Miracle-dz/UniFAR-FTUs huggingface dataset:
The Referral System between Primary and Secondary Health Care in Saudi Arabia for Patients with Type 2 Diabetes: A Systematic Review

Background In Saudi Arabia, the mortality of diabetes is currently reported at 6%. A well-administered referral system is crucial in aiding the management of this disease. Method A single reviewer employed a systematic approach to searching the literature databases with regard to the question: what are the attributes of referral systems in Saudi Arabia for patients with type 2 diabetes (T2D)? The results were analysed in order to provide recommendations to improve the Saudi health system. Results Twelve primary studies were identified from a systematic search. Overall, the 12 studies did not clearly mention any of the factors of a good referral system. The referral problems identified by this study included patients' unnecessary requests for referral, unstructured referral letters, and unclear dissemination guidelines for referral. Conclusions This research attempted to identify the efficiency of the referral processes that were implemented for patients with T2D. The majority of the included studies were completely silent on the main referral factors for patients. If this review is representative of the referral system in Saudi Arabia, then, in the context of T2D, current referrals are unsafe. Further research on the quality of the referral system, taking into account at least some of the WHO referral guidelines, is required.
Gene expression profile of peripheral blood in colorectal cancer.

AIM Optimal molecular markers for detecting colorectal cancer (CRC) in a blood-based assay were evaluated. METHODS A matched (by variables of age and sex) case-control design (111 CRC and 227 non-cancer samples) was applied. Total RNAs isolated from the 338 blood samples were reverse-transcribed, and the relative transcript levels of candidate genes were analyzed. The training set was made of 162 random samples of the total 338 samples. A logistic regression analysis was performed, and odds ratios for each gene were determined between CRC and non-cancer. The samples (n = 176) in the testing set were used to validate the logistic model, and an inferred performance (generality) was verified. By pooling 12 public microarray datasets(GSE 4107, 4183, 8671, 9348, 10961, 13067, 13294, 13471, 14333, 15960, 17538, and 18105), which included 519 cases of adenocarcinoma and 88 controls of normal mucosa, we were able to verify the selected genes from logistic models and estimate their external generality. RESULTS The logistic regression analysis resulted in the selection of five significant genes (P < 0.05; MDM2, DUSP6, CPEB4, MMD, and EIF2S3), with odds ratios of 2.978, 6.029, 3.776, 0.538 and 0.138, respectively. The five-gene model performed stably for the discrimination of CRC cases from controls in the training set, with accuracies ranging from 73.9% to 87.0%, a sensitivity of 95% and a specificity of 95%. In addition, a good performance in the test set was obtained using the discrimination model, providing 83.5% accuracy, 66.0% sensitivity, 92.0% specificity, a positive predictive value of 89.2% and a negative predictive value of 73.0%. Multivariate logistic regressions analyzed 12 pooled public microarray data sets as an external validation. Models that provided similar expected and observed event rates in subgroups were termed well calibrated. A model in which MDM2, DUSP6, CPEB4, MMD, and EIF2S3 were selected showed the result in logistic regression analysis (H-L P = 0.460, R2= 0.853, AUC = 0.978, accuracy = 0.949, specificity = 0.818 and sensitivity = 0.971). CONCLUSION A novel gene expression profile was associated with CRC and can potentially be applied to blood-based detection assays.
Effect of Sintering Temperature on the Hysteresis Properties of Barium Titanate Ceramic

In this work, barium titanate (BaTiO3 or BT) ceramic has been prepared by aconventional mixed oxide method with sintering temperature at 1250-1450 oC. The sampleswere characterized the phase formation by using X-ray diffraction analysis (XRD), thedensity by using Archimedes method, the microstructure by scanning electron microscope(SEM) and the hysteresis properties by using modified Sawer-Tower circuit. The hysteresisparameters such as saturation polarization (Ps), remanent polarization (Pr) and coercive field(Ec) were measured as a function of sintering temperatures. The results show that thesaturation polarization (Ps) increases with increasing sintering temperature, whereas theremanent polarization (Pr) and the coercive field (Ec) decrease, a characteristic of theenhanced ferroelectric interaction for BT ceramic.
Autonomous quantum thermal machine for generating steady-state entanglement

We discuss a simple quantum thermal machine for the generation of steady-state entanglement between two interacting qubits. The machine is autonomous in the sense that it uses only incoherent interactions with thermal baths, but no source of coherence or external control. By weakly coupling the qubits to thermal baths at different temperatures, inducing a heat current through the system, steady-state entanglement is generated far from thermal equilibrium. Finally, we discuss two possible implementations, using superconducting flux qubits or a semiconductor double quantum dot. Experimental prospects for steady-state entanglement are promising in both systems.
Shooting Alone: The Pre‐Attack Experiences and Behaviors of U.S. Solo Mass Murderers

This paper outlines the sociodemographic, developmental, antecedent attack, attack preparation, and commission properties of 115 mass murderers between 1990 and 2014. The results indicate that mass murderer attacks are usually the culmination of a complex mix of personal, political, and social drivers that crystalize at the same time to drive the individual down the path of violent action. We specifically focus upon areas related to prior criminal engagement, leakage, and attack location familiarity. Whether the violence comes to fruition is usually a combination of the availability and vulnerability of suitable targets that suit the heady mix of personal and political grievances and the individual's capability to engage in an attack from both a psychological and technical capability standpoint. Many individual cases share a mixture of unfortunate personal life circumstances coupled with an intensification of beliefs/grievances that later developed into the idea to engage in violence.
Early human symbolic behavior in the Late Pleistocene of Wallacea

Significance We present evidence from the Late Pleistocene of Sulawesi, Indonesia, where an unusually rich and unique symbolic complex was excavated from archaeological deposits spanning 30,000 to 22,000 y ago. Including previously unknown practices of self-ornamentation, used ochre, pigmented artifacts, and portable art, these findings advance our knowledge of the cultural repertoires of modern humans in Pleistocene Wallacea, including the nonparietal artworks and symbolic material culture of some of the world’s earliest known “cave artists. ” Wallacea, the zone of oceanic islands separating the continental regions of Southeast Asia and Australia, has yielded sparse evidence for the symbolic culture of early modern humans. Here we report evidence for symbolic activity 30,000–22,000 y ago at Leang Bulu Bettue, a cave and rock-shelter site on the Wallacean island of Sulawesi. We describe hitherto undocumented practices of personal ornamentation and portable art, alongside evidence for pigment processing and use in deposits that are the same age as dated rock art in the surrounding karst region. Previously, assemblages of multiple and diverse types of Pleistocene “symbolic” artifacts were entirely unknown from this region. The Leang Bulu Bettue assemblage provides insight into the complexity and diversification of modern human culture during a key period in the global dispersal of our species. It also shows that early inhabitants of Sulawesi fashioned ornaments from body parts of endemic animals, suggesting modern humans integrated exotic faunas and other novel resources into their symbolic world as they colonized the biogeographically unique regions southeast of continental Eurasia.
A head-to-head pharmacodynamic comparison of prasugrel vs. ticagrelor after switching from clopidogrel in patients with coronary artery disease: results of a prospective randomized study.

AIMS Pharmacodynamic (PD) studies comparing prasugrel and ticagrelor have reached inconsistent findings. Therefore, a comprehensive investigation comparing the PD effects of prasugrel vs. ticagrelor after switching from clopidogrel therapy, exploring both loading dose (LD) and maintenance dose (MD) regimens represented the aim of this study. METHODS AND RESULTS Patients (n = 110) with coronary artery disease were randomized to prasugrel (60 mg LD/10 mg MD q.d.) or ticagrelor (180 mg LD/90 mg MD b.i.d) therapy for 1 week. Pharmacodynamic assessments were conducted using three assays (vasodilator-stimulated phosphoprotein, VerifyNow P2Y12, and light transmittance aggregometry, LTA) at baseline, 30 min, 2, 24 h, and 1 week. The impact of initiating ticagrelor MD 12 vs. 24 h after LD administration was also assessed. Switching clopidogrel-treated patients to an LD of prasugrel or ticagrelor was associated with a reduction in platelet reactivity at 30 min and was sustained at all time points up to 1 week with the MD (P < 0.001 for all assays). Platelet reactivity was similar with prasugrel and ticagrelor with all assays at 30 min, 2 h, and 1 week (P > 0.05 for all time points), with the exception of LTA at 30 min (lower with prasugrel; P = 0.003). At 24 h, platelet reactivity was lower among patients initiating ticagrelor MD after 12 vs. 24 h post-LD. Rates of high platelet reactivity (HPR) were markedly reduced and similar between groups. CONCLUSION Prasugrel and ticagrelor exert similar levels of P2Y12 inhibition achieving more potent PD effects and reduced HPR rates compared with clopidogrel which are reached promptly following LD and sustained with MD. CLINICALTRIALSGOV IDENTIFIER NCT01852175.
The correlations of socioeconomic status, disease activity, quality of life, and depression/anxiety in Chinese patients with rheumatoid arthritis

Abstract This study aimed (i) to investigate the relationships among socioeconomic status, disease activity, quality of life, and the psychological status in Chinese rheumatoid arthritis (RA) patients; (ii) to explore the possible risk factors of anxiety and depression. A total of 160 RA patients underwent standardized laboratory examinations and completed several questionnaires. Independent samples t-tests, χ2 analyses, and logistic regression modeling were used to analyze the data. We found 30.6% RA patients were anxiety, and 27.5% had depression, which were significantly higher than the control group (7.8 and 11.7%, respectively). And there were significant correlations among education, pain, disease activity, medication adherence, functional capacity, quality of life, and anxiety/depression. Meanwhile, logistic regression analysis revealed that poor quality of life and low education level were significantly associated with anxiety/depression in RA patients. In conclusion, there were significant relationships among education, quality of life, and anxiety/depression in Chinese RA patients.
Cutting Edge: Protection by Antiviral Memory CD8 T Cells Requires Rapidly Produced Antigen in Large Amounts

Numerous attempts to produce antiviral vaccines by harnessing memory CD8 T cells have failed. A barrier to progress is that we do not know what makes an Ag a viable target of protective CD8 T cell memory. We found that in mice susceptible to lethal mousepox (the mouse homolog of human smallpox), a dendritic cell vaccine that induced memory CD8 T cells fully protected mice when the infecting virus produced Ag in large quantities and with rapid kinetics. Protection did not occur when the Ag was produced in low amounts, even with rapid kinetics, and protection was only partial when the Ag was produced in large quantities but with slow kinetics. Hence, the amount and timing of Ag expression appear to be key determinants of memory CD8 T cell antiviral protective immunity. These findings may have important implications for vaccine design.
Software Requirements Analyst Profile: A Descriptive Study of Brazil and Mexico

Software requirements analyst work is considered crucial in the software development lifecycle. This paper presents a descriptive study on the software requirements analyst profile, considering Brazilian and Mexican markets, two countries that lead IT investment ranking in Latin America. To identify the competences expected by the Brazilian and Mexican markets for software requirements professionals was the study objective. The competency model considers a set of knowledge, skills and attitudes. Content analysis and Nvivo software were used to categorize 311 job ads for software requirements analysts between 2016 and 2017. In terms of knowledge, the importance of higher education for both countries was identified. "Using techniques and tools," "methodological competence," "good written communication," and "good verbal communication" were identified as relevant skills. The most important attitudes identified were: "analytical thinking," "organization," "interpersonal relationship" and "information sharing. " Most of results obtained confirm requirements analyst skills pointed out by other authors, but there are some differences due to the geographic context. At the same time, findings can help improve the understanding of different approaches in the requirements engineering field in the two countries and professionals working particularly in the Latin American market.
Prenatal Exposure to Perfluoroalkyl Substances and Adiposity in Early and Mid-Childhood

Background: Few studies have examined whether prenatal exposure to perfluoroalkyl substances (PFASs) is associated with childhood adiposity. Objective: We examined associations of prenatal exposure to PFASs with adiposity in early and mid-childhood. Methods: We measured plasma PFAS concentrations in 1,645 pregnant women (median, 9.6 weeks gestation) enrolled in Project Viva, a prospective pre-birth cohort study in Massachusetts (USA), between 1999 and 2002. We assessed overall and central adiposity in 1,006 children in early childhood (median, 3.2 years) and 876 in mid-childhood (median, 7.7 years) using anthropometric and dual X-ray absorptiometry (DXA) measurements. We fitted multivariable linear regression models to estimate exposure-outcome associations and evaluated effect modification by child sex. Results: Median (25–75th percentiles) prenatal plasma perfluorooctanoate (PFOA), perfluorooctane sulfonate (PFOS), perfluorohexane sulfonate (PFHxS), and perfluorononanoate (PFNA) concentrations in children assessed in early childhood were 5.6 (4.1–7.7), 24.8 (18.4–33.9), 2.4 (1.6–3.8), and 0.6 (0.5–0.9) ng/mL, respectively. Among girls, each interquartile range increment of prenatal PFOA concentrations was associated with 0.21 kg/m2 (95% CI: –0.05, 0.48) higher body mass index, 0.76 mm (95% CI: –0.17, 1.70) higher sum of subscapular and triceps skinfold thickness, and 0.17 kg/m2 (95% CI: –0.02, 0.36) higher DXA total fat mass index in mid-childhood. Similar associations were observed for PFOS, PFHxS, and PFNA. We observed null associations for boys and early-childhood adiposity measures. Conclusions: In this cohort, prenatal exposure to PFASs was associated with small increases in adiposity measurements in mid-childhood, but only among girls. Citation: Mora AM, Oken E, Rifas-Shiman SL, Webster TF, Gillman MW, Calafat AM, Ye X, Sagiv SK. 2017. Prenatal exposure to perfluoroalkyl substances and adiposity in early and mid-childhood. Environ Health Perspect 125:467–473; http://dx.doi. org/10.1289/EHP246
Hemodilution and Endothelial Cell Regulation of Whole Blood Coagulation.

Background Beyond localized damage to the circulatory system and surrounding tissue, trauma stresses endothelial cells throughout the vasculature, potentially leading to hemorrhagic or thrombotic complications away from the injury site. Objective Use a whole blood endothelial cell model to define the effects of crystalloid fluid therapy on protein C pathway regulation of tissue factor-initiated coagulation. Methods Tissue factor-initiated coagulation was studied in the presence of EA.hy926 cells. Blood was diluted to 70% or 40% using normal saline or lactated ringers. Analyses of coagulation dynamics included clot times, thrombin formation (thrombin-antithrombin complex), FV activation/inactivation, fibrinogen consumption, FXIII activation, and platelet activation. Results In all donors, the onset of thrombin generation was not altered in 70% blood using either diluent; with the blood component reduced to 40%, clot time was prolonged two-fold when normal saline was utilized but was unchanged with lactated ringers. The timing of the activations of FV, fibrinogen, and platelets paralleled the effects of dilution on clot times. Extensive inactivation of FVa was observed in undiluted blood and where lactated ringers was the diluent but not in trials with 40% blood/60% normal saline. Conclusion Feedback inhibition of tissue factor-initiated coagulation by the protein C pathway is not compromised by hemodilution with crystalloids.
Maximizing CNN accelerator efficiency through resource partitioning

Convolutional neural networks (CNNs) are revolutionizing machine learning, but they present significant computational challenges. Recently, many FPGA-based accelerators have been proposed to improve the performance and efficiency of CNNs. Current approaches construct a single processor that computes the CNN layers one at a time; the processor is optimized to maximize the throughput at which the collection of layers is computed. However, this approach leads to inefficient designs because the same processor structure is used to compute CNN layers of radically varying dimensions. We present a new CNN accelerator paradigm and an accompanying automated design methodology that partitions the available FPGA resources into multiple processors, each of which is tailored for a different subset of the CNN convolutional layers. Using the same FPGA resources as a single large processor, multiple smaller specialized processors increase computational efficiency and lead to a higher overall throughput. Our design methodology achieves 3.8x higher throughput than the state-of-the-art approach on evaluating the popular AlexNet CNN on a Xilinx Virtex-7 FPGA. For the more recent SqueezeNet and GoogLeNet, the speedups are 2.2x and 2.0x.
The probable role of adrenomedullin and nitric oxide in childhood attention deficit hyperactivity disorder

Abstract Background: The role of adrenomedullin hormone, which has been shown to be associated with many psychiatric disorders, in the etiology of ADHD and its relation to disease is not yet known. Aim: In this study, it was aimed to compare plasma adrenomedullin and nitric oxide (NO) levels of newly diagnosed, treatment-naive patients with ADHD with healthy children. Methods: A total of 45 children with ADHD and 45 healthy children were included. The Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version (K-SADS), a semi-structured interview, was applied to all cases by child and adolescent psychiatrist. Age and gender matched participants who admitted to the hospital for any other reasons without any psychiatric diagnosis according to K-SADS were selected as a control group. Sociodemographic data form and The Turgay DSM-IV-Based Child and Adolescent Disruptive Behavioral Disorders Screening and Rating Scale-parental form were applied to the all groups. NO and adrenomedullin levels were analysed by ELISA method with specific commercial kits. Results: There was no statistically significant difference in NO and adrenomedullin levels, neither between the groups nor ADHD subtypes. A positive correlation between adrenomedullin and NO levels was found in both the case (r = 0.659) and the control groups (r = 0.494). Conclusions: Besides being the first study to evaluate adrenomedullin levels to elucidate the etiology of childhood ADHD as well as NO, significant differences was not found between the case and the control groups in terms of NO and adrenomedullin levels.
Evaluation of a modified rat model for functional dyspepsia

Background/Aim: The purpose of this study was to establish a modified rat model with functional dyspepsia (FD) and analyze the changes in gastrointestinal motility and brain-gut peptide levels in serum and brain-gut axis. Materials and Methods: Male Wistar rats were divided into control group (Con) and FD model group. FD model was established by stimulating semi-starvation rats via tail damping, provocation, and forced exercise fatigue until gastrointestinal motility disorder appeared, and then levels of motilin, leptin, cholecystokinin (CCK), and vasoactive intestinal peptide (VIP) were detected in serum by enzyme linked immunosorbent assay and in duodenum, antrum, and hypothalamus by immunohistochemistry, reverse transcriptase-polymerase chain reaction, and Western blot. Results: The results showed rates of intestinal propulsion and gastric emptying slowed down markedly compared to Con (P < 0.05), the gastrointestinal electric activity attenuated, and migrating motor complex (MMC) interrupted in the model group. The levels of leptin and VIP markedly increased, but motilin decreased as compared to the Con (P < 0.05) in serum and in the above tissues. It is interesting that the level of CCK decreased in the antrum and duodenum but increased in the hypothalamus as compared to Con (P < 0.05). Conclusions: The modified rat model meets the diagnostic criteria of FD and can be used as a method for studying FD in animals.
Large-System Analysis of Artificial-Noise-Assisted Communication in the Multiuser Downlink: Ergodic Secrecy Sum Rate and Optimal Power Allocation

Security and privacy have become increasingly critical demands in wireless networks, which, however, are particularly susceptible to eavesdropping attacks due to the broadcast nature of radio signals. This paper considers the problem of secure communication in the multiuser downlink with a passive eavesdropper (Eve), whose channel state information (CSI) is unavailable. The transmitter simultaneously transmits concurrent information signals to the users and artificial noise (AN) to Eve. We first assume that all users' CSI is perfectly known by the transmitter and derive a closed-form expression for the ergodic secrecy sum rate (SSR) in the large-system limit. We then use it as an objective function to optimize the power allocation between information signals and the AN. It shows that more power needs to be used for AN when Eve has more antennas and when the system serves fewer users. We also extend the analysis to the imperfect-CSI scenario, where the SSR saturates at high transmit power, and it is better to create more AN than to increase the signal strength when the channel estimation error is large. We derive a scale law of feedback bits (for frequency-division duplexing (FDD) systems) to maintain a constant rate offset compared with the perfect-CSI case and the optimal length of training sequence (for time-division duplexing (TDD) systems) to maximize the effective SSR. It shows that more feedback bits and longer training sequences are required to deal with the eavesdropping problem. Closed-form expressions derived in this paper can reduce the complexity of system analysis and design.