nils-herrmann/clean_scirepeval huggingface dataset:
Reducing Readmissions After Stroke With a Structured Nurse Practitioner/Registered Nurse Transitional Stroke Program
Venue: Stroke

Our aim was to determine whether a standardized Transitional Stroke Clinic (TSC) led by nurse practitioners could reduce 30 day and 90 day readmissions for stroke or transient ischemic attack patients discharged home.  Phase I consisted of nurse practitioners calling only high risk patients discharged home within 7 days and performing an office visit within 2 to 4 weeks of discharge. Phase II consisted of all patients discharged home receiving both a 2 day follow up phone call by a registered nurse and a follow up visit with a nurse practitioner within 7 to 14 days. Differences in process metrics and readmissions across the 2 phases and overall were assessed. Increasing complexity with multiple chronic conditions (diabetes mellitus, coronary artery disease, and congestive heart failure) was represented in a continuous variable from 0 to 3. Multivariable logistic regression models for 30 day and 90 day readmissions were performed with adjustment for National Institutes of Health Stroke Scale (NIHSS) and previous hospitalizations.  From October 2012 through September 2015, 510 patients were enrolled. From phase I to II, a higher proportion of follow up calls were made and days from discharge to TSC decreased. Patients readmitted within 30 days were less likely to show for TSC visits (60.85% versus 76.3% P=0.021) Multivariable modeling showed that TSC visit was associated with a 48% reduction in 30 day readmission (odds ratio, 0.518; 95% confidence interval, 0.272 0.986) whereas multiple chronic conditions and previous stroke/transient ischemic attack increased the risk. TSC visit did not impact 90 day readmissions.  Evaluation in a nurse practitioner led structured clinic is a model that may reduce readmissions at 30 days for stroke patients discharged home.
Registered nurse, healthcare support worker, medical staffing levels and mortality in English hospital trusts: a cross sectional study
Venue: BMJ Open

To examine associations between mortality and registered nurse (RN) staffing in English hospital trusts taking account of medical and healthcare support worker (HCSW) staffing.  Secondary care provided in acute hospital National Health Service (NHS) trusts in England.  Two data sets are examined: Administrative data from 137 NHS acute hospital trusts (staffing measured as beds per staff member) A cross sectional survey of 2917 registered nurses in a subsample of 31 trusts (measured patients per ward nurse) Outcome measure Risk adjusted mortality rates for adult patients (administrative data) Results For medical admissions, higher mortality was associated with more occupied beds per RN (RR 1.22, 95% CI 1.04 to 1.43, p=0.02) and per doctor (RR 1.10, 95% CI 1.05 to 1.15, p <0.01) employed by the trust whereas, lower HCSW staffing was associated with lower mortality (RR 0.95, 95% CI 0.91 to 1.00, p=0.04) In multivariable models the relationship was statistically significant for doctors (RR 1.08, 95% CI 1.02 to 1.15, p=0.02) and HCSWs (RR 0.93, 95% CI 0.89 to 0.98, p<01) but not RNs (RR 1.14, 95% CI 0.95 to 1.38, p=0.17) Trusts with an average of =6 patients per RN in medical wards had a 20% lower mortality rate compared to trusts with >10 patients per nurse (RR 0.80, 95% CI 0.76 to 0.85, p<0.01) The relationship remained significant in the multivariable model (RR 0.89, 95% CI 0.83 to 0.95, p<0.01) Results for surgical wards/admissions followed a similar pattern but with fewer significant results.  Ward based RN staffing is significantly associated with reduced mortality for medical patients. There is little evidence for beneficial associations with HCSW staffing. Higher doctor staffing levels is associated with reduced mortality. The estimated association between RN staffing and mortality changes when medical and HCSW staffing is considered and depending on whether ward or trust wide staffing levels are considered.
Effect of a Nontechnical Skills Intervention on First Year Student Registered Nurse Anesthetists' Skills During Crisis Simulation.
Venue: AANA journal

Simulation based education provides a safe place for student registered nurse anesthetists to practice non technical skills before entering the clinical arena. An anesthetist's lack of nontechnical skills contributes to adverse patient outcomes. The purpose of this study was to determine whether an educational intervention on nontechnical skills could improve the performance of nontechnical skills during anesthesia crisis simulation with a group of first year student registered nurse anesthetists. Thirty two first year students volunteered for this quasi experimental study. Each subject was videotaped and rated as he or she performed 6 simulated crisis scenarios: 3 scenarios before the intervention and 3 after the intervention. Findings revealed that the nontechnical skills mean posttest score was greater than pretest scores: t (df 31) 1.99, P .028. The mean gain in scores for standardized nontechnical skills were significantly greater than those for standardized technical skills: t (df 30) 1.81, P .04. In conclusion, a 3 hour educational intervention on nontechnical skills resulted in significant improvement. Nontechnical skills therefore are not acquired through experience, but rather through instruction. An educational intervention using the Anaesthetists' Non Technical Skills system is a valuable tool in the measurement of nontechnical skills assessment of first year student registered nurse anesthetists.
Increasing Registered Nurse Retention Using Mentors in Critical Care Services
Venue: The health care manager

Recruiting and training 1 newly hired registered nurse can cost thousands of dollars. With a high percentage of these newly hired nurses leaving their first place of employment within their first year, the financial implications may be enormous. It is imperative that health care facilities invest in recruiting and retention programs that retain high quality nurses. Mentorship programs in retaining and easing the transition to practice for new graduate nurses, re entry nurses, and nurses new to a specialty area are critical in nurse retention. Discussion in this study includes the effect of implementing a mentor program into the critical care services area of a 325 bed not for profit community hospital in northern Indiana. Based on this study, nurses with a mentor were retained at a 25% higher rate than those not mentored. Implementation of a mentor program reduced the training cost to the facility and increased retention and morale.
Mental health service use in adults with suicidal ideation within a nationally representative sample of the Korean population.
Venue: Journal of affective disorders

Use of mental health services (MHS) by people with suicidal ideation is critical in prevention of suicide, and identification of the factors that influence MHS use may assist in providing efficient interventions and treatments for suicidal individuals. Thus, we investigated the association between socioeconomic factors and use of MHS in people with suicidal ideation.  We analyzed the data of the Fifth Korea National Health and Nutrition Examination Survey 2010 2012, a nationally representative cross sectional study of the Korean population. Among the 24,173 people from the national health survey, we investigated the socioeconomic, clinical, and health related characteristics of 2616 participants aged 19 years and older with suicidal ideation within the previous year.  In the logistic regression analyses, after adjusting for potentially confounding factors, the odds ratio (OR) for nonuse of MHS was significant in the subjects aged 65 years or older (OR=4.90) aged 50 64 years (OR=2.11) with 10 12 years of education (OR=1.87) widowed (OR=2.75) with economic activity (OR=1.60) with an employment status of paid employee (OR=1.97) without depressive mood (OR=2.73) having not attempted suicide (OR=4.04) and with no reported problems in their usual activities (OR=2.17) LIMITATIONS We did not use standardized assessment tools to evaluate suicidal ideation and depressive mood.  We observed a significant influence of several socioeconomic factors, depressive mood, and suicide attempts on the MHS use of adults with suicidal ideation, based on a nationally representative sample of the Korean population.
The Impact of a Participatory Care Model on Work Satisfaction of Care Workers and the Functionality, Connectedness, and Mental Health of Community Dwelling Older People
Venue: Issues in mental health nursing

This study describes and evaluates an innovative program designed to reduce functional decline among seniors, using a participatory care approach and integrated health teams. The evaluation provides older people and community support workers (CSWs) with the opportunity to share their experiences of being involved with an innovative program to reduce functional decline (mobility, skin integrity, nutrition, mental health, continence) of older, community dwelling adults implemented by a Nursing Service in a major capital city in Australia. As part of the program, CSWs were trained to provide care that aimed to reduce functional decline, and improve the quality of life for the care recipients. Data were collected through in depth interviews with older people receiving care and a focus group (FG) was conducted with CSWs. Seven themes emerged during data analysis: 1) functionality/independence; 2) prevention; 3) confidence; 4) connection; 5) the approach; 6) care plans; and 7) the role of the CSWs. The relationship built between care giver and receiver and the mutual respect facilitated through adopting a participatory care approach was crucial. This relationship focused care contributed to improved functionality and consequently quality of life for the older person, and for the CSW professional it contributed to their development, improved satisfaction with their role, and increased pride in the difference they make in the lives of their clients. Opportunities for improvement of the program included ensuring that participants understood the rationale for all aspects of the program, including regular reminders, as well as the use of regular reviews of individual outcomes.
A Cross Cultural Examination of SNS Usage Intensity and Managing Interpersonal Relationships Online: The Role of Culture and the Autonomous Related Self Construal
Venue: Front. Psychol.

Perception of the autonomy and relatedness of the self may be influenced by one's experiences and social expectations within a particular cultural setting. The present research examined the role of culture and the Autonomous Related self construal in predicting for different aspects of Social Networking Sites (SNS) usage in three Asian countries, especially focusing on those aspects serving interpersonal goals. Participants in this cross cultural study included 305 university students from Malaysia (n 105) South Korea (n 113) and China (n 87) The study explored specific social and interpersonal behaviors on SNS, such as browsing the contacts' profiles, checking for updates, and improving contact with SNS contacts, as well as the intensity of SNS use, hypothesizing that those with high intensity of use in the Asian context may be doing so to achieve the social goal of maintaining contact and keeping updated with friends. Two scales measuring activities on other users' profiles and contact with friends' profiles were developed and validated. As predicted, some cross cultural differences were found. Koreans were more likely to use SNS to increase contact but tended to spend less time browsing contacts' profiles than the Malaysians and Chinese. The intensity of SNS use differed between the countries as well, where Malaysians reported higher intensity than Koreans and Chinese. Consistent with study predictions, Koreans were found with the highest Autonomous Related self construal scores. The Autonomous Related self construal predicted SNS intensity. The findings suggest that cultural contexts, along with the way the self is construed in different cultures, may encourage different types of SNS usage. The authors discuss study implications and suggest future research directions.
Constrained Multilegged Robot System Modeling and Fuzzy Control With Uncertain Kinematics and Dynamics Incorporating Foot Force Optimization
Venue: IEEE Transactions on Systems, Man, and Cybernetics: Systems

This paper studies the optimal distribution of feet forces and control of multilegged robots with uncertainties in both kinematics and dynamics. First, a constrained dynamics for multilegged robots and the constrained environment model are established by considering both kinematic and dynamic uncertainties. Under an external wrench for multilegged robots, the foot forces and moments of the supporting legs can be formulated as quadratic programming problems subject to linear and nonlinear constraints. The neurodynamics of recurrent neural network is developed for foot force optimization. For the obtained optimized tip point force and the motion of legs, we propose a hybrid task space trajectory and force tracking based on fuzzy system and adaptive mechanism that are used to compensate for the external perturbation, kinematics, and dynamics uncertainties. The tracking of task space trajectory and constraint force is achieved under unknown dynamical parameters, constraints, and disturbances. Extensive simulations have been provided to verify the effectiveness of the proposed scheme.
Validation of western blot for Histoplasma capsulatum antibody detection assay
Venue: BMC Infectious Diseases

BackgroundHistoplasmosis is worldwide systemic mycoses caused by the dimorphic fungus Histoplasma capsulatum. The isolation and identification of H. capsulatum in culture is the reference test for histoplasmosis diagnosis confirmation. However, in the absence of it, serology has been used as a presumptive diagnosis through antibody and antigen detection. The purpose of the present study was to validate an immunoassay method (western blot) for antibodies detection in the diagnosis of histoplasmosis.MethodsTo validate the western blot (WB) a study was conducted using 118 serum samples from patients with histoplasmosis and 118 serum controls collected from January 2000 to December 2013 in residents of the Rio de Janeiro State, Brazil. Diagnostic validation parameters were calculated based on the categorization of results obtained in a 2 x 2 table and subjected to statistical analysis. In addition, the viability of deglycosylated histoplasmin antigen (ptHMIN) onto nitrocellulose membranes previously sensitized was evaluated during the same period.ResultsThe WB test showed sensitivity of 94.9 specificity of 94.1 positive predictive value of 94.1 negative predictive value of 94.9 accuracy of 94.5 and almost perfect precision. Besides, the strips have proved to be viable for using at least 5 years after ptHMIN antigen sensitization.ConclusionWestern blot test using ptHMIN provides sensitive, specific, and faster results. Therefore, could be considered a useful tool in the diagnosis of histoplasmosis being used by public health system, even in situations where laboratory facilities are relatively limited.
High sensitivity far infrared laser diagnostics for the C 2U advanced beam driven field reversed configuration plasmas.
Venue: The Review of scientific instruments

A high sensitivity multi channel far infrared laser diagnostics with switchable interferometry and polarimetry operation modes for the advanced neutral beam driven C 2U field reversed configuration (FRC) plasmas is described. The interferometer achieved superior resolution of 1 x 1016 m 2 at >1.5 MHz bandwidth, illustrated by measurement of small amplitude high frequency fluctuations. The polarimetry achieved 0.04deg instrument resolution and 0.1deg actual resolution in the challenging high density gradient environment with >0.5 MHz bandwidth, making it suitable for weak internal magnetic field measurements in the C 2U plasmas, where the maximum Faraday rotation angle is less than 1deg. The polarimetry resolution data is analyzed, and high resolution Faraday rotation data in C 2U is presented together with direct evidences of field reversal in FRC magnetic structure obtained for the first time by a non perturbative method.
A Four Plate Compact Capacitive Coupler Design and LCL Compensated Topology for Capacitive Power Transfer in Electric Vehicle Charging Application
Venue: IEEE Transactions on Power Electronics

This paper proposes a four plate compact capacitive coupler and its circuit model for large air gap distance capacitive power transfer (CPT) The four plates are arranged vertically, instead of horizontally, to save space in the electric vehicle charging application. The two plates that are on the same side are placed close to each other to maintain a large coupling capacitance, and they are of different sizes to maintain the coupling between the primary and secondary sides. The circuit model of the coupler is presented, considering all six coupling capacitors. The LCL compensation topology is used to resonate with the coupler and provide high voltage on the plates to transfer high power. The circuit model of the coupler is simplified to design the parameters of the compensation circuit. Finite element analysis is employed to simulate the coupling capacitance and design the dimensions of the coupler. The circuit performance is simulated in LTspice to design the specific parameter values. A prototype of the CPT system was designed and constructed with the proposed vertical plate structure. The prototype achieved an efficiency of 85.87% at 1.88 kW output power with a 150 mm air gap distance.
Fiber chip edge coupler with large mode size for silicon photonic wire waveguides.
Venue: Optics express

Fiber chip edge couplers are extensively used in integrated optics for coupling of light between planar waveguide circuits and optical fibers. In this work, we report on a new fiber chip edge coupler concept with large mode size for silicon photonic wire waveguides. The coupler allows direct coupling with conventional cleaved optical fibers with large mode size while circumventing the need for lensed fibers. The coupler is designed for 220 nm silicon on insulator (SOI) platform. It exhibits an overall coupling efficiency exceeding 90% as independently confirmed by 3D Finite Difference Time Domain (FDTD) and fully vectorial 3D Eigenmode Expansion (EME) calculations. We present two specific coupler designs, namely for a high numerical aperture single mode optical fiber with 6 um mode field diameter (MFD) and a standard SMF 28 fiber with 10.4 um MFD. An important advantage of our coupler concept is the ability to expand the mode at the chip edge without leading to high substrate leakage losses through buried oxide (BOX) which in our design is set to 3 um. This remarkable feature is achieved by implementing in the SiO2 upper cladding thin high index Si3N4 layers. The Si3N4 layers increase the effective refractive index of the upper cladding near the facet. The index is controlled along the taper by subwavelength refractive index engineering to facilitate adiabatic mode transformation to the silicon wire waveguide while the Si wire waveguide is inversely tapered along the coupler. The mode overlap optimization at the chip facet is carried out with a full vectorial mode solver. The mode transformation along the coupler is studied using 3D FDTD simulations and with fully vectorial 3D EME calculations. The couplers are optimized for operating with transverse electric (TE) polarization and the operating wavelength is centered at 1.55 um.
Broadband 2 x 2 adiabatic 3 dB coupler using silicon on insulator sub wavelength grating waveguides.
Venue: Optics letters

We report on a compact, broadband, 2x2 adiabatic 3 dB coupler using sub wavelength gratings (SWGs) for silicon on insulator waveguides. In our device, two SWG waveguides that support two transverse electric modes and have tapered waveguide widths were used to achieve an adiabatic mode evolution of the two waveguide system for broadband 3 dB power splitting. We present results for a SWG adiabatic 3 dB coupler that has an overall coupler length of 50 mm and achieves broadband power splitting over a 130 nm wavelength range with an imbalance of no greater than 0.3 dB and with low excess losses of less than 0.5 dB.
An Introduction To Child Development

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Nutrients and the microenvironment to feed a T cell army.
Venue: Seminars in immunology

T cells have dramatic functional and proliferative shifts in the course of maintaining immune protection from pathogens and cancer. To support these changes, T cells undergo metabolic reprogramming upon stimulation and again after antigen clearance. Depending on the extrinsic cell signals, T cells can differentiate into functionally distinct subsets that utilize and require diverse metabolic programs. Effector T cells (Teff) enhance glucose and glutamine uptake, whereas regulatory T cells (Treg) do not rely on significant rates of glycolysis. The dependence of these subsets on specific metabolic programs makes T cells reliant on these signaling pathways and nutrients. Metabolic pathways, such as those regulated by mTOR and Myc, augment T cell glycolysis and glutaminolysis programs to promote T cell activity. These pathways respond to signals and control metabolism through both transcriptional or post transcriptional mechanisms. Epigenetic modifications also play an important role by stabilizing the transcription factors that define subset specific reprogramming. In addition, circadian rhythm cycling may also influence energy use, immune surveillance, and function of T cells. In this review, we focus on the metabolic and nutrient requirements of T cells, and how canonical pathways of growth and metabolism regulate nutrients that are essential for T cell function.