing surgical procedures. Geriatric anesthesia is emerging from a ‘subspecialty’ to the mainstream of today's anesthesia and perioperative care. Much has been written on anesthesia for the elderly, but this review will concentrate on selected topics related to elderly care that represent current unresolved and pertinent issues for the care of the elderly surgical patient. Recent findings Postoperative cognitive dysfunction, cardiac diastolic dysfunction and prophylactic perioperative β-blockade in the process of major noncardiac surgery are three main topics that have recently attracted great interest in clinical practice and research, and have therefore been chosen as the selected topics for this current review. Summary Although age is a clear risk factor for postoperative cognitive dysfunction, the association of general anesthesia with cognitive dysfunction is less clear, as is the effect of anesthesia per se or surgery on long-term cognitive dysfunction. Cardiac diastolic dysfunction is a relatively new and evolving concept in anesthesia and perioperative medicine, yet clearly diastolic dysfunction even with a normal ejection fraction may have a significant effect on the perioperative outcome and management of elderly patients. Small, but powerful studies have shown significant outcome benefit with prophylactic perioperative β-blockade in high-risk patients undergoing major noncardiac surgery. Data from other studies, however, are still conflicting and the final verdict awaits larger scale outcome studies.
Low complexity robust adaptive beamforming for general-rank signal model with positive semidefinite constraint

We propose a low complexity robust beamforming method for the general-rank signal model, to combat against mismatches of the desired signal array response and the received signal covariance matrix. The proposed beamformer not only considers the norm bounded uncertainties in the desired and received signal covariance matrices, but also includes an additional positive semidefinite constraint on the desired signal covariance matrix. Based on the worst-case performance optimization criterion, a computationally simple closed-form weight vector is obtained. Simulation results verify the validity and robustness of the proposed beamforming method.
Organ Location Determination and Contour Sparse Representation for Multiorgan Segmentation

Organ segmentation on computed tomography (CT) images is of great importance in medical diagnoses and treatment. This paper proposes organ location determination and contour sparse representation methods (OLD-CSR) for multiorgan segmentation (liver, kidney, and spleen) on abdomen CT images using an extreme learning machine classifier. First, a location determination method is designed to obtain location information of each organ, which is used for coarse segmentation. Second, for coarse-to-fine segmentation, a contour gradient and rate change based feature point extraction method is proposed. A sparse optimization model is developed for refining the contour feature points. Experimentations with 153 CT images demonstrate the performance advantages of OLD-CSR as compared with related work.
Update on Biochemistry of Plant Volatiles Biochemistry of Plant Volatiles

Plants have a penchant for perfuming the atmosphere around them. Since antiquity it has been known that both floral and vegetative parts of many species emit substances with distinctive smells. The discovery of the gaseous hormone ethylene 70 years ago brought the realization that at least some of the compounds emitted may have physiological significance without any distinctive smell to humans. At present, more than 1,000 low Mr organic compounds have been reported to be emitted from plants, although a comprehensive list is available only for floral volatiles (Knudsen et al., 1993). Our knowledge of the occurrence and distribution of plant volatiles has been significantly extended in the last 15 years thanks to the adoption of simple, sensitive methods for headspace sampling and the availability of relatively inexpensive bench-top instruments for gas chromatography-mass spectrometry. The substances reported are largely lipophilic products with molecular masses under 300. Most can be assigned to the following classes (in order of decreasing size): terpenoids, fatty acid derivatives including lipoxygenase pathway products, benzenoids and phenylpropanoids, C5-branched compounds, and various nitrogen and sulfur containing compounds. Nearly all of these classes are emitted from vegetative parts as well as flowers (Knudsen et al., 1993), and some are even emitted from roots (Steeghs et al., 2004). A major discovery of the last decade is that plants commonly emit much greater amounts and varieties of volatiles after herbivore damage, and not just from the site of injury (Pare and Tumlinson, 1999). Major progress in plant volatile research, as in other areas of plant biology, has come from the use of molecular and biochemical techniques. A large number of genes encoding enzymes of volatile biosynthesis have recently been reported. In vitro characterization of the heterologously expressed enzymes, especially determination of their substrate and product specificity, has helped clarify the pathways of volatile formation. In addition, investigation of the spatial and temporal patterns of gene expression has provided new information on the factors regulating the emission of plant volatile compounds. In this update, we survey the latest advances on the biosynthesis and regulation of plant volatiles, beginning with a brief review of the function of these substances.
Short-term clinical effects of adjunctive antimicrobial photodynamic therapy in periodontal treatment: a randomized clinical trial.

OBJECTIVE The aim of this study was to assess the effect of adjunctive antimicrobial photodynamic therapy (aPDT) in chronic periodontitis. MATERIAL AND METHODS Twenty patients with untreated chronic periodontitis were included. All teeth received periodontal treatment comprising scaling and root planing. Using a split-mouth design, two quadrants (test group) were additionally treated with aPDT. Sulcus fluid flow rate (SFFR) and bleeding on probing (BOP) were assessed at baseline, 1 week and 3 months after treatment. Relative attachment level (RAL), probing depths (PDs) and gingival recession (GR) were evaluated at baseline and 3 months after treatment. RESULTS Baseline median values for PD, GR and RAL were not different in the test group and control group. Values for RAL, PD, SFFR and BOP decreased significantly 3 months after treatment in the control group (median delta RAL: -0.35 mm, inter-quartile range: 0.21 mm), with a higher impact on the sites treated with adjunctive aPDT (median delta RAL: -0.67 mm, inter-quartile range: 0.36 mm, p<0.05). GR increased 3 months after treatment with and without adjunctive aPDT (p<0.05), with no difference between the groups (p>0.05). CONCLUSIONS In patients with chronic periodontitis, clinical outcomes of conventional subgingival debridement can be improved by adjunctive aPDT.
Cuing of movement in Parkinson's disease

The extent to which individual discrete movements of Parkinson's disease (PD) patients could be facilitated by external cues was addressed in a simple sequential button-pressing task. A total of 16 PD patients and their individually age- and sex-matched controls participated. By systematically varying the placement of an auditory cue in each discrete movement of the sequence, the locus that best facilitated each person's performance could be determined. When the placement of the cue was individually tailored for each individual in the movement cycle, and a selected subset of such movements were individually cued, it was found to significantly facilitate sequential movement only for the PD patients and not the controls. However, the benefit accruing to PD patients from such selective cuing was far less than when all such movements in a sequence receive cuing, indicating the probable role of response set in Parkinsonian facilitation. A second experiment, this time involving 12 PD patients and their matched controls, examined the extent of dependence of PD patients' performance on external information. Although Parkinsonian performance was improved by the presence of advance visual information, as predicted, nevertheless the provision of irrelevant delayed cues failed to disrupt performance. Although PD patients did not therefore appear stimulus bound, they may nevertheless depend extensively on external stimuli in performing sequential movements. It was concluded that problems in the smooth sequencing of movements is a major aspect of the movement deficit in PD, which could perhaps be attributed to loss of automatic internal cuing mechanisms from the dysfunctional basal ganglia.
Large variations occur in bone density measurements of children when using different software

BackgroundPaediatric dual X-ray absorptiometry (DXA) studies present a number of technical problems. One of these is that the edge detection algorithms designed for the adult skeleton may fail for paediatric studies. Hologic provide alternative algorithms for low bone density studies. AimTo assess low-density software for the analysis of paediatric DXA studies and to compare with the adult protocol. MethodsOur centre has scanned 450 normal children as part of a normal range study. A subgroup of 103 children was selected using a random number generator. The group was distributed evenly between males and females and across the age range 5–17 years. Each individual underwent both a lumbar spine and a whole-body scan on a Hologic QDR-4500W DXA scanner. Both scans were analysed using the standard adult protocol and then re-analysed using the Hologic experimental paediatric protocol for whole body and the Hologic low-density protocol for lumbar spine. ResultsBoth lumbar spine protocols showed an increase in bone mineral density with age; however, the low-density protocol always produced a lower bone mineral density result than the adult protocol. Bland–Altman analysis showed limits of agreement of 0.031–0.093 g · cm−2 (male, 0.032–0.089 g · cm−2; female, 0.031–0.096 g · cm−2). This represents a mean difference of 9%. Five results showed differences greater than the upper limit of agreement. All these cases were children under 11 years of age who had large areas of spine not identified as bone by the adult protocol. These children were all below the 30th percentile for the body mass index. The whole-body protocols showed similar increases in bone mineral density with age; however, the experimental paediatric protocol always produced a lower bone mineral density result than the adult protocol. Paired results showed limits of agreement of 0.0668–0.130 g · cm−2 (male, 0.063–0.124 g · cm−2; female, 0.073–0.134 g · cm−2). This represents a mean difference of 11%. Five results showed differences greater than the upper limit of agreement. ConclusionsFor anteroposterior (AP) lumbar spine scans, the use of the paediatric algorithm in children under 11 years of age would prevent the largest failures in analysis. For whole-body scanning, the adult algorithm showed no major failures in children of 11 years or older. It is hoped that forthcoming improvements in whole-body density analysis will improve the results for those under 11 years of age. Normal range data should be generated for any new algorithm to allow proper interpretation of clinical studies.
International Union of Pharmacology. XXXIV. Lysophospholipid Receptor Nomenclature

The lysophospholipids, lysophosphatidic acid (LPA) and sphingosine 1-phosphate (S1P), are now recognized as important extracellular signaling molecules. These lipid mediators are pleiotropic; among the most common cellular responses are mitogenesis, cell survival (anti-apoptosis), inhibition of adenylyl cyclase and calcium mobilization. Physiologic events associated with these mediators include platelet aggregation, vasopressor activity, wound healing, immune modulation, and angiogenesis. Many of the actions of LPA and S1P are mediated through a set of eight G protein-coupled receptors. Five of these are S1P-prefering while the remaining three are LPA receptors. These receptors are expressed widely and in aggregate signal through a variety of heterotrimeric G proteins. The lysophospholipid receptor family is referred to commonly as the “Edg” group (e.g., Edg-1, Edg-2, etc.). Herein, the molecular pharmacology of the lysophospholipid receptors is reviewed briefly, and a rational nomenclature for LPA and S1P receptors that is consistent with the International Union of Pharmacology guidelines is proposed.
Comparative analysis of Scheduling Algorithms in Network On Chip using Network Calculus

The design of on chip interconnection architecture (NoC) should carefully take on consideration both hardware and communication constraints in order to build up a system that meets quality of service requirements. In the NoC architecture, the on chip switch available hardware and software resources drive up the global performances of the communication processes. Therefore it is crucial, before the physical design process, to carry out the required capacities such as buffer depth and management-tasks of a flit. In fact, one of the most critical parameters that can affect communication characteristics are the available memory space in addition to flit-time processing according to a given scheduling approach. This paper deals with these concepts. It presents a study of mesh NoC using Network Calculus (NC) theory. We aggregate the individual temporal properties of each component given in switch model to obtain the formula of backlog size and the delay bound. Second we apply theses formulas to calculate the maximum endto-end delay for NoC 2 ×2 communication scenarios and the buffer requirement on such switch. This helps to specify the best physical and logical characteristics that can achieve enhanced
A Kernel Gabor-Based Weighted Region Covariance Matrix for Face Recognition

This paper proposes a novel image region descriptor for face recognition, named kernel Gabor-based weighted region covariance matrix (KGWRCM). As different parts are different effectual in characterizing and recognizing faces, we construct a weighting matrix by computing the similarity of each pixel within a face sample to emphasize features. We then incorporate the weighting matrices into a region covariance matrix, named weighted region covariance matrix (WRCM), to obtain the discriminative features of faces for recognition. Finally, to further preserve discriminative features in higher dimensional space, we develop the kernel Gabor-based weighted region covariance matrix (KGWRCM). Experimental results show that the KGWRCM outperforms other algorithms including the kernel Gabor-based region covariance matrix (KGCRM).
Analytical approach to custom datapath design

Addresses the problem of the layout design automation of a datapath cell. We present a novel approach to the transistor placement problem for custom datapath design and we demonstrate that it can be applied to practical designs. Our approach is based on an analytical model which employs a mixed integer linear programming (MILP) technique. The novelty and originality of the method is the efficient management of the complexity of the underlying mathematical model. Our prototype tool automatically handles transistor merging, folding and intra-cell component sharing.
The Concept of Patient Motivation: A Qualitative Analysis of Stroke Professionals’ Attitudes

Background and Purpose— The purpose of this work was to investigate how stroke rehabilitation professionals understand the concept of motivation and the ways that they use this concept in their clinical practice. Methods— This qualitative study used semistructured, in-depth interviews with the professionals working in the stroke unit of an inner-city teaching hospital in the UK. Results— Motivation was a frequently used concept and was described as an important determinant of rehabilitation outcome. Motivation was attributed to patients on the basis of their demeanor (proactivity was equated with motivation, passivity with lack of motivation) and their compliance with rehabilitation (compliance was seen as indicative of motivation, noncompliance as a lack of motivation). These criteria were found to have blurred boundaries. The determinants of motivation were located partly in personality factors but also in social factors. Central among the social factors were aspects of the professionals’ own behavior taken to positively and negatively affect motivation. Some professionals reported treating unmotivated patients differently from motivated ones, especially if these unmotivated patients were elderly. Motivation was described as a potentially dangerous label. Conclusions— Professionals are wary of the concept of motivation yet commonly use it in their clinical practice. The blurred boundaries of the criteria used to identify motivation mean that patients must strike a delicate balance between proactivity and compliance to avoid being categorized as unmotivated. The way the concept of motivation is used in clinical practice might have negative implications for patient care, eg, when reticent yet motivated patients are labeled unmotivated.
Functional Outcome of Percutaneous Achilles Tendon Repair Vs Open Repair : A Comparative Study

Achilles tendon rupture treatment by percutaneous technique and open repair are well established procedures. There is no consensus as to whether there is difference in outcome between percutaneous and open repair. Achilles Tendon rupture score, an outcome measure developed and validated was used to assess the final outcome in addition to clinical assessment and complications. ATRS was documented at admission of the patient and every third month visit up to one year from surgery. Ankle range of motion and complications were also charted. Patients who did not complete one year follow up are excluded from the study. 26 patients successfully completed the follow up. 11 patients fall into percutaneous group and 15 patients into open repair group. In addition to sports injury we found occupational injuries as common mode of injury in our cohort. At end of 1 year the mean ATRS was 89.4 in percutaneous group and 81.6 in open repair group. Complication rate of 30.6% was identified (20.4% minor and 10.2% major). Our results conclude that there is no significant difference in functional outcome between the two groups. We found wound complications and infection are higher in open repair and sural nerve is at more risk for injury in percutaneous technique.
Overnight Polysomnographic Characteristics and Oxygen Saturation of Healthy Infants, 1 to 18 Months of Age, Born and Residing At High Altitude (2,640 Meters).

BACKGROUND Approximately 8% of the world population resides above 1,600 m, with about 10 million people living above 2,500 m in Colombia. However, reference values for polysomnography (PSG) and oxygen saturation (Spo2) of children < 2 years old residing at high altitude are currently unavailable. METHODS Healthy infants aged 1 to 18 months born and residing at high altitude (Bogotá: 2,640 m) underwent overnight PSG. Four age groups were defined: group 1, < 45 days; group 2, 3 to 4 months; group 3, 6 to 7 months; and group 4, 10 to 18 months. Of 122 children enrolled, 50 had three consecutive PSG tests and were analyzed as a longitudinal subcohort. RESULTS A total of 281 PSG tests were performed in 122 infants (56% girls): group 1, 106 PSG tests; group 2, 89 PSG tests; group 3, 61 PSG tests; and group 4, 25 PSG tests. Active sleep diminished and quiet sleep increased with maturation. Apnea-hypopnea indexes (total, central, and obstructive) were highest in group 1 (21.4, 12.4, and 6.8/h total sleep time, respectively) and diminished with age (P < .001). Mean Spo2 during waking and sleep increased with age (P < .001). Nadir Spo2 values during respiratory events were lower in younger infants. Longitudinal assessments of 50 infants confirmed the temporal trends described for the cross-sectional dataset. CONCLUSIONS Healthy infants (≤ 18 months old) born and residing at high altitude show preserved sleep architecture but higher apnea-hypopnea indexes and more prominent desaturation with respiratory events than do those living at low altitude. The current study findings can be used as reference values for infants at high altitude.
Variation in Medicare's local coverage policies: content analysis of local medical review policies.

OBJECTIVE To assess variation in the content of Medicare's local medical review policies. STUDY DESIGN Six case studies to compare differences in coverage policies by diagnosis codes, procedure codes, and indications for use. METHODS All carrier policies from 48 carrier contracts (n = 5213) posted to the Centers for Medicare & Medicaid Services Web site were downloaded on May 31, 2001. All policies in the data set were coded based on a typology: new technology (NT), extensions of new technology (TE), and utilization management (UM) of widely used procedures. We identified policies addressing the same procedure or technology. We required at least 20 separate policies in each case study to allow meaningful comparisons. We randomly selected 1 case study of a diagnostic and 1 for a treatment modality from each policy type (NT, TE, and UM). RESULTS Given previous research on local carriers, we expected to find variations among policies in each case study. We found substantial similarity, however, among policies covering the NT and TE types. We found significantly more variation among our UM-type case studies. CONCLUSIONS Medicare legislation has called for greater coverage policy consistency in Medicare. This analysis on variation in policy content, part of a larger study on variation in Medicare's local coverage process, provides data on policy content differences. Policy reform should reflect the nature of and reasons for policy variation as suggested by the findings of this research.
Correlates of adverse childhood events among adults with schizophrenia spectrum disorders.

OBJECTIVE Multiple studies have found that childhood adversity is related to a range of poor mental health, substance abuse, poor physical health, and poor social functioning outcomes in the general population of adults. However, despite the high rates of childhood adversity in schizophrenia, the clinical correlates of these events have not been systematically evaluated. This study evaluated the relationship between adverse experiences in childhood and functional, clinical, and health outcomes among adults with schizophrenia. METHODS The authors surveyed 569 adults with schizophrenia regarding adverse childhood events (including physical abuse, sexual abuse, parental mental illnesses, loss of a parent, parental separation or divorce, witnessing domestic violence, and foster or kinship care). The relationships between cumulative exposure to these events and psychiatric, physical, and functional outcomes were evaluated. RESULTS Increased exposure to adverse childhood events was strongly related to psychiatric problems (suicidal thinking, hospitalizations, distress, and posttraumatic stress disorder), substance abuse, physical health problems (HIV infection), medical service utilization (physician visits), and poor social functioning (homelessness or criminal justice involvement). CONCLUSIONS The findings extend the results of research in the general population by suggesting that childhood adversity contributes to worse mental health, substance abuse, worse physical health, and poor functional outcomes in schizophrenia.