Miracle-dz/UniFAR-FTUs huggingface dataset:
From bed-blocking to delayed discharges: precursors and interpretations of a contested concept

Delayed hospital discharges have been identified as a problem for the English National Health Service and have prompted several policy and service development responses in the last decade. However, bed-blocking is an issue surrounded by rival interpretations on how and why hospital delays occur and the way in which they are measured. To better understand this contested concept, this paper provides a brief description of the historical accounts that framed the emergence of delayed hospital discharges as a phenomenon. Three key features of the bed-blocking concept are also analysed: the reduction of patients' length of stay to improve efficiency, the intrinsic methodological difficulties of measuring hospital delays and the most common reasons for delayed discharges. A description of the characteristics of the patients frequently labelled as delayed discharge, their common traits and how these have been examined by previous research is also provided. Finally, this paper argues that the presence of hospital delays in a health system tends to be considered as an indicator of two possible system inefficiencies: a failure in the discharge planning process, which generally blames social services departments for not ensuring timely services, or a shortage of alternative forms of care for this group of patients.
Strategic groups in health care: a literature review

The purpose of this study is to review the literature that discusses the relationship between strategic group membership and performance in the nursing home industry. This literature review examines the relationship between organizational structure and performance in the nursing home industry. Results from these studies suggest industry stability of segmentation; limitation of strategic choice due to high mobility barriers (as represented by facility, staffing and location variables); quality is controlled by the existing combinations of industry regulation and market competition; and the existence of performance differences among strategic groups.
Vaccination against paratuberculosis

Johne’s disease, or paratuberculosis, is a chronic granulomatous enteritis in ruminants caused by Mycobacterium avium subsp. paratuberculosis (MAP) affecting principally cattle, sheep and goats. Primarily, there are two clinical signs: cachexia and chronic diarrhea (less common in goats and sheep). This disease results in considerable economic losses in livestock industry, particularly the dairy sector. The route of transmission is mostly by the fecal–oral route, but hygienic measures and culling of shedding animals are not sufficient to eradicate this disease. Moreover, diagnostic tools available at this moment are not powerful enough to perform early and specific diagnosis. Existing vaccines, based on whole killed or live-attenuated bacteria, can delay the unset of clinical symptoms but do not protect against infection. Moreover, vaccinated animals develop antibodies that interfere with existing serodiagnostic tests for paratuberculosis and they become reactive in the tuberculin skin test, used for the control of bovine tuberculosis. This review summarizes the current knowledge of the immune responses induced by MAP infection, with focus on cattle studies. It provides an overview of the existing MAP vaccines and comments on the development of second-generation subunit vaccines based on new technologies.
Asynchronous Photoexcited Electronic and Structural Relaxation in Lead Free Perovskites.

Vacancy-ordered lead free perovskites with more stable crystalline structure have been intensively explored as the alternatives for resolving the toxic and long-term stable issues of Lead halide perovskites (LHPs). The dispersive energy bands produced by the closely packed halide octahedral sublattice in these perovskites are meanwhile anticipated to facility the mobility of charge carriers. However, these perovskites suffer from unexpectedly poor charge carrier transport. To tackle this issue, we have employed the ultrafast, elemental-specific X-ray transient absorption (XTA) spectroscopy to directly probe the photoexcited electronic and structural dynamics of a prototypical vacancy-ordered lead-free perovskite - Cs3Bi2Br9. We have discovered that the photogenerated holes quickly self-trapped at Br centers (< 10 ps), simultaneously distorting the local lattice structure, likely forming small polarons in the configuration of Vk center (Br2- dimer). More significantly, we have found a surprisingly long-lived, structural distorted state with a lifetime of ~ 59 μs, which is about three orders of magnitude slower than that of the charge carrier recombination. Such long-lived structural distortion may produce a transient "background" under continuous light illumination, influencing the charge carrier transport along the lattice framework.
Why does neurorehabilitation fail

Following neurorehabilitation, many patients show limited benefit, generalization, or maintenance of gains over time. Some of the reasons that account for modest outcomes are discussed with particular reference to the differences between patients' needs and aspirations, the nature of patient-clinician interactions, and patients' rehabilitation readiness. The role of a more client-centered approach is reviewed, as well as the importance of facilitating patients' capacity to identify problems, develop goals, consider options, and make choices. It is proposed that effective outcomes depend on the clinicians' success in harnessing patients' intrinsic motivation to change.
Quality of experience: defining the criteria for effective interaction design

At the heart of interaction design are the people who explore, learn from, play with, and respond to products. Their experiences, as they use a range of products, from off the shelf software to websites, from electronic games to medical diagnostic equipment, are what effective interaction design is all about. This article focuses on the design of electronic products, but it is also relevant to all sorts of objects and places with which people interact: from potato peelers, shampoo and snowboards to gardens, buildings and cities—and to the experiences they provide.
Evidence for a quantitative genetic influence on the formation of aortic valves with two leaflets in the Syrian hamster

Summary We studied the morphology of the aortic valves of 1,036 Syrian hamsters belonging to two families subjected to high endogamous pressure. Most (n=955) specimens were examined using a corrosion-cast technique. In the remaining 81 specimens, valvar morphology was assessed by means of a stereomicroscope, and in 18 of these cases a histologic study was also performed. In one of the families, a high proportion (30.5%) of hamsters had aortic valves with two leaflets, the aortic sinuses being oriented ventrodorsally. The percentage of such anomalous valves was found to be positively correlated with the inbreeding coefficient of specimens. In the other family, the occurrence of an aortic valve with two leaflets was a sporadic event. Stereoscopic and histologic observations demonstrated that, in 52 of 63 aortic valves with three leaflets, the ventral commissure between the right and left leaflets was partially fused, while in 10 other cases this commissure was completely fused. In addition, in nine of 18 aortic valves with two leaflets, there was a more or less well-developed raphe located in the ventral aortic sinus, approximately where the true ventral commissure would have been. Our observations suggest the existence of a continuous spectrum of aortic valvar morphology, ranging from a valve with three leaflets and no fusion of the ventral commissure to an aortic valve with two leaflets devoid of any raphe. This spectrum seems to be the result of the interaction of genetic and intrauterine environmental factors. Results of crosses between both related and unrelated hamsters suggest that the observed morphology in individuals is the result of quantitative inheritance.
A Prolific Solvate Former, Galunisertib, Under the Pressure of Crystal Structure Prediction, Produces Ten Diverse Polymorphs.

The solid form screening of galunisertib produced many solvates, prompting an extensive investigation into possible risks to the development of the favored monohydrate form. Inspired by crystal structure prediction, the search for neat polymorphs was expanded to an unusual range of experiments, including melt crystallization under pressure, to work around solvate formation and the thermal instability of the molecule. Ten polymorphs of galunisertib were found, however, the structure predicted to be the most stable has yet to be obtained. We present the crystal structures of all 10 unsolvated polymorphs of galunisertib, showing how state-of-the-art characterization methods can be combined with emerging computational modelling techniques to produce a complete structure landscape and assess the risk of late appearing, more stable polymorphs. The exceptional conformational polymorphism of this prolific solvate former invites further development of methods, computational and experimental, that are applicable to larger, flexible molecules with complex solid form landscapes.
Multiobjective Optimization Design for Skew and Sweep Parameters of Two-Stage Blades of Axial Fan

Computer aided design and numerical simulation have been widely applied in optimization design of fan blades. In this paper, skew and sweep parameters of two-stage blades of an axial fan are optimized by using the particle swarm optimization algorithm. First, the skew and sweep parameters of two-stage blades of an axial fan are defined. Second, response surface methodology is used to study the relationship between the skew and sweep parameters of two-stage blades and the total pressure and the efficiency of the axial fan. The response surface model that describes the relationship between the skew and sweep of two-stage blades and the total pressure and the efficiency of the axial fan is established. Finally, with the skew and sweep of two-stage blades being design variables and the total pressure and the efficiency being the objectives, a particle swarm optimization algorithm is developed to solve this complex multiobjective optimization problem. The optimal result shows that the total pressure increases by 49.1 Pa and the efficiency increases by 1.55%. In addition, the aerodynamic performance of the axial fan is improved. This research has significance to optimization design of the axial fan.
Talent identification in soccer

Some studies showed that most professional soccer players were born on the same date. The aim of this study was to investigate talent identification among players of the 2006 FIFA World Cup according to the distribution of their birth date in different playing positions in five continents of the world (Asia, Africa, Europe, North Africa and South America). Information about birth dates of 736 players was collected from FIFA website. χ2 Test and analysis of variance were used to assess the differences among the players' birth dates. The results showed no significant effect in different positions between players born in the first and second halves of a month and between players born in different months (p>0.05). Although the number of births between August and October were more than other seasons, the difference was not significant (p>0.05). Also, no significant effect was found between different positions and the players' birth season (p>0.05). No significant effect was found between month and season of births in five continents (p>0.05). Although the mean of height and the mean of weight of the players born between August and October were more than other seasons, this difference was not significant (p>0.05). It can be concluded that birth date of players of the 2006 FIFA World Cup was similar to the distribution of playing positions and continents. Talent identification according to the birth date is not reliable.
A statewide survey on computing education pathways and influences: factors in broadening participation in computing

In computing education, we have only just started developing methods for accurately measuring a student's understanding of introductory computing, let alone characterizing a whole classroom, school, or university system. As part of evaluating the impact of "Georgia Computes! " we sought an understanding the factors influencing undergraduate enrollment in introductory computing for an entire state in the United States of America. We gathered surveys from over 1400 undergraduate students in introductory computing classes from 19 higher-education institutions in a single state. The analysis provided insight into the impact of "Georgia Computes! ", into the connections between stages of the computing education pathways, and how factors that influence students' pursuit of computing differ between genders and majority/minority group students.
Transapical access and closure devices: rationale and current status

In the past years transcatheter aortic valve implantation became a highly standardized option for the treatment of high-risk patients suffering from severe aortic stenosis. The number of transcatheter aortic valve implantation procedures is increasing exponentially worldwide. In this context the transapical approach should be considered as a safe and reproducible alternative access to the left ventricle with some specific advantages compared with transfemoral, transaortic and transsubclavian approach due to its antegrade nature. To further ease the transapical access first apical closure devices have been developed and entered first clinical trials.
Angina pectoris: current therapy and future treatment options

Angina pectoris is the consequence of an inequality between the demand and supply of blood to the heart. Angina manifests itself as chest pain or discomfort and is a common complaint of patients in the hospital and in the clinic. There are, in fact, roughly half a million new cases of angina per year. Chest pain, while having many etiologies, is generally considered to be most lethal when related to a cardiac cause. In this review, the authors outline the current medical and surgical therapies that are used in the management of angina. Highlights of the various clinical trials that have assisted in the investigation of these therapies are summarized also. Then, the authors provide a focused review of the novel therapy options for angina that are currently being explored. From new medical treatments to revised surgical techniques to the discovery of stem cell therapy, many innovative options are being investigated for the treatment of angina.
Tachyarrhythmias and catheter ablation in adult congenital heart disease

Advances in surgical technique have had an immense impact on longevity and quality of life in patients with congenital heart disease. However, an inevitable consequence of these surgical successes is the creation of a unique patient population whose anatomy, surgical history and haemodynamics result in the development of a challenging and complex arrhythmia substrate. Furthermore, this patient group remains susceptible to the arrhythmias seen in the general adult population. It is through a thorough appreciation of the cardiac structural defect, the surgical corrective approach, and haemodynamic impact that the most effective arrhythmia care can be delivered. Catheter ablation techniques offer a highly effective management option but require a meticulous attention to the real-time integration of anatomical and electrophysiological information to identify and eliminate the culprit arrhythmia substrate. This review describes the current approach to the interventional management of patients with tachyarrhythmias in the context of congenital heart disease.
Analytic modeling of SSD write performance

Solid state drives (SSDs) update data by writing a new copy, rather than overwriting old data, causing prior copies of the same data to be invalidated. These writes are performed in units of pages, while space is reclaimed in units of multi-page erase blocks, necessitating copying of any remaining valid pages in the block before reclamation. The efficiency of this cleaning process greatly affects performance under random workloads; in particular, in SSDs the write bottleneck is typically internal media throughput, and write amplification due to additional internal copying directly reduces application throughput. We present the first precise closed-form solution for write amplification under greedy cleaning for uniformly distributed random traffic, and validate its accuracy via simulation. In addition we also present the first models which predict performance degradation for both LRU cleaning and greedy cleaning under simple non-uniform traffic conditions; simulation results show the first model to be exact and the second to be accurate within 2%. We extend the LRU model to arbitrary combinations of random traffic, and demonstrate its use in predicting cleaning performance for real-world workloads. The utility of these analytic models lies in their amenability to optimization techniques not feasible in simulation. We examine the strategy of separating "hot" and "cold" data, showing that for our traffic model, such separation eliminates any loss in performance due to non-uniform traffic. We show how a system which separates hot and cold data may shift free space from cold to hot data in order to achieve improved performance, and how numeric methods may be used with our model to find the optimum operating point, which approaches a write amplification of 1.0 for increasingly skewed traffic. We examine online methods for achieving this optimal operating point, and show that a control strategy based on our model achieves near-optimal performance for a number of real-world block traces.
The current status of transcutaneous aortic valve implantation

Transcatheter aortic valve implantation (TAVI) is a relatively novel procedure first performed in 2002 and has undergone rapid development since then. Its main indication is treatment of severe symptomatic aortic valve stenosis. Initially, the procedure was indicated for very sick patients who were not eligible for surgical aortic valve replacement. However, rapid development of the technology and operator skill required for TAVI allowed widening of the indications for its use. Currently, there is evidence that TAVI could be better than the surgical intervention in a broad population and not only in the most sick. This paper reviews the medical literature regarding TAVI, including the relevant medical equipment, different modes of its deployment, main complications of the procedure, main indications and contraindications, and the outcome of the patients who undergo it.
Indoor-outdoor activity recognition by a smartphone

It is increasingly important to recognize daily activity pattern in order to detect early sign of dementia in the aging society. This paper shows indoor-outdoor activity recognition using only a smartphone. We developed an indoor living activity recognition engine and an outdoor migration activity recognition engine, and combined them into an Android™ application. The former recognizes not only "resting" or "walking" but also user's various living activities such as "vacuuming" and "brushing teeth" by using a built-in accelerometer and a built-in microphone. The latter engine recognizes the user's means of migration, namely, "resting," "walking," "running," and "boarding" by using a built-in accelerometer. It enables users to continuously recognize indoor-outdoor activities by switching between the two engines depending on an acquisition condition of GPS satellites.
Serum Thyroglobulin Stability for Immunoassay

Background: Serum thyroglobulin (Tg) measurements may be affected by preanalytical factors, such as sample handling and processing, which is not quite clear at present. Methods: The authors measured Tg in sera left on the clot (4°C), or timely pipetted off the clot (RT), or subjected to 5 cycles of freezing (–80°C, 3 months at cycle 4 and 24 h at the other cycles) and thawing (RT, 1 h). Results: Sample storage for 4 to 24 h yielded Tg concentrations of 102.4% to 104.5% (P=0.484) for unseparated, and 98.4% to 102.1% (P=0.202) for timely separated sera relative to baseline samples (1 h). Freezingthawing resulted in significant decreases in Tg concentrations (P<0.001) by mean 30.7% after the last cycle, with the greatest singlecycle decrease by mean 18.1% at cycle 4. Conclusion: Thyroglobulin is stable for at least 24 h in unseparated sera at 4°C or separated sera at room temperature, but not in sera undergoing even a short period of frozen storage.
Relationship between glycosylated hemoglobin A1c and coronary flow reserve in patients with Type 2 diabetes mellitus

Type 2 diabetes mellitus patients are at increased risk for macrovascular and microvascular complications. Both in vivo and in vitro studies of small arteries and arterioles of diabetic subjects demonstrate impaired endothelial function without anatomic lesions. Coronary flow reserve (CFR) is a surrogate marker of coronary microcirculatory endothelial function in diabetic patients without significant stenosis of the associated epicardial coronary artery. Glycosylated hemoglobin A1c is related to likelihood of occurrence of microvascular events. The objective of this article is to report on recent developments in multiple noninvasive techniques to assess CFR and their use in aiding the understanding of the relationship of CFR, glycemic control and cardiovascular outcomes.
A Fit between Clinical Workflow and Health Care Information Systems: Not waiting for Godot but making the journey

textabstractHealth care has long suffered from inefficiencies due to the fragmentation of patient care information and the lack of coordination between health professionals [1]. Health care information systems (HISs) have been lauded as tools to remedy such inefficiencies [2, 3]. The primary idea behind the support of their implementation in health care is that these systems support clinical workflow and thereby decrease medical errors [2]. However, their introduction to health care settings have been accompanied by a transformation of the way their primary users, care providers, carry out clinical tasks and establish or maintain work relationships [4]. Studies have shown that these transformations have not always been productive [5, 6].
From anatomy to function: diagnosis of atherosclerotic renal artery stenosis

Atherosclerotic renal artery stenosis (ARAS) affects 7% of the over 65 s and will be increasingly common with an ageing population. ARAS obstructs normal renal perfusion with adverse renal and cardiovascular consequences. Drug therapy is directed at reducing atherosclerotic risk. Two recent major trials of revascularization for ARAS showed that clinical outcomes were not improved beyond those offered by optimal drug therapy in most patients. This reflects experimental data showing that restoration of blood flow alone may not attenuate a cascade of tissue injury. A shift from anatomic to functional imaging of ARAS coupled to novel therapies might improve clinical outcomes in selected patients. This review outlines the case for separately assessing hemodynamic significance of arterial stenosis and functional reserve of renal parenchymal tissue. The authors consider current and emerging diagnostic techniques for ARAS and their potential to allow individualized and functionally directed treatments.