Miracle-dz/UniFAR-FTUs huggingface dataset:
ACCF/AHA New Insights Into the Methodology of Performance Measurement: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Performance Measures

Since the publication of the initial American College of Cardiology (ACC)/American Heart Association (AHA) Methodology for the Selection and Creation of Performance Measures,1 there has been an explosion in the development and application of performance measures. Although initially envisioned as a means for physician-led quality-improvement efforts, performance measures have been primarily used as tools for accountability and performance-based reimbursement instead. Given the centrality of and experience with performance measures for quantifying healthcare quality, the American College of Cardiology Foundation (ACCF)/AHA Task Force on Performance Measures sought to update its methodology so that ongoing efforts to measure performance could benefit from emerging insights. The original methodology, proposed in 2005,1 remains the foundation for developing process performance measures. The principal recommendations of the 2005 report are summarized in Table 1. The 2010 report does not address detailed issues of analysis,3 pay for performance,4 or nonfinancial rewards for better performance5 because these topics have been addressed in other statements. The focus of the 2010 report is to provide a state-of-the-art perspective on the construction, collection, and emerging directions of performance measurement as a means to improve healthcare quality. View this table: Table 1. ACCF/AHA Attributes of Performance Measures Figure 1. An overview of the steps in providing care by domain. Reprinted from Spertus et al.1 Performance measures that articulate discrete processes of care, as opposed to structural aspects of care or outcomes, are distinctly different from both clinical practice guidelines and appropriate use criteria because they represent a subset of the clinical guidelines for which the evidence is sufficiently strong: typically where the highest-quality evidence of benefit unequivocally exceeds risk (Class I recommendation, Level of Evidence: A),8 failure to provide the therapy to an eligible patient meaningfully reduces the likelihood that the patient will experience the best possible outcome. In this report, …
Modeling and Simulation of Rapid Depressurizations of Hydrocarbon Gas Mixture Flowing at Unsteady High Velocity in Piping Transport System

Rapid depressurizations are among the most critical flow conditions relevant to hydrocarbon gas transport systems. High pressure jumps can be present along the piping, and thermodynamic characteristics should be defined carefully in order to properly predict critical phenomena as shock wave propagation or low temperatures achieved by the fluid and the pipe wall in order to avoid hazardous problems. Usually a onedimensional finite volumes technique called Roe’s method, which assumed ideal gas, is used to study such kind of flows. Often a liquid phase is formed as a result of gas expansion, and the assumption of ideal gas becomes no longer valid. In this work a model using equation of state suitable for hydrocarbon gas mixture (SRK and PR are preferred) which cover all possible phase ranges of the fluid, including the two-phase region in which both liquid and vapor states coexist, was developed.The flow scheme refers to a homogeneous equilibrium model where the fluid properties are averaged with respect to phase mass or volume fractions. The assumption of homogeneity is justified by the high velocity of flow in blowdown pipes, where liquid droplets might be dispersed in the gas core. Thermodynamic equilibrium conditions occur when the high velocity system is fed by a stream having a high void fraction. In fact the transport systems here considered usually contain gas only or gas with a small amount of liquid (“gas-condensate” fluids). Calculation results are reported, showing comparison with referenced data or results obtained using other computer codes, and calculations regarding other flow conditions as well. Keywords-Unsteady two-phase flow; Rapid depressurizations; Shock waves; Multichocking.
Repetitive exposure to zinc oxide nanoparticles induces dna damage in human nasal mucosa mini organ cultures

Data on the toxicological properties of zinc oxide nanoparticles (ZnO‐NPs) is incomplete. ZnO‐NPs may enter humans via inhalation or ingestion. The aim of the current study was to evaluate ZnO‐NP‐induced genotoxicity in three‐dimensional (3D) mini organ cultures (MOCs) of human nasal mucosa following repeated exposure to ZnO‐NP and regeneration. Nasal MOCs of 10 patients and ZnO‐NPs were cultivated for one week and then characterized by electron microscopy. Nasal MOCs were partially covered by ciliated epithelium after one week of cultivation. ZnO‐NPs were distributed to the cytoplasm and the nucleus. MOCs were exposed once, twice, or three times to 0.1 or 5 μg/ml of ZnO‐NPs for 1 hr per exposure and were then evaluated for cytotoxicity and genotoxicity. MOCs were cultivated for 24 hr after the triple ZnO‐NP exposure to allow for regeneration. ZnO‐NP exposure did not result in significant cytotoxicity or apoptosis, as determined by trypan blue exclusion and caspase‐3 activity, respectively. A significant increase in DNA damage was detected following repetitive exposure compared to single exposure to ZnO‐NPs at 5 μg/ml, but not 0.1 μg/ml ZnO‐NPs. At both concentrations of ZnO‐NP, DNA fragmentation increased after 24 hr of regeneration. In contrast, DNA damage which was induced by the positive control, methyl methanesulfonate, was significantly reduced after 24‐hr regeneration. Thus, our results suggest that repetitive exposure to low concentrations of ZnO‐NPs results in persistent or ongoing DNA damage. Environ. Mol. Mutagen. 2011. © 2011 Wiley‐Liss, Inc.
[Study on chemical constituents of flavonoids in fresh herb of Houttuynia cordata].

OBJECTIVE To study the flavonoid constituents in fresh herb of Houttuynia cordata. METHOD Various column packing materials including Diaion HP - 20, Sephadex LH - 20, ODS and silica gel were employed for the isolation and purification of compounds from H. cordata. The structures of the compounds were identified by physiochemical properties and spectral analysis. RESULT Five compounds were isolated, and their structures were identified as quercetin-3-O-beta-D-galactoside-7-O-beta-D-glucoside (1), kaempferol-3-O-alpha-L-rhamnopyranosyl-(1 --> 6)-beta-D-glucopyranoside (2), quercitrin (3), hyperin (4), quercetin 3-O-alpha-L-rhamnopyranosyl-7-O-beta-D-glucopyranoside (5). CONCLUSION Compounds 1, 2 and 5 were separated from H. cordata for the first time.
A fast relay selection algorithm over 60GHz mm-wave systems

Due to the weak diffraction, millimeter-wave (mm-Wave) communication is vulnerable to human blockage. Relay technology is an effective way to cope with LOS link interruption. However, how to quickly find appropriate relay is critical to network performance due to the need of transmission continuity. This paper proposes a fast relay selection (FRS) algorithm based on the geographical location information. By narrowing the relay candidates in specific sectors, FRS greatly reduces the relay searching overhead time compared with traditional exhaustive relay selection (ERS). Simulation results show that FRS improves searching efficiency at the expense of the minimal loss of channel capacity.
Meta-analysis of chemotherapy versus combined modality treatment trials in Hodgkin's disease. International Database on Hodgkin's Disease Overview Study Group.

DESIGN To perform a meta-analysis of all randomized trials that compared chemotherapy (CT) alone versus combined modality treatment (CT + radiotherapy [RT]) for which individual patient data could be made available. PATIENTS AND METHODS Data on 1,740 patients treated on 14 different trials that included 16 relevant comparisons have been analysed. Eight comparisons were designed to evaluate the benefit of additional RT after the same CT (CT1 v CT1 + RT; additional RT design). Eight comparisons were designed to evaluate whether RT in a combined modality setting can be substituted by CT using either more cycles of the same CT or regimens that contain additional drugs (CT1 + CT2 v CT1 + RT or CT1 v CT2 + RT; parallel RT/CT design). RESULTS Additional RT showed an 11% overall improvement in tumor control rate after 10 years (P = .0001; 95% confidence interval [CI], 4% to 18%). No difference could be detected with respect to overall survival (P = .57; 95% CI, -10% to 4%). In contrast, when combined modality treatment was compared with CT alone in the parallel-design trials, no difference could be detected in tumor control rates (P = .43; 95% CI, -6% to 9%), but overall survival was significantly better after 10 years in the group that did not receive RT (P = .045; 8% difference; 95% CI, 1% to 15%). There were significantly fewer fatal events among patients in continuous complete remission (relative risk [RR], 1.73; 95% CI, 1.17 to 2.53; P = .005) if no RT was given. CONCLUSION Combined modality treatment in patients with advanced-stage Hodgkin's disease overall has a significantly inferior long-term survival outcome than CT alone if CT is given over an appropriate number of cycles. The role of RT in this setting is limited to specific indications.
Shruti-II: A vernacular speech recognition system in Bengali and an application for visually impaired community

In this paper we introduce the SPHINX3-based Bengali Automatic Speech Recognition(ASR) system Shruti-II and an E-mail application based on it. This ASR system converts standard Bengali continuous speech to Bengali Unicode. Due to the limited availability of access to computer, visually impaired community can use speech as an input method for various computer-based application. This paper also demonstrates an application based on Shruti-II which is made for the visually challenged people. Those people can send E-mail by using this system.
Psychophysiologic factors contributing to functional performance in people with COPD: are there gender differences?

The purpose of this study was to compare the functional performance profiles of men and women with chronic obstructive pulmonary disease, describe the extent to which physiologic impairment, physical symptoms, and psychosocial resources contribute in a cumulative manner to performance, and outline the extent to which these contributions differ across gender. Secondary data analyses were employed. Although women (n = 45) reported more functional difficulty than men (n = 44) in 9 of 12 Sickness Impact Profile categories, the differences were not significant. Using hierarchical regression procedures, physiologic, symptomatic, and interactive variables predicted total (R2 = .64) and physical performance (R2 = .52), while symptomatic and psychosocial variables predicted psychosocial performance (R2 = .53). Results indicate that models of functional performance may be different for men and women.
Lysozyme levels in cystic fibrosis of the pancreas.

The significance of lysozyme in various body fluids has been discussed in several reviews. 1-3 In general, it is held that lysozyme, as it appears in tears and saliva, exerts a protective influence against bacterial invasion if present in an adequate concentration. Lysozyme exerts its protective effect by hydrolyzing certain structural polysaccharides in the bacterial cell wall, thus causing the dissolution of many bacteria, particularly cocci. Granulocytes 4 also contain "lysozyme-like" enzymes which are released when the cells are injured. 5-7 In areas where there has been a leukocytic proliferation due either to infection or irritation, relatively high levels of lysozyme may be observed. 4,8 The study of the lysozyme activity of various body fluids from patients with cystic fibrosis was considered to be of interest in view of the almost constant development of chronic pulmonary suppuration in this disease. Abnormally high lysozyme levels were observed in the duodenal fluids
Protein polymorphism generated by differential RNA editing of a plant mitochondrial rps12 gene

The rps12 gene transcripts encoding mitochondrial ribosomal protein S12 are partially edited in petunia mitochondria. Different petunia lines were found vary in the extent of rps12 transcript editing. To test whether multiple forms of RPS12 proteins are produced in petunia mitochondria as a result of partial editing, we probed mitochondrial proteins with specific antibodies against edited and unedited forms of a 13-amino-acid RPS12 peptide spanning two amino acids affected by RNA editing. Both antibodies reacted with mitochondrial proteins at the expected size for RPS12 proteins. The amounts of unedited RPS12 protein in different petunia lines correlate with the abundance of unedited transcripts in these plants. Unedited rps12 translation products are also detected in other plant species, indicating that polymorphism in mitochondrial rps12 expression is widespread. Moreover, we show that RPS12 proteins recognized by both edited-specific and unedited-specific antibodies are present in a petunia mitochondrial ribosome fraction. These results demonstrate that partially edited transcripts can be translated and that the protein product can accumulate to detectable levels. Therefore, genes exhibiting incompletely edited transcripts can encode more than one gene product in plant mitochondria.
Adenovirus stimulation of transcription by RNA polymerase III: evidence for an E1A‐dependent increase in transcription factor IIIC concentration.

Human cells expressing adenovirus E1A proteins transcribe transfected tRNA and adenovirus VAI genes at greater than 10‐fold higher levels than uninfected HeLa cells. Here we show that the increased transcription observed in vivo is reflected in the in vitro transcriptional activity of cell extracts. Depletion of E1A protein from these extracts by immunoprecipitation with a monoclonal antibody did not diminish the activity, suggesting that E1A proteins do not stimulate transcription directly. Fractionation of the extracts by chromatography on phosphocellulose suggests that the higher activity of extracts of adenovirus‐infected cells was due to increased activity of the transcription factor (TF) which is the limiting component required for specific initiation of tRNA and VAI transcription in extracts of uninfected HeLa cells, i.e. TFIIIC. Template commitment titrations further suggest that the increased TFIIIC activity was due to an increase in the concentration of active TFIIIC. On the basis of these results and recent genetic analyses of early adenovirus promoters, we suggest that E1A proteins stimulate transcription of adenovirus genes indirectly by increasing the effective in vivo concentration of the limiting cellular transcription factors required for their transcription.
Unconventional Energy of Stable Systems

ing of the evolution, the state of ρ at any given instant t = ti can be taken for ideally entrained by fitting. Due to this and since ρ is assumed smooth in t, the effect of the irreducibility of I and [H, ρ] to invariants is weak for t’s close to ti. So, it may seem reasonable to judge about their figure of merit for not small t − ti by popular perturbation methods of dynamical systems, e.g. [8]. But such insight is insufficient and fails in the long run beyond the domain of ideal to match the future with the past. As the relience on such perturbation theories conforms to the trends of ρ in line with a dressed Hamiltonian, it conduces to the belief in this energy function theory beyond its above-established rigid constraints. By virtue of the considered canonical feature the system’s behavior in externally applied fields changes generally in a non-conservative way. It shows up vigorously in systems under fields of high frequences, particularly near resonances, including parametric and combinational. The averaged effect of hf fields in the lowest, quadratic order in field amplitude results in static vortex forces along with strong potential. Thereat, the quasisteady states, fluctuations and stability of systems at resonances appear quite different from what the theories of quasi-energy and generalized thermodynamic potential prescribe. Various essential effects of this kind, their general features and methods of analysis were elucidated in our work cited in [5]. The extended equilibrium notion and measurements In the above, along with the new notion of energy we have come to a new notion of equilibrium states – the extention of habitual stereotype of system states of rest to the equilibrium states of motion that take place in an immencely wider area of conditions. The conclusion has come from the equations (5) describing generally irreversible kinetics with ∂ρ/∂t 6= 0 and allows for the states of fast motion. However, it relates to the nonequilibrium statistical physics associated with an irreversible transfer of energy rather as a contraposition, for the matter concerns the physics of systems in equilibrium states in outer stationary conditions when the energy is conserved. Is there then a derogation from stationarity? The question is not so academic as principal for the measurements and understanding of the claimed principles. The stationarity for the case is the invariance of
Evolutionspsychologie der Sexualität

Das Verständnis der menschlichen Sexualität bleibt ohne die evolutionspsychologische Perspektive notwendigerweise unvollständig. Der Versuch, das Wesen des Menschen allein aus den gesellschaftlichen Bedingungen, denen er unterworfen ist, zu erklären, würde seine zunächst einmal biologische Natur verleugnen und darum zu kurz greifen. Man sollte sich da nichts vormachen: Wir sind mit all unseren körperlichen und psychischen Ausstattungen Kinder des Pleistozäns und optimiert dafür, in kleineren Gemeinschaften als Jäger und Sammler durch die Savanne zu ziehen (selbst Ackerbau und Viehzucht sind vergleichsweise moderne Errungenschaften). Viele unserer Bedürfnisse, Vorlieben und Abneigungen, die wir meistens als Selbstverständlichkeiten hinnehmen und nicht hinterfragen, lassen sich aus der stammesgeschichtlichen Entwicklung des Menschen als genetisch manifestierte Anpassungen an frühere Lebensbedingungen erklären. Diese Lebensbedingungen haben sich für die meisten Menschen weitreichend und in einem rasanten Tempo geändert, die genetische Ausstattung ist jedoch noch weitestgehend die alte geblieben und oftmals nicht optimal an die heutige Lebensweise angepasst. Anders als alle anderen Spezies ist der Mensch durch seine kulturelle und wissenschaftliche Evolution in einer nie dagewesenen Weise in der Lage, seine Umwelt selbst zu gestalten und für die Befriedigung seiner Bedürfnisse zu sorgen. Das scheint auf den ersten Blick erfreulich und erstrebenswert zu sein, hat aber bei näherer Betrachtung oft fatale Folgen. Denn unsere Bedürfnisse haben keineswegs den adaptiven Zweck, jederzeit und vollständig befriedigt zu werden. Vielmehr dienen sie der Verhaltensregulation unter den längst nicht mehr gegebenen Umweltbedingungen, in denen der Mensch sich als Art entwickelt hat. Verhaltensweisen, die dort und damals sinnvoll und vorteilhaft für das Überleben und den Reproduktionserfolg waren, sind es nicht automatisch auch noch heute. Als Beispiel sei der uns angeborene Appetit auf Süßigkeiten herangezogen. Eine ultimate EDITORIAL 105
Effects of captopril administration on pulmonary haemodynamics and tissue oxygenation during exercise in ACE gene subtypes in patients with COPD: a preliminary study

Background: We have previously shown that angiotensin converting enzyme (ACE) DD genotype is associated with exaggerated pulmonary hypertension and disturbance of tissue oxygenation during exercise in patients with chronic obstructive pulmonary disease (COPD). A pilot study was designed to examine the effects of captopril on these exercise related variables in COPD patients categorised according to ACE gene polymorphisms. Methods: Thirty six patients with COPD (II=13, ID=11, DD=12) received oral captopril (25 mg) or placebo in a randomised, double blind, crossover manner and underwent right heart catheterisation with exercise. Results: Mean pulmonary arterial pressure (mPAP), pulmonary vascular resistance (PVR), and lactate concentration after exercise with both placebo and captopril were higher in patients with the DD genotype than in those with the II or ID genotypes. In contrast, mixed venous oxygen tension (Pvo2) was lower in patients with the DD genotype than in those with the other genotypes. Moreover, mPAP, PVR, and lactate concentration after exercise were lower in the captopril group than in the placebo group in patients with the II or ID genotype, but not in those with the DD genotype. Pvo2 after exercise was higher with captopril than with placebo in patients with the II genotype, but not in those with the other genotypes. Conclusions: These findings suggest that pulmonary haemodynamic variables and state of tissue oxygenation during exercise are dependent on ACE genotypes, and that captopril administration effectively influences these exercise related variables. Although the sample size in this pilot study was limited, it is likely that the improvement in exercise related variables in COPD patients with the II genotype is relatively sensitive to captopril.
Ausfall- und Risikoprämie im Kreditzinssatz

In diesem Beitrag wird herausgearbeitet, welche Bestandteile ein Kreditzinssatz enthält. Zu unterscheiden sind Nominalzinssatz, Effektivzinssatz und die erwartete Rendite des Kreditgebers. Letztere stellt aus Sicht des Kreditnehmers die Fremdkapitalkosten dar. Der aus dem Kreditvertrag abzuleitende Effektivzinssatz enthält sowohl eine Ausfallprämie als auch eine Risikoprämie i.e.S. Die Frage nach den Determinanten dieser Prämien führt zur Betrachtung der Marktbewertung von Krediten. In diesem Zusammenhang erfolgt eine Einführung in die Bewertung von Krediten auf Basis der Optionspreistheorie.
Clinical differences between interstitial lung disease associated with clinically amyopathic dermatomyositis and classic dermatomyositis.

BACKGROUND Interstitial lung disease (ILD) associated with clinically amyopathic dermatomyositis (CADM) is a potentially fatal condition in which the clinical features are not well understood. The aim of the present study was to clarify the differences in clinical characteristics and prognosis of patients with ILD associated with CADM (CADM-ILD) and classic dermatomyositis associated with ILD (DM-ILD). METHODS We retrospectively studied consecutive patients with CADM-ILD and classic DM-ILD who were hospitalized between 2001 and 2007 at Nagasaki University Hospital. The study group consisted of 11 patients with CADM-ILD and 16 patients with classic DM-ILD. We compared the clinical features and prognosis between the two forms. RESULTS The Pao(2)/Fio(2) ratio was significantly lower in patients with CADM-ILD than in patients with classic DM-ILD. The lymphocyte subsets ratio in the BAL fluid of patients with CADM-ILD was significantly higher than the corresponding ratio in patients with classic DM-ILD. ILD is classified as acute or chronic, and the acute subtype was more common in patients with CADM-ILD than in those with classic DM-ILD. The mortality rate for patients with CADM-ILD (45%) was much higher than that for patients with classic DM-ILD (6%), and all of the CADM deaths occurred in the group of patients with acute CADM-ILD. CONCLUSION Our data suggest that the higher prevalence of the acute subtype of ILD in patients with CADM results in a higher mortality rate for patients with CADM-ILD.