---
language:
- en
license: apache-2.0
tags:
- sentence-transformers
- sentence-similarity
- feature-extraction
- dense
- text-embeddings-inference
- generated_from_trainer
- dataset_size:100000
- loss:CachedMultipleNegativesRankingLoss
- llama-cpp
- gguf-my-repo
base_model: sentence-transformers/embeddinggemma-300m-medical
widget:
- source_sentence: 'What are the potential effects of stopping inhaled corticosteroid
    (ICS) therapy in patients with chronic obstructive pulmonary disease (COPD)?

    '
  sentences:
  - "Postoperative infections convey substantially increased clinical risks and increases\
    \ in health care costs. Infections by Staphylococcus aureus (S. aureus), other\
    \ gram positive organisms, including Clostridium difficile, gram-negative organisms\
    \ including pseudomonas, Escherichia. coli, enterococci, and fungal infections\
    \ are important because of their increasing frequencies, resistance to antibiotics,\
    \ and associated deaths and disability [1] . Infections due to S. aureus are of\
    \ particular concern in the face of increasing methicillin resistance (MRSA).\
    \ A retrospective study of surgical patients based on medical records found 0.47\
    \ invasive S. aureus infections per 100 procedures, of which 51% were due to MRSA\
    \ [2] . In that study, cardiothoracic procedures had the highest infection rate\
    \ (0.79 per 100), followed by 0.62 per 100 for neurosurgical procedures, and 0.37\
    \ per 100 for orthopedic procedures. Among 133,450 S. aureus infections isolated\
    \ from 1998 to 2009 from medical and surgical patients in an integrated health\
    \ plan, 40% were MRSA [3] .\n\n Efforts to reduce the frequency of S. aureus infections\
    \ following surgical procedures have focused both on prevention and treatment.\
    \ Preventive measures aim to reduce nosocomial infections transmitted to patients\
    \ by hospital workers or hospital facilities [4, 5] or on identifying and treating\
    \ surgical patients who are carriers of MRSA organisms when they enter the hospital\
    \ [4, 6, 7, 8, 9] . Use of the multicomponent MRSA bundle (nasal screening, contact\
    \ isolation, hand hygiene, leadership, and monitoring) has been very effective\
    \ in reducing the frequency of postoperative infections [10] . We focused our\
    \ study on cardiovascular, orthopedic and gastro-intestinal surgery due to a combination\
    \ of their high frequency in Medicare beneficiaries and the risks of were 15.0%\
    \ infection in the literature.\n\n Infections related to cardiothoracic surgery\
    \ are mainly wound infections, septicemia, endocarditis, and pneumonia [11] .\
    \ Patients who have surgery on the ascending aorta and require 48 hours or more\
    \ mechanical ventilation following the procedure or require reoperation and heart\
    \ transplant recipients are at especially high risk [12] . Among orthopedic surgery\
    \ procedures, knee or hip replacement or arthroplasty are accompanied by especially\
    \ high risks of post-operative infections, with S. aureus being the most frequent\
    \ organism cultured [13, 14] . A large questionnaire study found that infections\
    \ following orthopedic surgery are usually not detected until after discharge\
    \ from the surgical admission, often at a subsequent hospital admission [15] .\n\
    \n To our knowledge, previous studies of postoperative infections caused by S.\
    \ aureus, based on medical records, were limited to clinical populations in a\
    \ few institutions and a few weeks of follow up. Our study uses claims data for\
    \ a large and nationally representative sample of Medicare beneficiaries. To avoid\
    \ missing delayed effects, we examine the occurrence of S. aureus infections for\
    \ up to 180 days following common cardiovascular (CV), orthopedic, or gastrointestinal\
    \ (GI) surgical procedures among Medicare beneficiaries. We also examine the effects\
    \ of S. aureus infection on length of stay and mortality.\n\n \n\n The study was\
    \ approved by the Brandeis University Committee for the Protection of Human Studies\
    \ in Research. As the study was based entirely on existing data without patient\
    \ names or identifying numbers, no patient consent was required.\n\n This study\
    \ used Medicare entitlement data and Part A claims data (primarily inpatient hospital\
    \ care) from the random 5% sample of beneficiaries in Medicare's chronic condition\
    \ warehouse (CCW). The claims for such persons in the CCW as of Jan. 1, 2004 plus\
    \ new entrants to the CCW through 2007 were pooled to construct the study's analytical\
    \ file [16] .\n\n Three main categories of surgery were studied: CV, orthopedic\
    \ and GI surgeries. CV surgeries were classified into coronary artery bypass graft\
    \ (CABG), percutaneous coronary interventions (PCI), and other. PCI was included\
    \ because it is the most frequent cardiovascular procedure, was usually done as\
    \ an inpatient procedure in Medicare beneficiaries, and is often an alternative\
    \ to CABG [17] . Orthopedic surgeries were grouped into hip, knee, or other. GI\
    \ surgeries were classified into gastric, laparotomy, or other. Surgical procedures\
    \ were identified by specific International Classification of Diseases (ICD) inpatient\
    \ procedure codes listed in Table S1 . Codes were selected based on review of\
    \ coding manuals, prior literature, and the medical knowledge of the two physician\
    \ authors (WS, JS).\n\n The design was a retrospective cohort study consisting\
    \ of Medicare fee-for-service patients in the 5% sample who underwent one or more\
    \ of the specified types of surgery during an acute hospital admission."
  - "Stopping ICS therapy at 6 months leads to relapse of bronchial inflammation and\
    \ hyperresponsiveness, dyspnea, and poorer health status, with acceleration of\
    \ FEV 1 decline. Combination therapy with ICS and a long-acting ␤ 2 -agonist does\
    \ not provide further anti-inflammatory effects compared with fluticasone alone\
    \ but improves the level of Adjusted mean change in log-transformed bronchial\
    \ cell counts (per 10 Ϫ7 m 2 lamina propria) over time during treatment with fluticasone,\
    \ 500 g twice daily, for 30 months; fluticasone, 500 g twice daily, for 6 months\
    \ plus placebo for 24 months; fluticasone, 500 g twice daily, and salmeterol,\
    \ 50 g twice daily, for 30 months; and placebo, twice daily, for 30 months in\
    \ patients with chronic obstructive pulmonary disease. Error bars represent 95%\
    \ CIs. FEV 1 without further influencing FEV 1 decline. Our findings indicate\
    \ that a subphenotype of patients with COPD who are steroid-naive and have moderate\
    \ airway obstruction and airway hyperresponsiveness are sensitive to longterm\
    \ ICS therapy. These prolonged effects on inflammation and lung function do not\
    \ imply causality but suggest that disease modification can be achieved in particular\
    \ phenotypes of patients with COPD.\n\n We observed differential effects of ICS\
    \ on inflammatory cell counts. Although smoking may reduce corticosteroid responsiveness\
    \ (31) , our data show that at least part of the inflammation in COPD remains\
    \ sensitive to this treatment. The contribution of CD8 ϩ cells to inflammation\
    \ and the relevant antigen-specific triggers in COPD are still unknown. CD4 ϩ\
    \ cells may contribute to activation and memory formation of CD8 ϩ cells, as well\
    \ as provide help for B cells (32). Mast cells and their secreted enzymes can\
    \ drive various processes relevant to inflammation and remodeling (33) . Although\
    \ in vitro studies suggest that corticosteroids are less effective in inhibiting\
    \ activation of mast cells than activation of T cells (34) , our data indicate\
    \ that corticosteroids can have selective anti-inflammatory effects in COPD. The\
    \ observed increase in intact epithelium by ICS has also been found in persons\
    \ with asthma (35) . Corticosteroid-induced changes in epithelial integrity and\
    \ inflammation correlated with improvements in methacholine PC 20 , which supports\
    \ the notion that airway hyperresponsiveness in COPD can be a marker of disease\
    \ activity (36, 37) .\n\n The clinical novelty of our findings is that antiinflammatory\
    \ effects observed with long-term ICS treatment associate with reduced FEV 1 decline\
    \ in COPD. Previous short-term studies that investigated patients with COPD and\
    \ similar degrees of airway obstruction (20, 21, 38) have shown anti-inflammatory\
    \ effects of ICS in COPD. We show that these beneficial effects are maintained\
    \ during long-term treatment of up to 30 months. The detrimental effects of discontinuing\
    \ ICS therapy on Adjusted mean change and 95% CI over time during treatment with\
    \ fluticasone, 500 g twice daily, for 30 months; fluticasone, 500 g twice daily,\
    \ for 6 months followed by placebo for 24 months; fluticasone, 500 g twice daily,\
    \ and salmeterol, 50 g twice daily, for 30 months; and placebo, twice daily, bronchial\
    \ inflammation are also novel. Previous short-term studies of the combination\
    \ of a LABA and ICS demonstrated anti-inflammatory effects versus placebo (39)\
    \ or additional reductions of bronchial CD8 ϩ cells and macrophages versus ICS\
    \ alone (22). Our data suggest that this is not a long-lasting additional effect;\
    \ we observed a slight increase in CD3\n\n ϩ and plasma cells. The attenuated\
    \ FEV 1 decline in our patients with COPD contrasts with large COPD trials from\
    \ the 1990s (7) (8) (9) . The more recent TORCH study (15) did show reductions\
    \ in FEV 1 decline in patients with COPD who received therapy with ICSs, LABAs,\
    \ or both. Our results suggest that the improvement in the level of FEV 1 in the\
    \ combination group might be due to a residual bronchodilator effect of salmeterol\
    \ and not further disease modification. Discrepancies between the previous trials\
    \ and our study may be due to differences in study samples, which may provide\
    \ a clinical message.\n\n Our study comprised a common subset of patients with\
    \ COPD. First, by choosing steroid-naive patients, we aimed to exclude patients\
    \ with unknown previous benefits from ICS therapy at baseline and avoid the problem\
    \ of selective dropouts in the placebo group."
  - "The messages that did not achieve significant improvements in knowledge postintervention\
    \ ('Respect others' and 'Avoid drugs, alcohol and tobacco') did, however, record\
    \ the two highest scores at the preintervention stage, which demonstrates the\
    \ existing high level of children's knowledge in these areas. These two messages,\
    \ which were retained from the original 'FIFA 11 for Health' programme, have consistently\
    \ shown significant postintervention increases in knowledge in Africa and Latin\
    \ America. [8] [9] [10] [11] The relatively higher baseline score for the message\
    \ 'Respect others' may reflect differences in the status of women in Denmark and\
    \ the focus of the session for Europe (respect and help others, avoid bullying)\
    \ compared to the status of women and the content of the 'Respect women and girls'\
    \ session used in previous interventions. For example, the lifetime prevalence\
    \ of physical and/or sexual violence against women reported for Denmark was 28%,\
    \ whereas in Brazil it was 39%, and in the five African countries this varied\
    \ from 43% (Namibia) to 60% (Tanzania). 21 For the message 'Avoid drugs, alcohol\
    \ and tobacco', the situation appears to be far more complex and the reason for\
    \ the intervention not achieving an increase in children's knowledge remains puzzling\
    \ considering the role of alcohol, for example, in the national cultures. For\
    \ example, in the five African countries, alcohol consumption (L/capita per year)\
    \ ranges from 2.5 in Malawi to 10.8 in Namibia and 8.7% in Brazil; whereas in\
    \ Denmark, alcohol consumption is higher at 11.4 L/capita per year. 22 Scores\
    \ for the PedsQL questionnaire identified significant improvements in the social\
    \ and school dimension of well-being for the intervention group, but not for the\
    \ control group. These results give further support to previously reported benefits\
    \ of physical activity. In particular, it has been reported that 9-to 11-year-old\
    \ children who meet the recommended daily physical activity guidelines exhibit\
    \ higher well-being scores for satisfaction, comfort, resilience, achievement,\
    \ self-esteem and social acceptance than children who do not. 23 There are many\
    \ intervention programmes designed to increase physical activity or health knowledge\
    \ of children, but only few programmes that attempt to increase both and none\
    \ that has evaluated a combined physical activity and health education programme.\
    \ 24 25 The closest in concept to the modified 'FIFA 11 for Health' programme\
    \ is the school-based two-stage 'Dutch Obesity Intervention in Teenagers' (DOiT)\
    \ programme: stage-1 is aimed at raising awareness about dietary energy balance\
    \ and stage-2 is aimed at improving children's food choices and level of physical\
    \ activity. 26 This programme achieved significantly lower levels of body fat,\
    \ lower consumption of sugary drinks, and lower screen-viewing times among children\
    \ aged 12-14 years. 26 27 Given the social, environmental, educational and financial\
    \ situation in Europe, communicable diseases generally do not threaten the population\
    \ to the extent that these do in other regions of the world. In Europe, NCDs are\
    \ the major health threat due to consumption of unhealthy, convenience foods,\
    \ and limited time spent on physically challenging activities: a situation of\
    \ particular concern among children. 28 The current recommendation for physical\
    \ activity is 60 min of moderate to vigorous activity daily for children 5 ; however,\
    \ evidence shows that large proportions of children in Europe do not achieve this.\
    \ 1 It has long been recognised that being overweight during childhood is a risk\
    \ factor for being overweight in adulthood; [29] [30] [31] therefore, it is essential\
    \ to address the problem of being overweight at school age in order to reduce\
    \ the threat from NCDs in later life. The children's positive views about the\
    \ programme together with the observed increases in health knowledge, and the\
    \ social and school dimensions of well-being indicate that the proposed modified\
    \ 'FIFA 11 for Health' programme could support the WHO regional campaign against\
    \ NCDs in Europe. 6 What are the findings? ▸ The 'FIFA 11 for Health' education\
    \ programme has been modified for the European setting. ▸ The modified programme\
    \ focuses on physical activity and health knowledge related to non-communicable\
    \ diseases among school-aged children. ▸ The modified programme increased levels\
    \ of knowledge about non-communicable diseases among 10-to 12-year-old Danish\
    \ school children. ▸ Children's scores on the social dimension of well-being were\
    \ enhanced following participation in the programme.\n\n How might it impact on\
    \ clinical practice in the future?\n\n ▸ Children in Europe show a high prevalence\
    \ of overweight and obesity. ▸ National Governments are seeking cost-effective\
    \ initiatives to reduce the economic and health burden associated with overweight\
    \ and obese children. ▸ The 'FIFA 11 for Health' programme for Europe can be easily\
    \ assimilated into school curricula to provide children with effective health\
    \ education and physical activity.\n\n questionnaires provided by Johan Wikman,\
    \ Line Sandager, Ida Lundager, Stine Nylandsted Jensen, Andreas Møller and Mads\
    \ Madsen (Copenhagen Centre for Team Sport and Health, University of Copenhagen).\
    \ In addition, the authors would like to thank the 9 schools in Frederikssund,\
    \ Roskilde, Frederiksberg and Copenhagen Municipalities and the 22 individual\
    \ teachers who delivered the programme in their schools, without whose support\
    \ the interventions would not have been possible. Last, but not the least, the\
    \ authors would like to thank the children who participated in the study.\n\n\
    \ Contributors CWF modified the FIFA 11 for Health programme for the European\
    \ context, analysed the data, prepared the first draft of the paper, revised the\
    \ manuscript and approved the final submission. CO modified the FIFA 11 for Health\
    \ programme for the European context, implemented the intervention, analysed the\
    \ data, revised the manuscript and approved the final submission. MNL implemented\
    \ the intervention, revised the manuscript and approved the final submission.\
    \ A-ME implemented the programme, provided statistical analysis of the data, revised\
    \ the manuscript and approved the final submission. LO implemented the programme,\
    \ revised the manuscript and approved the final submission. AJ and JD modified\
    \ the FIFA 11 for Health programme for the European context, commented on the\
    \ manuscript and approved the final submission. PK modified the FIFA 11 for Health\
    \ programme for the European context, implemented the intervention, analysed the\
    \ data, revised the manuscript and approved the final submission.\n\n Funding\
    \ FIFA Medical Assessment and Research Centre.\n\n Competing interests J Dvorak\
    \ is the FIFA Chief Medical Officer.\n\n Provenance and peer review Not commissioned;\
    \ externally peer reviewed.\n\n Open Access This is an Open Access article distributed\
    \ in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC\
    \ 4.0) license, which permits others to distribute, remix, adapt, build upon this\
    \ work non-commercially, and license their derivative works on different terms,\
    \ provided the original work is properly cited and the use is non-commercial.\
    \ See: http://creativecommons.org/ licenses/by-nc/4.0/"
- source_sentence: 'What are some potential factors that can contribute to force variability
    during constant isometric contractions?

    '
  sentences:
  - "index Wnger Xexion) because of the experiment by Prodoehl and Vaillancourt (2009)\
    \ . Their results were similar to ours despite the fact that they used higher\
    \ force levels than our study (5 and 40% MVC) and diVerent eVectors (elbow Xexion\
    \ and dorsiXexion). One potential diVerence between the and Newell (2006a, b)\
    \ was the monitor size. We used a 27 in. display, whereas SosnoV and Newell used\
    \ a 17 in. display. It is possible that the visual feedback could have temporarily\
    \ gone oV the screen on a 17 in. display such that subjects received less information\
    \ at higher gains. Hong and Newell (2008) examined this issue and showed that\
    \ at high feedback gain levels the visual feedback can exceed the screen height\
    \ when the display is small (Hong and Newell 2008) . Nonetheless, all these studies\
    \ agree that increases in visual feedback gain from low (e.g., 2 pixels/N) to\
    \ moderate visual feedback gains (e.g., 64 pixels/N) will signiWcantly reduce\
    \ force variability.\n\n The results of this paper also support recent Wndings\
    \ (Baweja et al. 2009b) , which demonstrated that force variability did not vary\
    \ signiWcantly when comparing 12.8 with 51.2 pixels/N and 15 with 3,000 pixels/N.\
    \ In this paper, we examined 13 visual feedback gains per subject, and show that\
    \ signiWcant diVerences in force variability reliably occur only when the comparison\
    \ is between very low (0.5-4 pixels/N) and moderate-to-high visual feedback gains\
    \ (>64 pixels/N). An interesting Wnding from the Baweja et al. (2009a, b) paper\
    \ was that force variability was signiWcantly lower when visual feedback of the\
    \ force was removed. Therefore, this could have indicated that at very low visual\
    \ gains (close to 0 pixels/N) force variability would decrease. The current manuscript\
    \ clearly demonstrates that even with extremely low visual feedback gains (0.5\
    \ pixels/N) force variability is signiWcantly higher compared with moderate visual\
    \ feedback gains. It is possible that complete removal of visual feedback changes\
    \ the strategies used by the subject to maintain the force constant. For example,\
    \ the subject may rely more on proprioceptive information rather than searching\
    \ for visual feedback to perform visuomotor corrections.\n\n It is well accepted\
    \ that the variability in force during constant isometric contractions is primarily\
    \ due to oscillations in force from 0-2 Hz Christou et al. 2004; Christou 2005;\
    \ Baweja et al. 2009b ). Our Wndings clearly demonstrate that when the visual\
    \ feedback gain increased from low to moderate visual feedback gains force variability\
    \ decreased due to decreased power in the 0-1 and 3-7 Hz bands. The reduction\
    \ in power from 0-1 Hz explained »50% of the decrease in force variability, whereas\
    \ the reduction in power from 3-7 Hz explained »20% of the decrease in force variability.\
    \ These results, therefore, demonstrate that visuomotor corrections can alter\
    \ the oscillations in force via modulation of the 0-1 Hz and 3-7 Hz bands. Although\
    \ other studies have shown that visuomotor corrections can change the oscillations\
    \ in force (Miall et al. 1993; Baweja et al. 2009b ), these results demonstrate\
    \ that low-frequency oscillations in force (0-1 Hz) cannot be entirely explained\
    \ from visuomotor corrections. This is evident because force output at very low\
    \ visual feedback gains (e.g., 0.5 Hz) also contained low-frequency oscillations\
    \ (0-1 Hz). Low-frequency oscillations have been attributed to the coherent modulation\
    \ of motor unit discharge at low frequencies (De Luca and Erim 1994; Brown 2000;\
    \ Vaillancourt et al. 2003) , variability in motor unit discharge due to synaptic\
    \ noise Moritz et al. 2005) , intrinsic neuronal properties such as active calcium\
    \ conductance (Falcke 2003) , heart rate (Hunter et al. 2007) , and breathing\
    \ (Turner 2002; Li and Yasuda 2007) .\n\n Furthermore, the exact physiological\
    \ mechanism that induced the modulation (decrease in power) within these frequency\
    \ bands remains unclear. One possibility is that the change in low-frequency oscillations\
    \ (0-1 Hz) occurred by changing the breathing amplitude (Fulks et al. 2008) .\
    \ The 3-7 Hz modulation can be potentially explained by decreasing the number\
    \ of newly recruited motor units (initial rates of newly recruited motor units\
    \ range from 5-7 Hz and contribute the most to the variability of force; Enoka\
    \ and Fuglevand 2001) ."
  - "Cancer continues to be one of the leading causes of death both worldwide and\
    \ in the United States. While incidence and mortality rates are both dropping\
    \ in the United States, primarily attributed to reductions in smoking, the burden\
    \ of the disease remains extremely high. The American Cancer Society estimates\
    \ that 1,685,210 new cases were diagnosed in 2016 alone, and 595,690 patients\
    \ succumbed to the illness [1] .\n\n Several natural and artificial substances\
    \ have been found to be carcinogenic in humans. Benzene, a colorless liquid compound\
    \ historically used in the printing industry as a component of inks as well as\
    \ being a starting material in the chemical and drug industries (as a component\
    \ in rubbers, lubricants, dyes, detergents, and pesticides) has been implicated\
    \ in the causation of several types of leukemia and other blood-related cancers\
    \ [2] . Since being identified as a human carcinogen, non-industrial use of benzene\
    \ has been limited. However, industrial processes continue to release large amounts\
    \ of benzene into the atmosphere, creating potential exposures for workers and\
    \ the public at large.\n\n In recent years, researchers have begun using newer\
    \ techniques to estimate the effect that exposure to ambient air pollutants, including\
    \ benzene, has on the health of the general population. Mirzahosseini & Atabi\
    \ [3] conducted a GIS-based study estimating the environmental benzene levels\
    \ in Tehran, Iran. The methodology that the authors used was based on collecting\
    \ samples at several locations around the city using a portable air monitoring\
    \ device, and using those values to estimate ambient benzene levels around the\
    \ city using the inverse weighted distance (IWD) technique. The authors found\
    \ that the ambient levels of benzene in Tehran's air were between 2 and 20 times\
    \ higher than the international standard (1.56 ppb). They also estimated the excess\
    \ cancer risk imposed by the heightened benzene levels in different neighborhoods\
    \ in Tehran using an excess risk model developed by the EPA. The study falls short,\
    \ however, in investigating the association between benzene levels and observed\
    \ cancer incidence or mortality, due to the unavailability of cancer outcomes\
    \ data containing geographical markers.\n\n Eiten et al. [4] performed a spatial\
    \ analysis of air pollution and cancer incidence rates in the Haifa Bay region\
    \ in Israel. The exposures of interest in this study were PM 10 , resulting from\
    \ vehicle traffic and industrial processes, as well as SO 2 , a marker of industrial\
    \ emissions, while the outcomes of interest were lung cancer, bladder cancer,\
    \ and non-Hodgkin's lymphoma. Using data from Israel's national cancer registry,\
    \ the authors analyzed 143 residential wards (neighborhoods) in Haifa Bay and\
    \ initially demonstrated that cancers did not follow a spatially random distribution.\
    \ Subsequently, they used kriging to extrapolate region-wide estimates of the\
    \ study exposures based on values from 17 SO 2 monitoring stations and 8 PM 10\
    \ monitoring stations within the study area. For each ward being analyzed, the\
    \ average of the kriged estimates was used as the exposure level for the individuals\
    \ who resided in each ward. The authors reported that SO 2 was not associated\
    \ with any of the three types of cancer, but PM 10 showed a significant association\
    \ with lung cancer in males, with each additional microgram in the environment\
    \ associated with a 12% increase in lung cancer risk.\n\n The use of conventional\
    \ linear regression models, such as Ordinary Least Squares (OLS) linear regression,\
    \ presents the same problem of spatially autocorrelated residuals, violating the\
    \ key assumption of independent and identically distributed error structure and\
    \ alternative methods of testing the significance of any risk factors are necessary\
    \ [5] . Statisticians have developed spatial regression models that are analogous\
    \ to those models previously used for time-series analysis, which allowed for\
    \ the correlation (in this case, between neighboring regions rather than subsequent\
    \ time periods) in the outcome data [6] . This approach, which includes both simultaneous\
    \ and conditional auto-regression models, allows modelling the observed values\
    \ as the realizations of a distribution that depends on the values seen in neighboring\
    \ areas [6] .\n\n Finally, the problem of using observed values to extrapolate\
    \ over larger areas has been addressed using a method called kriging, introduced\
    \ by Georges Matheron, who is considered the founder of geostatistical theory\
    \ [5] . Kriging is a minimum-mean-squared-error used to predict spatial values\
    \ based on the distribution of the observed values [6] . Various types of kriging\
    \ have been developed, including simple kriging (analogous to linear prediction),\
    \ ordinary kriging (based on a hypothetical mean that is common across the study\
    \ region), universal kriging (where the mean structure is non-stationary, i.e.,\
    \ varying based on location) and block kriging (used to predict lattice data from\
    \ geospatial observations)."
  - "Foreign body aspiration in toddlers, which presents a serious issue in developing\
    \ countries, not only remains a diagnostic and therapeutic conundrum to otolaryngologists,\
    \ but presents a major hazard to anesthetists, especially during emergencies when\
    \ confronting the postoperatively compromised airway. Reports have focused on\
    \ the ventilation mode and anesthesiology delivery route. The most suitable anesthetic\
    \ technique for adequate ventilation and oxygenation during rigid bronchoscopy\
    \ (RB) is still under investigation. The aim of this study is to review our 20-year\
    \ experience (1991) (1992) (1993) (1994) (1995) (1996) (1997) (1998) (1999) (2000)\
    \ (2001) (2002) (2003) (2004) (2005) (2006) (2007) (2008) (2009) (2010) in the\
    \ airway management and the subsequent outcomes of RB in children with an inhaled\
    \ tracheobronchial foreign body (TFB).\n\n \n\n \n\n Institutional review board\
    \ approval from the Eye and ENT (EENT) Hospital of Fudan University (Shanghai,\
    \ China) was obtained; a total of 3203 charts of children (<12 years of age) with\
    \ suspected inhaled foreign bodies underwent RB in 1991-2010 (past 2 decades)\
    \ were reviewed. Exclusion criteria included incomplete data sets (34 cases) and\
    \ an emergency invasive airway (tracheal intubation or tracheostomy) prior to\
    \ the RB procedure (20 cases); therefore, a total of 3149 patients were retrospectively\
    \ studied. Data included patient characteristics (age, gender, weight, respiratory\
    \ system impairment), foreign body details (type, duration, location), whether\
    \ anesthetic management or complications ever occurred, and interventions and\
    \ outcomes. An active respiratory symptom was referred to the presence of abnormal\
    \ clinical signs or laboratory examination as follows:\n\n Wheezing symptoms with\
    \ asthma history and/or pneumonia, atelectasis, or bronchiectasis diagnosed by\
    \ a chest X-ray. The fl ow chart of the diagnostic algorithm of TFB aspiration\
    \ in children at the EENT Hospital is shown in Figure 1 .\n\n Postoperatively\
    \ pulmonary complications were defi ned as the existence of severe hypoxemia,\
    \ laryngeal edema, complete laryngospasm, pneumothorax, atelectasis, and death.\n\
    \n Anesthesia was induced by inhalational or intravenous anesthetics. The former\
    \ was performed by 8% sevofl urane in oxygen (6-8 L/min) aspiration, while the\
    \ latter was accomplished by the infusion of fentanyl 1 μg/kg and propofol 2.5\
    \ mg/kg. Ventilation modes during anesthesia maintenance were divided into two\
    \ types: (i) Controlled ventilation (CV), in which small bolus doses of succinylcholine\
    \ 1 mg/kg were repeatedly administered to maintain muscle relaxation and total\
    \ intravenous anesthesia (TIVA) with propofol (150-250 μg·kg\n\n ) and remifentanil\
    \ (0.1-0.2 μg·kg −1 ·min −1 ) infusion were used; and (ii ) spontaneous ventilation\
    \ (SV), in which inhalation or intravenous drugs were administered. The former\
    \ was delivered using the sevoflurane approach (8% in oxygen inhalation) with\
    \ a semi-circle anesthesia breathing circuit, whereas the latter was delivered\
    \ by the intravenous induction of γ-hydroxybutyrate (50-80 μg/kg) [1] or dexmedetomidine\
    \ (1-2 μg/kg) over 10 min followed by an infusion of 0.2-0.6 μg·kg\n\n . Prior\
    \ to RB insertion, 2% lidocaine (dose max 4 mg/kg) was sprayed onto the epiglottis\
    \ and larynx and between the vocal cords.\n\n The choice of ventilation airway\
    \ device was based on the anesthesiologist's experience and patients' circumstances.\
    \ In patients with suspected subglottic TFB, an SV technique was used to avoid\
    \ converting a proximal partial obstruction to a complete obstruction. The avoidance\
    \ of positive ventilation was also used in cases of a defi nite preoperative mediastinum\
    \ emphysema/pneumothorax for fear of inducing iatrogenic-related barotrauma. CV\
    \ and SV are the two main techniques used during RB. CV is composed of intermittent\
    \ positive pressure ventilation (IPPV) and manual jet ventilation (MJV). In the\
    \ IPPV group, PPV was commenced through the breathing circuit, which was connected\
    \ as a T-shaped piece to the side arm of the RB (Storz, Tuttlingen, Germany)."
- source_sentence: What are the key features and etiologies of giant cell interstitial
    pneumonia (GIP), and how does it manifest in viral infections and pneumoconiosis?
  sentences:
  - "The calcium ion (Ca 2+ ) is very important in the regulation of several signaling\
    \ pathways that are contributed to many cellular processes such as proliferation,\
    \ differentiation, apoptosis, gene expression, and fluid and hormones secretions.\
    \ The (Ca 2+ ) homeostasis is monitored under the effect of certain G-protein\
    \ coupled receptor-family C known as calcium sensing receptor (CASR). 2 The highest\
    \ expression of CASR is usually seen in the kidney and the chief cells in parathyroid\
    \ tissues. However, other organs may express CASR on their surfaces such as colon.\
    \ 3 In the colon, CASR enhances the differentiation of colonocytes which in turn\
    \ reduces the formation of neoplasia in the colon. 4 Moreover, it inhibits fluid\
    \ and electrolyte secretion, which could potentially serve as a treatment for\
    \ diarrheal disease. 5 It may also help the ions of Ca 2+ to upregulate proteins\
    \ which modulate duodenal Ca 2+ absorption in vivo, although the certain molecular\
    \ mechanisms behind this physiological process are not clear. 6 The human CASR\
    \ gene is located on chromosome 3q13.33-q21.1 and contains 11 exons, two promoters\
    \ and two 5′-untranslated exons (exon 1A and 1B) that yield alternative transcripts,\
    \ but encoding the same protein. 7 As many other genes, any genetic variations\
    \ in the CASR gene, either in the form of mutations or single nucleotide polymorphisms\
    \ (SNPs), can result in a loss or gain of function, which in turn lead to significant\
    \ alterations in circulating concentrations of calcium that is associated not\
    \ only with disorders of the parathyroid glands, but also with other conditions\
    \ such as bone disorders, vascular disorders, and cancer.\n\n Colorectal cancer\
    \ (CRC) is considered one of the most prevalent cancers with high incidence and\
    \ morbidity rate worldwide. According to the latest report from the National Cancer\
    \ Registry (NCR) at King Faisal Specialist Hospital and Research Centre (KFSHRC)\
    \ in Saudi Arabia, CRC represents the first and the third most common cancer types\
    \ among males and females, respectively.\n\n 8 Although significant advances in\
    \ the diagnosis and treatment have been made for CRC patients in Saudi Arabia,\
    \ the overall 5-year survival rate was (44.6%) for the period 1994-2004 with a\
    \ high percentage of distant metastasis (28.4%) in patients at the time of presentation\
    \ and rectal cancer represented (41%) of all colorectal cancer cases diagnosed\
    \ in 2010. 8 This poor overall 5-year survival rate is partially due to the lifestyle\
    \ such as diet and physical activity and partially due to acquired drug resistance.\
    \ The CASR is able to respond to a variety of ligands, including polyvalent cations\
    \ and amino acids. Therefore, any changes of pH and ionic strength that occur\
    \ in cancer cells may affect the activity of the CASR and subsequently affect\
    \ its capability to integrate several signaling pathways. Most of the published\
    \ articles revealed that CASR expression play a protective role in CRC patients\
    \ through several mechanisms such as binding toxic secondary bile acids and/or\
    \ ionized fatty acids and neutralizing them in form of insoluble calcium soaps,\
    \ 10 or by affecting several signaling transductions such as stimulating cell\
    \ differentiation, inducing apoptosis and inhibiting proliferation.\n\n 11 To\
    \ the best of our knowledge, no studies have been conducted to correlate the relation\
    \ between genetic polymorphisms in CASR gene and risk of CRC in Saudi patients.\
    \ Therefore, this study was aimed to determine the genetic distribution and allele\
    \ frequency of two SNPs in CASR gene in drug-resistant CRC patients that are routinely\
    \ visiting King Abdulaziz University Hospital (KAUH) to reveal the possible effect,\
    \ if present, on the pathogenesis of CRC.\n\n In this study, 100 CRC patients\
    \ and 124 controls were included. The purpose of the research was explained and\
    \ a written consent of the participants as well as their answers on a questionnaire\
    \ were obtained. The study was approved by the biomedical ethics unit at faculty\
    \ of medicine, King Abdulaziz University (KAU) (reference no. 378-17). Several\
    \ anthropometric measurements such as body weight, height, body mass index (BMI),\
    \ waist and hip circumference, and waist-to hip-ratio (WHR) were calculated for\
    \ all participants. All blood samples were drawn into lavender top vacutainers\
    \ containing anticoagulants (EDTA) and were obtained from oncology clinics at\
    \ King Abdulaziz University Hospital (KAUH) in Jeddah, KSA from the period January\
    \ 2016 to September 2016. Genomic deoxyribonucleic acid (gDNA) was extracted from\
    \ peripheral blood leukocytes in whole blood samples using QIAamp DNA Mini Kit\
    \ (QIAGEN, Hilden, Germany) following the manufacturer's instructions."
  - "Katzenstein, but in addition, also cases showing fibroblastic foci associated\
    \ with emphysema blebs and fibrosis (Fig. 20) . In these cases, also RB could\
    \ be seen in different areas. In contrast to UIP, there were no honeycomb lesions\
    \ and almost all lobules showed changes of centrilobular emphysema. Some of these\
    \ patients were clinically diagnosed as having chronic obstructive pulmonary disease\
    \ (COPD); in others, the lesions were found incidentally because of pneumothorax.\
    \ So this might represent another form of smoking-induced lung fibrosis, probably\
    \ resulting from the release of toxic enzymes from macrophages and subsequent\
    \ alveolar septa destruction and repair.\n\n Acute interstitial pneumonia/diffuse\
    \ alveolar damage Many different agents can cause AIP/DAD. Classical ones are\
    \ viral infections, but toxic inhalation, drug reactions, and all variants of\
    \ shock reactions will also present with this morphologic picture. The features\
    \ have been described above, so we need to focus only on specific changes pointing\
    \ to a specific etiology. In viral infection, the most characteristic feature\
    \ is the viral inclusion body, which can present either as nice large inclusion\
    \ bodies (cytomegalovirus [CMV], respiratory syncytial virus [RSV]) or by red-violet-stained\
    \ nucleic acids forming illdefined speckles in nuclei and/or cytoplasm (adenovirus)\
    \ [27] . Typically, the infected cell shows enlargement, an atypical large bizarre\
    \ nucleus, and an accentuated nuclear membrane due to increased nucleic acid traffic\
    \ induced by the virus. These cellular features can last for several months. In\
    \ contrast to preneoplastic lesions in viral infection, the atypical cells are\
    \ single cells being grouped together with otherwise normal-looking pneumocytes.\n\
    \n Giant cell interstitial pneumonia (see also under pneumoconiosis) GIP has a\
    \ quite narrow etiologic spectrum either being caused by hard metal dust or by\
    \ viral infection. The former will be discussed later. Several viruses can cause\
    \ GIP, the classical one being measles virus. However, in contrast to pneumoconiosis\
    \ in infections, the giant cells are mixed epithelial as well as macrophagocytic.\
    \ The epithelial giant cells (Hecht cells) are transformed pneumocytes type II\
    \ in whom nuclear division was not followed by cell division, giving rise to multinucleation\
    \ [110] . The additional features are identical to DAD as described above. Especially\
    \ within the epithelial cells, viral inclusion bodies can be found (Suppl. Fig.\
    \ 36 ). Besides measles, RSV can also present, with this picture predominantly\
    \ in children [111] .\n\n We have already described OP under the idiopathic ILDs,\
    \ so we have only to focus on other causes of OP. OP can have a great variety\
    \ of causes. In many cases, this is a post-infectious organization of a purulent\
    \ bacterial bronchopneumonia, when for several reasons the exudate could not be\
    \ completely degraded and, therefore, has to be organized by granulation tissue.\
    \ Also, in viral infections, organizing DAD is morphologically identical to OP,\
    \ as discussed previously. In other cases, OP is a form of organization of an\
    \ autoimmune disease, usually in the inactive phase. The resolution phase of toxic\
    \ inhalation is usually in the form of OP, and drug-induced lung toxicity is also\
    \ often organized the same way (Suppl. Fig. 29 ).\n\n Chronic pneumonia of infancy\
    \ Originally, surfactant-related IP with alveolar proteinosis were included into\
    \ chronic pneumonia of infancy (CPI); however, since the different causes of alveolar\
    \ proteinosis were discovered, it has been excluded. Therefore, CPI has been reduced\
    \ to those pediatric interstitial diseases with unknown cause. It is now quite\
    \ rare. CPI is characterized by an infiltration of lymphocytes and macrophages/histiocytes\
    \ in the alveolar septa, accumulation of debris within the alveoli, and hyperplasia\
    \ of type II pneumocytes (Suppl. Fig. 37 ), all causing thickening of the septa\
    \ and impaired gas exchange. CPI predominantly occurs in newborn or small children\
    \ [112, 113] . In many instances, a careful investigation of the biopsies might\
    \ uncover underlying infectious diseases, such as Wilson-Mikity syndrome and infections\
    \ caused by respirotropic viruses, Chlamydiae, or uroplasms [114] ; another cause\
    \ might be gastroesophageal reflux [115] . In rare instances, a metabolic disease,\
    \ interstitial glycogenosis, might be the cause of CPI [116, 117] ."
  - "The consequences of pulp exposure from caries, trauma or tooth preparation misadventure\
    \ can be severe, with pain and infection the result. The morbidity associated\
    \ with treating pulp exposures is consequential, often requiring either extraction\
    \ or root canal therapy. Both the loss of the tooth and its replacement, or endodontic\
    \ treatment and tooth restoration, involve multiple appointments and considerable\
    \ expense. An alternative procedure to extraction or endodontic therapy is pulp\
    \ capping, in which a medicament is placed directly over the exposed pulp (direct\
    \ pulp cap), or a cavity liner or sealer is placed over residual caries (indirect\
    \ pulp cap) in an attempt to maintain pulp vitality and avoid the more extensive\
    \ treatment dictated by extraction or endodontic therapy. Although many products\
    \ have been suggested, a recent Cochrane Review found that evidence is lacking\
    \ as to the most appropriate pulp capping material. 1 In addition, various factors\
    \ are believed to influence the success of both direct and indirect pulp capping.\
    \ It is the purpose of this literature review to examine the evidence, issues\
    \ and materials relevant to pulp capping.\n\n This review was undertaken as preparatory\
    \ work for an essay at the annual meeting of the Academy of Operative Dentistry.\
    \ It also served to provide the background and scientific rationale for a clinical\
    \ trial on direct pulp capping being undertaken in the Northwest PRECEDENT Practice-based\
    \ Research Network (PBRN).\n\n No specific criteria were applied a priori as to\
    \ what articles would be accepted into this review. Rather, it was hoped that\
    \ the span of literature reviewed would be as comprehensive as possible. PubMed\
    \ and Ovid databases were searched for any articles that met the criteria of containing\
    \ \"pulp capping,\" \"direct pulp capping,\" \"indirect pulp capping,\" \"sealed\
    \ dental caries\" or \"pulp capping materials.\" No date limits were applied.\
    \ An initial screen of returned abstracts was accomplished, and relevant full-length\
    \ articles from peer-reviewed periodicals were obtained. Pertinent citations contained\
    \ in the full-length articles were used as sources for additional review.\n\n\
    \ The ultimate goal of a review such as this is to derive conclusions based on\
    \ the evidence that can be applied to clinical practice. Just as any astute clinician\
    \ will discuss the procedures, advantages, risks and patient questions (PARQ)\
    \ prior to initiating a course of treatment, it is important for the reader to\
    \ be aware of the shortcomings in the greater body of literature regarding pulp\
    \ capping. It is only in this context that the reader can be aware of the challenges\
    \ and shortcomings inherent in drawing definitive conclusions from the pulp capping\
    \ literature. The following \"informed consent statements\" are for the purpose\
    \ of stressing these challenges and shortcomings.\n\n The typical clinical study\
    \ for pulp capping contains the following features:\n\n 1. The patient is young\
    \ (typically 15-25 years of age) and healthy.\n\n 2. The patient is going to have\
    \ premolars (subject teeth) extracted for orthodontic reasons.\n\n 3. The subject\
    \ teeth are free of caries, cracks or other defects.\n\n 4. The teeth are isolated\
    \ with a rubber dam, receive a pumice prophylaxis and are often times disinfected\
    \ (sometimes with two antibiotic solutions).\n\n A sterile bur is used to initiate\
    \ cavity preparation. When nearing the pulp, a new sterile bur is replaced in\
    \ the handpiece and pulp exposure is initiated as atraumatically as possible.\n\
    \n 6. Hemorrhaging is controlled with sterile materials.\n\n While these procedures\
    \ help to standardize the experimental technique and maintain internal validity,\
    \ they do not reflect the circumstances under which most practitioners are confronted\
    \ with a potential pulp cap situation.\n\n The true \"gold standard\" of pulp\
    \ status is histological analysis. Unfortunately, the true state of pulp health\
    \ or pathology cannot be determined by clinical signs, symptoms or radiologic\
    \ appearance. Clinicians have only relatively crude assessments, such as the application\
    \ of hot or cold temperatures, an electric current, percussion of the tooth, changes\
    \ in the appearance of associated soft tissues and patient reports of symptoms.\
    \ However, numerous studies including histological analysis have demonstrated\
    \ a chronically inflamed pulp, but the patients reported no symptoms, the investigators\
    \ discerned no signs and no apical/radicular pathology was noted on radiographs.\
    \ It must also be kept in mind that most studies that include histological analysis\
    \ are of quite a short duration, typically two to four months.\n\n 3-4,6-9\n\n\
    \ Much research on pulp capping has been accomplished in animals, from lower species,\
    \ such as mice and dogs, to primates. However, the results of pulp capping in\
    \ animals often does not reflect what will happen in humans. It is necessary to\
    \ be very cautious in taking the results of animal pulp capping studies and applying\
    \ them to human patients.\n\n 3-4,7,10-12\n\n Some studies do not maintain a consistent\
    \ methodology within the study. For example, the restorative regimen may vary\
    \ among the experimental groups."
- source_sentence: 'How does serum P2-microglobulin (32-m) level relate to renal impairment
    in multiple myelomatosis?

    '
  sentences:
  - "SEVERAL INDICES have been proposed for the clinical stratification of multiple\
    \ myelomatosis. The system devised by Durie & Salmon (1975) , using a panel of\
    \ clinical biochemical factors, has the advantage of being correlated with survival\
    \ and predictive of the response to treatment. Hence any new biochemical test,\
    \ to be considered seriously for the stratification of multiple myelomatosis,\
    \ must be capable of providing information comparable to the more complex systems\
    \ in current use. There is growing evidence that serum P2-microglobulin (32-m)\
    \ level is often increased in multiple myelomatosis (Shuster et al., 1976; Belleville\
    \ et al., 1978) . However, P2-m is a low-mol. wt. protein (11,800 dalton) and\
    \ its serum levels depend on both its production and its renal clearance. Elevation\
    \ of serum /2-m occurs in renal clearance. Elevation of serum :2-m occurs in renal\
    \ impairment (Revillard, 1979) . As some form of renal involvement will occur\
    \ eventually in about half of the patients with multiple myelomatosis (DeFronzo\
    \ et al., 1978) it could be argued that the measurement of serum /2-m is only\
    \ providing refined information about multiple myeloma that might be of particular\
    \ importance in patients with normal serum creatinine, and may be a simple substitute\
    \ for the serial measurement of paraprotein levels in the monitoring of multiple\
    \ myelomatosis.\n\n Two group of patients were studied; all fulfilled the accepted\
    \ criteria for the diagnosis of myelomatosis (Chronic Leukaemia-Myeloma Task Force,\
    \ 1973 Kaplan & Meier (1958) and the significance between the survival of the\
    \ subsets calculated by the log-rank method (Peto et al., 1977 The serum /2-mn\
    \ was measured by the Phadebas radioimmunoassay (Pharmacia, Uppsala, Sweden).\
    \ The normal limits for this assay in blood donors are 0 8-2-4 mg/l. Creactive\
    \ protein was measured by radial immunodiffusion, using antisera and standards\
    \ obtained from the Behring Institut, Marburg/Lahn, Germany. Serum levels > 10\
    \ mg/l were considered abnormal, but a discriminant level of 20 mg/l was adopted\
    \ as being indicative of active infection. Serum creatinine was measured by Jaffe's\
    \ method: a value of 140 HM wNas arbitrarily taken as the upper limit of normal\
    \ in this population. The choice of the serum /2-m 4 mg/l cut-off as the basis\
    \ for stratification of the patients into good and bad prognosis groups wAas made\
    \ after reference to results obtained in \"normal\" subjects, over 60 years of\
    \ age, AN-here the median was 2-2 mg/l and range 1 2-40 mg/l (Agerup, personal\
    \ communication) .\n\n The general relationship between serum /2-m level at first\
    \ presentation and the probability of survival in Group I, is shown in Fig. 1\
    \ The relation of serum f2-m levels and creatinine levels in patients in whom\
    \ renal impairment is indicated by elevated creatinine, is shown in Fig. 4 , where\
    \ comparison is made with the regression slopes for these variates in chronic\
    \ renal failure and systemic lupus erythematosus, as published by Hall (1979)\
    \ . It will be seen that there is a wide range of serum ,82-m levels for a particular\
    \ creatinine level. The correlation coefficient, as measured by the Spearman ranking\
    \ test, was r = 0-61, P = 0.01. In the longitudinal studies, levels of serum ,B2-m\
    \ > 15 mg/l were always associated with creatinine > 140 ,uM. But considerable\
    \ change in serum ,82-m levels, either downwards during the reduction of the larger\
    \ tumour burdens or upwards as the mass expanded, could occur without a coincidental\
    \ change in serum creatinine.\n\n The discriminant power of serum ,B2-m level\
    \ of 4 mg/l is apparent from the survival studies (Fig. 1) where good and bad\
    \ prognostic groups are distinguished. It will require a larger series to define\
    \ the level for optimal separation of these 2 groups. There is also a clear relation\
    \ between serum /2-m levels and estimates Hall (1979) .\n\n of tumour mass, using\
    \ the system devised by Durie & Salmon ( Once the creatinine begins to rise, the\
    \ effect of hyperproduction is magnified and the serum /2-m is elevated more than\
    \ is usual for chronic renal disease. Assuming that the raised levels are due\
    \ to excess production, it is not known whether this P2-m comes from the mature\
    \ plasma cells, their precursors or other cells of the lymphoid series. Studies\
    \ of lymphoid disease indicate that raised serum /32-m can accompany a variety\
    \ of benign and malignant diseases involving B or T lymphocytes (Cooper & Spati,\
    \ 1979) . Whatever the cell type or types contributing to the production df /2-m,\
    \ its origin is most probably from the turnover of HLA on cell membranes, where\
    \ /2-m forms the light chain of HLA (Cresswell et at., 1974) .\n\n In practice\
    \ the measurement of serum /32-m, at first presentation, would appear to be useful\
    \ for the stratification of multiple myeloma, especially when the creatinine level\
    \ is normal. The frequency of a renal impairment at first presentation has been\
    \ reported as 43/237 (18-1%) by Woodruff et al. (1979) , and 18% by Alexanian\
    \ et al. (1975) using criteria less strict than ours.\n\n High levels of serum\
    \ P2-m at diagnosis or after 12-18 months carry a poor prognosis, and such levels\
    \ are frequently encountered in IgA and IgG myeloma without an elevated serum\
    \ creatinine (Table II) . Furthermore, serum /2-m could well be a better reflection\
    \ of the tumour mass than the serum paraprotein levels, and may offer a particular\
    \ advantage for the monitoring of Bence Jones myelomatosis, as it is difficult\
    \ to measure the serum concentrations of light chains accurately. Severe acute\
    \ infections do not necessarily raise serum 32-m, which is independent of the\
    \ serum acute-phase reactive protein response (Cooper & Spati, 1979) . This may\
    \ account for the lack of rise of P2-m in the terminal periods of life of those\
    \ patients in Fig. 1 and 2 whose intercurrent infection was the immediate cause\
    \ of death.\n\n Measurement of serum 32-m is simpler and less problematical than\
    \ existing staging systems and paraprotein estimations. It may prove particularly\
    \ applicable to the stratification and subsequent monitoring of patients with\
    \ myelomatosis in the multi-centre clinical trial."
  - "The joint is multiply innervated such that anesthetics applied to the exiting\
    \ dorsal sacral nerve roots blocks sensation outside the joint but not pain elicited\
    \ by joint pressurization. 7 In blinded randomized trials, radiofrequency ablation\
    \ (RFA) of sacral nerve root lateral branches was effective in at least temporarily\
    \ relieving pain in patients with SIJ pain, 8, 9 providing definitive proof not\
    \ only that the SIJ is a source of pain but also that the pain can be treated\
    \ successfully.\n\n SIJ pathology can cause proximal buttocks pain that may radiate\
    \ into the lower back, groin, or lower extremity. 6 In a detailed diagnostic study\
    \ of outpatients with lower back pain, the SIJ was thought to be the source of\
    \ up to 15-23% of all chronic lower back pain. 10, 11 SIJ pain is an even more\
    \ common explanation for post-lumbar fusion lower back pain. 12 Causes of SIJ\
    \ pain include osteoarthritic degeneration, SIJ disruption as a result of trauma\
    \ or pregnancy, inflammatory disease, tumor, and infection. Radiographic findings\
    \ in the SIJ are common 13 but are not necessarily predictive of the presence\
    \ of SIJ pain. In typical practice, crosssectional imaging of the pelvis and lumbar\
    \ spine is done to rule out other concomitant pathology that could explain pain\
    \ in the buttocks or groin.\n\n Nonsurgical treatments for SIJ disorders include\
    \ medical management, physical therapy, manipulation, intra-articular steroid\
    \ injections, prolotherapy, chiropractic, and RFA. Other than for RFA, no high-quality\
    \ evidence exists to support the effectiveness of nonsurgical treatments for SIJ\
    \ pain. Two blinded controlled trials of RFA of sacral nerve root lateral branches\
    \ have shown short-term improvement in pain 8, 9 ; a 12-month follow-up study\
    \ showed a modest long-term response rate after this treatment.\n\n 14 SIJ fusion\
    \ was first described in the 1920s, 15 and several singlecenter retrospective\
    \ reports suggest that it may be moderately effective for the treatment of pain\
    \ in this patient population. [16] [17] [18] [19] [20] [21] Pain relief is likely\
    \ mediated by SIJ stabilization, reducing the need for active coordinated muscular\
    \ control and passive ligamentous stability to facilitate effective load transfer\
    \ across the SIJ. Unfortunately, open SIJ fusion is highly invasive and is associated\
    \ with long hospital stays and recovery times, high nonunion rates (9%-41% 18,\
    \ 22, 23 ), poor long-term response rates, and low levels of satisfaction. 24\
    \ Minimally invasive SIJ fusion systems are now available using various US Food\
    \ and Drug Administration-cleared implants. Placed through less invasive surgical\
    \ approaches, these devices are designed to provide the benefits of SIJ fusion\
    \ with faster recovery times as a result of reduced iatrogenic injury to surrounding\
    \ tissues. Minimally invasive SIJ fusions now account for 90% of all SIJ fusions.\
    \ 25 Most published reports (primarily single-center retrospective cohorts [26]\
    \ [27] [28] [29] [30] [31] [32] and a combined multicenter analysis 33 ) describe\
    \ the placement of multiple triangular titanium implants coated with a porous\
    \ titanium plasma spray (iFuse Implant System, SI-BONE, Inc, San Jose, California)\
    \ across the SIJ under fluoroscopic guidance. These reports provide evidence that\
    \ minimally invasive SIJ fusion relieves pain and disability.\n\n Previously,\
    \ we reported 6-month results of a randomized controlled trial comparing SIJ fusion\
    \ using iFuse Implant System and nonsurgical management (NSM) . 34 This study\
    \ showed that SIJ fusion produced superior improvements in pain, disability, and\
    \ quality-of-life outcomes at 1, 3, and 6 months after treatment relative to NSM.\
    \ This report presents the 12-month follow-up from this study, including an analysis\
    \ of subjects who crossed over from NSM to surgical treatment after the 6-month\
    \ visit (which was permitted according to the study protocol).\n\n Investigation\
    \ of Sacroiliac Fusion Treatment (INSITE) is an ongoing prospective, multicenter,\
    \ parallel-group, unblinded randomized controlled trial. Enrollment took place\
    \ between January 2013 and May 2014 at 19 spine surgery clinics in the United\
    \ States. The study protocol (registered on http://www.clinicaltrials.gov [NCT01681004])\
    \ was approved by the Institutional Review Board at each participating clinical\
    \ site before patient enrollment. The study was sponsored by the device manufacturer\
    \ (SI-BONE, Inc). All study sites underwent both remote and periodic on-site data\
    \ monitoring and all study data were source verified.\n\n Adult (age, 21-70 years)\
    \ patients were eligible to participate if they had a confirmed diagnosis of SIJ\
    \ dysfunction caused by degenerative sacroiliitis or SIJ disruption."
  - "For example, some respondents described infertility treatment as a service that\
    \ hospitals wanted to hold on to, even if they had to make creative arrangements\
    \ for the aspects prohibited by Catholic doctrine. Catholicism teaches that procreation\
    \ should not be separated from intercourse within the context of heterosexual\
    \ marriage. Thus, procedures to extract eggs or sperm, or to fertilize an egg\
    \ in vitro, are prohibited in a Catholic facility. But provision of fertility\
    \ drugs is permitted, as are medical visits that do not involve handling eggs,\
    \ sperm or embryos. Noting that no one at her Catholic facility was allowed to\
    \ provide fertility services, one respondent explained:\n\n \"Now, they're getting\
    \ a little crafty with how they get around it, and they go off-campus [to provide\
    \ such services]. So we actually do now have…an infertility specialist, who is\
    \ starting up an in vitro fertilization clinic off-campus.… We had somewhere to\
    \ send them anyway before-it was just out of the system-but now the system wants\
    \ the business.\"\n\n Similarly, one perinatologist explained that her Catholic\
    \ hospital objected when she suggested that she stop accepting obstetric patient\
    \ transfers during the previable period because she could not provide a full range\
    \ of care to those patients. This respondent had cared for a pregnant patient\
    \ whose fetus had a severe heart defect, and the patient' s membranes had ruptured\
    \ at 19 weeks. The respondent had approved an induction of labor, and had then\
    \ been accused by her Catholic ethics committee of performing an illicit abortion.\
    \ The respondent recounted her response and subsequent interaction with the ethics\
    \ committee:\n\n \" After the meeting, the respondent noted that once the opposition\
    \ had left the room, \"several people came up to me and said, 'No, no, no, don't\
    \ stop accepting those patients. ' [The] nurse vice president, the chairman of\
    \ the ethics committee, kind of quietly afterwards…[came] up to me and [said],\
    \ 'You know, we don't disagree with what you did, and we don't want you to not\
    \ accept those referrals…because we're a referral hospital, and you start losing\
    \ community hospitals, where getting to another hospital for urgent treatment\
    \ may be especially diffi cult.\n\n One of the strengths of this study was that\
    \ it included a diverse group of obstetrician-gynecologists who have worked in\
    \ Catholic hospitals around the United States. Our open-ended interviews allowed\
    \ themes about referral processes and barriers to emerge naturally in the respondents'\
    \ own words and from their personal experiences. Most of the physicians we interviewed\
    \ were drawn from a nationally representative survey sample, but the interview\
    \ sample itself was not representative, so we cannot generalize respondents' experiences\
    \ and perspectives to the entire population of U.S. obstetrician-gynecologists.\n\
    \n It is also important to note that the hospital policies described here are\
    \ fi ltered through the experiences and perspectives of the physicians interviewed.\
    \ We did not directly speak to hospital administrators, ethicists or others in\
    \ position to enforce the Catholic directives. In the survey from which this sample\
    \ was derived, 48% of obstetrician-gynecologists who described religion as \"\
    not very important\" in their lives experienced a confl ict with their religious\
    \ hospital, compared with 20% of those for whom religion was \"most important.\"\
    \n\n 11 Physicians' own beliefs and attitudes may therefore affect their reporting\
    \ of hospital referral policies.\n\n Little research has been done on referrals\
    \ for reproductive health services. In a nationally representative survey, primary\
    \ care physicians were asked what doctors should do when they felt a service was\
    \ clinically indicated but was prohibited by their hospital' s religious policies.\
    \ Some 86% responded that the right course of action was to refer the patient\
    \ to a different facility. 15 But this belief may not readily translate into patients'\
    \ getting timely information and referrals, and barriers other than Catholic hospital\
    \ policy may also play a role. In a 2010-2011 study of reproductive health facilities\
    \ (not specifi cally religious ones) that did not provide abortion but were located\
    \ fairly near an abortion provider, callers posing as patients received a direct\
    \ abortion referral in only 46% of instances. 16 In a separate study, in Nebraska,\
    \ only 52% of family medicine providers and obstetrician-gynecologists believed\
    \ that clinicians have a professional obligation to refer patients for abortion\
    \ services, and 17% said they would in no way participate in an abortion referral.\
    \ 17 The nonprofi t organization Provide reviewed both published literature and\
    \ expert guidance on abortion referrals, and found a need for research evaluating\
    \ the effectiveness of abortion referrals and the role of the referral process\
    \ in women' s access to care. 18 Prominent bioethicists and obstetrician-gynecologists\
    \ have debated whether physicians who hold a personal moral objection to abortion\
    \ should be required to refer patients to a physician who will safely provide\
    \ it. 19, 20 However, they have not addressed the behavior of institutions (or\
    \ the not have the option of providing abortions for their own patients the way\
    \ others would."
- source_sentence: 'What are some potential limitations in projecting the future demand
    for joint replacement surgeries?

    '
  sentences:
  - "The chronic inflammation of rheumatoid arthritis mainly affects the synovial\
    \ membranes of multiple joints and potentially involves vasculitis and pulmonary,\
    \ ocular and cardiovascular systems. After the onset of the inflammation, the\
    \ synovium changes dramatically (Edwards, 1998) . The synovial intima is filled\
    \ with B-lymphocytes engaged in antibody production against unknown antigens (Bläß,\
    \ Engel, & Burmester, 1999) . Infiltrations of plasma cells into the synovia are\
    \ highly associated with inflammation of rheumatoid arthritis (Dong, Li, Liu,\
    \ & Zhu, 2009; Reparon-Schuijt et al., 1998) . The resulting immune complexes\
    \ activate macrophages and complement and drive a T-cell dependent antibody production\
    \ in the synovial tissue. The immune complexes are mainly rheumatoid factors that\
    \ are defined as auto-antibodies against Fc-fragments of IgG (Tighe & Carson,\
    \ 2001) and occur in about 90% of rheumatoid arthritis patients (Dörner, Egerer,\
    \ Feist, & Burmester, 2004) . Normally\n\n Rheumatoid arthritis is a desastrous\
    \ progressive autoimmune disease for which no causative cure is available, simply\
    \ because the eliciting antigens are unknown despite intesive research efforts.\
    \ Most patients have also Rheumatiod factor activity where antibodies bind to\
    \ their own structures within the constant region. Here we considered, wether\
    \ mutations in the constant regions of immunoglobulins could represent the eliciting\
    \ antigens.\n\n rheumatoid factors bind to an antibody-antigen complex and facilitate\
    \ clearance by binding to Fcreceptors, fixation of complement and antigen processing\
    \ by B-lymphocytes (Carson, Chen, & Kipps, 1991) . The rheumatoid factor binding\
    \ site resides in CH 2 -CH 3 domain of Fc (Artandi, Calame, Morrison, & Bonagura,\
    \ 1992; Bonagura et al., 1998; Sutton et al., 1998) . However, rheumatoid factors\
    \ are also found in other conditions of B-cell hyperreactivity.\n\n The driving\
    \ force for autoimmune diseases are self-reactive antibodies directed against\
    \ \"altered self\" which can be modified proteins (Trouw, Huizinga, & Toes, 2013)\
    \ . So far posttranslational modifications have been detected in citrullinated\
    \ antigens that are highly specific for rheumatoid arthritis. Citrulline residues\
    \ arise from arginine by peptidyl arginine deiminase. However, this posttranslational\
    \ modification cannot fully explain the pathogenesis of rheumatoid arthritis (Klareskog,\
    \ Amara, & Malmström, 2014) .\n\n Changes of IgG glycosylation in the IgG were\
    \ also thought to be involved in rheumatoid arthritis (Parekh et al., 1985) ,\
    \ but recent studies showed that the glycosylation loci are not associated with\
    \ rheumatoid arthritis (Yarwood et al., 2016) .\n\n Other modifications include\
    \ oxidized IgG that are recognized by circulating lymphocytes leading to a proliferative\
    \ response and secrete IL-2 (Grinnell, Yoshida, & Jasin, 2005) . IgG is also covalently\
    \ cross linked by reactive oxygen and nitric oxide products secreted by inflammatory\
    \ cells (Uesugi, Hayashi, & Jasin, 1998) .\n\n IgG has long been implicated in\
    \ the pathogenesis of rheumatoid arthritis. When immune complexes from synovial\
    \ fluids of patients with rheumatoid arthritis were analyzed for their constituents,\
    \ mainly IgG and IgM antibodies were found (Male & Roitt, 1981) . They did not\
    \ contain antibodies with rheumatoid factor specificity and a structural alteration\
    \ of the IgG was considered as a cause for antigenicity (Carter, Makh, Ponsford,\
    \ & Elson, 1989) . Sutton, Corper, Bonagura, and Taussig (2000) suggested that\
    \ rheumatoid factors bind Fc-region and foreign antigen antigens simultaneously\
    \ and the affinity is potentiated by somatic mutation. Indeed, Fc-binding antibodies\
    \ from rheumatoid arthritis synovial fluids show imprints of an antigen-dependent\
    \ process of somatic hypermutation and clonal selection in the variable regions\
    \ of the L-and H-chains (Van Esch et al., 2003) . It is clear that the synovium\
    \ of patients with rheumatoid arthritis is prone to mutations (Firestein, 2010)\
    \ and several multi-evidence genes in genome wide studies have been identified\
    \ (Whitaker et al., 2015) ."
  - "23 In cases of splenic B-cell lymphomas that do not fulfill the World Health\
    \ Organization 2008 criteria for better established or provisional entities, a\
    \ diagnosis of splenic B-cell lymphoma/leukemia unclassifiable should be preferred.\n\
    \n Differentiating SMZL from lymphoplasmacytic lymphoma (LPL) may be challenging,\
    \ particularly on BM biopsy, because SMZL may show a monoclonal serum component\
    \ and plasmacytic morphology, and both entities lack a distinct phenotype. LPL,\
    \ which develops primarily in the spleen, homogeneously infiltrates the white\
    \ pulp without MZ pattern and without monocytoid B cells. MYD88 L265P mutation,\
    \ present in almost all cases of LPL and rare in SMZL, may be a useful diagnostic\
    \ tool. 25 A further diagnostic pitfall may be represented by detection of a BM\
    \ clonal infiltrate in cases of non-CLL monoclonal B lymphocytosis. 26 Finally,\
    \ secondary splenic localization of EMZL presents a pattern that overlaps with\
    \ that of SMZL, but clinical dissemination is crucial for differentiation. Splenic\
    \ involvement virtually excludes a diagnosis of nodal MZL; apart from the differential\
    \ expression of IRTA1, which is negative in SMZL, 11, 22 clinical correlation\
    \ is critical for reaching a correct diagnosis when dealing with a BM biopsy.\n\
    \n The cellular origin of SMZL is still debated, and its identification is essential\
    \ to correctly classify this lymphoma and to elucidate its pathobiology. According\
    \ to the World Health Organization classification, the postulated normal counterpart\
    \ of SMZL is a B cell of unknown differentiation stage. 11 According to studies\
    \ of Ig gene rearrangements, a derivation from antigen-experienced B cells has\
    \ been postulated in the \n\n -, ,25% of cases; -/1, 25%-50% of cases; 1/-, 50%-75%\
    \ of cases; 1, .75% of cases.\n\n FL, follicular lymphoma; NMZL, nodal marginal\
    \ zone lymphoma; SDRPL, splenic diffuse red pulp lymphoma.\n\n *Sporadic cases\
    \ reported.\n\n vast majority of SMZL. [27] [28] [29] Skewing of the Ig gene repertoire\
    \ toward the use of the IGHV1-2*04 allele in SMZL suggests that they could derive\
    \ from a progenitor population adapted in the spleen to particular antigenic challenges,\
    \ although definitive answers on the issue of the cell of origin of SMZL will\
    \ admittedly be provided only through multidisciplinary examination of the immune\
    \ repertoire and transcriptome of normal B-cell populations of the spleen compartments.\n\
    \n The contribution of antigen stimulation to SMZL pathogenesis is suggested by\
    \ the highly restricted Ig gene repertoire, including stereotyped configuration\
    \ of the B-cell receptor (BCR) in ;10% of cases 30 and selective usage of the\
    \ Ig heavy chain variable IGHV1-2*04 allele in ;30%.\n\n 31 Although the epitope\
    \ recognized by IGHV1-2*04-expressing BCR is unknown, the features of IGHV1-2*04\
    \ rearrangements, including minimal somatic mutations and the long complementarity-determining\
    \ region 3 sequence with common motifs, suggest a possible selection of T-cell-independent\
    \ MZ B cells by superantigens and thus a role of antigenic drive in lymphomagenesis.\n\
    \n Cytogenetic and genetic lesions SMZL lacks recurrent chromosomal translocations,\
    \ including translocations that are typical of other lymphoma types such as the\
    \ t(14;18) translocation affecting BCL2 in follicular lymphoma, the t(11;14) translocation\
    \ affecting CCND1 in MCL, and the t(11;18), t(14;18), and t(1;14) translocations\
    \ affecting the BIRC3/MALT1, MALT1, and BCL10 genes, respectively, in EMZL. The\
    \ lack of these abnormalities may help distinguish SMZL from pathologically mimicking\
    \ tumors. Approximately 30% of SMZL show hemizygous 7q deletion, which is also\
    \ frequently seen in splenic B-cell lymphoma/leukemia unclassifiable, but rarely\
    \ in other lymphoma subtypes.\n\n 32,33 The gene(s) targeted by the 7q deletion\
    \ remain obscure despite the combined investigation of genomic and transcriptomic\
    \ profiles and mutation analysis of a number of candidate genes.\n\n Unbiased\
    \ genomic studies have unraveled the typical coding genome of SMZL. [37] [38]\
    \ [39] [40] [41] [42] [43] However, because of the limited number of SMZL genomes\
    \ and/or exomes available so far, the full spectrum of lesions that contribute\
    \ to the malignant transformation of SMZL remains unknown."
  - "We also asked whether current trends are advancing according to earlier expectations\
    \ [6] .\n\n Our study has several limitations. Our projections are based on the\
    \ historical growth trajectory of joint replacement surgeries, and do not take\
    \ into account potential limitations in the availability of surgeons or limited\
    \ economic resources by private and public payers and hospitals in the future.\
    \ For example, a shortage in the number of surgeons will have a substantial influence\
    \ on the actual number of procedures that are performed. We also have not incorporated\
    \ the potential for future alternative technologies, such as cartilage regeneration\
    \ or tissue engineering, or drug therapies that limit the progression of joint\
    \ diseases, which may preempt the need for TJR. We were also unable to account\
    \ for the potential impact of changes in economy, which may place additional economic\
    \ burden on patients to pay substantial out-of pocket expenses for these procedures,\
    \ depending on their insurance coverage. Our study also did not consider potential\
    \ changes in healthcare policies, such as adoption of volume standards or regionalization\
    \ of TJR to high volume centers [5] , which could limit the access to care and\
    \ decrease the future demand. The above economic, policy, and scientific factors\
    \ cannot be readily incorporated in the statistical model. Our study was also\
    \ focused on the procedural trends in the U.S.; followup research may include\
    \ an analysis of trends in other countries, though the availability of historical\
    \ TJR trends in other countries may be limited. Nonetheless, these limitations\
    \ in no way diminish the importance of conducting and regularly updating surgical\
    \ projections to help guide future research, surgeon training, and public health\
    \ policy decisions. Our study also incorporated a more conservative projection,\
    \ which relied only on the future changes in population growth, while maintaining\
    \ current rates of adoption of TJR. Despite these limitations, our current findings\
    \ are expected to have implications in the private coverage and reimbursement\
    \ of joint replacement procedures in the future, as patients less than 65 years\
    \ of age are not typically covered by Medicare, which today funds the majority\
    \ of total joint replacement procedures in the United States.\n\n We found the\
    \ relative size of the young patient population for TJR has grown between 1993\
    \ and 2006. While 25% to 32% of primary or revision TJRs were performed in patients\
    \ less than 65 years old in 1993, these proportions have increased to 40% to 46%\
    \ in the most recent NIS data. The increasing trend in younger patients undergoing\
    \ TJR has also been reported for different, but partly overlapping, historical\
    \ periods. For example, Jain et al. reported that the proportion of primary TKA\
    \ patients aged less than 60 years increased from 12.5% to 19.5% (+56%) between\
    \ 1990-1993 and 1998-2000 [4] . In addition, for patients aged under 70 years,\
    \ the proportion increased by 9% from 45.6% to 49.6%. Due to the difference in\
    \ the stratification by age categories, we were unable to make a direct comparison\
    \ with the data by Jain et al. [4] . However, our findings that the historical\
    \ volume of TJR procedures in the younger patient population have been increasing\
    \ is consistent with these previously reported trends.\n\n While we previously\
    \ forecasted an increase in demand for primary hip and knee replacement in 2030\
    \ by 174% and 673% [6] , respectively, the current study underscores the contribution\
    \ that young patients are expected to play in the Fig. 2A -B Historical incidence\
    \ of primary total hip arthroplasty (A) and primary total knee arthroplasty (B)\
    \ from 1993-2006, superimposed with previous projections [6] , and the updated\
    \ projections from the current study. The dotted lines represent the 95% CI for\
    \ the projections.\n\n future utilization of primary TJR surgery, if historical\
    \ trends in prevalence continue into the future. The statistical modeling approach\
    \ we have employed in the current and previous study fits a multivariate but linear\
    \ Poisson regression model to the historical prevalence of TJR procedures. However,\
    \ because the size of the population subgroups is free to change nonlinearly in\
    \ the future based on the Census Bureau's projection, the actual projected incidence\
    \ of surgical demand is therefore not constrained to be a linear function over\
    \ time. The demand for primary hip and knee arthroplasty between 2004 and 2006\
    \ generally exceeded our previous projections, which employed an identical methodology.\
    \ However, we are unable to judge, based on the limited window of new data for\
    \ validation, whether a more complex modeling approach would provide a more reliable\
    \ forecast of demand for surgical procedures.\n\n Our previous methodology provided\
    \ a reasonable shortterm forecast of the demand for revision hip and knee surgeries\
    \ between 2004 and 2006. In particular, for 2006, we observed a slight decrease\
    \ in the estimated number of primary THA and TKA procedures compared to 2005 (Fig.\
    \ 2 ), but this decrease fell within the uncertainty of the estimates."
datasets:
- tomaarsen/miriad-4.4M-split
pipeline_tag: sentence-similarity
library_name: sentence-transformers
metrics:
- cosine_accuracy@1
- cosine_accuracy@3
- cosine_accuracy@5
- cosine_accuracy@10
- cosine_precision@1
- cosine_precision@3
- cosine_precision@5
- cosine_precision@10
- cosine_recall@1
- cosine_recall@3
- cosine_recall@5
- cosine_recall@10
- cosine_ndcg@10
- cosine_mrr@10
- cosine_map@100
model-index:
- name: EmbeddingGemma-300m trained on the Medical Instruction and RetrIeval Dataset
    (MIRIAD)
  results:
  - task:
      type: information-retrieval
      name: Information Retrieval
    dataset:
      name: miriad eval 1kq 31kd
      type: miriad-eval-1kq-31kd
    metrics:
    - type: cosine_accuracy@1
      value: 0.822
      name: Cosine Accuracy@1
    - type: cosine_accuracy@3
      value: 0.926
      name: Cosine Accuracy@3
    - type: cosine_accuracy@5
      value: 0.945
      name: Cosine Accuracy@5
    - type: cosine_accuracy@10
      value: 0.976
      name: Cosine Accuracy@10
    - type: cosine_precision@1
      value: 0.822
      name: Cosine Precision@1
    - type: cosine_precision@3
      value: 0.30866666666666664
      name: Cosine Precision@3
    - type: cosine_precision@5
      value: 0.18900000000000003
      name: Cosine Precision@5
    - type: cosine_precision@10
      value: 0.0976
      name: Cosine Precision@10
    - type: cosine_recall@1
      value: 0.822
      name: Cosine Recall@1
    - type: cosine_recall@3
      value: 0.926
      name: Cosine Recall@3
    - type: cosine_recall@5
      value: 0.945
      name: Cosine Recall@5
    - type: cosine_recall@10
      value: 0.976
      name: Cosine Recall@10
    - type: cosine_ndcg@10
      value: 0.9026163565413016
      name: Cosine Ndcg@10
    - type: cosine_mrr@10
      value: 0.8787773809523813
      name: Cosine Mrr@10
    - type: cosine_map@100
      value: 0.8797433274658335
      name: Cosine Map@100
  - task:
      type: information-retrieval
      name: Information Retrieval
    dataset:
      name: miriad test 1kq 31kd
      type: miriad-test-1kq-31kd
    metrics:
    - type: cosine_accuracy@1
      value: 0.802
      name: Cosine Accuracy@1
    - type: cosine_accuracy@3
      value: 0.907
      name: Cosine Accuracy@3
    - type: cosine_accuracy@5
      value: 0.942
      name: Cosine Accuracy@5
    - type: cosine_accuracy@10
      value: 0.963
      name: Cosine Accuracy@10
    - type: cosine_precision@1
      value: 0.802
      name: Cosine Precision@1
    - type: cosine_precision@3
      value: 0.30233333333333323
      name: Cosine Precision@3
    - type: cosine_precision@5
      value: 0.18840000000000004
      name: Cosine Precision@5
    - type: cosine_precision@10
      value: 0.09630000000000001
      name: Cosine Precision@10
    - type: cosine_recall@1
      value: 0.802
      name: Cosine Recall@1
    - type: cosine_recall@3
      value: 0.907
      name: Cosine Recall@3
    - type: cosine_recall@5
      value: 0.942
      name: Cosine Recall@5
    - type: cosine_recall@10
      value: 0.963
      name: Cosine Recall@10
    - type: cosine_ndcg@10
      value: 0.886217623753175
      name: Cosine Ndcg@10
    - type: cosine_mrr@10
      value: 0.8611063492063495
      name: Cosine Mrr@10
    - type: cosine_map@100
      value: 0.862951336054453
      name: Cosine Map@100
---

# dontia/embeddinggemma-300m-medical-Q8_0-GGUF
This model was converted to GGUF format from [`sentence-transformers/embeddinggemma-300m-medical`](https://huggingface.co/sentence-transformers/embeddinggemma-300m-medical) using llama.cpp via the ggml.ai's [GGUF-my-repo](https://huggingface.co/spaces/ggml-org/gguf-my-repo) space.
Refer to the [original model card](https://huggingface.co/sentence-transformers/embeddinggemma-300m-medical) for more details on the model.

## Use with llama.cpp
Install llama.cpp through brew (works on Mac and Linux)

```bash
brew install llama.cpp

```
Invoke the llama.cpp server or the CLI.

### CLI:
```bash
llama-cli --hf-repo dontia/embeddinggemma-300m-medical-Q8_0-GGUF --hf-file embeddinggemma-300m-medical-q8_0.gguf -p "The meaning to life and the universe is"
```

### Server:
```bash
llama-server --hf-repo dontia/embeddinggemma-300m-medical-Q8_0-GGUF --hf-file embeddinggemma-300m-medical-q8_0.gguf -c 2048
```

Note: You can also use this checkpoint directly through the [usage steps](https://github.com/ggerganov/llama.cpp?tab=readme-ov-file#usage) listed in the Llama.cpp repo as well.

Step 1: Clone llama.cpp from GitHub.
```
git clone https://github.com/ggerganov/llama.cpp
```

Step 2: Move into the llama.cpp folder and build it with `LLAMA_CURL=1` flag along with other hardware-specific flags (for ex: LLAMA_CUDA=1 for Nvidia GPUs on Linux).
```
cd llama.cpp && LLAMA_CURL=1 make
```

Step 3: Run inference through the main binary.
```
./llama-cli --hf-repo dontia/embeddinggemma-300m-medical-Q8_0-GGUF --hf-file embeddinggemma-300m-medical-q8_0.gguf -p "The meaning to life and the universe is"
```
or 
```
./llama-server --hf-repo dontia/embeddinggemma-300m-medical-Q8_0-GGUF --hf-file embeddinggemma-300m-medical-q8_0.gguf -c 2048
```