Miracle-dz/UniFAR-FTUs huggingface dataset:
Polimedicação em Idosos Submetidos a Tratamento Oncológico

Introdução: O paciente idoso com câncer possui risco potencial de polimedicação pelo aumento de comorbidade e complexidade do tratamento do câncer que, muitas vezes, inclui múltiplos antineoplásicos e medicamentos de suporte. Objetivo: Identificar a frequência de polimedicação, o uso de medicamentos potencialmente inapropriados e a interação medicamentosa em pacientes idosos com câncer. Método: Coletaram-se informações sociodemográficas, farmacológicas e clinicas de 20 pacientes idosos (≥65 anos) com câncer, polimedicados (≥cinco medicamentos), de julho a agosto de 2016, em um ambulatório em São Luís – MA, por meio de prontuário eletrônico e questionários aplicados em entrevistas. Para analise dos dados, utilizaram-se as ferramentas: Classificação Anatômica Terapêutica Química, Micromedex®, Drugs®, Lexicomp® e o Manual de fitoterápicos da Anfarmag. O Beers Criteria 2015 foi utilizado para identificação dos medicamentos potencialmente inapropriados para idosos. Resultados: Entre os pacientes, 70% eram do sexo masculino, com idade media de 73 anos (DP=7,9). Os tipos de câncer mais prevalentes foram os de próstata e mama. Quanto às comorbidades, as cardiovasculares e as endócrinas foram as mais relatadas. Foram identificados 134 medicamentos prescritos e de automedicação, dos quais, 41 eram antineoplásicos. Oitenta por cento dos pacientes estavam expostos a risco potencial de interação medicamentosa, totalizando 90 (63,2% de gravidade moderada, 21,2% importante e 8,8% menor). Detectaram-se quatro interações envolvendo plantas medicinais e sete medicamentos inapropriados para idosos em 20% e 65% dos pacientes, respectivamente. Conclusão: Entre os pacientes incluídos neste estudo, verificou-se a ocorrência de polimedicação, de interações medicamentosas potenciais e do uso de medicamentos potencialmente inapropriados para idosos.
Sustainable Business Innovation model for Manipulating Tactics and Changing Consumer Behavior: Based on Mobile Phone Operators in Bangladesh

This study aims at developing a business innovation model for manipulating tactics and changing consumer behavior on mobile phone operators in Bangladesh. Now-a-days, the mobile phone has part and parcel of our daily life. The specific objectives are to explore the customers' expectations and perceptions; To analyze the factors that affect users for switching to another cell phone operators and finally to find out the ways of sustainability of existing phone operators. The methodology used the qualitative method based on the inductive research approach and an interview technique was employed for data collection. Semi-structured with an open-ended questionnaire were used as instruments for gathering data. A total of 40 (forty) interviewees was taken as a sample based on purposive random sampling techniques. The findings confirmed that some significant service gap between the SIM Company concerning influencing factors except factor. The originality of this study is that a unique business model has been designed based on consumer behavior change for five selected Subscriber Identity Module (SIM) companies in Bangladesh. Also, the model has demonstrated by taking cases of SIM companies. This study outlined future directions for developing a business model of mobile phone companies that could be utilized in other business sectors.
Determining international parasport success factors for UK para-athletics

Parasport is attracting increased attention, with many nations adopting a systematic approach to the pursuit of international sporting success. The acceptance of an approach developed in a non-disabled context assumes that the determinants of success are concomitant for parasport and non-disabled sport alike. Policy development in this area is currently underdeveloped and a significant knowledge gap is evident. This knowledge gap provides the rationale for this study based on three principal factors: A lack of studies examining international parasport success factors; a lack of studies examining international sporting success factors in sport-specific contexts and; an absence of studies that address both dimensions. This study aims to address this gap in the literature by determining international parasport success factors for UK para-athletics. The study undertakes a critical realist approach, using a mixed methods research design. A four-phase sequential design was adopted which included both quantitative surveys completed by para-athletes and their coaches and qualitative semi-structured interviews, with athletes, coaches and UK Athletics staff. The results of this study suggest that the determinants of success identified for para-athletics include the factors identified in previous non-disabled studies but that there are additional variable factors for consideration. The relevant variable factors identified by this study are grouped as the nature of impairment (acquired or congenital); the level of support and care needs; and the level of equipment needs. This study provides a model illustrating the influences of these variables on the determinants of success, which may be of value for the development of para-athletics policies and the design of parasport support structures in the future. Consideration of the DIPAS model can enable improved structures and enhanced support of para-athletes, consequently improving success rates and ensuring appropriate spend of public money. It is recommended that the research approach is repeated in nations that perform comparably in para-athletics. Further research within athletics is advised to explore variance across event disciplines and ensure appropriate allocation of resources.
A safe and cheap method for closing the appendiceal stump in laparoscopic appendectomy: Hand made loop

Purpose: Our aim in this study is to describe the handmade loop as a modified technique for closing the appendiceal stump and discuss its effects on outcome. Meterials and Methods:Patients who underwent laparoscopic appendectomy due to acute appendicitis between January 2012 and January 2015 and in whom the handmade loop technique was used were included in the study.The demographic and clinical findings, surgical complications and length of stay in hospital were all retrieved from patients files. Results were discussed with relevant literature. Results:A total of 197 patients were enrolled in the study. 111 male (56.3%) and 86 female (43.6%) patients were operated. Median age of the patients was 30.9 ± 12.9. The mean operative time was 52.5 ± 20.4 minutes. In 14 patients (7.1%) a complicated appendicitis (perforation/ abscess) was observed. Mean duration of hospital stay was 2.49 ± 1.25 days. 8 patients (9.1%) experienced post op complications. These were trocar site infection in 12 patients, postoperative ileus in the early postoperative period in 4 patients, and one pelvic abscess (treated with percutaneous drainage). None required re operation. Conclusion:The handmade loop is a safe method to close the appendix stump in laparoscopic appendectomy. Using this method can reduce the cost of laparoscopic appendectomy. Pam Med J 2017;(2):130-134
Invasive Weed Optimization Technique-Based ANN to the Prediction of Rock Tensile Strength

In many site investigation phases of civil and mining engineering projects, the tensile strength of the rocks is one of the most significant parameters that must be identified. This parameter can be determined directly through laboratory tests. However, conducting such laboratory tests is costly and time consuming. In this paper, a new artificial neural network (ANN)-based model is developed to predict rock tensile strength, using the invasive weed optimization (IWO) technique. Granite samples for the purpose of this research were selected from a tunnel located in Malaysia and underwent appropriate laboratory tests (i.e., Schmidt hammer, point load, dry density, as well as the Brazilian tensile strength (BTS) as system output). A simple regression analysis was carried out, and the obtained results confirmed the need for developing a model with multiple inputs, rather than one with only a single input, in order to predict BTS values. Aiming to highlight the capability of an IWO-ANN model in estimating BTS, artificial bee colony (ABC)-ANN and imperialism competitive algorithm (ICA)-ANN were also applied and developed. The parameters required for the ANN-based models were obtained using different parametric studies. According to calculated performance indices, a new hybrid IWO-ANN model can provide a higher accuracy level for the prediction of BTS compared to the ABC-ANN and ICA-ANN models. The results showed that the IWO-ANN model is a suitable alternative solution for a robust and reliable engineering design.
Forecasting Recharging Demand to Integrate Electric Vehicle Fleets in Smart Grids

Electric vehicle fleets and smart grids are two growing technologies. These technologies provided new possibilities to reduce pollution and increase energy efficiency. In this sense, electric vehicles are used as mobile loads in the power grid. A distributed charging prioritization methodology is proposed in this paper. The solution is based on the concept of virtual power plants and the usage of evolutionary computation algorithms. Additionally, the comparison of several evolutionary algorithms, genetic algorithm, genetic algorithm with evolution control, particle swarm optimization, and hybrid solution are shown in order to evaluate the proposed architecture. The proposed solution is presented to prevent the overload of the power grid.
Proceso infeccioso en paciente inmunodeprimido

Historia clinica: Varon de 57 anos, que ingresa por disfagia, fiebre y sindrome general de un mes de evolucion tras una estancia en un balneario de la costa mediterranea. Serologia positiva para VIH. A las tres semanas fallece por insuficiencia respiratoria.
The Effects of P-Hydroxycinnamic Acid in Ameliorating Spatial Learning and Flexibility Deficits in Rats with Chronic Cerebral Hypoperfusion

Cerebral blood reduction resulting in oligemic energy failure and metabolic insufficiency initiates gradual neurodegeneration and cognitive impairments. We investigated the neuroprotective effects of p-hydroxycinnamic acid (pHCA) on neurodegeneration in association with cognitive impairments in rats with chronic cerebral hypoperfusion (CCH). Forty male Sprague-Dawley rats were randomly divided into 4 groups: Sham-veh, 2VO-veh, 2VO-pHCA50 and 2VO-pHCA100. We used modified 2-vessel occlusion (2VO) to induce CCH, and the 2 latter groups were given 50 mg/kg and 100 mg/kg of pHCA after the 2VO operation, respectively, which continued for 3 weeks. The behavioral tests consisted of anxiety-like behavior tested in an elevated plus maze (EPM) and hippocampal-dependent spatial learning and flexibility tested in a Morris water maze (MWM). Brain oxidative status, infarction, vulnerable hippocampus and corpus callosum (CC) white matter degeneration were evaluated. The results showed that modified 2VO induced reversible short-term anxiolytic-like behavior in the EPM (p 0.05) with significance infarction, vulnerable hippocampal CA1, CA3, DG and CC degeneration (p < 0.05). These were found along with significant spatial learning and flexibility deficits (p < 0.05). Additionally, 100 mg/kg of pHCA significantly ameliorated the spatial learning and flexibility deficits, which coincided with the significant decreases of infarction volume, CA1, CA3 and CC degeneration (p < 0.05). We conclude that pHCA’s improving effects on spatial learning and flexibility deficits are neuroprotective against oligemic energy failure-induced vulnerable neuronal and white matter degeneration in CCH rats.
The effects on carotid artery intima-media wall thickness and development of atherosclerosis in children on anti-epileptic drug monotherapy

1 Epidemiological, clinical and experimental investigations have shown that anti-epileptic drugs (AED) predispose to atherosclerosis by altering the lipid profile. 2 It has been well documented that atherosclerotic vascular alterations may start early in life and progress with age. 3 The first signs of hyperlipidemia can be detected in childhood and fatty streaks, which are the earliest pathologic lesions of atherogenic process, can be observed in the aorta and coronary arteries of individuals by the age of 20. 4,5 Non-invasive measurement of carotid intima-media thickness ABSTRACT Background: Children with seizure disorder and requiring long-term anti-epileptic drugs are predisposed for development of atherosclerosis. We monitored the carotid artery intima wall thickness of the children on Antiepileptic drug monotherapy along with their lipid profile for a period of one year. Methods: Children under 18 years, who were newly diagnosed with epilepsy or were already on anti-epileptic drug monotherapy were included in the study period of one year. They were then prospectively followed-up at three months and again between the sixth and twelfth month’s period. A high-resolution B-mode ultrasound using a 5-7 MHz linear transducer was employed for measuring the thickness of the carotid intima-media thickness (cIMT). The biochemical parameters including fasting lipid profile, body mass index and dietary habits were also taken. Results: A total of 130 children were included in the study. The values of cIMT observed were 0.38 mm (0.1 mm) and 0.41 mm (0.1mm) in the new (control) and old cases respectively. The values of cIMT were significantly increased in patients receiving Carbamazepine (CBZ) and Phenytoin after 3 months of therapy and with increase in age and duration of intake of anti-epileptic drugs. There were no gender differences in the value of cIMT. Conclusions: The values of serum cholesterol, LDL and HDL were significantly increased in children on CBZ and valproic acid. There was no difference in the lipid profiles of children on Phenytoin and Phenobarbitone. However, the atherogenic indices of the children taking any of the four anti-epileptic drugs were normal.
A critical review of the literature regarding physical therapy management of patients with total knee arthroplasty

This review analyzes the research literature on physical therapy management of patients anticipating or recovering from total knee arthroplasty (TKA). Using databases and keywords, several relevant studies were found. Twenty-four studies met the criteria and were classified according to Sackett’s levels of evidence. Fifteen studies were graded as level I, five studies as level II, one as level IV, and three as level V. From the levels of evidence, seven grade A, four grade B, and one grade C recommendations were developed, with grade A being the most significant. The results of this review found that there is a potential benefit to using accelerated procedures (initiation of rehabilitation within 24 hr after TKA). Encouraging patients to perform active range of motion exercise would be a better option than passive range of motion and that physiotherapy can focus on more functional rehabilitation, such as preparing to return to daily activities. Eccentric exercise of the hamstring is one of the effective methods to recover knee extension after TKA. A multidisciplinary rehabilitation program, including a physician specializing in physical medicine and rehabilitation, a physical therapist, a psychologist, a social worker, a nutritionist, and an orthopaedic surgeon in the outpatient setting, does not reduce the use of rehabilitation services or yield faster achievement of functional recovery or quality of life. Functional training and balance training are safe treatment methods and have the potential to decrease functional limitations. Clinical recommendations and future research directions also are provided.
Hedging and the regret theory of the competitive firm

This paper examines the production and hedging decisions of the competitive firm under price uncertainty when the firm is not only risk averse but also regret averse. Regret-averse preferences are characterized by a modified utility function that includes disutility from having chosen ex-post suboptimal alternatives. The extent of regret depends on the difference between the actual profit and the maximum profit attained by making the optimal production and hedging decisions had the firm observed the true realization of the random output price. While the separation theorem holds under regret aversion, the prevalence of hedging opportunities may have perverse effect on the firm's optimal output level, particularly when the firm is sufficiently regret averse. The full-hedging theorem, however, does not hold. We derive sufficient conditions under which the regret-averse firm's optimal futures position is an under-hedge (over-hedge). We further show that the firm optimally increases (decreases) its futures position when the price risk possesses more positive (negative) skewness.
Assessment of systemic blood flow in the newborn infant.

Preterm infants are vulnerable to brain injury which is thought to be caused partly by abnormalities in cerebral perfusion. However the accurate assessment of cerebral and general systemic perfusion remains a challenge in the newborn infant. Commonly used clinical parameters such as blood pressure and blood lactate concentrations are imperfect predictors of blood flow. Cardiac output measurements used in older children do not reflect true systemic perfusion in the neonate due to shunting of blood through persisting fetal pathways. Echocardiographic measurements of descending aortic (DAo) and superior vena caval (SVC) blood flow may provide more reliable assessment of neonatal systemic perfusion. This thesis evaluates these techniques in the first days of postnatal life. Measures of flow volume in the SVC and DAo were found to be feasible in the vast majority of infants, and were performed without significantly affecting cardiorespiratory status. Assessment of SVC flow volume showed similar repeatability to other measures of blood flow in neonates when assessed by a single observer, as did assessment of velocity of flow in the DAo. We then used these techniques to further assess the transitional circulation, and found no evidence of a positive association between arterial blood pressure and volume of systemic perfusion. Contrary to previous assumptions that ductal shunting compromises systemic perfusion, we found that left ventricular output tended to increase with increasing shunt through the ductus arteriosus, thereby maintaining upper, though not necessarily lower, body perfusion.
Metagenomic insights into the metabolism and ecologic functions of the widespread DPANN archaea from deep-sea hydrothermal vents

Due to the particularity of metabolism and the importance of ecological roles, the archaea living in deep-sea hydrothermal system always attract great attention. Included, the DPANN superphylum archaea, which are massive radiation of organisms, distribute widely in hydrothermal environment, but their metabolism and ecology remain largely unknown. In this study, we assembled 20 DPANN genomes comprised in 43 reconstructed genomes from deep-sea hydrothermal sediments, presenting high abundance in the archaea kingdom. Phylogenetic analysis shows 6 phyla comprising Aenigmarchaeota, Diapherotrites, Nanoarchaeota, Pacearchaeota, Woesearchaeota and a new candidate phylum designated DPANN-HV-2 are included in the 20 DPANN archaeal members, indicating their wide diversity in this extreme environment. Metabolic analysis presents their metabolic deficiencies because of their reduced genome size, such as gluconeogenesis, de novo nucleotide and amino acid synthesis. However, they possess alternative and economical strategies to fill this gap. Furthermore, they were detected to have multiple capacities of assimilating carbon dioxide, nitrogen and sulfur compounds, suggesting their potentially important ecologic roles in the hydrothermal system. IMPORTANCE DPANN archaea show high distribution in the hydrothermal system. However, they possess small genome size and some incomplete biological process. Exploring their metabolism is helpful to know how such small lives adapt to this special environment and what ecological roles they play. It was ever rarely noticed and reported. Therefore, in this study, we provide some genomic information about that and find their various abilities and potential ecological roles. Understanding their lifestyles is helpful for further cultivating, exploring deep-sea dark matters and revealing microbial biogeochemical cycles in this extreme environment.
Cancer-Related Fatigue Clinical Guideline and Protocol for Hospitalized Oncology Patients: A Quality Improvement Project

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Extrapolation of daily air temperatures of Egypt from MODIS LST data

Abstract The limited and poor spatial distribution of meteorological stations is inadequate to reconstruct accurate regional air temperature maps, which are important for environmental planning and resources management. This study aimed to generate a gridded dataset of max/min daily surface air temperatures for Egypt based on remotely sensed data acquired from the MODIS land surface temperature (LST) product. Linear regression analysis was performed between observed air temperatures from ground weather stations and LST records from satellite images. Regression coefficients were as high as 0.8 between min air temperature and night LST data, compared to 0.77 for max air temperature and day LST. Statistical analysis reveals significant correlations (p < .01) for both regression relationships. MODIS data showed a satisfactory performance in producing regional monthly and annual as well as diurnal surface air temperatures maps for Egypt. MODIS data could also highlight the influence of topography, vegetation and lithology on air temperatures.
Turn-Off Delay-Controlled Bidirectional DC–DC Resonant Converter With Wide Gain Range and High Efficiency

Series resonant converter can only operate efficiently within a narrow voltage gain range, which limits the use for battery charging applications. Thus, this article proposes a turn-off delay-controlled bidirectional series resonant (TFD-BSR) converter to extend the voltage gain range and enhance the efficiency. Instead of frequency modulation, the turn-off delay of the corresponding bottom switches is adopted to regulate the direction and amplitude of power flow. First, high peak and low valley voltage gain is obtained at fixed switching frequency. As a result, wide voltage range is extended. Second, the voltage gain is independent of auxiliary and magnetizing inductors, and hence, a large value for the two inductors, which depresses the circulating losses significantly, can be designed just considering zero-voltage switching (ZVS) conditions. In addition, all the active switches can operate with ZVS, which further enhances the efficiency. Operation principles, voltage gain characteristics, ZVS analysis, and design method of the proposed TFD-BSR converter are analyzed in detail. Finally, the feasibility and performance of the proposed converter are validated by simulations and experimental results from a 3.5-kW prototype.