Miracle-dz/UniFAR-FTUs huggingface dataset:
Yoğun Bakım Ünitesindeki Septik Şok Hastalarında Şok İndekslerinin Erken Dönem Sonuçları Öngörmede Kullanılabilirliği

Utility of Shock Indexes in Predicting Early Results of Septic Shock Patients in Intensive Care Unit ABSTRACT Objectives: Some parameters are currently being used in Intensive Care Units (ICU) in order to predict mortality. In our study, we aimed to determine the usability of shock index (SI), modified shock index (MSI) and age shock index (ASI) in order to predict the clinical outcomes and mortality of patients with sepsis and septic shock. Study Design: We retrospectively evaluated the results of patients who were hospitalized in ICU, between January 1, 2018 and December 31, 2018. Patients and Methods: Age, gender, co-morbidities, acute physiology and chronic health evaluation II (APACHE II) scores, length of mechanical ventilation, length of hospital stay, SI, MSI, ASI and mortality were recorded in patients with sepsis. Results: We evaluated 172 patients with sepsis. SI, MSI, ASI levels were significantly higher in patients with mortality (p < 0.05). For SI, the area under the receiver operating characteristic (ROC) curve was 0.649 (95% CI = 0.573–0.720, p = 0.0003) and the cutoff value for shock index was 1.06 (sensitivity: 62%, 95% CI: 51-72.3; specificity: 67.44%, 95% CI: 56.5-77.2). For MSI, the area under the ROC curve was 0.585 (95% CI = 0.508–0.659, p = 0.049) and the cutoff value was 1.69 (sensitivity: 37.9%, 95% CI: 27.7-49; specificity: 82.5%, 95% CI: 72.9-89.9). For ASI, the area under the ROC curve was 0.613 (95% CI = 0.536–0.686, p = 0.0078) and the cutoff value was 87.42 (sensitivity: 40.2%, 95% CI: 29.9–51.3; specificity: 82.56%, 95% CI: 72.9–89.9). Conclusion: The shock indexes were found out to be significant in predicting mortality in septic patients. While the sensitivity was limited in 3 shock indexes, specificity was determined to be significantly higher in both ASI and MSI, and significantly lower in SI.
EXPERIMENTAL OPHTHALMOLOGY – EX VIVO MODELLING OF NEOVASCULAR DISEASES IN OPHTHALMOLOGY

The results of our experimental study showed the cellular exposure effects of four different anti-VEGF drugs upon fibroblast-like cell strain L 929 chosen as a model of the fibroblast-based cellular matrix of CNV in vitro . The results demonstrate the effect of anti-VEGF drugs on the proliferative activity and vital indices, including survival, proliferative and mitotic activity, apoptosis and dependence. It shows that the small concentration of anti-VEGF drugs (ranibizumab 12.5 𝜇 g/mL, bevacizumab 3.13 𝜇 g/mL, pegaptanib 0.15 𝜇 g/mL, and aflibercept 0.04 𝜇 g/mL) present a pronounced antiproliferative effect on the L 929 cells. Within the four anti-VEGFs, only bevacizumab increased the apoptosis of L 929 cells in all concentrations used. The reproductive cellular death of L 929 cell culture was proven by the inhibition of the cellular proliferation and increased heterogeneity of these cells under anti-VEGFs exposure. Bevacizumab, pegaptanib, and aflibercept showed a marked dose-dependent antiproliferative effects on the L 929 cells, which increased with increasing the dose. On the contrary, after incubation with ranibizumab, there appeared to be a compensation of the antiproliferative and apoptotic drug action by a cellular proliferation despite the increase in the anti-VEGFs concentration used. A self-digestive or self-recycling mechanism found in L 929 cells and considered to be the sings of true autophagy could explain partially the compensatory cellular proliferation.
Nonprofit Policy Forum

The 2010 Affordable Care Act expanded Medicaid eligibility to states’ residents with incomes below the federal poverty line, creating both opportunities and challenges to hospitals in states that adopted the new Medicaid eligibility. This article explores the effect ofMedicaid expansions on nonprofit hospitals. Using data from Internal Revenue Service and a difference-in-differences design, this article examines the impact of the expansions on the number of, contributions to, and profitability of nonprofit hospitals. The results suggest thatMedicaid expansions did not affect the number and profitability of nonprofit hospitals; however, the expansions were associated with a reduction in contributions to certain types of hospitals by around 23%. Therefore, the effects of policy changes vary by the type of nonprofit hospitals, which then need to find better strategies to cope with these changes.
Performance of orthogonal based modulation schemes for TH-UWB communication systems

: This paper describes a combined modulation scheme for TH-UWB radio systems using on-oﬀ keying (OOK) and pulse shape modulation (PSM). For this scheme, a set of orthogonal pulses is used to represent bits in a symbol. These orthogonal pulses are transmitted simultaneously in the same time slot resulting in a composite pulse. The proposed transmission scheme can achieve higher data rate by using fewer number of pulses and receiver correlators than PSM. Due to the presence of OOK, the proposed scheme requires minimum energy and is applicable for energy constrained TH-UWB systems.
ACE use cases

Constrained devices are nodes with limited processing power, storage space and transmission capacities. These devices in many cases do not provide user interfaces and are often intended to interact without human intervention. This document comprises a collection of representative use cases for the application of authentication and authorization in constrained environments. These use cases aim at identifying authorization problems that arise during the lifecylce of a constrained device and are intended to provide a guideline for developing a comprehensive authentication and access control solution for this class of scenarios. Where specific details are relevant, it is assumed that the devices use the Constrained Application Protocol (CoAP) as communication protocol, however most conclusions apply generally.
Airborne Infections-the Past and the Futurel

Ebb and flow is as characteristic of research as of other activities of man. The transmission of infections through the air is a good example. Interest in airborne infections has had three flood tides in the past four centuries. The first was a long one. We can trace its beginning to 1546, when Fracastorius published his theory of contagion and explained that transmission of infections might occur by simple contact, by indirect contact, or by transmission from a distance. From that time on, the concept of airborne disease captured men's minds. "This most excellent canopy, the air," says Hamlet, "why it appeareth nothing to me but a foul and pestilent congregation of vapors. " Hence, in times of epidemics the air was filled with the smoke of sulfur, camphor, tar, or pitch, and people religiously shut out the night air, walked away from noisome smells, or, if they couldn't avoid them, held perfumed kerchiefs to their noses. The idea that diseases were spread by bad air (i.e., malaria) or by the influence (i.e., influenza) of planets, carried through the air, was too simple and naive an explanation. It was eventually discredited because attempts to apply it failed to stop the spread of infections. By the middle of the 19th century, it had been almost completely discarded by the medical profession (1). Pasteur's demonstration in 1861 that bacteria were consistently present in the unsterilized air and Lister's report in 1867 of the control of suppuration of wounds by measures which included a phenol spray should have stimulated everyone to vigorous attempts to control airborne infections. But this did not happen-for several reasons. For one thing, as I have said, all of the measures that could be conceived for limiting the spread of infection by air had already been tried and had failed. Also, it became evident to those surgeons who studied Lister's techniques carefully (rather than opposing them violently or aping them completely, as most did), that his method owed its success mainly to the suppression of contact infections. This was verified when Macewen about 1880 successfully used instruments and dressings sterilized by boiling and discarded the phenol spray. Finally, other public health measures had been successful and here, as elsewhere, nothing succeeds like success. To understand this, let us try to picture sanitary
Supramalleolar Lateral Opening-Wedge Osteotomy in Conjunction With Progressive Collapsing Foot Deformity Reconstruction for PCFD With Ankle Instability

Background: Reconstruction of progressive collapsing foot deformity (PCFD) with ankle instability (PCFD class E) remains a substantial challenge to orthopaedic surgeons. We report the outcomes of PCFD class E treated by means of a relatively standard PCFD foot reconstruction approach with the addition of a supramalleolar lateral opening-wedge osteotomy. Methods: We conducted a retrospective study of 13 patients (15 ankles) who underwent this procedure for PCFD class E between 2010 and 2021. Mean follow-up time was 3.8 (range, 2-6.3) years. Clinical assessment was based on the Japanese Society for Surgery of the Foot (JSSF) ankle/hindfoot scale as well as a Self-Administered Foot Evaluation Questionnaire (SAFE-Q). Radiographic assessments, including identification of the mechanical ankle joint axis point and a modified valgus Takakura-Tanaka osteoarthritis grade, were recorded. Results: The mean JSSF score improved significantly from 45.2 preoperatively to 83.9 postoperatively (P < .001). SAFE-Q scores at the final follow-up were 70.1 for the pain and pain-related subscale, 75.4 for the physical functioning and daily living subscale, 83.0 for the social functioning subscale, 74.4 for the shoe-related subscale, and 78.1 for the general health and well-being subscale. Radiographic measurements showed improvement in the tibiotalar tilt angle (average improvement: 5.4 degrees); orientation of the talus joint line relative to the ground (average improvement: 14.0 degrees); anteroposterior talus–first metatarsal angle (average improvement: 11.2 degrees), talonavicular coverage angle (average improvement: 21.6 degrees), and lateral talus–first metatarsal angle (average improvement: 17.0 degrees). Postoperatively, the mechanical ankle joint axis point moved medially for all patients and into the medial half of the ankle joint for 7 patients. The modified osteoarthritis stage improved postoperatively in most cases. Conclusion: In this select and relatively small group of patients who had a supramalleolar lateral opening-wedge osteotomy combined with PCFD reconstruction, we measured general improvement in JSSF scores and radiographic variables. Long-term durability of the procedure remains unknown. This procedure may be an option for preserving the ankle joint in treatment of PCFD class E with osteoarthritis of the ankle. Level of Evidence: Level IV, therapeutic.
APOLD1 loss causes endothelial dysfunction involving cell junctions, cytoskeletal architecture, and Weibel-Palade bodies, while disrupting hemostasis

Vascular homeostasis is impaired in various diseases thereby contributing to the progression of their underlying pathologies. The endothelial immediate early gene Apolipoprotein L domain-containing 1 (APOLD1) helps to regulate endothelial function. However, its precise role in endothelial cell biology remains unclear. We have localized APOLD1 to endothelial cell contacts and to Weibel-Palade bodies (WPB) where it associates with von Willebrand factor (VWF) tubules. Silencing of APOLD1 in primary human endothelial cells disrupted the cell junction-cytoskeletal interface, thereby altering endothelial permeability accompanied by spontaneous release of WPB contents. This resulted in an increased presence of WPB cargoes, notably VWF and angiopoietin-2 in the extracellular medium. Autophagy flux, previously recognized as an essential mechanism for the regulated release of WPB, was impaired in the absence of APOLD1. In addition, we report APOLD1 as a candidate gene for a novel inherited bleeding disorder across three generations of a large family in which an atypical bleeding diathesis was associated with episodic impaired microcirculation. A dominant heterozygous nonsense APOLD1:p.R49* variant segregated to affected family members. Compromised vascular integrity resulting from an excess of plasma angiopoietin-2, and locally impaired availability of VWF may explain the unusual clinical profile of APOLD1:p.R49* patients. In summary, our findings identify APOLD1 as an important regulator of vascular homeostasis and raise the need to consider testing of endothelial cell function in patients with inherited bleeding disorders without apparent platelet or coagulation defects.
Removal of Fe++ from Wastewater Using Sludge-polymer Hybrid Adsorbents

Removal of Fe by adsorption on sludge-polymer hybrid adsorbents was studied. Sludge was collected from domestic disposal wastewater. Thermal treatment of sludge particles was carried out at 200, 400 and 600°C to improve adsorption capacity. Polyvinylidene fluoride (PVDF) commercial polymer was mixed with the sludge in different mass ratios. Surface morphology and chemical structure of treated sludge were investigated using SEM and FTIR. Parameters studied are initial concentration of Fe, contact time, sludge dose, heat treatment of the sludge, and sludge/polymer mixing ratio. Within the present range of studied parameters the removal efficiency of Fe increases with increasing sludge dose. Increasing initial concentration of Fe from 50 to 100 ppm increases the removal efficiency by a factor of maximum of 1.73. Further increasing in concentration from 100 to 150 ppm leads to decrease in removal efficiency up to 43%. Sludge-PVDF hybrid adsorbent improved removal efficiency up to 63.6%. Experimental data fits to Freundlich linear model. The mechanism of adsorption of Fe by sludge adsorbent was found to take place through a monolayer and heterogeneous surface. Potential applications of the present data in removing heavy metals from industrial waste solutions were highlighted. Słowa kluczowe: metale ciężkie, osady ściekowe, polimery, hybrydowe adsorbenty, izoterma adsorpcji
A decade of discovery: the stunning progress of premature ovarian insufficiency research in China

Abstract Premature ovarian insufficiency (POI) is one of the key aspects of ovarian infertility. Due to early cession of ovarian function, POI imposes great challenges on the physiological and psychological health of women and becomes a common cause of female infertility. In the worldwide, there has been a special outpouring of concern for about 4 million reproductive-aged women suffering from POI in China. Driven by advances in new technologies and efforts invested by Chinses researchers, understanding about POI has constantly been progressing over the past decade. Here, we comprehensively summarize and review the landmark development and achievements from POI studies in China spanning 2011–2020, which aims to provide key insights from bench to bedside. Summary Sentence In this review, we offered a glimpse on POI research by Chinese researchers and highlighted leading developments and landmark achievements in etiological, diagnostic, and therapeutic progress in the past decade.
Hostile‐helpless states of mind: A scoping review of risk factors, correlates, and consequences

Abstract Chronic relational trauma can lead to the formation of pervasively unintegrated attachment representations in adulthood, referred to as Hostile‐Helpless (HH) states of mind. Individuals with this type of attachment disorganization evidence conflicting evaluations of caregivers and have difficulty reflecting on their traumatic childhood experiences. This scoping review is the first to systematically integrate the results of all empirical studies on HH states of mind in an effort to highlight the scientific and clinical contributions of the concept and guide future research. Following Arksey and O'Malley's (2005) Methodological Framework, cross‐reference keywords were searched in three databases (PsycArticles, Psychology and Behavioral Sciences Collection, ProQuest). In total, 19 studies met inclusion criteria and were included in the synthesis. Results suggest that prevalence rates of HH states of mind increase as a function of adults' psychosocial risk status. Findings also reveal that the long‐term consequences of early trauma are greater in the presence of a HH state of mind, whereas the absence of a HH state of mind acts as a protective factor against the intergenerational transmission of maladaptation. Finally, results support the discriminant validity of the HH classification against other forms of attachment disorganization in adulthood. Research gaps and future research directions are discussed.
Malaria Parasite Classification Framework using a Novel Channel Squeezed and Boosted CNN.

Malaria is a life-threatening infection that infects the red blood cells (RBCs) that gradually grows throughout the body. The plasmodium parasite is caused by a female anopheles mosquito bite and severely affects numerous individuals within the world every year. Therefore, early detection tests are required to predict infected parasitic cells. The proposed technique exploits deep convolutional neural network (CNN) learning capability to detect the thin-blood smear parasitic patients from healthy individuals. In this regard, the detection is accomplished using a novel STM-SB-RENet block-based CNN that employs the idea of split-transform-merge (STM) and channel Squeezing-Boosting (SB) in a modified fashion. In this connection, a new convolutional block-based STM is developed, which systematically implements region and edge operations to explore the parasitic malaria pattern related to region-homogeneity, structural obstruction, and boundary-defining features. Moreover, the diverse boosted feature maps are achieved by incorporating the new channel SB and Transfer Learning (TL) idea in each STM block at abstract, intermediate, and target levels to capture minor contrast and texture variation between parasitic and normal artifacts. The malaria input images to the proposed models are initially transformed using discrete wavelet transform to generate enhanced and reduced feature space. The proposed architectures are validated using hold-out cross-validation on the National Institute of Health Malaria dataset. The proposed methods outperform the train from scratch, and TL-based fine-tuned existing techniques. The considerable performance (accuracy: 97.98%, sensitivity: 0.988, F-score: 0.980, and AUC: 0.996) of STM-SB-RENet suggests that it can be utilized to screen parasitic malaria patients.
The Center for Nursing Inquiry: Developing Nurse-Led Inquiry

T he health care industry acknowledges a 17-year gap from research completion to implementation of an evidence-based practice (EBP) change in the clinical setting—known as the leaky pipeline. Typically, clinical nurses comprise the largest workforce of any hospital or health care system; therefore, they are the leading providers of EBPs. However, there are indications of a disconnection between the evidencebased daily practice of nurses and the actual conduct of literature reviews and appraisals to determine best evidence. Additionally, the literature indicates that in order for nurses to engage in EBP they need the proper education, supportive leadership, and resources. Moreover, during their fundamental education, the majority of clinical nurses receive minimal exposure to research methods, quality improvement frameworks, and EBP models. Once embedded in the practice environment, they are ill-equipped to challenge, sustain, or improve current practices with confidence and competence. However, nurses demonstrate natural curiosity, a passion for learning inquiry work, and a drive to provide the best possible care to their patients. To that end, the Center for Nursing Inquiry was developed.
The importance of the motor system in the development of music‐based forms of auditory rehabilitation

Hearing abilities decline with age, and one of the most commonly reported hearing issues in older adults is a difficulty understanding speech when there is loud background noise. Understanding speech in noise relies on numerous cognitive processes, including working memory, and is supported by numerous brain regions, including the motor and motor planning systems. Indeed, many working memory processes are supported by motor and premotor cortical regions. Interestingly, lifelong musicians and nonmusicians given music training over the course of weeks or months show an improved ability to understand speech when there is loud background noise. These benefits are associated with enhanced working memory abilities, and enhanced activity in motor and premotor cortical regions. Accordingly, it is likely that music training improves the coupling between the auditory and motor systems and promotes plasticity in these regions and regions that feed into auditory/motor areas. This leads to an enhanced ability to dynamically process incoming acoustic information, and is likely the reason that musicians and those who receive laboratory‐based music training are better able to understand speech when there is background noise. Critically, these findings suggest that music‐based forms of auditory rehabilitation are possible and should focus on tasks that promote auditory–motor interactions.
Auditory cortical plasticity after cochlear implantation in asymmetric hearing loss is related to spatial hearing: a PET H215O study

Abstract In asymmetric hearing loss (AHL), the normal pattern of contralateral hemispheric dominance for monaural stimulation is modified, with a shift towards the hemisphere ipsilateral to the better ear. The extent of this shift has been shown to relate to sound localization deficits. In this study, we examined whether cochlear implantation to treat postlingual AHL can restore the normal functional pattern of auditory cortical activity and whether this relates to improved sound localization. The auditory cortical activity was found to be lower in the AHL cochlear implanted (AHL-CI) participants. A cortical asymmetry index was calculated and showed that a normal contralateral dominance was restored in the AHL-CI patients for the nonimplanted ear, but not for the ear with the cochlear implant. It was found that the contralateral dominance for the nonimplanted ear strongly correlated with sound localization performance (rho = 0.8, P < 0.05). We conclude that the reorganization of binaural mechanisms in AHL-CI subjects reverses the abnormal lateralization pattern induced by the deafness, and that this leads to improved spatial hearing. Our results suggest that cochlear implantation enables the reconstruction of the cortical mechanisms of spatial selectivity needed for sound localization.