sentence-transformers How to use sentence-transformers/embeddinggemma-300m-medical with sentence-transformers:
from sentence_transformers import SentenceTransformer
model = SentenceTransformer("sentence-transformers/embeddinggemma-300m-medical")
sentences = [
"What are the potential effects of stopping inhaled corticosteroid (ICS) therapy in patients with chronic obstructive pulmonary disease (COPD)?\n",
"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/"
]
embeddings = model.encode(sentences)
similarities = model.similarity(embeddings, embeddings)
print(similarities.shape)
# [4, 4] 
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