Miracle-dz/UniFAR-FTUs huggingface dataset:
Measuring diagnoses: ICD code accuracy.

OBJECTIVE To examine potential sources of errors at each step of the described inpatient International Classification of Diseases (ICD) coding process. DATA SOURCES/STUDY SETTING The use of disease codes from the ICD has expanded from classifying morbidity and mortality information for statistical purposes to diverse sets of applications in research, health care policy, and health care finance. By describing a brief history of ICD coding, detailing the process for assigning codes, identifying where errors can be introduced into the process, and reviewing methods for examining code accuracy, we help code users more systematically evaluate code accuracy for their particular applications. STUDY DESIGN/METHODS We summarize the inpatient ICD diagnostic coding process from patient admission to diagnostic code assignment. We examine potential sources of errors at each step and offer code users a tool for systematically evaluating code accuracy. PRINCIPLE FINDINGS Main error sources along the "patient trajectory" include amount and quality of information at admission, communication among patients and providers, the clinician's knowledge and experience with the illness, and the clinician's attention to detail. Main error sources along the "paper trail" include variance in the electronic and written records, coder training and experience, facility quality-control efforts, and unintentional and intentional coder errors, such as misspecification, unbundling, and upcoding. CONCLUSIONS By clearly specifying the code assignment process and heightening their awareness of potential error sources, code users can better evaluate the applicability and limitations of codes for their particular situations. ICD codes can then be used in the most appropriate ways.
Stabilization of double inverted pendulum system by using a fractional differential compensator

In this paper stability problem of double inverted pendulum controlled by a fractional differential compensator is investigated. Pendubot is an underactuated mechanical system, i.e. it has only one control input and two degrees of freedom. Detailed mathematical model of Pendubot is derived using the Rodriguez method and then fractional order lead compensator is introduced in order to stabilize it around unstable upright position. D-decomposition method is used to solve the problem of asymptotic stability of closed loop system. Stability regions in control parameters space are calculated using this technique, which allows tuning of the fractional differential compensator to be carried out.
Understanding Consumer Evaluations of Personalised Nutrition Services in Terms of the Privacy Calculus: A Qualitative Study

Background: Personalised nutrition (PN) may provide major health benefits to consumers. A potential barrier to the uptake of PN is consumers' reluctance to disclose sensitive information upon which PN is based. This study adopts the privacy calculus to explore how PN service attributes contribute to consumers' privacy risk and personalisation benefit perceptions. Methods: Sixteen focus groups (n = 124) were held in 8 EU countries and discussed 9 PN services that differed in terms of personal information, communication channel, service provider, advice justification, scope, frequency, and customer lock-in. Transcripts were content analysed. Results: The personal information that underpinned PN contributed to both privacy risk perception and personalisation benefit perception. Disclosing information face-to-face mitigated the perception of privacy risk and amplified the perception of personalisation benefit. PN provided by a qualified expert and justified by scientific evidence increased participants' value perception. Enhancing convenience, offering regular face-to face support, and employing customer lock-in strategies were perceived as beneficial. Conclusion: This study suggests that to encourage consumer adoption, PN has to account for face-to-face communication, expert advice providers, support, a lifestyle-change focus, and customised offers. The results provide an initial insight into service attributes that influence consumer adoption of PN.
Policies and opportunities for physical activity in middle school environments.

BACKGROUND This study examined physical activity opportunities and barriers at 36 geographically diverse middle schools participating in the Trial of Activity for Adolescent Girls. METHODS Principals, physical education and health education department heads, and program leaders were interviewed to assess policies and instructional practices that support physical activity. RESULTS Schools provided approximately 110 hours per year in physical education instruction. Approximately 20% of students walked or bicycled to school. Eighty-three percent of schools offered interscholastic sports and 69% offered intramural sports. Most schools offered programs for girls, but on average, only 24 girls ( approximately 5%) in the schools attended any programs. Only 25% of schools allowed after school free play. An overall score created to assess school environmental support for physical activity indicated that, on average, schools met 6.7 items of 10 items. Free/reduced lunch program participation versus not (p = .04), perceived priority of physical education instruction over coaching (p = .02), and safety for walking/bicycling to school (p = .02) predicted environmental support score. CONCLUSIONS Schools have policies and practices that support physical activity, although unfavorable practices exist. Schools must work with community partners and officials to provide environments that optimally support physical activity, especially schools that serve low-income students.
The Epstein–Barr virus‐binding site on CD21 is involved in CD23 binding and interleukin‐4‐induced IgE and IgG4 production by human B cells

Human CD21 has previously been described as a receptor for the C3d,g and iC3b proteins of complement, as a receptor for the gp350/220 envelope glycoprotein of the Epstein–Barr virus (EBV) and also as a receptor for interferon‐α (IFN‐α). Structurally, CD21 consists of 15 to 16 short consensus repeats (SCR) of 60 to 75 amino acids followed by a transmembrane domain and an intracytoplasmic region. We reported that CD23, a low‐affinity receptor for IgE (FcεR2), is a new functional ligand for CD21. We recently found that the sites of interaction of CD23 on CD21 are on SCR 5 to 8 and 1–2. The first site is a lectin–sugar type of interaction and the second site is a protein–protein interaction. We report here that amongst the other ligands for CD21 (EBV, C3d,g and IFN‐α), only EBV is able to inhibit the binding of CD23 to CD21. Furthermore, even a peptide from gp350/220 of EBV known to bind to CD21 is able to decrease CD23 binding to CD21. Since CD23/CD21 pairing is important in the control of IgE production, we tested the effect of the EBV‐derived peptide on immunoglobulin production from peripheral blood mononuclear cells and purified tonsillar B cells. Interestingly, the EBV‐peptide inhibited IgE and IgG4 production induced by interleukin‐4, in a dose‐dependent manner. The same results were obtained using either peripheral blood mononuclear cells or purified tonsillar B cells. Another CD21 ligand, C3, did not affect binding of CD23 to CD21 nor the production of IgE and IgG4. This study indicates that blocking CD23 binding to CD21 SCR 2 on human B cells selectively modulates immunoglobulin production.
New public management

New public management is a topical phrase to describe how management techniques from the private sector are now being applied to public services. This book provides a completely up-to-date overview of the main theoretical models of public sector management, and examines the key changes that have occurred as more and more public services are contracted out to private organisations, as the public sector itself grapples with 'internal markets'. Drawing on economics, organisational theory and poliltics, Jan-Erik Lane presents new public management from an analytical perspective. This book uses game theory and empirical studies in order to assess the pros and cons of new public management.
Drosophila Polycomb‐group regulated chromatin inhibits the accessibility of a trans‐activator to its target DNA.

The genes of the Polycomb‐group (Pc‐G) are responsible for maintaining the inactive expression state of homeotic genes. They act through specific cis‐regulatory DNA elements termed PREs (Pc‐G Response Elements). Multimeric complexes containing the Pc‐G proteins are thought to induce heterochromatin‐like structures, which stably and heritably inactivate transcription. We have tested the functional role of the FAB fragment, a PRE of the bithorax complex. We find that this element behaves as an orientation dependent silencer, capable of inducing mosaic gene expression on neighboring genes. Transgenic fly lines were constructed containing a PRE adjacent to a reporter gene inducible by the yeast GAL4 trans‐activator. The competition between the activator and Pc‐G‐containing chromatin was visualized on polytene chromosomes using immunocytochemistry. The Pc‐G protein Polycomb and GAL4 have mutually exclusive binding patterns, supporting the notion that Pc‐G‐induced chromatin structures can prevent activators from binding to their target sequences. However, this antagonistic function can be overcome by high doses of GAL4, even in the absence of DNA replication.
Digital Phase Control of an Integrated Resonant Igniter Using a Soft Saturation Core for High Intensity Discharge Lamps

The paper proposes a robust resonant ignition technique for low frequency square wave (LFSW) ballasts without requiring additional igniter components or increase in component size or weight. The LC filter of the LFSW ballast is used at start-up in a resonant mode for lamp ignition. In order to achieve the high voltage gain required for lamp ignition, significantly higher current and volt-seconds are imposed on the filter inductor during resonant ignition than in steady-state LFSW operation. The proposed solution uses a Kool Mu soft saturation inductor core material to prevent core saturation during ignition without requiring an increase in core size or weight from the design for steady-state LFSW operation. A digital phase controller is used during the ignition sequence to gradually sweep the phase lag of the inductor current from 90° down towards resonance. This results in a robust ignition sequence while maintaining zero voltage switching despite variations of inductance value in the presence of soft saturation core dynamics. Experimental results are presented to demonstrate reliable ignition of 150 W metal halide (MH) and 150 W high pressure sodium (HPS) lamps using the proposed techniques.
On the structural convergence of biomolecular simulations by determination of the effective sample size.

Although atomistic simulations of proteins and other biological systems are approaching microsecond timescales, the quality of simulation trajectories has remained difficult to assess. Such assessment is critical not only for establishing the relevance of any individual simulation but also in the extremely active field of developing computational methods. Here we map the trajectory assessment problem onto a simple statistical calculation of the "effective sample size", that is, the number of statistically independent configurations. The mapping is achieved by asking the question, "How much time must elapse between snapshots included in a sample for that sample to exhibit the statistical properties expected for independent and identically distributed configurations? " Our method is more general than autocorrelation methods in that it directly probes the configuration-space distribution without requiring a priori definition of configurational substates and without any fitting parameters. We show that the method is equally and directly applicable to toy models, peptides, and a 72-residue protein model. Variants of our approach can readily be applied to a wide range of physical and chemical systems.
Estrogen and Stress Interact to Regulate the Hypothalamic Expression of a Human Proenkephalin Promoter‐β‐Galactosidase Fusion Gene in a Site‐Specific and Sex‐Specific Manner

Gonadal steroids and physiological stressors affect the regulation of proenkephalin (PPE) gene expression in the paraventricular (PVN) and ventromedial (VMH) hypothalamic nuclei. To examine the effects of these modulators at the cellular level, the current study utilized a transgenic mouse line that expresses a human proenkephalin promoter/bacterial β‐galactosidase fusion gene (ENK‐1). Previous studies have demonstrated that the regulatory sequences included in this transgene are sufficient to support appropriate transcriptional regulation of the reporter gene in the PVN of male ENK‐1 mice in response to stress. The present experimental paradigm was designed to examine possible interactions of sex and circulating estrogen levels with the opioid responses to acute systemic stressors, an intraperitoneal injection of hypertonic (1.5 M) or isotonic (0.15 M) saline. Adult ENK‐1 mice were gonadally intact, gonadectomized, or 21 days postpartum. Forty‐eight hours before perfusion, castrated males and ovariectomized females received either 10 μg estradiol benzoate or oil vehicle and 4 animals per group received no further treatment. Six h before perfusion, remaining animals received a single intraperitoneal injection of either hypertonic or isotonic saline. Tissues were sectioned through the hypothalamus and processed for X‐gal histochemistry. In the VMH of ovariectomized females that received isotonic saline, estrogen significantly elevated transgene expression. This effect was not seen in females that only received estrogen or in those that received the severe systemic stressor of an injection of hypertonic saline. Estrogen and stress did not interact to elevate transgene expression in the VMH of males. A different pattern of expression was observed in the PVN; injection of hypertonic saline induced transgene expression only in gonadally intact males and in castrated males given estrogen. These findings demonstrate that stress and estrogen have sex‐specific and site‐specific regulatory effects on the expression of a PPE promoter transgene in hypothalamic neurons.
Asymmetrical Dimethylarginine Inhibits Shear Stress–Induced Nitric Oxide Release and Dilation and Elicits Superoxide-Mediated Increase in Arteriolar Tone

l-arginine is the substrate used by NO synthase to produce the vasodilator NO. However, in several human diseases, such as hyperhomocysteinemia, diabetes mellitus, and hypertension, there is an increase in serum levels of methylated l-arginines, such as asymmetrical dimethylarginine (ADMA), which cannot be used by NO synthase to produce NO. Yet, the functional consequence of increased levels of ADMA on the vasomotor function of resistance vessels has not been delineated. We hypothesized that elevated levels of exogenous ADMA inhibit NO mediation of flow/shear stress–dependent dilation of isolated arterioles. In the presence of indomethacin, isolated arterioles from rat gracilis muscle (≈165 &mgr;m at 80 mm Hg) were incubated with ADMA (10−4 mol/L), which eliminated the dilations to increases in intraluminal flow (control: from 164±5.4 to 188±3.8 &mgr;m versus ADMA: from 171±6.1 to 173±6.3 &mgr;m at 20 &mgr;L/min). ADMA did not affect dilations to nifedipine (10−6 mol/L; control: 63.4±2%, ADMA: 65.8±3%) or 8-bromo cGMP (10−4 mol/L; control: 51.2±2.1%, ADMA: 49.3±3.4%). In addition, ADMA elicited significant constriction of arterioles (from 173±17 &mgr;m to 138±16 &mgr;m at 80 mm Hg), which was prevented by previous incubation of arterioles with polyethylene-glycol (PEG) superoxide dismutase (SOD; 120 U/mL, control: 155±11 &mgr;m versus ADMA: 150±14 &mgr;m). Correspondingly, ADMA increased PEG-SOD reversible manner the production of vascular superoxide assessed by lucigenin-enhanced chemiluminescence and ethidium bromide fluorescence. Thus, increased levels of ADMA in various diseases could inhibit the regulation of arteriolar resistance by shear stress–induced release of NO and elicit superoxide-mediated increase in basal tone, both of which favor the development of hypertension.
Sustainability‐oriented capabilities for eco‐innovation: Meeting the regulatory, technology, and market demands

Despite consensus in the literature that regulation, technology push, and market pull drive eco‐innovation (EI), evidence remains limited on the diverse firm capabilities needed to boost EI. Building on the natural‐resource‐based view of the firm and the EI literature, this paper posits that firms need to renew and realign their capabilities, and ultimately develop distinctive sustainability‐oriented capabilities, in order to meet the rapidly changing regulatory, technology, and market demands. Results of the analysis, based on a survey of U.K. firms, reveal that EIs are more likely to arise when firms (a) build capabilities on voluntary self‐regulation (i.e., executive driven environmental management system and corporate social responsibility) because such organizational capabilities allow them to address increasing regulatory pressures; (b) invest in environmental research and development (i.e., eco‐RD and (c) develop capabilities in green market sensing as such capabilities allow them to address green consumption needs.
Identification and function of proteolysis regulators in seminal fluid

Proteins in the seminal fluid of animals with internal fertilization effect numerous responses in mated females that impact both male and female fertility. Among these proteins is the highly represented class of proteolysis regulators (proteases and their inhibitors). Though proteolysis regulators have now been identified in the seminal fluid of all animals in which proteomic studies of the seminal fluid have been conducted (as well as several other species in which they have not), a unified understanding of the importance of proteolysis to male fertilization success and other reproductive processes has not yet been achieved. In this review, we provide an overview of the identification of proteolysis regulators in the seminal fluid of humans and Drosophila melanogaster, the two species with the most comprehensively known seminal fluid proteomes. We also highlight reports demonstrating the functional significance of specific proteolysis regulators in reproductive and post‐mating processes. Finally, we make broad suggestions for the direction of future research into the roles of both active seminal fluid proteolysis regulators and their inactive homologs, another significant class of seminal fluid proteins. We hope that this review aids researchers in pursuing a coordinated study of the functional significance of proteolysis regulators in semen. Mol. Reprod. Dev. © 2012 Wiley Periodicals, Inc.
Technology in the Internet age

Internet electronic products have requirements different from those of personal computers (PCs). The increasing importance of Internet electronics is driving changes in development of IC technology. One important characteristic of the Internet Age is computational disaggregation. Whereas, over the past 20 years, PCs have been characterized by ever-increasing computation capabilities, emerging Internet electronic products are characterized by sufficient computation to achieve the function in a small, often portable, form factor. The imperative for lower cost, which enables penetration into mass markets, is a second area where Internet electronic products differ from PCs. Disaggregation and cost requirements are driving an unprecedented degree of system-on-a-chip (SoC) integration. In the Internet Age, SoC integration means more than integrating different digital cores. It also means integrating functions that are realized today in different technologies: logic, memory, analog, power management, passives and radio or wireline driver, depending on the product. Because SoC integration is motivated primarily by cost, diverse functions must be integrated together in standard CMOS with minimal cost addition. Cost-effective embedded memory technology also needs to be developed. Current examples of SoC integration include cell phones, cable/DSL modems, and Internet audio. These representative examples, together with others, are driving changes in the way ICs are developed. In the latter half of the decade, it is likely that SoC integration will expand to include MEMS, microphotonics, and on-chip energy sources. Moore's Law scaling will continue at least through the end of this decade, but SoC integration will become an increasingly important technology imperative for continued cost reduction throughout the Internet Age.
Psoriasis in solid organ transplant patients: best practice recommendations from The Medical Board of the National Psoriasis Foundation

Abstract Background: Treatment of solid organ transplant patients who have psoriasis can be a therapeutic challenge. Biologic and systemic drugs used to treat psoriasis can result in an increase in infections or malignancies. Objective: We sought to develop a treatment algorithm for organ transplant recipients (OTR) diagnosed with psoriasis vulgaris. Methods: A systematic literature search for psoriasis treatment in organ transplant patients was performed using MEDLINE and GOOGLE. Results: In mild-to-moderate disease, topical therapy should be a first-line treatment. In moderate-to-severe disease, first-line treatment is acitretin with narrow band ultraviolet light (NBUVB), NBUVB, or acitretin. Second-line treatment is increasing the current antirejection drug dose. Other systemic or biologic therapies should be reserved for more severe or refractory cases. Conclusion: No systematic clinical studies have been done to explore psoriasis treatments among affected solid organ transplant patients who have psoriasis, and only a few case reports are available. The algorithm for best practices was developed based on these reports and on the clinical experience and judgment of the Medical Board of the National Psoriasis Foundation. There remains a need for further research on the management of psoriasis in the organ transplant patient population.
Reduction in the number of CGG repeats on the FMR1 gene in carriers of genetic disorders versus noncarriers

Objective CGG repeat expansion on the fragile X mental retardation 1 (FMR1) gene is used to diagnose fragile X syndrome. Previous studies have discussed the correlation between the number of CGG repeats and its associated phenotypic components. The objective of this study is to determine whether the number of CGG repeats differ between carriers of genetic disorders versus noncarriers. Methods We performed a retrospective chart review of 2867 patients who received genetic screening at our fertility clinic between June 2013 and July 2015. The number of CGG repeats on allele 1 and allele 2 on the FMR1 gene was collected and it was specified whether the patient was a carrier or a noncarrier of a specific mutation. Patients with CGG repeats greater than or equal to 45 were excluded from the study. Results Carriers (n=759) had a reduced number of repeats compared to noncarriers (n=2024) on allele 1 (p=.03), allele 2 (p=.02) and the average of both alleles (p=.01). Additionally, the number of CGG repeats from the ten most carried diseases from the cohort were used and tested individually for clinical significance against the number of repeats in the noncarriers. A reduction in repeats was shown in several mutations and a few were outliers. Conclusion Our results demonstrate that there is a significant reduction in the number of CGG repeats in carriers of genetic mutations. A larger scale study of disease carrying patients would be beneficial.