Miracle-dz/UniFAR-FTUs huggingface dataset:
Electronic Health Record Portals adoption: Empirical model based on UTAUT2

ABSTRACT Background: The future of healthcare delivery is becoming more citizen centered, as today’s user is more active and better informed. Governmental institutions are promoting the deployment and use of online services such as Electronic Health Record (EHR) portals. This makes the adoption of EHR portals an important field to study and understand. Objective: The aim of this study is to understand the factors that drive individuals to adopt EHR portals. Methods: This study applies the extended unified theory of acceptance and usage technology (UTAUT2) to explain patients’ individual adoption of EHR portals. An online questionnaire was administered. We collected 386 valid responses. Results: The statistically significant drivers of behavioral intention are performance expectancy (=0.17; p < 0.01), effort expectancy (=0.17; p < 0.01), social influence (=0.10; p < 0.05), and habit (=0.37; p < 0.001). Habit (=0.28; p < 0.001) and behavioral intention (=0.24; p < 0.001) are the statistically significant drivers of technology use. The model explains 52% of the variance in behavioral intention and 31% of the variance in technology use. Conclusions: By testing an information technology acceptance model, we are able to determine what is more valued by patients when it comes to deciding whether to adopt EHR portals or not.
Dexmedetomidine-Fentanyl versus Midazolam-Fentanyl in Pain Management of Distal Radius Fractures Reduction; a Randomized Clinical Trial

Introduction: Currently, using various combinations of narcotic and analgesic drugs has received attention for induction of sedation and analgesia due to their synergy in controlling pain and anxiety. The present study was designed with the aim of comparing dexmedetomidine-fentanyl combination with midazolam-fentanyl in this regard. Methods: In this randomized clinical trial, patients diagnosed with distal radius fracture who had visited the emergency department (ED) were allocated to either the group receiving the combination of fentanyl-midazolam or the one receiving dexmedetomidine-fentanyl for procedural sedation and analgesia (PSA) and were compared regarding analgesic characteristics, time to recovery and side effects. Results: 80 patients with the mean age of 42.08 ± 12.17 (18 - 60) years were randomly allocated to 2 groups of 40 (83.80% male). The 2 groups did not have a significant difference regarding baseline characteristics as well as pain severity. Mean pain score at the time of procedure was 3.47 ± 1.37 in dexmedetomidine and 2.85 ± 1.05 in midazolam group (p = 0.025). In addition, time to recovery in dexmedetomidine and midazolam groups was 6.60 ± 1.86 minutes and 12.70 ± 1.70 minutes, respectively (p < 0.001). Out of the 9 patients who experienced treatment failure, 8 (88.90%) patients were in dexmedetomidine group and 1 (11.10%) was in midazolam group (p = 0.029). Absolute risk increase rate of treatment failure in case of using dexmedetomidine instead of midazolam was 17.50% (95%CI: 4.19 – 30.81) and number needed to harm was 6.00 (95% CI: 3.20 – 23.80). Conclusion: Although the combination of dexmedetomidine-fentanyl had a shorter time to recovery compared to midazolam-fentanyl for induction of sedation and analgesia, the treatment failure rate in case of using dexmedetomidine with 1 µg/kg increased 17.5% and about 1 out of each 6 patients needed a rescue dose.
A fully electronically controllable Schmitt trigger and duty cycle‐modulated waveform generator

The paper introduces a new Schmitt trigger consisting of only one multiple‐output current inverting differential input transconductance amplifier with no passive element. The proposed circuit is simple and usable up to 100 MHz with the advantage of electronically controlled threshold levels and amplitude of the output. The circuit is also little sensitive to temperature and benefits from low power dissipation (0.5 mW). The amplitude of the output current is tunable electronically from 5 nA to 500 μA, which is a wide tunable range. The effects of transistors mismatch on proposed Schmitt trigger have also been explored. The utility of the proposed circuit is further justified through its application as a triangular/square wave generator, with a maximum frequency of 75 MHz. Duty cycle modulation through electronic means is also shown for the generator circuit, where duty cycle results for 80, 20, and 95% have been included, by varying external control current. The cadence VIRTUOSO simulation results by using generic process design kit 90‐nm technology are shown to confirm the proposed theory. The proposed circuits are also verified through experimental results by using commercial integrated circuits: AD844 and LM13700. All the simulated and experimental results promise potential applications of the proposed circuits in instrumentation and communication systems. Copyright © 2017 John Wiley & Sons, Ltd.
Inter-Rater Reliability: Dependency on Trait Prevalence and Marginal Homogeneity

Researchershavecriticizedchance-correctedagreementstatistics,particularly theKappastatistic,asbeingverysensitivetoraters'classiflcationprobabilities(marginal probabilities) and to trait prevalence in the subject population. Consequently, several authorshavesuggestedthatmarginalprobabilitiesbetestedforhomogeneityandthatany comparison between reliability studies be preceded by an assessment of trait prevalence amongsubjects.Theobjectiveofthispaperisthreefold:(i)todemonstratethatmarginal homogeneitytestingdoesnotpreventtheunpredictableresultsoftenobtainedwithsome ofthemostpopularagreementstatistics,(ii)topresentasimpleandreliableinter-rater agreement statistic, and (iii) to gain further insight into the dependency of agreement statistics upon trait prevalence.
Simeprevir plus sofosbuvir in patients with chronic hepatitis C virus genotype 1 infection and cirrhosis: A phase 3 study (OPTIMIST‐2)

Hepatitis C virus (HCV)–infected patients with cirrhosis are historically a difficult‐to‐treat population and are at risk of hepatic decompensation. In the phase 2 COSMOS study that evaluated simeprevir (HCV NS3/4A protease inhibitor) + sofosbuvir (HCV nucleotide analogue NS5B polymerase inhibitor) ± ribavirin for 12 or 24 weeks in HCV genotype (GT)1–infected patients, high rates of sustained virologic response 12 weeks after planned end of treatment (SVR12) were achieved, including in patients with cirrhosis (METAVIR score F4). This phase 3, open‐label, single‐arm study (OPTIMIST‐2 [NCT02114151]) evaluated the efficacy and safety of 12 weeks of simeprevir + sofosbuvir in HCV GT1–infected treatment‐naive or treatment‐experienced patients with cirrhosis. Patients (aged 18‐70 years) with chronic HCV GT1 infection and documented presence of cirrhosis received oral simeprevir 150 mg once daily + sofosbuvir 400 mg once daily for 12 weeks. The primary efficacy endpoint of the study was the proportion of patients achieving SVR12 versus a composite historical control (SVR12 rate of 70%). Safety and patient‐reported outcomes were assessed. Overall, 103 patients received treatment. SVR12 with simeprevir + sofosbuvir (83%, 95% confidence interval 76%‐91%) met the primary objective of superiority versus the historical control (70%). SVR12 rates for treatment‐naive and treatment‐experienced patients were 88% (44/50) and 79% (42/53), respectively. Adverse events occurred in 72 (70%) patients, with most (64%) being grade 1 or 2. Serious adverse events (none considered related to study treatment) occurred in five (5%) patients, and three (3%) patients discontinued all study treatment due to adverse events. Patient‐reported outcomes improved from baseline to follow‐up week 12. Conclusion: Simeprevir + sofosbuvir for 12 weeks achieved superiority in SVR12 rates versus the historical control in treatment‐naive and treatment‐experienced HCV GT1‐infected patients with cirrhosis and was generally safe and well tolerated. (Hepatology 2016;64:360‐369)
Micro‐ribonucleic acid‐binding site variants of type 2 diabetes candidate loci predispose to gestational diabetes mellitus in Chinese Han women

Emerging evidence has suggested that the genetic background of gestational diabetes mellitus (GDM) was analogous to type 2 diabetes mellitus. In contrast to type 2 diabetes mellitus, the genetic studies for GDM were limited. Accordingly, the aim of the present study was to extensively explore the influence of micro‐ribonucleic acid‐binding single‐nucleotide polymorphisms (SNPs) in type 2 diabetes mellitus candidate loci on GDM susceptibility in Chinese.
The Power of Exclusion using Automated Osteometric Sorting: Pair‐Matching ,

This study compares the original pair‐matching osteometric sorting model (J Forensic Sci 2003;48:717) against two new models providing validation and performance testing across three samples. The samples include the Forensic Data Bank, USS Oklahoma, and the osteometric sorting reference used within the Defense POW/MIA Accounting Agency. A computer science solution to generating dynamic statistical models across a commingled assemblage is presented. The issue of normality is investigated showing the relative robustness against non‐normality and a data transformation to control for normality. A case study is provided showing the relative exclusion power of all three models from an active commingled case within the Defense POW/MIA Accounting Agency. In total, 14,357,220 osteometric t‐tests were conducted. The results indicate that osteometric sorting performs as expected despite reference samples deviating from normality. The two new models outperform the original, and one of those is recommended to supersede the original for future osteometric sorting work.
Caenorhabditis elegans aristaless/Arx gene alr-1 restricts variable gene expression

Variable expressivity of mutant phenotypes in genetically identical individuals is a phenomenon widely reported but poorly understood. For example, mutations in the gene encoding the transcription factor ALR-1 in Caenorhabditis elegans result in variable touch receptor neuron (TRN) function. Using single-molecule in situ hybridization, we demonstrate that this phenotypic variability reflects enhanced variability in the expression of the selector gene mec-3, which is needed, together with unc-86, for the differentiation of the TRNs. In a yeast expression system, ALR-1 enhances MEC-3/UNC-86–dependent transcription from the mec-3 promoter, showing that ALR-1 can enhance bulk mec-3 expression. We show that, due to stochastic fluctuations, autoregulation of mec-3 is not sufficient for TRN differentiation; ALR-1 provides a second positive feedback loop that increases mec-3 expression, by restricting variability, and thus ensures TRN differentiation. Our results link fluctuations in gene expression to phenotypic variability, which is seen in many mutant strains, and provide an explicit demonstration of how variable gene expression can be curtailed in developing cells to ensure their differentiation. Because ALR-1 and similar proteins (Drosophila Aristaless and human ARX) are needed for the expression of other transcription factors, we propose that proteins in this family may act to ensure differentiation more generally.
Arsenic and Obesity: A Comparison of Urine Dilution Adjustment Methods

Introduction: A commonly used approach to adjust for urine dilution in analyses of biomarkers is to adjust for urinary creatinine. However, creatinine is a product of muscle mass and is therefore associated with body mass. In studies of urinary analytes and obesity or obesity-related outcomes, controlling for creatinine could induce collider stratification bias. We illustrate this phenomenon with an analysis of urinary arsenic. Objective: We aimed to evaluate various approaches of adjustment for urinary dilution on the associations between urinary arsenic concentration and measures of obesity. Methods: Using data from the National Health and Nutrition Examination Survey, we regressed body mass index (BMI) and waist-to-height ratios on urinary arsenic concentrations. We compared eight approaches to account for urine dilution, including standardization by urinary creatinine, osmolality, and flow rates, and inclusion of these metrics as independent covariates. We also used a recently proposed method known as covariate-adjusted standardization. Results: Inverse associations between urinary arsenic concentration with BMI and waist-to-height ratio were observed when either creatinine or osmolality were used to standardize or as covariates. Not adjusting for dilution, standardizing or adjusting for urinary flow rate, and using covariate-adjusted standardization resulted in null associations observed between arsenic concentration in relation to BMI and waist-to-height ratio. Conclusions: Our findings suggest that arsenic exposure is not associated with obesity, and that urinary creatinine and osmolality may be colliders on the causal pathway from arsenic exposure to obesity, as common descendants of hydration and body composition. In studies of urinary biomarkers and obesity or obesity-related outcomes, alternative metrics such as urinary flow rate or analytic strategies such as covariate-adjusted standardization should be considered. https://doi.org/10.1289/EHP1202
Choline/methionine nutrition of starting broiler chicks. Three models for estimating the choline requirement with economic considerations.

Experiments were conducted to test the hypothesis that metabolically labile methyl groups and not methionine per se are limiting the growth of starting broiler chicks fed corn-soy-grease diets formulated to meet NRC (1977) recommendations (except for methionine). The basal diet contained approximately 23% protein, 3200 kcal ME/kg. 32% methionine, . 42% cystine, and 1300 ppm choline. In the first two experiments the diets were fed to quadruplicate lots of 10 chicks in battery brooders. Average weight gain (g) and feed per unit gain for supplements of methyl group sources were: 1) methionine: 424, 1.48; 2) choline Cl: 406, 1.49; and 3) betaine HCl: 416, 1.48. These values were not significantly different from one another (P greater than .05) but were significantly different (P less than .05) from the values for the basal (362, 1.57) and from the DL-homocystine supplemented groups (376, 1.56). This indicated that methyl group utilization was not impaired by a lack of the carbon skeleton of methionine. Five 3-week assays with five groups of 10 chicks per treatment (1050 chicks) were conducted to determine the choline requirement using the basal diet without supplemental methionine. Results from the five assays were pooled in computing regressions. Significant regressions (P less than .05) were found for broken-line linear (R2 = .630), quadratic (R2 = .556), and saturation kinetic (R2 = .642) models. The requirement was determined to approximately 2130 ppm by the broken-line linear model. The most economic feeding levels were estimated to be 4100 and 1910 ppm by the quadratic and saturation kinetic models, respectively. The economic implications of the three models are discussed.
Bioavailability of amino acids in plant feedstuffs determined by in vitro digestion, chick growth assay, and true amino acid availability methods.

An in vitro, pepsin-pancreatin digestibility method was used to estimate the bioavailabilities of amino acids in plant feedstuffs, including two cultivars of four cereal grains and three high-protein feedstuffs. As a technique for separating hydrolytic products from substrate, trichloroacetic acid (TCA) was compared with three ultrafiltration techniques. Solutions were filtered continuously by a membrane of 500-Dalton pore size (cUF) and terminally by membranes of 500 Dalton (tUF) and 10,000 Dalton (CX). Additionally, bioavailability of amino acids was determined in vivo by the true amino acid availability (TAAA) method and utilization of lysine was determined by chick growth assay (CGA). Correlations of in vitro and in vivo estimates of availabilities were ranked CX = cUF greater than tUF greater than TCA for total amino acids and were ranked similarly for most individual amino acids. When determined using the superior technique, correlation between in vitro digestibilities of amino acids and TAAA were moderately high for the combined cereal grains (r = .92), were lower when data included wheat middlings (r = .90), but were unreliable when data included soybean meal and corn gluten meal (r = .29). Prediction of CGA values from in vitro digestibility was less reliable (r = .42) than that using TAAA values. There was agreement between values for lysine availability when determined for six grain samples by CGA and TAAA (r = .79). Evaluation from the correlations of the in vitro with the in vivo estimates of availabilities indicated that terminal filtration by a membrane of medium pore size (10,000 Dalton) or continuous filtration by a membrane of very low pore size (500 Dalton) made separations superior to those of terminal filtration (500 Dalton) and TCA precipitation.
The potential impact of prophylactic human papillomavirus vaccination on oropharyngeal cancer

The incidence of oropharyngeal cancer (OPC) is significantly increasing in the United States. Given that these epidemiologic trends are driven by human papillomavirus (HPV), the potential impact of prophylactic HPV vaccines on the prevention of OPC is of interest. The primary evidence supporting the approval of current prophylactic HPV vaccines is from large phase 3 clinical trials focused on the prevention of genital disease (cervical and anal cancer, as well as genital warts). These trials reported vaccine efficacy rates of 89% to 98% for the prevention of both premalignant lesions and persistent genital infections. However, these trials were designed before the etiologic relationship between HPV and OPC was established. There are differences in the epidemiology of oral and genital HPV infection, such as differences in age and sex distributions, which suggest that the vaccine efficacy observed in genital cancers may not be directly translatable to the cancers of the oropharynx. Evaluation of vaccine efficacy is challenging in the oropharynx because no premalignant lesion analogous to cervical intraepithelial neoplasia in cervical cancer has yet been identified. To truly investigate the efficacy of these vaccines in the oropharynx, additional clinical trials with feasible endpoints are needed. Cancer 2016;122:2313–2323. © 2016 American Cancer Society.
Effect of Addition of TaC on Properties of Ti_3SiC_2 Ceramics

The material of 20%(mass fraction,same below)TaC/Ti3SiC2 was prepared by reactive hot pressing method.The phase constituent,mechanical properties and oxidation resistance were investigated.The results showed that:(1) The densification,flexural strength and fracture toughness of 20%TaC/Ti3SiC2 increase with the increase of hot pressing temperature;(2) The oxidation resistance of 20% TaC/Ti3SiC2 is much higher than that of monolithic Ti3SiC2 and 20% SiC/Ti3SiC2 composites;(3) The oxidized layers of TaC/Ti3SiC2 are composed of two layers.The outer layer is TiO2.And the inner layer is the mixture of TiO2,SiO2 and the eutectoid of TiO2 and Ta2O5.
Low-Level Endogenous PSMA Expression in Nonprostatic Tumor Xenografts Is Sufficient for In Vivo Tumor Targeting and Imaging

Prostate-specific membrane antigen (PSMA) is highly expressed in prostate cancer and within the neovasculature of other solid tumors. The nonprostatic expression of PSMA has been reported exclusively within the neovasculature endothelial cells of nonprostatic cancers; however, there are few reports on PSMA expression in epithelial cells. Herein, we describe PSMA expression in nonprostatic epithelial cells and characterize the potential of PSMA-binding agents to noninvasively detect that expression. Methods: PSMA expression data were extracted from publicly available genomic databases. Genomic data were experimentally validated for PSMA expression—by quantitative reverse transcription polymerase chain reaction, flow cytometry, and Western blotting—in several nonprostatic cell lines and xenografts of melanoma and small cell lung cancer (SCLC) origin. The feasibility of PSMA detection in those tumor models was further established using PSMA-based nuclear and optical imaging agents and by biodistribution, blocking, and ex vivo molecular characterization studies. Results: We discovered that a small percentage of nonprostatic cancer cell lines and tumors express PSMA. Importantly, PSMA expression was sufficiently high to image established melanoma and SCLC xenografts using PSMA-based nuclear and optical imaging agents. Conclusion: These results indicate that PSMA expression in nonprostatic tumors may not be limited to the endothelium but may also include solid tumor tissue of nonprostatic cancers including melanoma and SCLC. Our observations indicate broader applicability of PSMA-targeted imaging and therapeutics.
Medium chain triglycerides (MCT) formulas in paediatric and allergological practice

Fats constitute the most significant nutritional source of energy. Their proper use by the body conditions a number of complex mechanisms of digestion, absorption, distribution, and metabolism. These mechanisms are facilitated by fats made of medium chain fatty acids; therefore, they are an easy and quick source of energy. Thus, an increased supply of medium chain triglycerides (MCT) is particularly important in patients with disturbances of digestion and absorption such as disturbed bile secretion, classic coeliac disease, short bowel syndrome, inflammatory diseases of the intestines, disturbed outflow of lymph, some metabolic disease, and severe food allergies, as well as in prematurely born neonates. Use of preparations containing an additive of MCT is limited, especially if they are to be used for a longer period of time. With a large quantity of MCT in a diet, there is a risk of deficiency of necessary unsaturated fatty acids and some fat-soluble vitamins. The caloricity of MTC compared to long-chain triglycerides is lower, and formulas with MCT are characterised by higher osmolality. Medium chain triglycerides is not recommended as an additive to standard formulas for healthy children. The use of MCT should be limited to strictly specified medical indications.
Genital Chlamydia trachomatis and Neisseria gonorrhoeae infections among women in sub-Saharan Africa: A structured review

Chlamydia trachomatis and Neisseria gonorrhoeae constitute major public health problems among women, but the burden of infection in sub-Saharan Africa is poorly documented. We conducted a structured review of the prevalence and incidence of genital, oral and anal C. trachomatis and N. gonorrhoeae infection in women in sub-Saharan Africa. We searched Medline, EMBASE and Web of Science over a 10-year period for studies on epidemiology of genital, oral and anal chlamydial infection and gonorrhoea in women in all countries of sub-Saharan Africa. We assessed geographic and demographic differences in prevalence and incidence of infection; weighted mean prevalence estimates were calculated with a random-effect model. A total of 102 study results were included, with data available for 24/49 of sub-Saharan countries. The weighted prevalence of chlamydial infection was lower among women in community-based studies (3.9%; 95% CI: 2.9–5.1%) than for women recruited at primary healthcare facilities (6.0%; 95% CI: 4.2–8.4%, p < 0.001); the same was observed for gonorrhoea (2.2%; 95% CI: 1.2–4.0% vs. 4.2%; 95% CI: 3.2–5.6%, p < 0.001). Prevalence of Chlamydia among sex workers was 5.5% (95% CI: 4.2–7.3%) and gonorrhoea 7.6% (95% CI: 5.4–11%). Seven studies reported on incidence which varied between 0.75–28 and 2.8–17 per 100 person-years-at-risk for chlamydial infection and gonorrhoea, respectively. Only two studies reported on anal infections and one on oral infection. This overview underscores the considerable incidence and prevalence of genital C. trachomatis and N. gonorrhoeae in women in different settings in sub-Saharan Africa. Better control strategies are warranted to reduce the burden of infection and to prevent long-term complications of these infections.