Miracle-dz/UniFAR-FTUs huggingface dataset:
Lean thinking in hospitals: is there a cure for the absence of evidence? A systematic review of reviews

Objective Lean interventions aim to improve quality of healthcare by reducing waste and facilitate flow in work processes. There is conflicting evidence on the outcomes of lean thinking, with quantitative and qualitative studies often contradicting each other. We suggest that reviewing the literature within the approach of a new contextual framework can deepen our understanding of lean as a quality-improvement method. This article theorises the concept of context by establishing a two-dimensional conceptual framework acknowledging lean as complex social interventions, deployed in different organisational dimensions and domains. The specific aim of the study was to identify factors facilitating intended outcomes from lean interventions, and to understand when and how different facilitators contribute. Design A two-dimensional conceptual framework was developed by combining Shortell's Dimensions of capability with Walshes’ Domains of an intervention. We then conducted a systematic review of lean review articles concerning hospitals, published in the period 2000–2012. The identified lean facilitators were categorised according to the intervention domains and dimensions of capability provided by the framework. Results We provide a framework emphasising context by relating facilitators to domains and dimensions of capability. 23 factors enabling a successful lean intervention in hospitals were identified in the systematic review, where management and a supportive culture, training, accurate data, physicians and team involvement were most frequent. Conclusions In the absence of evidence, the two-dimensional framework, incorporating the context, may prove useful for future research on variation in outcomes from lean interventions. Findings from the review suggest that characteristics and local application of lean, in addition to strategic and cultural capability, should be given further attention in healthcare quality improvement.
The importance of geologists and geology in tsunami science and tsunami hazard

Abstract Up until the late 1980s geology contributed very little to the study of tsunamis because most were generated by earthquakes which were mainly the domain of seismologists. In 1987–88 however, sediments deposited as tsunamis flooded land were discovered. Subsequently they began to be widely used to identify prehistorical tsunami events, providing a longer-term record than previously available from historical accounts. The sediments offered an opportunity to better define tsunami frequency that could underpin improved risk assessment. When over 2200 people died from a catastrophic tsunami in Papua New Guinea (PNG) in 1998, and a submarine landslide was controversially proven to be the mechanism, marine geologists provided the leadership that led to the identification of this previously unrecognized danger. The catastrophic tsunami in the Indian Ocean in 2004 confirmed the critical importance of sedimentological research in understanding tsunamis. In 2011, the Japan earthquake and tsunami further confirmed the importance of both sediments in tsunami hazard mitigation and the dangers from seabed sediment failures in tsunami generation. Here we recount the history of geological involvement in tsunami science and its importance in advancing understanding of the extent, magnitude and nature of the hazard from tsunamis.
Multi-Project Software Engineering: An Example

In this paper we present an approach for developers to benefit from multi-project software knowledge. As we show in this paper, this can be achieved by gathering information about how numerous software projects are being built, and about the interrelation of the modules within the projects. Compared to approaches that only monitor a single project, the contribution of our approach is that it not only supports the reuse of isolated software modules or libraries but also the knowledge surrounding the code and individual projects. For instance, if a component is replaced with another probably better implementation within a project, this knowledge can be shared with all relevant projects. In this paper, we show how the collection of such data allows developers to learn about such decisions from other projects, and hence how to benefit from such “multi-project” knowl-
Bridging large gaps in the injured spinal cord: mechanical and biochemical tissue adaptation

Incidence and consequences of spinal cord injuries: Worldwide, every year 250,000–500,000 people suffer from spinal cord injury (SCI; www.who.int, 2013). Traumatic lesions of the spinal cord lead to primary and secondary injury mechanisms, which result in axon damage, loss of signal conduction, demyelination of axons and long-lasting deficits in motor and sensory function. The extent of the damage and the subsequent functional loss depend on the spinal level and the severity of the primary injury. Furthermore, pathophysiological and pathomorphological responses in acute and chronic SCI share similar but also different requirements for treatment. To date, SCI is a generally incurable condition, and, although numerous therapeutic strategies to treat SCI have been developed and tested in the last decades (Bradbury and McMahon, 2006), no experimental treatment to achieve substantial axonal regeneration and myelination with accompanying significant behavioral recovery has been successfully translated into a clinical therapy. In this regard, it is also important to take into consideration that even sophisticated combinatorial and sometimes ethically problematic treatment approaches (i.e., embryonic stem cell grafting) face limitations and lack substantial additive benefit regarding functional outcome compared to single component treatments in complete SCI. In SCI patients, rehabilitative training is currently the treatment of choice (Awai and Curt, 2016) that can facilitate the process of recovery to certain but limited extents particularly in severely injured patients. Making use of the basic concepts and safe methods of mechanical and biochemical bridging, it is, however, possible to achieve a remarkable improvement of locomotor function after complete thoracic transection of the spinal cord as shown in adult rats. Two novel treatment procedures, the low pressure mechanical adaptation of severed spinal stumps (Brazda et al., 2013, 2016) and a simple biochemical polymer approach (Estrada et al., 2014; Brazda et al., 2016), as introduced here, promoted beneficial effects on axon growth as well as invasion and activity of various other cell types, which are also affected by SCI. Examples are endothelial cells which were involved in angiogenetic events, and peripheral Schwann cells which myelinated regenerating axons. Very importantly, both treatments led to locomotor improvements after complete thoracic spinal transection, which has, to our knowledge, not been exceeded by any other single component or combinatorial treatment.
All Optical WDM-to-OTDM Conversion at Reduced Channel Spacing using HNLF

With the growing requirement for advanced speeds and better capacity brought about by speedy data expansion on the Internet, Optical time division multiplexing attracted much attention for its high speed operations and ability to overcome the electronic bottleneck problems. In this article, 4x10 Gb/s WDM/OTDM conversion using super continuum(SC) generation at 100Ghz is proposed for 12Km, 24Km and 36Km using SPWRM( Symmetrical pulse width reduction module). HNLF based multiplexing eliminate the requirement of extra pump sources and provide cost effective solution.FWM (four wave mixing) demultiplexing using SOA(semiconductor optical amplifiers) is achieved for all the 4 channels with acceptable limits of BER=10 at 24Km.
Protein Kinase C‐Activating Tumor Promoters Enhance the Differentiation of Astrocytes in Aggregating Fetal Brain Cell Cultures

Abstract: Serum‐free aggregating cell cultures of fetal rat telencephalon treated with the potent tumor promoter phorbol 12‐myristate 13‐acetate (PMA) showed a marked, rapid, and sustained increase in the activity of the astrocyte‐specific enzyme glutamine synthetase (GS). This effect was accompanied by a small increase in RNA synthesis and a progressive reduction in DNA synthesis. Only mitotically active cultures were responsive to PMA treatments. Since in aggregate cultures astrocytes are the preponderant cell type, both in number and mitotic activity, it can be concluded that PMA induces and/or enhances the terminal differentiation of astrocytes. The developmental expression of GS was also greatly stimulated by mezerein, a potent nonphorbol tumor promoter, but not by 4α‐phorbol 12,13‐didecanoate, a nonpromoting phorbol ester. Since both tumor promoters, PMA and mezerein, are potent and specific activators of C‐kinase, it is suggested that C‐kinase plays a regulatory role in the growth and differentiation of normal astrocytes.
Magnetic Resonance Imaging of Spinal Infection

This article reviews the pathophysiology of spinal infection and its relevance for imaging. Magnetic resonance imaging (MRI) is the modality with by far the best sensitivity and specificity for spinal infection. The imaging appearances of spinal infection in MRI are outlined, and imaging techniques are discussed. The problems of clinical diagnosis are outlined. There is some emphasis on the MRI differentiation of pyogenic and nonpyogenic infection and on the differential diagnosis of spinal infection centered on the imaging presentation.
Priming the Secure Attachment Schema Affects the Emotional Face Processing Bias in Attachment Anxiety: An fMRI Research

Our study explored how priming with a secure base schema affects the processing of emotional facial stimuli in individuals with attachment anxiety. We enrolled 42 undergraduate students between 18 and 27 years of age, and divided them into two groups: attachment anxiety and attachment secure. All participants were primed under two conditions, the secure priming using references to the partner, and neutral priming using neutral references. We performed repeated attachment security priming combined with a dual-task paradigm and functional magnetic resonance imaging. Participants’ reaction times in terms of responding to the facial stimuli were also measured. Attachment security priming can facilitate an individual’s processing of positive emotional faces; for instance, the presentation of the partner’s name was associated with stronger activities in a wide range of brain regions and faster reaction times for positive facial expressions in the subjects. The current finding of higher activity in the left-hemisphere regions for secure priming rather than neutral priming is consistent with the prediction that attachment security priming triggers the spread of the activation of a positive emotional state. However, the difference in brain activity during processing of both, positive and negative emotional facial stimuli between the two priming conditions appeared in the attachment anxiety group alone. This study indicates that the effect of attachment secure priming on the processing of emotional facial stimuli could be mediated by chronic attachment anxiety. In addition, it highlights the association between higher-order processes of the attachment system (secure attachment schema priming) and early-stage information processing system (attention), given the increased attention toward the effects of secure base schema on the processing of emotion- and attachment-related information among the insecure population. Thus, the following study has applications in providing directions for clinical treatment of mood disorders in attachment anxiety.
Remote Activation of Host Cell DNA Synthesis in Uninfected Cells Signaled by Infected Cells in Advance of Virus Transmission

ABSTRACT Viruses modulate cellular processes and metabolism in diverse ways, but these are almost universally studied in the infected cell itself. Here, we study spatial organization of DNA synthesis during multiround transmission of herpes simplex virus (HSV) using pulse-labeling with ethynyl nucleotides and cycloaddition of azide fluorophores. We report a hitherto unknown and unexpected outcome of virus-host interaction. Consistent with the current understanding of the single-step growth cycle, HSV suppresses host DNA synthesis and promotes viral DNA synthesis in spatially segregated compartments within the cell. In striking contrast, during progressive rounds of infection initiated at a single cell, we observe that infection induces a clear and pronounced stimulation of cellular DNA replication in remote uninfected cells. This induced DNA synthesis was observed in hundreds of uninfected cells at the extended border, outside the perimeter of the progressing infection. Moreover, using pulse-chase analysis, we show that this activation is maintained, resulting in a propagating wave of host DNA synthesis continually in advance of infection. As the virus reaches and infects these activated cells, host DNA synthesis is then shut off and replaced with virus DNA synthesis. Using nonpropagating viruses or conditioned medium, we demonstrate a paracrine effector of uninfected cell DNA synthesis in remote cells continually in advance of infection. These findings have significant implications, likely with broad applicability, for our understanding of the ways in which virus infection manipulates cell processes not only in the infected cell itself but also now in remote uninfected cells, as well as of mechanisms governing host DNA synthesis. IMPORTANCE We show that during infection initiated by a single particle with progressive cell-cell virus transmission (i.e., the normal situation), HSV induces host DNA synthesis in uninfected cells, mediated by a virus-induced paracrine effector. The field has had no conception that this process occurs, and the work changes our interpretation of virus-host interaction during advancing infection and has implications for understanding controls of host DNA synthesis. Our findings demonstrate the utility of chemical biology techniques in analysis of infection processes, reveal distinct processes when infection is examined in multiround transmission versus single-step growth curves, and reveal a hitherto-unknown process in virus infection, likely relevant for other viruses (and other infectious agents) and for remote signaling of other processes, including transcription and protein synthesis.
Reversing and Smoothing the Multinomial Naive Bayes Text Classifier

Lehrstuhl fu¨r Informatik VI, RWTH Aachen – University of TechnologyD-52056 Aachen (Germany)ney@informatik.rwth-aachen.deAbstract. The naive Bayes text classiﬁer has long been a core tech-nique in information retrieval and, more recently, it has emerged as afocus of research itself in machine learning. This paper is concerned withthe naive Bayes text classiﬁer in its multinomial model instantiation.This model and an “equivalent” reversed version proposed here are in-terpreted under the statistical framework of log-linear modelling. Thereversed version provides an alternative way for parameter estimation,which (in a broad sense) is actually the main issue considered. The pa-per is to a large extent devoted to the study of the eﬀects of parametersmoothing and document length normalization. For the purpose of pa-rameter smoothing, we consider a standard smoothing method for textclassiﬁcation and two alternative techniques that are often used in thecontext of statistical language modelling for speech recognition. Empiricalresults are provided comparing these techniques and the eﬀect of lengthnormalization for both the multinomial model and its reversed version.
Cardioplegic strategies to protect the hypertrophic heart during cardiac surgery

Cardioplegic arrest and cardiopulmonary bypass are key triggers of myocardial injury during aortic valve surgery. Cardioplegic ischaemic arrest is associated with disruption to metabolic and ionic homeostasis in cardiomyocytes. These changes predispose the heart to reperfusion injury caused by elevated intracellular reactive oxygen species and calcium. Cardiopulmonary bypass is associated with an inflammatory response that can generate systemic oxidative stress which, in turn, provokes further damage to the heart. Techniques of myocardial protection are routinely applied to all hearts, irrespective of their pathology, although different cardiomypathies respond differently to ischaemia and reperfusion injury. In particular, the efficacy of cardioprotective interventions used to protect the hypertrophic heart in patients with aortic valve disease remains controversial. This review will describe key cellular changes in hypertrophy, response to ischaemia and reperfusion and cardioplegic arrest and highlight the importance of optimising cardioprotective strategies to suit hypertrophic hearts.
The design, implementation and evaluation of SMART: a scheduler for multimedia applications

Real-time applications such as multimedia audio and video are increasingly populating the workstation desktop. To support the execution of these applications in conjunction with traditional non-realtime applications, we have created SMART, a Scheduler for Multimedia And Real-Time applications. SMART supports applications with time constraints, and provides dynamic feedback to applications to allow them to adapt to the current load. In addition, the support for real-time applications is inte grated with the support for conventional computations. This allows the user to prioritize across real-time and conventional computations, and dictate how the processor is to be shared among applications of the same priority . As the system load changes, SMART adjusts the allocation of resources dynamically and seamlessly. SMAR T is unique in its ability to automatically shed real-time tasks and re gulate their execution rates when the system is overloaded, while providing better value in underloaded conditions than previously proposed schemes. We have implemented SMART in the Solaris UNIX operating system and measured its performance against other schedulers in e xecuting real-time, interacti ve, and batch applications. Our results demonstrate SMART’s superior performance in supporting multimedia applications.
Development of food frequency questionnaires and a nutrient database for the Prospective Urban and Rural Epidemiological (PURE) pilot study in South India: methodological issues.

PURPOSE To develop Food Frequency Questionnaires (FFQs) and nutrient databases for urban and rural Indian populations with diverse dietary habits for the PURE (Prospective Urban and Rural Epidemiological) pilot study. PROCEDURE 24 hour dietary recalls were obtained from 84 rural and 60 urban subjects. From a comprehensive food list, separate FFQs were developed for the two groups. Nutrient analysis of the FFQ required the selection of foods, development of recipes and application of these to cooked foods to develop a nutrient database. The FFQs were piloted in 80 urban and 77 rural subjects. Separately for each group, a stepwise regression method was used to identify foods contributing to a cumulative 90% of variance to total energy intake. Nutrient and food group intakes were compared using an independent t-test. MAIN FINDINGS The urban and the rural FFQs contained 129 and 102 foods respectively, of which 82 foods were common to both. Fourteen urban foods and eight rural foods explained a cumulative 90% of variance for total energy intake. Daily intakes for most nutrients and food groups were two to three fold higher in the urban than in the rural group. CONCLUSIONS In Indian populations with diverse dietary habits, using standard methods to develop separate FFQs can capture dietary intakes adequately. To develop nutrient databases, substitution of local food composition tables with data from other sources using standard methods to match foods can be adopted.
ADAPTATION TO SUBMAXIMAL PHYSICAL TRAINING

Submaximal training can induce adaptational changes in the skeletal muscles, cardiovascular system, respiratory system, endocrine system, etc. Knowledge of the signs of adaptation and its magnitude, the factors causing it, as well as an awareness of the significance of the adaptation for the improvement of physical capacity to exercise is essential to develop an optimal training programme and with an adequate recovery process to achieve the maximum positive effect with the minimum negative effect on the athlete’s health. Body adaptation resulting from regular aerobic training can involve adaptation of the muscle enzyme systems, changes in the vascularization and type characteristic of muscle fibers, metabolic changes in the trained muscles and muscle groups related to the glucose utilization and the use of glycogen and fats as sources of energy, changes in the blood, the immune and coagulation status of the body, as well as changes in the parameters of aerobic working capacity of the organism. Regular submaximal exercises have been found to increase the activity of key oxidative enzymes in the metabolic pathway for the breakdown of carbohydrates - hexokinase (HK) and citrate synthase (CS) and fats – 3-hydroxyacyl-CoA dehydrogenase (3-HAD) and carnitine palmitoyltransferase (CPT) and in the respiratory chain citochrome c oxidase (CCO). Submaximal training induces vascularization in the muscles containing predominantly oxidative muscle fibers. The muscle fibers in the groups of muscles trained submaximally can even undergo a type transformation. The insulin-mediated glucose transport in the cells of the recruited muscles is selectively increased. A metabolic adaptation occurs as the body shifts from using carbohydrates for energy to using fats; the subsequent “glycogen-sparing” effect enhances the working capacity. Permanent changes occur in the humoral immunity evidenced by the increase of the serum IgA and IgG concentrations. The system of oxygen transport in the blood adjusts to more economical operation. As a final result both the external system of oxygen delivery and the mitochondrial system of oxygen utilization undergo adaptation which leads to a moderate increase of maximal oxygen consumption, but greater increase of the oxygen running economy.
The SMART approach for software process engineering

Describes a methodology for software process engineering and an environment, SMART, that supports it. SMART supports a process life-cycle that includes the modeling, analysis, and execution of software processes. SMART's process monitoring capabilities can be used to provide feedback from the process execution to the process model. SMART represents the integration of three separately developed process mechanisms, and it uses two modeling formalisms (object-oriented data representation and imperative-style programming language) to bridge the gap between process modeling, analysis, and execution. SMART demonstrates the meta-environment concept, using a process modeling formalism as input specification to a generator that produces process-centered software engineering environments (PSEEs). Furthermore, SMART supports a team-oriented approach for process modeling, analysis, and execution. <<ETX>>