Miracle-dz/UniFAR-FTUs huggingface dataset:
Calibration and discrimination by daily Logistic Organ Dysfunction scoring comparatively with daily Sequential Organ Failure Assessment scoring for predicting hospital mortality in critically ill patients*

Objective The Logistic Organ Dysfunction (LOD) score has been proved effective in evaluating severity during the first day in an intensive care unit but has not been evaluated later. To evaluate attributable mortality related to nosocomial events, organ dysfunction scores that remain accurate throughout the intensive care unit stay are needed. The objective of this study was to evaluate how accurately daily LOD scoring predicts mortality comparatively with daily Sequential Organ Failure Assessment (SOFA) scoring. Design Prospective multicenter study. Setting Six intensive care units in France. Patients A total of 1685 patients with intensive care unit stays longer than 48 hrs were included in this study (511 hospital deaths). Median age was 66 yrs, and median Simplified Acute Physiology Score II at admission was 38. For each patient, a senior physician recorded the variables needed to compute organ dysfunction scores daily throughout the intensive care unit stay. Interventions None. Measurements and Main Results SOFA and LOD scores were computed daily during the first 7 days. Calibration was evaluated based on goodness-of-fit by the Hosmer-Lemeshow chi-square statistic (lower chi-square values and higher p values indicate better fit) and discrimination based on the receiver operating characteristics (ROC) area under the curve (AUC; a ROC-AUC of 1 indicates faultless discrimination and a ROC-AUC of 0.5 indicates the effects of chance alone). Because calibration of both scores was poor at all time points (p < .001), customization was performed using the total score (model 1) or separate introduction of each dysfunction (model 2). The performance of customized LOD and SOFA scores on a given day in predicting mortality was assessed in those patients who spent at least one more calendar day in the intensive care unit. The original LOD and SOFA scores had satisfactory ROC-AUC values (0.720 to 0.766). Internal consistency of both scores was acceptable (p < 10−4 for each organ dysfunction). After customization, the original scores calibrated well between days 1 and 7. Discrimination by both scores was better with model 2 (AUC-ROC, 0.729–0.784). Conclusion Daily LOD and SOFA scores showed good accuracy and internal consistency, and they could be used to adjust severity for events occurring in the intensive care unit.
Impersonation Challenges Associated With E-Assessment of University Students

Online examination (E-assessment) is an increasingly important component of online courses, and student authentication is widely seen as one of the major concerns for online examinations. Due to the inherent anonymity of being online, compared to taking an examination in a classroom environment, students may attempt to artificially boost their scores in online examination. This may occur by having another individual take the exam for them, which a typical user/password authentication scheme cannot detect. This research aims to investigate authentication challenges to online examinations, review benefits, constraints of existing authentication traits, and discuss alternative techniques. This will lead to the use of a profile based authentication framework (PBAF) together with user-id and password for the authentication of students during online examinations. The proposed –solution will utilize profile based challenge questions, user-id and password, which will be verified by development of PBAF in a virtual learning environment. The sample size will be obtained from a group of E-learning University students. Descriptive method of research will be used in order to develop better understanding of finding out what is happening, to seek new insight, to ask questions and to assess phenomena in a new light with the use of questionnaires. Data will be analyzed through descriptive statistics where graphs, pie charts, frequency distribution tables and histograms will be used, factor analysis will be employed. Statistical Package for the Social Sciences (SPSS) will also be used as software to analyze data. As a result of this research e-assessment will be deemed more secure in terms of the authentication process. Key Words: Authentication, E-Learning,E-Assessment, Impersonation
A Comparative Study to Assess the Determinants and Outcomes of Sepsis Treated in Medical Wards and ICU in an Indian Teaching Hospital.

INTRODUCTION Sepsis is the primary cause of death from infection worldwide. In resource-limited countries, increasing number of sepsis is managed in non-ICU settings, in Medical Wards (MW). AIM To compare the burden, aetiology and short term outcome of sepsis treated in MW with ICU. MATERIALS AND METHODS Prospective, observational, analytical study in sepsis patients in general MW and medical ICU in a tertiary care hospital. Two hundred forty five sepsis patients (MW=150, ICU=95), ≥18 years, selected randomly, were studied to compare aetiology, co-morbidities, clinical & microbiological profile and short-term outcome between MW and ICU sepsis. Sepsis following surgery, trauma, those transferred to/from ICU, those with other life threatening diseases were excluded. Chi-square test/Fisher's-exact test was used for comparing ratios. A 'p-value' <0.05 was considered statistically significant. RESULTS Sepsis was more common in elderly males, both in MW and ICU (median age: 56.7, 59.2 years; male: female ratios = 1.34:1, 1.63:1 respectively). Frequency of presenting symptoms, co-morbidities and sources of sepsis were similar in both groups (p>0.05). Frequency of positive microbiological culture, pattern of microbial flora and antimicrobial resistance patterns were similar in both groups (p>0.05). Number of antibiotics used was significantly higher in ICU compared to MW (p<0.01); multi-organ dysfunction and mortality were significantly higher in ICU settings (55.8% vs. 38.7%, p=0.04; 48.4% vs. 32.6%, p=0.041 respectively). While sepsis and severe sepsis were significantly higher in MW (34.6% vs. 22.1 %, p=0.03; 47.3% vs. 26.3%, p<0.01 respectively), septic shock was significantly higher in ICU (51.6% vs. 18.0%, p<0.01). Mortality in both settings was highest in septic shock (55.5% and 61.2%, p>0.05) and multi-organ dysfunction (55.1% and 64.2%, p>0.05). Duration of hospital stay was significantly shorter in MW than ICU (7.3 vs. 11.0 days, p<0.01). CONCLUSION Our study aimed to identify determinants and outcome of sepsis in MW and compare with ICU settings. Antibiotic usage in the two settings differed: concurrent use of ≥3 antibiotics, and carbapenems & linezolid usage were significantly higher in ICU compared to MW. Sepsis in MW had significantly lower incidence of multi-organ failure, lower mortality and shorter hospital stay compared to ICU.
Gut instincts: microbiota as a key regulator of brain development, ageing and neurodegeneration

There is a growing realisation that the gut–brain axis and its regulation by the microbiota may play a key role in the biological and physiological basis of neurodevelopmental, age‐related and neurodegenerative disorders. The routes of communication between the microbiota and brain are being unravelled and include the vagus nerve, gut hormone signalling, the immune system, tryptophan metabolism or by way of microbial metabolites such as short chain fatty acids. The importance of early life gut microbiota in shaping future health outcomes is also emerging. Disturbances of this composition by way of antibiotic exposure, lack of breastfeeding, infection, stress and the environmental influences coupled with the influence of host genetics can result in long‐term effects on physiology and behaviour, at least in animal models. It is also worth noting that mode of delivery at birth influences microbiota composition with those born by Caesarean section having a distinctly different microbiota in early life to those born per vaginum. At the other extreme of life, ageing is associated with a narrowing in microbial diversity and healthy ageing correlates with a diverse microbiome. Recently, the gut microbiota has been implicated in a variety of conditions including depression, autism, schizophrenia and Parkinson's disease. There is still considerable debate as to whether or not the gut microbiota changes are core to the pathophysiology of such conditions or are merely epiphenomenal. It is plausible that such neuropsychiatric disorders might be treated in the future by targeting the microbiota either by microbiota transplantation, antibiotics or psychobiotics.
A model for diauxic growth

A model is developed to predict batch and continuous culture behavior of fermentations on two different carbon and energy sources. The basic assumption of the model is that the permease for the favored substrate is constitutive, whereas the permease for the second substrate is subject to induction and catabolite repression. Simulations of the model show features of diauxic growth described in the literature.
Assessing risk and resilience of critical infrastructures in the fuel and energy economy involving failure cascading effects

A practical procedure of risk and resilience assessment, with cascading failures occurring in the fuel and energy economy, is proposed. It is based on the threshold values and multi-energy methods. The probability analysis of the equipment damage is carried out using vulnerability models for various equipment classes and in the process the probit-functional analysis is applied. Resilience indices-criteria are used for assessing the resilience of plants as complex mechanical systems. The procedure proposed enables calculating threshold values of cascading failure; safe distances for equipments; probability assessment of failure propagation. It also adds to identifying the facilities triggering cascading effects; probability of the equipment damage; to assessing the amount of damage and the damage loss rate. The strategy (procedure) allows ranking the equipment as related to the risk of domino effects’ occurrence; analyzing consequences for each cascade direction and the possibility of its propagation on to the following level; evaluating the resilience state of the plant as a technical system. The damage amount and damage loss rate are evaluated comparing the load received and predetermined threshold values of cascading failure for various equipment classes. The strategy (procedure) developed will allow judging about safety of one or other type of a tank farm containing hydrocarbons; the results obtained in the process and the actual data converge. This strategy (procedure) is strongly recommended to be applied by experts in the field of industrial safety in developing industrial safety manifests, safety justification as well as in developing safety registration certificates of critical infrastructures.
A meta-analysis of the risk of boys with isolated cryptorchidism developing testicular cancer in later life

Background Significant variability exists for the relative risk (RR) of testicular malignancy in isolated cryptorchidism. Objective To perform a meta-analysis to clarify the true magnitude of this risk, allowing clinicians to better counsel patients and their families. Setting Secondary research conducted by undergraduate researchers, clinical academics and a clinical statistician. Design, data sources, and methods A search of the English literature was performed for studies relating to testicular cancer and cryptorchidism, published between 1 January 1980 and 31 December 2010, using Embase and Medline databases. 735 papers were identified and analysed by four authors independently in accordance with our inclusion and exclusion criteria. Studies reporting an association between cryptorchidism and subsequent development of testicular malignancy were included. Genetic syndromes or other conditions which predisposed to the development of cryptorchidism were excluded. Pooled estimates and 95% CIs for the RRs were calculated. Results Nine case–control studies and three cohort studies were selected. The case–control studies included 2281 cases and 4811 controls. Cohort studies included 2 177 941 boys, with a total of 345 boys developing testicular cancer (total length of follow-up was 58 270 679 person-years). The pooled RR was 2.90 (95% CI 2.21 to 3.82) with significant heterogeneity (p<0.00001; I2=89%). Conclusion Boys with isolated cryptorchidism are three times more likely to develop testicular cancer. The limitations of this study must be acknowledged, in particular, possible publication bias and the lack of high-quality evidence focusing on the risk of malignancy in boys with isolated cryptorchidism.
Tailoring the properties of a zero-valent iron-based composite by mechanochemistry for nitrophenols degradation in wastewaters

ABSTRACT Zero-valent iron (ZVI) is a valuable material for environmental remediation, because of its safeness, large availability, and inexpensiveness. Moreover, its reactivity can be improved by addition of (nano-) particles of other elements such as noble metals. However, common preparation methods for this kind of iron-based composites involve wet precipitation of noble metal salt precursors, so they are often expensive and not green. Mechanochemical procedures can provide a solvent-free alternative, even at a large scale. The present study demonstrates that it is possible to tailor functional properties of ZVI-based materials, utilizing high-energy ball milling. All main preparation parameters are investigated and discussed. Specifically, a copper-carbon-iron ternary composite was prepared for fast degradation of 4-nitrophenol (utilized as model pollutant) to 4-aminophenol and other phenolic compounds. Copper and carbon are purposely chosen to insert specific properties to the composite: Copper acts as efficient nano-cathode that enhances electron transfer from iron to 4-nitrophenol, while carbon protects the iron surface from fast oxidation in open air. In this way, the reactive material can rapidly reduce high concentration of nitrophenols in water, it does not require acid washing to be activated, and can be stored in open air for one week without any significant activity loss.
Effect of H2O2 on CCK‐8‐evoked changes in mitochondrial activity in isolated mouse pancreatic acinar cells

Background information. This paper studies the effect of H2O2 on mitochondrial responses evoked by CCK‐8 (cholecystokinin 8) in mouse pancreatic acinar cells. Cytosolic ([Ca2+]c) and mitochondrial ([Ca2+]m) free‐calcium concentrations, mitochondrial inner membrane potential (ψm) and FAD autofluorescence were monitored using confocal laser scanning microscopy.
Caries and restoration prevention.

BACKGROUND The authors analyzed studies of decayed, missing and filled (DMF) rates for surfaces and teeth in Norway published during the last 30 years. The result of active fluoride therapy combined with a change in criteria for when to place restorations led to a marked reduction in the need for restorations. METHODS The authors reviewed independent, cross-sectional DMF studies of representative samples of young adults performed every 10 years during the period 1973 through 2006. The clinicians involved in the studies used standardized and calibrated methods. The authors of this article also reviewed an additional series of studies collecting DMF data from representative samples of 15-year-old adolescents that also had been carried out independently from 1979 through 1996. In these studies, the investigators examined clinical records and bitewing radiographs with attention to progression of carious lesions and restorative treatments. RESULTS The authors noted a marked reduction in the mean decayed, missing and filled surface (DMFS) scores from 1973 through 2006 in the two adult groups. They also found a significant decrease in treatment of caries. The reduction was most marked after the mid-1990s. They noted that the most dramatic change in the data from the 15-year-olds resulted from a change in the treatment criteria during the 1980s. Approximal lesions in enamel were monitored by the investigators of those studies in combination with the use of fluoride toothpaste. CONCLUSION AND CLINICAL IMPLICATIONS A caries treatment approach based on active caries-preventive treatment and restrictive criteria for restoration placement are good bases for reducing the need for restorations as shown in cross-sectional studies reviewed.
Recurrent abdominal pain in children.

CONTEXT Recurrent abdominal pain is one of the commonest gastrointestinal complaints in children, affecting approximately 10% of school aged children and adolescents. There is no consensus with regards to etiology, investigation and management of this common problem. This review addresses some of the issues related to epidemiology, etiology, management and prognosis of recurrent abdominal pain. EVIDENCE ACQUISITION We reviewed current literature on this broad subject, specially concentrating on epidemiology, etiology and, basic and advanced management strategies, from 1958 to date, using PubMed, Embase, Cochrane database and cross references. RESULTS The majority of the affected children have functional gastrointestinal diseases. The exact cause of pain remains obscure. New evidence suggests that emotional stress, visceral hypersensitivity and gastrointestinal motility disorders may play a vital part in its origin. Pharmacological treatments are commonly used in an effort to manage symptoms, despite the lack of data supporting their efficacy. CONCLUSIONS Most children with recurrent abdominal pain have functional gastrointestinal diseases and a detailed history, examination and basic stool, urine and hematological investigations are sufficient to exclude organic pathology in them. Despite the magnitude of the problem, knowledge on the effective management options is poor.
Introduction – Advancing Leadership for Social Justice in a Globalized World

Today's educational leaders are faced with a myriad of challenges. They must navigate through and meet the demands of a complex and ever-changing educational landscape, amidst the constant scrutiny placed on them by multiple interest groups internal and external to the school context. Further, while the concern for creating more equitable and just schools is given lip service in policy circles, the extent to which social justice and equity are placed in the forefront of existing educational leadership preparation programs remains problematic as those who prepare school leaders continue to grapple with what social justice means, as well as ways to embed such practices throughout their programs of study.
Impact of poorly controlled hypertension on healthcare resource utilization and cost.

OBJECTIVE To examine the relation between blood pressure (BP) control and utilization and cost of healthcare resources. STUDY DESIGN A retrospective database study of managed care patients in New Mexico from January 1, 1996, to December 31, 1997. PATIENTS AND METHODS We stratified 1000 hypertensive patients into categories based on average and maximum BP. Antihypertensive medication use and cost, number of physician visits, and interval between hypertension-related physician visits were determined. RESULTS Medication costs increased progressively across all BP categories from lowest to highest, and higher average systolic BP (SBP) was significantly correlated with increased cost (P < .001). There were significant correlations between higher maximum BP and greater number of hypertension-related physician visits (P < .001). Mean number of visits for BP groups was 5.5 for patients with a maximum diastolic BP (DBP) < 85 mm Hg and 10.0 for those with a maximum DBP > or = 100 mm Hg (P < .001). Patients with a maximum SBP > or = 180 mm Hg averaged 9.7 visits, whereas those with a maximum SBP < 120 mm Hg averaged 4.1 visits (P < .001). Both SBP and DBP were significantly correlated with time to next visit (P < .001). Mean visit intervals ranged from 44 days for patients with an SBP < 85 mm Hg to 25 days for those with an SBP > or = 180 mm Hg (P < .001). A similar association was found between DBP and visit interval. CONCLUSIONS Poor control of hypertension is associated with higher drug costs and more physician visits. Aggressive treatment might help reduce managed care costs and resource utilization.
High contact resistance readings on clean microwave mobile contacts

In a real-life environment, metallic surfaces are always covered with an insulating film of some type. This can be partly minimized by the use of noble metals for contacts, but even in case of gold, the best material in terms of reactivity with the environment, such films occur. The contact resistance consists therefore in constriction resistance and film (or tunneling) resistance. Gold is known to have little affinity in creating frictional polymers (5% when compared with platinum) but it is known to have some affinity regarding absorption of carbon atoms forming the so-called carbon-oxygen film. Analysis of contacts that exhibited high contact resistance revealed presence of carbon and oxygen imbedded in the reed and probe contact surfaces. These carbon/oxygen areas were not visually identifiable using standard optical techniques, including UV light, and standard inspection magnification of 20 to 40 x. X-ray photo-electron spectroscopy (XPS) analysis revealed that there were no other elements present in the contact and non contact areas of the corresponding paths except Au, C and O. At the same time, measured bonding energies for carbon and oxygen, confirmed the most probable composition of the carbonaceous monolayer. Non-contact areas taken as a background in the evaluation had slightly different composition, however with the same type of carbon structures i.e. bonding energies. XPS measurements conducted on various contacts showed that the thickness of such a film is usually less than 10 nm. The work presents an analysis that shows, based on RF data interpretation, that the mobile contact member and the fixed contact member were in intimate contact and the equivalent dielectric constant of the insulating layer is higher than one. In addition, using typical values for the tunnel resistivity presented in reference books by R. Holm and K. E. Pitney it is possible to obtain high contact resistance readings comparable with the experimental data. Paper also examines test methodology and limitations in terms of ability to detect tunnel conduction through certain thicknesses of surface films.