Miracle-dz/UniFAR-FTUs huggingface dataset:
adherence to gOlD guidelines in real-life COPD management in the Puglia region of Italy

Background: COPD is a disease associated with significant economic burden. It was reported that Global initiative for chronic Obstructive Lung Disease (GOLD) guideline-oriented pharmacotherapy improves airflow limitation and reduces health care costs. However, several studies showed a significant dissociation between international recommendations and clinicians’ practices. The consequent reduced diagnostic and therapeutic inappropriateness has proved to be associated with an increase in costs and a waste of economic resources in the health sector. The aim of the study was to evaluate COPD management in the Puglia region. The study was performed in collaboration with the pulmonology centers and the Regional Health Agency (AReS Puglia). Methods: An IT platform allowed the pulmonologists to enter data via the Internet. All COPD patients who visited a pneumological outpatient clinic for the first time or for regular follow-ups or were admitted to a pneumological department for an exacerbation were considered eligible for the study. COPD’s diagnosis was confirmed by a pulmonologist at the moment of the visit. The project lasted 18 months and involved 17 centers located in the Puglia region. Results: Six hundred ninety-three patients were enrolled, evenly distributed throughout the region. The mean age was 71 ± 9 years, and 85% of them were males. Approximately 23% were current smokers, 63% former smokers and 13.5% never smokers. The mean post-bronchodilator forced expiratory volume in 1 second was 59% ± 20% predicted. The platform allowed the classification of patients according to the GOLD guidelines (Group A: 20.6%, Group B: 32.3%, Group C: 5.9% and Group D: 39.2%), assessed the presence and severity of exacerbations (20% of the patients had an exacerbation defined as mild [13%], moderate [37%] and severe [49%]) and evaluated the appropriateness of inhalation therapy at the time of the visit. Forty-nine percent of Group A patients were following inappropriate therapy; in Group B, 45.8% were following a therapy in contrast with the guidelines. Among Group C patients, 41.46% resulted in triple combination therapy, while ~ 14% of Group D patients did not have a therapy or were following an inappropriate therapy. In conclusion, 30% of all patients evaluated had been following an inadequate therapy. Subsequently, an online survey was developed to inquire about the reasons for the results obtained. In particular, we investigated the reasons why 30% of our population did not follow the therapy suggested by the GOLD guidelines: 1) why was there an excessive use of inhaled corticosteroids, 2) why a significantly high percentage was inappropriately treated with triple therapy and 3) why a consistent percentage (11%) of Group D patients were not treated at all. Conclusion: The data provides an overview on the management of COPD in the region of Puglia (Italy) and represents a resource in order to improve appropriateness and reduce the waste of health resources.
Phytochemical and antibacterial properties of root extracts from Portulaca oleracea Linn. (Purslane) utilised in the management of diseases in Nigeria

Background: Bacteria as etiological agents have been reported to cause many diseases and have increased the rate of mortality globally. Their resistance to conventional medicine has made medicinal plants a credible alternative in the management of diseases caused by bacterial infection. In the recent times many research efforts have been directed towards the exploration of phytoconstituents with antibacterial potentials. Medicinal plants are widely used as antibacterial agents because of their high therapeutic performance, low toxicity, and affordability. Aim: This work was designed to identify secondary metabolites present in root extracts of ethno-medicinally utilised Portulaca oleracea L. and evaluate their antibacterial activities. Setting: The roots of P. oleracea L. were obtained from the Forest Research Institute of Nigeria (FRIN), Ibadan, Nigeria and authenticated in the Forest Research Herbarium, where voucher samples were deposited with specimen voucher number FIH-112030. Methods: Phytochemical screening was carried out using standard qualitative tests and the antibacterial activity of extracts was evaluated using agar well diffusion method whilst the minimum inhibitory concentration (MIC) was evaluated by micro-dilution method. The screening was assessed against Bacillus subtilis, Candida albicans, Enterobacter cloacae, Escherichia coli, Klebsiella pneumoniae, Micrococcus luteus, Pseudomonas aeruginosa, Salmonella typhi, Shigella dysenteriae, Staphylococcus aureus and Streptococcus agalactiae , which are responsible for the transmission of common diseases in Nigeria. Statistical analysis was performed by one-way analysis of variance (ANOVA) with GraphPad Prism 8.0 and results were expressed as mean ± s.d. Duncan’s New Multiple range test were applied at 0.05 level of significance ( p < 0.05). Results: Phytochemical screening of P. oleracea L. showed the presence of carbohydrates, steroids, triterpenes, cardiac glycosides, and saponins. All extracts showed a high level of minimum inhibition concentration against the pathogens except K. pneumoniae, M. luteus and P. aeruginosa. Generally the antibacterial activity of extracts increased with decrease in polarity as compared with ciprofloxacin. The mean (± s.d.) values were significantly different by Duncan’s multiple range tests with p < 0.05. Conclusion: Portulaca oleracea L. has been identified for the first time as a good antibacterial agent, which corroborates the ethno-medicinal uses of the plant.
OPTIMAL SYNTHESIS OF FOUR ‐ BAR LINKAGE PATH GENERATION THROUGH EVOLUTIONARY COMPUTATION

2 Sustainable and Infrastructure Research and Development Center, Department of Mechanical Engineering, Faculty of Engineering, KhonKaen University, KhonKaen City, Thailand ABSTRACT: This paper presents the optimization of path generating of four-bar linkages using evolution algorithms (EAs). The design problem is assigned to minimize the error between desired and obtained coupler curves. Such mechanism synthesis is sometimes called dimensional analysis, which has the design variables as link lengths and other parameters. In this work, three evolutionary algorithms namely differential evolution (DE), hybrid population-based incremental learning and differential evolution (PBIL-DE) and adaptive differential evolution with optional external archive (JADE) are applied for finding the solutions. The results show that DE and JADE are the best methods for synthesizing the path generating of a four-bar linkage.
An outline of the Geology of New Caledonia; from Permian–Mesozoic Southeast Gondwanaland active margin to Cenozoic obduction and supergene evolution

The geological evolution of New Caledonia may be divided into three phases. The Gondwanan phase (Permian-Early Cretaceous), is marked by subduction along the SE Gondwaland margin. At that time, proto-New Caledonia was located in a fore-arc region in which volcanic-arc detritus accumulated; whilst accretion and subduction of oceanic and terrigenous material formed an accretionary complex metamorphosed into the blueschist facies. During the Late Cretaceous-Eocene, marginal rifting isolated New Caledonia, and after a short period of shallow water terrigenous sedimentation associated with minor volcanic activity, only pelagic sediments accumulated. A new NE-dipping subduction appeared to the E of New Caledonia at the Paleocene-Eocene boundary, it generated the eclogite-blueschist complex of northern New Caledonia, consumed the eastern Australian Plate, and eventually ended with Late Eocene obduction when the Norfolk Ridge blocked the subduction zone. Finally, during the post-Eocene phase, New Caledonia definitively emerged; this episode mainly corresponds to prominent regolith development and minor tectonic events that lead to the present morphology and to the development of supergene nickel ores.
Output feedback control for nonholonomic systems with non-vanishing disturbances

ABSTRACT A new adaptive output feedback controller is given for a class of nonholonomic systems with non-vanishing external disturbances and nonlinear uncertainties. The non-vanishing disturbance is regarded as the generalised system state and an extended state observer (ESO) is designed for the uncertain external disturbance in order to ensure the global asymptotical stability of the closed loop system. A novel observer/estimator is constructed for auxiliary system states and unknown parameter estimates. The integrator backstepping recursive technique based on a construction rule is applied to the design of the output feedback adaptive controller. The simulation example for a mobile robot with velocity and angle velocity measured deviation and disturbance is given to validate the effectiveness of the proposed method.
the online customer

This paper advances our theoretical understanding with regard to the online customer experience in a utilitarian context. The aim of this research is to understand if there is a need for online customer support during search for information and services on business support websites. In contrast to previous studies highlighting time distortion as part of the optimal customer experience, the findings of this research illustrate that customers are time conscious during a utilitarian search with the perceived length of time spent on the website influencing the customer experience. Additionally, the perceived length of time spent on the website influences the need to seek online customer support. The outcomes of customers requiring online customer support in relation to the customer experience have been established. The findings provide key managerial implications for economic development agencies and online business support providers on the requirement of online customer support and insight into the time conscious nature of customers in relation to the online customer experience.
THE EFFECT OF YERBA MATE (ILEX PARAGUARIENSIS) SUPPLEMENTATION ON NUTRIENT DIGESTIBILITY IN DAIRY COWS: AN IN SACCO AND IN VITRO STUDY.

Yerba Mate ( Ilex paraguariensis ), known for its potential human health benefit, was fed (250 gr/cow/day) to 3 rumen fistulated Holstein Friesian cows to investigate the influence of Yerba Mate (YM) on rumen fermentation. An in sacco and an in vitro study were done before and after feeding the cows for 14 days. During both studies dry matter disappearance (DMD) %, neutral detergent fibre (NDF) %, acid detergent fibre (ADF) %, crude protein disappearance (CPD) %, gas production and ammonia production were measured for pasture and concentrates after 0, 2, 6, 12, 24, 48 and 72 hours of incubation. The mean findings were a decrease in DMD % of in sacco pasture and concentrates and in vitro pasture, although these results were not statistically significant different (P>0.05) there is a clear biological relevant difference between the results before and after feeding the YM. Also a statistically significant (P<0.05) and biological relevant difference in gas production and ammonia production was found after feeding the YM. Further research is required to investigate the influence of Yerba Mate on rumen fermentation.
RECENT ADVANCES IN UNDERSTANDING THE RELATIONSHIP BETWEEN ADENOSINE METABOLISM AND THE FUNCTION OF T AND B LYMPHOCYTES IN DIABETES

Diabetes has become an increasingly prevalent disease worldwide. According to the WHO, there are more than 220 million diabetics worldwide, and it is estimated that this number will double by 2030. Increased susceptibility to infection is one of the pathological alterations associated with diabetes, apart from changes to the kidneys and cardiovascular system (1-3). Certain types of infections are more commonly found in patients with diabetes, while some types of infections are almost exclusive to diabetic patients. Studies on the impaired function of immune cells in diabetes are conducted for a long time, but the etiology of alterations in the functioning of T and B lymphocytes is still poorly understood. The impaired function of lymphocytes in diabetes may be attributed to the direct effect of hyperglycemia and/or hypoinsulinemia that alters the regulatory network of immune cells. Adenosine is an endogenous nucleotide that modulates the immune response. Its immunosuppressant and anti-inflammatory effects are recognized universally (4). The aim of this review is to summarize current knowledge on changes in adenosine metabolism and handling in diabetic lymphocytes. We relate described alterations to the individual functions of T and B cells.
Notes on Tasmanian eucalypts

A visit to Tasmania in February-March of the present year, has enabled me to look into some doubtful points, and also to consult Mr. Rodway, to whom I am very, grateful, although he is not responsible for my statements. The notes are in alphabetical order of species' names. C.R. means my "Critical Revision of the Genus Eucalyptus. "
Arandomized multicenter Phase II study of perioperative tiotropium intervention in gastric cancer patients with chronic obstructive pulmonary disease

Background Tiotropium, a long-acting inhaled anticholinergic drug, has been widely used in the treatment of chronic obstructive pulmonary disease (COPD). However, the issue of whether perioperative tiotropium improves postoperative outcomes for gastric cancer patients with COPD remains unclear. Thus, the aim of this study was to determine the efficacy of perioperative tiotropium intervention for gastric cancer patients with COPD. Patients and methods Eighty-four gastric cancer patients with mild-to-moderate COPD were randomly assigned to receive perioperative pulmonary rehabilitation alone (control group) or pulmonary rehabilitation with 18 µg of tiotropium once daily (tiotropium group). The patients in the tiotropium group received tiotropium for more than 1 week before surgery and for 2 weeks after surgery. Spirometry was performed prior to group assignment and at 2 weeks after surgery. Postoperative complications, forced expiratory volume in 1 second, forced vital capacity, and the ratio of forced expiratory volume in second to forced vital capacity (%) were compared between the two groups. Results There were no significant differences between the two groups in terms of age, body mass index, smoking, gastrectomy incision, operation time, and bleeding volume (all P>0.05). Postoperative complications and pulmonary functions did not differ significantly between the control and tiotropium groups. A subgroup analysis of gastric cancer patients with moderate COPD showed that perioperative tiotropium intervention significantly decreased the rate of postoperative complications compared with the control group (P=0.046). However, even after gastrectomy, many patients with mild COPD in both the control and tiotropium groups showed improved pulmonary function. Conclusion Although perioperative tiotropium intervention had no significant effects in gastric cancer patients with mild COPD, it may be beneficial in those with moderate COPD. Therefore, the next prospective study should further evaluate perioperative tiotropium intervention for gastric cancer patients with moderate-to-severe COPD.
The crossover conformational shift of the GTPase atlastin provides the energy driving ER fusion

state. However, whether crossover formation actually energizes fusion remains unclear, as do the sequence of events surrounding it. Here, we made mutations in atlastin to selec-tively destabilize the crossover conformation and used fluorescence-based kinetic assays to analyze the variants. All variants underwent dimerization and crossover concurrently, and at wild-type rates. However, certain variants were unstable once in the crossover dimer conformation, and crossover dimer stability closely paralleled lipid-mixing activity. Tethering, however, appeared to be unimpaired in all mutant variants. The results suggest that tethering and lipid mixing are catalyzed concurrently by GTP hydrolysis but that the energy requirement for lipid mixing exceeds that for tethering, and the full energy released through crossover formation is necessary for fusion.
Policies for biosimilar uptake in Europe: An overview

Across European countries, differences exist in biosimilar policies, leading to variations in uptake of biosimilars and divergences in savings all over Europe. The aim of this article is to provide an overview of different initiatives and policies that may influence the uptake of biosimilars in different European countries. Recommendations will be formulated on how to create sustainable uptake.
Real-Time Databases

Real-time databases manage time-constrained data and time-constrained transactions. They are useful in systems such as automated manufacturing, avionics, military command, control and communication, and programmed stock trading. In each of these applications, a computer system uses environmental data as input and must produce output to control its environment. Since data in the system represents the \current" state of the environment, the data is constrained to have been recorded recently enough to be considered valid. For instance, \current" sensor readings or \current" stock prices may be constrained to be no more than a few seconds old. Since environmental control must often be performed within a certain time interval to be correct, the transactions that operate on the data are also time-constrained. For instance, a military vehicle's evasive action, determined based on a transaction retrieving environmental data from the real-time database, may have to be performed by a certain deadline to be correct. This chapter describes the issues, research, and actual implementations of real-time database management systems. A real-time database is a component of a real-time system. A real-time system is one in which timing constraints, such as start times, deadlines, and periods, must be met for the application to be correct. There has been a great deal of work in real-time systems that in uence real-time database design. We summarize this work in Section 2 . The presence of real-time requirements adds requirements to real-time database management. Typical database management systems enforce logical consistency constraints only, whereas real-time databases have temporal consistency constraints, such as validity intervals for data and time constraints for transaction execution, that must also be enforced. In Section 3, we describe the additional dimension of temporal consistency constraints and the requirements on the real-time database management system that it imposes.
Do new cancer drugs offer good value for money? The perspectives of oncologists, health care policy makers, patients, and the general population

Background: In oncology, establishing the value of new cancer treatments is challenging. A clear definition of the different perspectives regarding the drivers of innovation in oncology is required to enable new cancer treatments to be properly rewarded for the value they create. The aim of this study was to analyze the views of oncologists, health care policy makers, patients, and the general population regarding the value of new cancer treatments. Methods: An exploratory and qualitative study was conducted through structured interviews to assess participants’ attitudes toward cost and outcomes of cancer drugs. First, the participants were asked to indicate the minimum survival benefit that a new treatment should have to be funded by the Spanish National Health System (NHS). Second, the participants were requested to state the highest cost that the NHS could afford for a medication that increases a patient’s quality of life (QoL) by twofold with no changes in survival. The responses were used to calculate incremental cost-effectiveness ratios (ICERs). Results: The minimum improvement in patient survival means that justified inclusions into the NHS were 5.7, 8.2, 9.1, and 10.4 months, which implied different ICERs for oncologists ( € 106,000/quality-adjusted life year [QALY]), patients ( € 73,520/QALY), the general population ( € 66,074/QALY), and health care policy makers ( € 57,471/QALY), respectively. The costs stated in the QoL-enhancing scenario were € 33,167, € 30,200, € 26,000, and € 17,040, which resulted in ICERs of € 82,917/QALY for patients, € 75,500/QALY for the general population, € 65,000/ QALY for oncologists, and € 42,600/QALY for health care policy makers, respectively. Conclusion: All estimated ICER values were higher than the thresholds previously described in the literature. Oncologists most valued gains in survival, whereas patients assigned a higher monetary value to treatments that enhanced QoL. Health care policy makers were less likely to pay more for therapeutic improvements compared to the remaining participants.
Human adipose tissue-derived mesenchymal stem cells in Parkinson's disease(cid:0)Inhibit T helper 17 cell differentiation and regulate immune balance towards a regulatory T cell phenotype

Parkinson's disease (PD), known as a neurodegenerative disorder, shows typical pathology of neuroin�ammation, which might be the result of the imbalance between regulatory T cells (Treg) and T helper 17 (Th17) cells. The present study aimed to investigate the modulating effect of Ad-MSCs on peripheral blood mononuclear cells (PBMCs) derived from PD patients. CD4 + peripheral blood T cells were isolated and co-cultured with Ad-MSCs at a ratio of 4:1 under Th17 or Treg polarizing conditions, respectively, for 4 days. Our results showed that Ad-MSCs speci�cally inhibited the differentiation of IL-17-producing CD4 + T cells collected from PBMCs of PD patients evidenced by the decreased expression of RORγt- the key transcription factor for Th17 cells, IL-6R, and IL-23R. In the meantime, Ad-MSCs and induced a functional CD4 + CD25 + Foxp3 + T regulatory cell phenotype evidenced by the secretion of IL-10. Furthermore, levels of LIF protein and its receptor mRNA were signi�cantly increased under both polarizing conditions. These �ndings suggest that the regulation of the Th17/Treg balance by Ad-MSCs was correlated with the increase in LIF secretion. Therefore, Ad-MSCs are an important player in modulating in�ammatory responses and a potential therapeutics for PD patients.
Noise in the intensive care unit and its influence on sleep quality : a multicenter observational study in Dutch intensive care units Supplementary material

In the main paper we focused on five acoustic parameters as having primary interest: average sound–pressure level (LAeq), background–noise level (L90), the rate of loud peaks per hour with a magnitude of at least 10 sone (LoudPeaks10S), and the number and duration of the restorative periods (NumRestPeriod and AvgDurRestPeriod). In addition to these parameters, we calculated an additional series of parameters thatwediscuss andpresent here. Collectively, these parameters enabled amore complete assessment of the acoustic environment of the participating ICUs. Note that for the visualizations below, we used the untransformed data and removed one outlier value for the average duration of restorative period.