Miracle-dz/UniFAR-FTUs huggingface dataset:
Clinical Documentation for Intensivists: The Impact of Diagnosis Documentation.

OBJECTIVES The aim of this review is to describe the interaction of clinical documentation with patient care, measures of patient acuity, quality metrics, research database accuracy, and healthcare reimbursement in order to highlight potential areas of improvement for intensivists. DATA SOURCES An online search of PubMed was undertaken as well as review of resources published by the American Academy of Pediatrics, the Society of Critical Care Medicine, the American Medical Association, and the Association of Clinical Documentation Improvement Specialists. STUDY SELECTION Selected publications included those that described coding, medical record documentation, healthcare reimbursement, quality metrics, administrative databases, Clinical Documentation Improvement programs, medical scribe programs, and various payment models. DATA EXTRACTION Relevant information was extracted to highlight the impact of diagnosis documentation on patient care, perceived patient severity of illness, quality metrics, and healthcare reimbursement. Query data from our hospital's Clinical Documentation Improvement program were reviewed to highlight areas of improvement within our own Division of Critical Care Medicine. Additionally, interventions to improve clinical documentation were incorporated into this review. DATA SYNTHESIS Available data in the literature indicate that documentation of precise diagnoses in the medical record has a positive impact on quality metrics, accuracy of administrative databases, hospital reimbursement, and perceived patient complexity. However, there is insufficient data to make conclusions regarding documentation of specific diagnoses and effects on patient care. Administrative responsibilities associated with documentation have been increasing, especially with the introduction of electronic medical records. CONCLUSIONS Documentation of specific diagnoses in the medical record is important in the broad context of our existing medical system but there is an associated burden in doing so. Widespread implementation of electronic medical record systems has inadvertently led to clinician dissatisfaction and burnout. Research is needed to further evaluate the impact of documentation on patient care as well as steps to decrease the associated burden.
Association of Intrinsic Brain Architecture With Changes in Attentional and Mood Symptoms During Development

Key Points Question Can brain imaging predict future psychiatric symptoms in children? Findings In this 4-year longitudinal cohort study, distinct patterns of resting-state functional connectivity in healthy children predicted changes in psychiatric symptoms. Weaker positive dorsolateral prefrontal connectivity with medial prefrontal cortex predicted a better developmental trajectory for attentional symptoms, whereas weaker positive dorsolateral prefrontal connectivity with subgenual anterior cingulate cortex predicted a worse trajectory for internalizing symptoms (eg, anxiety/depression). Meaning Brain imaging measures can contribute to early identification of children at risk for common psychiatric disorders and thus identify children in need of preventive treatments.
Quercetin modulates hyperglycemia by improving the pancreatic antioxidant status and enzymes activities linked with glucose metabolism in type 2 diabetes model of rats: In silico studies of molecular interaction of quercetin with hexokinase and catalase.

Quercetin was assessed for its antihyperglycemic effect in fructose-streptozotocin (STZ) induced diabetic rats. The oral administration of quercetin at the dosage of 25 and 50 mg/kg for 28 days remarkably reduced the level of blood glucose, glycosylated hemoglobin (Hb), and hepatic glycogen but enhanced plasma Hb concentration. The altered activities of glucose-6-phosphatase and hexokinase in diabetic rats were significantly improved upon quercetin treatment. Furthermore, the antioxidant activity of pancreatic superoxide dismutase, catalase (CAT), and reduced glutathione was effectively increased while the value for thiobarbituric acid reactive species was decreased. A significant reduction of glycemia was observed in the glucose tolerance test, 120 min after the glucose pulse. Also, the damage caused by fructose-STZ in the liver and pancreas of diabetic animals were restored to near normal. Molecular docking of quercetin showed a high affinity for hexokinase and CAT with a binding energy of -7.82 and -9.83 kcal/mol, respectively, more elevated than the standard drugs. PRACTICAL APPLICATIONS: Functional foods and nutraceuticals have increasingly interested the consumers in terms of health benefits and have started focussing on the prevention or cure of disease by the foods and their health-enhancing phytochemicals. Quercetin is one of the most potent naturally occurring antioxidants within the flavonoid subclasses, mostly distributed as a secondary metabolite in fruits, vegetables, and black tea. Based on the results exhibited in the present study, we proposed that the consumption of foods rich in quercetin could be a cheap and affordable nutraceutical that can be developed for the treatment of T2DM and its complications. Further studies on the safety aspects of quercetin in long-term usage are strongly recommended before implementing for the treatment of human diseases.
Feasibility of successfully breeding rhesus macaques (Macaca mulatta) to obtain healthy infants year‐round

Rhesus monkeys are typically seasonal breeders but can be induced to extend the timing of their mating and births under captive conditions. The following analyses evaluated the potential impact of extending their pregnancies and deliveries year‐round. Birth records from a large breeding colony housed in an indoor facility with a constant 14‐hr light/10‐hr dark cycle were analyzed across 25 years to examine seasonal trends in monkeys that mated in one of two ways: spontaneous in social groups or with a scheduled, timed‐mating protocol. The dates of delivery and birth weights for 2,084 infants were used in these analyses. Younger nulliparous females mating in social groups evinced a clear seasonal peak when birthing their first infant. However, older females, both primiparous and multiparous, could be bred continuously, which enable the birth of infants in every month of the year. Based on the live birth rate, infant birth weights, high survival rates, and the normal sex ratio of infants birthed year‐round, there were no adverse effects of breeding rhesus monkeys in this way. The continuous availability of infant births can be very advantageous for many types of research programs.
Arthroscopy-assisted surgery: The management of posterolateral tibial plateau depression fracture accompanying ligament injury: A case series and review of the literature

Tibial plateau fractures are multiple fracture patterns associated with soft-tissue injuries. Among which, the combined existence of posterolateral tibial plateau depression fracture with anterior cruciate ligament (ACL) rupture has been reported rarely. Meanwhile, surgical method for the treatment of depression fracture is fairly complex. The aim of this article is to show a case series of this unusual injury pattern and the therapy of posterolateral tibial plateau depression fracture accompanying ACL rupture. In our treatment, arthroscopy assisted reduction of depression fracture and ACL reconstruction reduces surgical trauma and leads to good functional recovery. We also review the current literature.
Congenital Middle Ear Malformation with Common Deafness Gene Mutation Analysis: A Review of 813 Profound Sensorineural Hearing Loss Child Patients

Deafness gene variants play a key role in inner ear malformations. However, the relationship between congenital middle ear malformations and common deafness genes (GJB2, SLC26A4, and mtDNA) in profound sensorineural hearing loss (SNHL) child patients remains poorly investigated. Here we showed that there was no statistical significance in the total mutation frequency of the three common deafness genes in the middle ear malformation group (21.2%, 41/193) in comparison with the normal middle ear and inner ear group (21.0%, 116/553) (χ2 = 0.0061, p = 0.940). Moreover, the mutation ratio of GJB2 and SLC26A4 in the middle ear malformation group (18.7%, 36/193; 2.6%, 5/193) was not significantly different from that in the normal middle ear and inner ear group (17.7%, 98/553; 2.4%, 13/553) (χ2 = 0.084, p = 0.772; χ2 = 0.0000, p = 1.000). The mutation ratio of GJB2 235delC and GJB2 79G>A in the middle ear malformation group (8.8%, 17/193; 8.8%, 17/193) was almost the same to that in the normal middle ear and inner ear group (8.6%, 48/553; 6.7%, 37/553) (χ2 = 0.0030, p = 0.957; χ2 = 0.9556, p = 0.328). The high jugular bulb subgroup analysis also showed the same results. Our findings suggested that GJB2, SLC26A4, and mtDNA mutations might not be related to the middle ear malformations in profound SNHL child patients. Anat Rec, 303:594–599, 2020. © 2019 American Association for Anatomy
Histopathologic Features of Fibrotic Knee Synovitis in a Young Adult With Seronegative Rheumatoid Arthritis.

T he synovium is the primary site of inflammatory process in patients with rheumatoid arthritis (RA). The RA synovitis is characterized by hyperplastic lining layer, increased vascularization, and pronounced infiltration of inflammatory cells. Conventional synthetic disease-modifying antirheumatic drugs as well as biologic agents may lead to a decrease in infiltrating cells and lining thickness. Krenn score had been used to classify lowand high-grade synovitis on the basis of enlarged lining layer, synovial stroma, and inflammatory infiltrate. Despite that arthritismediated articular damage had been well described, little is known about the degenerative changes occurring in the synovium. Here we describe the case of a 22-year-old female patient who presented in September 2016 with tender and swollen knees, wrists, and metacarpophalangeal joints bilaterally. Rheumatoid factor and anti–cyclic citrullinated peptide antibodies were negative, whereas antinuclear antibodies (1/1280) were detected along with negative extractable nuclear antigen panel. She was diagnosed with RA, fulfilling the 2010 American College of Rheumatology/European League Against Rheumatism classification criteria. Hydroxychloroquine 200 mg twice a day plus low-dose prednisone was started (28-joint Disease Activity Score [DAS28] 4.48) without improvement at 3 months (DAS28 4.20, with persistent left knee arthritis). FromApril 2017 toDecember 2017, an extensive diagnosticworkup, including computed tomography and positron emission tomography, was performed to rule out malignancy and infections. Finally, certolizumab pegol was started (DAS28 5.25). A few weeks later, treatment was stopped for urticaria at the injection site. In May 2018,methotrexate 10mg/wk plus low-dose prednisonewas started (DAS28 3.64, still counting left knee arthritis) and escalated to 15 mg/wk after 3 months without improvement. In March 2019, the patient was referred to our center. Ultrasound-guided synovial biopsy of the left kneewas carried out. Retrieved specimen showed synovitis (Krenn score 4) with hyperplastic lining, abundant CD68 type A synoviocytes (Fig. B), and quasi-complete sublining fibrosis (Fig. C). Rituximab at RA-approved dosage was started (DAS28 4.27); an improvement was seen at 3 months (DAS28 2.94). Fibrosis in synovial stroma is the stigmata of osteoarthritis and rarely occurs in patients with long-standing RA. Seronegative RA is characterized by synovitis with diffuse CD68 lining cells consistently with our findings. Conversely, the abundant stromal production not correlated with infiltrating immune cells is an unusual
Quadratus lumborum block versus transversus abdominis plane block for postoperative pain management after laparoscopic colorectal surgery

Abstract Background: This study aimed to compare the quadratus lumborum block (QLB) method with transversus abdominis plane block (TAPB) for postoperative pain management in patients undergoing laparoscopic colorectal surgery. Methods: Seventy-four patients scheduled for laparoscopic colorectal surgery were randomly assigned into 2 groups. After surgery, patients received bilateral ultrasound-guided single-dose of QLB or TAPB. Each side was administered with 20 ml of 0.375% ropivacaine. All patients received sufentanil as patient-controlled intravenous analgesia (PCIA). Resting and moving numeric rating scale (NRS) were assessed at 2, 4, 6, 24, 48 hours postoperatively. The primary outcome measure was sufentanil consumption at predetermined time intervals after surgery. Results: Patients in the QLB group used significantly less sufentanil than TAPB group at 24 and 48 hours (P < .05), but not at 6 hours (P = .33) after laparoscopic colorectal surgery. No significant differences in NRS results were found between the two groups at rest or during movement (P > .05). Incidence of dizziness in the QLB group was lower than in TAPB group (P < .05). Conclusions: The QLB is a more effective postoperative analgesia as it reduces sufentanil consumption compared to TAPB in patients undergoing laparoscopic colorectal surgery.
Echocardiographic evaluations of right ventriculo–arterial coupling in experimental and clinical pulmonary hypertension

Tricuspid annular systolic excursion (TAPSE) or velocities (s′) and right ventricular (RV) end‐systolic dimensions are predictors of outcome in patients with pulmonary hypertension (PH). We explored the value of combining peak s′ and RV end‐systolic area index (RVESAi) as a surrogate of RV‐pulmonary artery (RV–PA) coupling in a large animal of precapillary PH as well as clinically.
Transparency in Complex Computational Systems

Scientists depend on complex computational systems that are often ineliminably opaque, to the detriment of our ability to give scientific explanations and detect artifacts. Some philosophers have suggested treating opaque systems instrumentally, but computer scientists developing strategies for increasing transparency are correct in finding this unsatisfying. Instead, I propose an analysis of transparency as having three forms: transparency of the algorithm, the realization of the algorithm in code, and the way that code is run on particular hardware and data. This targets the transparency most useful for a task, avoiding instrumentalism by providing partial transparency when full transparency is impossible.
Title: Reduced graphene oxide wrapped hierarchical TiO2 nanorod composites for improved charge collection efficiency and carrier lifetime in dye sensitized solar cells

Three dimensional hierarchical TiO2 nanorods-reduced graphene oxide (HTNs-rGO) composites with different rGO wt% were directly grown on conducting glass substrate by an in situ hydrothermal process for improved charge separation and collection in dye sensitized solar cells (DSSCs). The crystal structure and chemical composition of as grown composites were confirmed by X-ray diffraction and optical studies. Electron microscopic studies on the composites surface morphologies revealed the formation of rGO wrapped or intertwined HTNs architectures onto the FTO substrates with thicknesses ranging from 14.33 to 15.70 μm. 2 wt% rGO loaded HTNs composite photoanode showed a superior power conversion efficiency of 4.54% as compared to the other wt% rGO loaded HTNs composite and bare HTNs photoanodes in DSSCs. This is due to optimal loading of rGO facilitating formation of a better charge transport channel within HTNs matrix and reducing charge transport resistance (Rtr), which resulted in a higher charge collection of HTNs-rGO composite. Besides, the solar cell current-voltage (J-V) and electrochemical impedance characterizations confirmed the superior light scattering and dye loading capabilities of HTNs, together with a low charge transport resistance and improved charge carrier lifetime in HTNs-rGO composites contributed to the photovoltaic performance enhancement of their DSSCs.
Comparing the Energy Consumption of Side Channel Attack Countermeasures and Lightweight Cryptography on Embedded Devices. In Proceedings of 2015 International Workshop on Secure Internet of Things

This paper uses an Instruction Set Architecture (ISA) based statistical energy model of an ARM Cortex-M4 microprocessor to evaluate the energy consumption of an implementation of AES with different side channel attack (SCA) countermeasures and an implementation of lightweight ciphers PRESENT, KLEIN and ZORRO with and without Boolean first order masking. In this way, we assess the additional energy consumption of using different SCA countermeasures and using lightweight block ciphers on 32 bit embedded devices. In addition to this, we provide a methodology for developing an ISA based energy model for cryptographic software with an accuracy of ±5%. In addition to providing our methodology for developing this model, we also show that using variations of instructions that reduce the size of code can reduce the energy consumption by as much as 30% − 40% and that memory instructions reduce the predictability of our energy model.
The Musical Style and Creative Elements of Shaanxi Erhu Works

As one of the representatives of folk musical instruments, Erhu is deeply loved by the general public. Affected by different geographical environments, Erhu has a strong local character in its musical style and performance techniques. These factors not only make the erhu expressive, but also make the music of the erhu more understandable. The material of Shaanxi Erhu music mainly comes from Shaanxi folk music. It not only has the commonality of general erhu music, but also has special local music personality in Shaanxi. This paper explores its artistic features through a brief analysis of the musical style and creative elements of Shaanxi erhu works. This summarizes the artistic value of the music creation and performance of Shaanxi erhu works, clarifies the positive influence of Shaanxi erhu works on the development of erhu art, and provides a direction for future erhu music creation.
The Readiness of Pre-service Teachers to work with Deaf Students in Inclusive Settings

The attitudes of pre-service teachers towards inclusive education seem to be influenced by a number of factors, like child-related factors like severity of disability, behavioral difficulties, teacher-related factors such as gender, experience, beliefs, education, and environmental factors like resources, and support from specialists. Several studies have showed that pre-service teachers tended to have positive sentiments, attitudes and less concerns about inclusive education, but very few studies have been carried out regarding pre-service teachers’ readiness to work with deaf students in inclusive settings. The purpose of the present study was to investigate the attitudes and concerns of pre-service teachers about deaf students and their readiness to teach with them in inclusive settings. The participants were 175 pre-service teachers from the department of Primary Education of the University of Patras, Greece, in their fourth year of study. They completed the Sentiments, Attitudes and Concerns about Inclusive Education Scale (SACIE) of Loreman, Earle, Sharma & Forlin ( 2007), with some modifications in order to be adapted to education of the deaf. Results indicated that pre-service teachers had neutral to positive attitudes towards inclusion of deaf students (subscale mean scores: Sentiments=3.04, Attitudes=2.38, Concerns=2.26). Statistical analysis revealed a number of predictive factors of the inclusion attitudes of pre-service teachers, like academic training, confidence in teaching, interaction with people with disabilities or deaf people, experience, knowledge of legislation, gender and age. The results of this study indicate the need of provision for a more specialized academic training to pre-service teachers, which will include fieldwork in teaching deaf students in inclusive settings, and interaction with them.
Effects of Laminaria Japonica Polysaccharides on the Survival of Non-Small-Cell Lung Cancer A549 Cells

Objective. To investigate the effect of Laminaria japonica polysaccharides (LJP) on the survival of non-small-cell lung cancer (NSCLC) A549 cells and its mechanism. Methods. In vitro: the cells were randomly divided into control group, LJP (5 mg/ml) group, LJP (10 mg/ml) group, and LJP (20 mg/ml) group. After corresponding treatment, the survival rate and the expression of proteins related to proliferation, apoptosis, epithelial-mesenchymal transition (EMT), and signaling pathway were detected by CCK8 assay and Western blot, respectively. In vivo: a xenograft model was established to detect the tumor volume and mass and the expression of the above pathway proteins. Results. Compared with the control group, LJP decreased the survival rate of A549 cells (P<0.05), inhibited the protein expression of Ki67 and PCNA (P<0.05), downregulated the expression of Bcl-2 while upregulated the expression of Bax, cl-caspase-3, and cl-caspase-9 (P<0.05), upregulated the expression of E-cadherin, downregulated the expression of vascular endothelial growth factor (VEGF) and N-cadherin (P<0.05), and downregulated β-catenin, transcription factor-4 (TCF4), and c-Myc protein expression levels (P<0.05). In vivo: LJP decreased the volume and mass of the xenograft tumors and downregulated β-catenin, TCF4, and c-Myc protein expression levels compared with the control group (P<0.05). Conclusion. LJP can inhibit the survival of non-small-cell lung cancer A549 cells in vitro, and its mechanism is related to the inhibition of activation of β-catenin/TCF4 pathway activation.
Performance Tuning for the Cray SV1

The introduction of cached vector operations and Multi-Stream (MSP) processors in Cray’s SV1 architecture will result in new design and performance tuning issues for developers of many scientific applications. In particular, code developed for Y-MP/C90/T90 series machines may require a significant additional tuning effort to achieve efficient performance on the SV1. Following an overview of the relevant SV1 architectural features and their theoretical performance implications, we describe several real-world research applications, which were profiled and tuned on both Cray T90 and SV1 systems at OSC. We analyze performance results in detail, highlighting tuning techniques that prove beneficial on the SV1. Finally, we discuss the insights gained into the process of migrating applications to Cray’s new architecture roadmap.
Exploring the Internal Determinants of Kuwaiti Banking Sector Profitability

The aim of this study is to examine the internal factors that mostly affects the profitability of Kuwaiti banking sector. Unlike previous studies, this paper uses the aggregate financials of the whole sector rather than taking each bank individually. The research is based on data spanning over the period 2011-2018. Results obtained from this study revealed that assets size, leverage, and assets quality had a statistically significant effect on both return on assets (ROA) and return on equities (ROE). On the other hand, management efficiency, capital adequacy, and assets growth showed insignificant effect on profitability.
ICLR 2020 Map Random Heatmap CRL Heatmap

Reinforcement learning (RL) has led to increasingly complex looking behavior in recent years. However, such complexity can be misleading and hides over-fitting. We find that visual representations may be a useful metric of complexity, and both correlates well objective optimization and causally effects reward optimization. We then propose curious representation learning (CRL) which allows us to use better visual representation learning algorithms to correspondingly increase visual representation in policy through an intrinsic objective on both simulated environments and transfer to real images. Finally, we show better visual representations induced by CRL allows us to obtain better performance on Atari without any reward than other curiosity objectives.