Miracle-dz/UniFAR-FTUs huggingface dataset:
Quality assessment of adult intensive care services: application of a tool adjusted to the reality of low-income countries

Objective To assess the quality of adult intensive care units. Methods This population-based, cross-sectional, observational, analytical study evaluated management type in Maranhão, Brazil. An assessment instrument was applied that assigned scores to each service (maximum 124 points). The units were categorized as insufficient (< 50% of the maximum score), typical (≥ 50% and <80% of the maximum score), or sufficient (≥ 80% of the maximum score). Results Of the 26 intensive care units in Maranhão, 23 were evaluated; 15 (65.2%) were located in the state capital, and 14 (60.9%) were public. The mean final score was 67.2 (54.2% of the maximum). The worst performance was observed with regard to processes (50.9%) in the units located outside the capital (p = 0.037) and for hospitals with 68 beds or fewer (p = 0.027). The result of the assessment categorized services as a function of the overall total points earned. Specifically, 8 (34.8%) services were assessed as insufficient, 13 (56.5%) were assessed as typical, and 2 (8.7%) were assessed as sufficient. Conclusion The majority of the intensive care units in this study were assessed as typical. These services must be better qualified. The priorities are the processes of the units located outside the capital and in small hospitals.
Subthreshold amyloid and its biological and clinical meaning

The development of in vivo imaging of the pathologic hallmark of Alzheimer disease (AD), β-amyloid (Aβ), altered the framing of its pathophysiology and formulation of inclusion criteria for clinical trials. Recent evidence suggests that in vivo measures of Aβ deposition below a threshold indicative of Aβ positivity carry critical information on future cognitive decline and accumulation of AD pathology, potentially already at a younger age. Here, we integrate the existing literature on histopathology of Aβ and its convergence and divergence with in vivo Aβ imaging. The evidence presented amounts to a reconceptualization, in which we advocate for a closer look into Aβ accumulation rates in earlier life, the factors that promote accumulation, comparative studies with different markers of Aβ, and longitudinal designs to elucidate when AD pathology rises and how it shifts from benign to malignant stages that ultimately define AD. These efforts open a new window of opportunity for disease-modifying interventions.
A Developmental Cascade from Prenatal Stress to Child Internalizing and Externalizing Problems.

OBJECTIVE This study utilized a developmental cascade approach to test alternative theories about the underlying mechanisms behind the association of maternal prenatal stress and child psychopathology. The fetal programming hypothesis suggests that prenatal stress affects fetal structural and physiological systems responsible for individual differences in child temperament, which further increases risk for internalizing and externalizing problems. Interpersonal models of stress transmission suggest that maternal stress influences child mental health via early parenting behaviors. We also examined a continuation of stress hypothesis, in which prenatal stress predicts child mental health via the continuation of maternal stress in the postpartum period. METHODS Participants were 1,992 mother-child pairs drawn from a prospective pregnancy cohort. Mothers reported on their perceived stress, anxiety, and depression during pregnancy and at 4-month postpartum. Birthweight was assessed via medical records of birthweight. At 4-month postpartum, hostile-reactive parenting behaviors were assessed. Child temperamental negative affect was measured at age 3. Child internalizing and externalizing problems were assessed at age 5. RESULTS Prenatal stress was associated with both internalizing and externalizing problems via postnatal stress and child temperament. Prenatal stress was also associated with externalizing behaviors via increased hostile-reactive parenting. After accounting for postnatal factors, prenatal stress continued to have a direct effect on child internalizing, but not externalizing, symptoms. CONCLUSION Results provide support for the fetal programming, interpersonal stress transmission, and continuation of stress models. Findings highlight the need for prenatal preventative programs that continue into the early postnatal period, targeting maternal stress and parenting behaviors.
Diet and exercise in obstructive sleep apnea patients with obesity: I'll breathe to that!

In the last 50 years, obstructive sleep apnea (OSA) has emerged as a highly prevalent condition and is characterized by increased upper airway collapsibility, particularly during sleep, leading to recurrent episodes of hypoxemia and hypercapnia that are usually terminated by arousals (1), leading to exploration of how obesity and OSA contribute to metabolic dysfunction and end-organ morbidity (2).
Blood in the Water Are there Honeymoon Effects Outside Software

1 Honeymoons In a previous paper at this workshop (and in a forthcoming full paper), we observed that software systems enjoy a security “honeymoon period” in the early stages of their life-cycles. Attackers take considerably longer to make their first discoveries of exploitable flaws in software systems than they do to discover flaws as systems mature. This is true even though the first flaws, presumably, actually represent the easiest bugs to find and even though the more mature systems tend to be more intrinsically robust. The software honeymoon effect is surprisingly pronounced and pervasive, occurring in virtually every kind of widely used software system, whether open or closed source and whether an operating system, word processor, graphical rendering system, or web browser. While the length of the honeymoon varies, far more often than not, the time between the discovery of the first zero day attack and the second will be considerably shorter than between the initial release and the first. In a forthcoming paper, we will examine various factors that appear to influence the honeymoon, but the central observation is this: honeymoons occur because, at the early stages of a software system’s life, the attacker’s (lack of) familiarity with the system matters far more than the system’s intrinsic security properties. As the first flaws are discovered, the community of attackers develops more expertise and becomes more efficient at discovering flaws, even after the “low hanging fruit” bugs are patched and eliminated (when, we would otherwise expect, flaws should become harder to find). This leads us to wonder whether there are security honeymoons in other aspects of system security besides software itself. In particular, are there honeymoon effects in basic security protocols? Cryptographic algorithms? Security architectures? A cursory initial analysis suggests that the answer may be an emphatic “yes”. In the rest of this position paper, we examine representative examples in security protocols (Needham-Schroeder), crypto algorithms (hash functions), and security architecture (virtual machines), where an analysis of inter-arrival times of published papers discussing attacks suggests that honeymoons are enjoyed across a wide range of computer security defenses.
Theoretical integration of user satisfaction and technology acceptance of the nursing process information system

Background The nursing process system (NPS) is used to establish the nursing process involving assessment, diagnosis, planning, intervention, and evaluation in solving the health problems of patients. Objectives The factors influencing the use of the NPS by nurses were analyzed based on user satisfaction and technology acceptance within the 3Q (service quality, information quality, and system quality) model. Methods In this cross-sectional quantitative study, the valid responses of 222 nurses to a questionnaire were obtained; these nurses worked at eight hospitals affiliated with public organizations in Taiwan. Structural equation modeling was used to analyze information quality, system quality, service quality, user satisfaction, perceived usefulness, perceived ease of use, perceived enjoyment, behavioral attitude, and intention after the nurses had used the NPS system for more than 1 month. Results Information quality, service quality, and system quality influenced user satisfaction. User satisfaction affected perceived usefulness, perceived ease of use, and perceived enjoyment and had the highest explanatory power (R2 = 0.75). Furthermore, perceived usefulness, perceived ease of use, and perceived enjoyment influenced behavioral attitude and intention to use the system. The proposed model explained 53% of the variance in the intention to use the NPS. Conclusions The relationships between the variables of the 3Q model were successfully used to examine the intention of nurses toward using the NPS. Using the findings of this study, designers and programmers can comprehensively understand the perceptions of nurses and further improve the performance of the NPS.
Single-center experience with the new generation Derivo Embolization Device in ruptured dissecting and blister aneurysms

Background Treatment of ruptured dissecting and blister aneurysms is technically challenging with potentially high morbidity and mortality. The Derivo Embolisation Device (Derivo) is a flow diverter stent designed for the treatment of intracranial aneurysms. Purpose To assess the safety and feasibility of the Derivo in the treatment of ruptured dissecting and blister aneurysms. Material and Methods We retrospectively analyzed all patients with ruptured dissecting and blister aneurysms treated with the Derivo between February 2016 and July 2018. Procedural details, complications, morbidity within 30 days, and angiographic aneurysm occlusion rates, initially and after six months, were assessed. Results In 10 patients 11 ruptured dissecting and blister aneurysms were treated with 12 Derivos as monotherapy. No aneurysm rebleeding was observed at follow-up. One treatment-related complication occurred including a coil perforation of an additionally treated aneurysm. One patient died due to brain edema. Initial digital subtraction angiography revealed complete (O’Kelly–Marotta [OKM] classification D) and favorable (OKM D+C) occlusion rate in three aneurysms. Six-month follow-up for digital subtraction angiography and clinical evaluation was available in 6/9 patients with complete (OKM D) occlusion in all aneurysms (6/6). Favorable (modified Rankin Scale [mRS] ≤ 2) and moderate (mRS 3) clinical outcome after a mean follow-up of 10 months was observed in six and two patients, respectively. Conclusion Endovascular treatment with the Derivo in ruptured dissecting and blister aneurysms revealed a sufficient initial division of aneurysms from the circulation without rebleeding. The Derivo is associated with high procedural and clinical short-term safety.
Ischemic Preconditioning Maintains Performance on Two 5-km Time Trials in Hypoxia.

PURPOSE The ergogenic effect of ischemic preconditioning (IPC) on endurance exercise performed in hypoxia remains debated and has never been investigated with successive exercise bouts. Therefore, we evaluated if IPC would provide immediate or delayed effects during two 5 km cycling time-trials (TTs) separated by ~1 h in hypoxia. METHODS In a counterbalanced randomized cross-over design, thirteen healthy males (27.5 ± 3.6 years) performed two maximal cycling 5 km TTs separated by ~1 h of recovery (TT1 25 min and TT2 2 h post IPC/SHAM), preceded by IPC (3 × 5 min occlusion 220 mmHg/reperfusion 0 mmHg, bilaterally on thighs) or SHAM (20 mmHg) at normobaric hypoxia (inspired fraction of oxygen [FIO2] of 16%). Performance and physiological (i.e., oxyhemoglobin saturation, heart rate, blood lactate, and Vastus Lateralis oxygenation) parameters were recorded. RESULTS Time to complete (P = 0.011) 5 km TT and mean power output (P = 0.005) from TT1 to TT2 were worse in SHAM, but not in IPC (P = 0.381/P = 0.360, respectively). There were no differences in time, power output or in physiological variables during the two TTs between IPC and SHAM. All muscle oxygenation indices differed (P < 0.001) during the IPC/SHAM with a greater deoxygenation in IPC. During the TTs, there was a greater concentration of total hemoglobin ([tHb]) in IPC than SHAM (P = 0.047) and greater [tHb] in TT1 than TT2. Further, the concentration of oxyhemoglobin ([O2Hb]) was lower during TT2 than TT1 (P = 0.005). CONCLUSION In moderate hypoxia, IPC allowed maintaining a higher blood volume during a subsequent maximal exercise, mitigating the performance decrement between two consecutive cycling time-trials.
Prediction of Load Sharing Among Spinal Components of a C5‐C6 Motion Segment Using the Finite Element Approach

Study Design. A finite element model of the ligamentous cervical spinal segment was used to compute loads in various structures in response to clinically relevant loading modes. Objective. To predict biomechanical parameters, including intradisc pressure, tension in ligaments, and forces across facets that are not practical to quantify with an experimental approach. Summary of Background Data. Finite element models of the cervical spine in their present form, because of inherent assumptions and simplifications, are not entirely satisfactory for studying the biomechanics of the intact, injured, and stabilized cervical spinal segment. Methods. A three‐dimensional finite element model of a C5‐C6 motion segment was developed from serial computed tomographic scans of a ligamentous cervical spinal segment. This model included nonlinear ligament definition, fully composite intervertebral disc, fluid nucleus, and Luschka's joints. The model‐based displacement predictions were in agreement with the experimental data. This model was used to predict load sharing and other related parameters in spinal elements in response to various loading modalities. Results. In axial compression, 88% of the applied load passed through the disc. The interspinal ligament experienced the most strain (29.5%) in flexion, and the capsular ligaments were strained the most (15.5%) in axial rotation. The maximum intradisc pressure was 0.24 MPa in the flexion with axial compression mode (1.8 Nm + 73.6 N). The anterior and posterior disc bulges increased with the increase in axial compression (up to 800 N). Conclusions. The results provide new insight into the role of various elements in transmitting loads. The model represents significant and essential advancement in comparison with previous finite element models, making it possible for such models to be used in investigating a broad spectrum of clinically relevant issues.
The Prevalence of the Disposition Effect in Mutual Funds’ Trades

Abstract U.S. equity mutual funds, on average, prefer realization of capital losses to capital gains. Nevertheless, a substantial fraction exhibits the disposition effect of realizing gains more readily than losses. My analysis suggests that learning effects have reduced the manifestation of the disposition effect over time, implying that academic research has influenced industry practices. When funds experience outflows and are managed by teams of portfolio managers, they are more susceptible to selling disproportionately more winners than losers. Disposition-driven behavior affects investment style, causing lower market betas and characteristics of value-oriented and contrarian styles, but has no observable effect on fund performance.
The Characterization of 18F-hGTS13 for Molecular Imaging of xC− Transporter Activity with PET

The aim of this study was development of an improved PET radiotracer for measuring xC− activity with increased tumor uptake and reduced uptake in inflammatory cells compared with (S)-4-(3-18F-fluoropropyl)-l-glutamate (18F-FSPG). Methods: A racemic glutamate derivative, 18F-hGTS13, was evaluated in cell culture and animal tumor models. 18F-hGTS13 was separated into C5 epimers, and the corresponding 18F-hGTS13-isomer1 and 18F-hGTS13-isomer2 were evaluated in H460 tumor–bearing rats. Preliminary studies investigated the cellular uptake of 18F-hGTS13-isomer2 in multiple immune cell populations and states. Results: 18F-hGTS13 demonstrated excellent H460 tumor visualization with high tumor-to-background ratios, confirmed by ex vivo biodistribution studies. Tumor-associated radioactivity was significantly higher for 18F-hGTS13 (7.5 ± 0.9 percentage injected dose [%ID]/g, n = 3) than for 18F-FSPG (4.6 ± 0.7 %ID/g, n = 3, P = 0.01). 18F-hGTS13-isomer2 exhibited excellent H460 tumor visualization (6.3 ± 1.1 %ID/g, n = 3) and significantly reduced uptake in multiple immune cell populations relative to 18F-FSPG. 18F-hGTS13-isomer2 exhibited increased liver uptake relative to 18F-FSPG (4.6 ± 0.8 vs. 0.7 ± 0.01 %ID/g), limiting its application in hepatocellular carcinoma. Conclusion: 18F-hGTS13-isomer2 is a new PET radiotracer for molecular imaging of xC− activity that may provide information on tumor oxidation states. 18F-hGTS13-isomer2 has potential for clinical translation for imaging cancers of the thorax because of the low background signal in healthy tissue.
Complex biliary stones management: cholangioscopy versus papillary large balloon dilation – a randomized controlled trial

Abstract Background and study aims Endoscopic removal of biliary stones has high success rates, ranging between 85 % to 95 %. Nevertheless, some stones may be challenging and different endoscopic methods have evolved. Papillary large balloon dilation after sphincterotomy is a widely used technique with success rates ranging from 68 to 90 % for stones larger than 15 mm. Cholangioscopy allows performing lithotripsy under direct biliary visualization, either by laser or electrohydraulic waves, which have similar success rate (80 % – 90 %). However, there is no study comparing these 2 techniques. Patients and methods From April 2014 to June 2016, 100 patients were enrolled and randomized in 2 groups, using a non-inferiority hypothesis: cholangioscopy + electrohydraulic lithotripsy (group 1) and endoscopic papillary large balloon dilation (group 2). The main outcome was complete stone removal. Adverse events were documented. Mechanical lithotripsy was not performed. Failure cases had a second session with crossover of the methods. Results The mean age was 56 years. 74 (75.5 %) patients were female. The initial overall complete stone removal rate was 74.5 % (77.1 % in group 1 and 72 % in group 2, P > 0.05). After second session the overall success rate achieved 90.1 %. Procedure time was significantly lower in group 2, – 25.2 min (CI95 % – 12.48 to – 37.91). There were no significant differences regarding technical success rate, radiologic exposure and adverse events. Conclusion Single-operator cholangioscopy-guided lithotripsy and papillary large balloon dilation are effective and safe approaches for removing complex biliary stones.
EXPERIMENTAL EVIDENCE FOR MULTIVARIATE STABILIZING SEXUAL SELECTION

Abstract Stabilizing selection is a fundamental concept in evolutionary biology. In the presence of a single intermediate optimum phenotype (fitness peak) on the fitness surface, stabilizing selection should cause the population to evolve toward such a peak. This prediction has seldom been tested, particularly for suites of correlated traits. The lack of tests for an evolutionary match between population means and adaptive peaks may be due, at least in part, to problems associated with empirically detecting multivariate stabilizing selection and with testing whether population means are at the peak of multivariate fitness surfaces. Here we show how canonical analysis of the fitness surface, combined with the estimation of confidence regions for stationary points on quadratic response surfaces, may be used to define multivariate stabilizing selection on a suite of traits and to establish whether natural populations reside on the multivariate peak. We manufactured artificial advertisement calls of the male cricket Teleogryllus commodus and played them back to females in laboratory phonotaxis trials to estimate the linear and nonlinear sexual selection that female phonotactic choice imposes on male call structure. Significant nonlinear selection on the major axes of the fitness surface was convex in nature and displayed an intermediate optimum, indicating multivariate stabilizing selection. The mean phenotypes of four independent samples of males, from the same population as the females used in phonotaxis trials, were within the 95% confidence region for the fitness peak. These experiments indicate that stabilizing sexual selection may play an important role in the evolution of male call properties in natural populations of T. commodus.
Automated MPEG audio-video summarization and description

The paper proposes a novel method for automatically summarizing MPEG coded audio-video content in the compressed domain, and describing audio-video summaries in the MPEG-7 standard format. Semantically important features for summary generation are carefully analyzed, and two types of summaries, digest and highlight, are extracted. A digest extraction is based on an audio level estimation and visual features analysis, where digest shots are adaptively determined for user-specified duration by utilizing the MPEG-7 based motion features. A highlight-based summarization from TV broadcast sports programmes is achieved by analyzing audio class and audio level. The extracted summaries and related features are described by the MPEG-7 description tools. Experimental results show that the digests and highlights can be successfully extracted in various kinds of contents without a priori knowledge of content characteristics.
Altered serum levels of vascular endothelial growth factor and glial-derived neurotrophic factor but not fibroblast growth factor-2 in treatment-naive children with attention deficit/hyperactivity disorder

Abstract Background and aim: Recent evidence suggests that growth factors might be involved in the pathophysiology of attention deficit hyperactivity disorder (ADHD). The aim of this study was to determine whether serum levels of brain-derived neurotrophic factor (BDNF), glial-derived neurotrophic factor (GDNF), neurotrophin-3 (NT-3), nerve growth factor (NGF), fibroblast growth factor-2 (FGF-2) and vascular endothelial growth factor (VEGF) were altered in children with ADHD. Methods: Serum levels of BDNF, GDNF, NT-3, NGF, VEGF and FGF-2 were analyzed in 49 treatment- naive children with ADHD and age, gender matched 36 healthy controls using enzyme-linked immunosorbent assay. ADHD symptoms were scored by Du Paul ADHD Rating Scale and Strengths and Difficulties Questionnaire. Results: We found that serum VEGF levels were significantly lower (p < 0.001) and GDNF levels were significantly higher in ADHD group compared to control group (p = 0.003). However, we found no correlations between ADHD symptoms and serum VEGF or GDNF levels. Furthermore, we observed no significant alterations in serum BDNF, NT-3, NGF, FGF-2 levels in children with ADHD. Conclusion: To our knowledge, the present study is the first to examine serum VEGF and FGF-2 levels in children with ADHD. Our results indicate that VEGF and GDNF might be involved in the etiology of ADHD. Further studies are required to determine the role of growth factors in the etiology and consequently in the treatment of ADHD.