Miracle-dz/UniFAR-FTUs huggingface dataset:
Automating Construction of Machine Learning Models With Clinical Big Data: Proposal Rationale and Methods

Background To improve health outcomes and cut health care costs, we often need to conduct prediction/classification using large clinical datasets (aka, clinical big data), for example, to identify high-risk patients for preventive interventions. Machine learning has been proposed as a key technology for doing this. Machine learning has won most data science competitions and could support many clinical activities, yet only 15% of hospitals use it for even limited purposes. Despite familiarity with data, health care researchers often lack machine learning expertise to directly use clinical big data, creating a hurdle in realizing value from their data. Health care researchers can work with data scientists with deep machine learning knowledge, but it takes time and effort for both parties to communicate effectively. Facing a shortage in the United States of data scientists and hiring competition from companies with deep pockets, health care systems have difficulty recruiting data scientists. Building and generalizing a machine learning model often requires hundreds to thousands of manual iterations by data scientists to select the following: (1) hyper-parameter values and complex algorithms that greatly affect model accuracy and (2) operators and periods for temporally aggregating clinical attributes (eg, whether a patient’s weight kept rising in the past year). This process becomes infeasible with limited budgets. Objective This study’s goal is to enable health care researchers to directly use clinical big data, make machine learning feasible with limited budgets and data scientist resources, and realize value from data. Methods This study will allow us to achieve the following: (1) finish developing the new software, Automated Machine Learning (Auto-ML), to automate model selection for machine learning with clinical big data and validate Auto-ML on seven benchmark modeling problems of clinical importance; (2) apply Auto-ML and novel methodology to two new modeling problems crucial for care management allocation and pilot one model with care managers; and (3) perform simulations to estimate the impact of adopting Auto-ML on US patient outcomes. Results We are currently writing Auto-ML’s design document. We intend to finish our study by around the year 2022. Conclusions Auto-ML will generalize to various clinical prediction/classification problems. With minimal help from data scientists, health care researchers can use Auto-ML to quickly build high-quality models. This will boost wider use of machine learning in health care and improve patient outcomes.
Adjunctive local antibiotic therapy in the treatment of peri-implantitis II: clinical and radiographic outcomes.

AIM To monitor over 12 months clinical and radiographic changes occurring after adjunctive local delivery of minocycline microspheres for the treatment of peri-implantitis. MATERIAL AND METHODS In 25 partially edentulous subjects, 31 implants diagnosed with peri-implantitis were treated. Three weeks after oral hygiene instruction, mechanical debridement and local antiseptic cleansing using 0.2% chlorhexidine gel, baseline (Day 0) parameters were recorded. Minocycline microspheres (Arestin) were locally delivered to each implant site with bone loss and a probing pocket depth (PPD) >or=5 mm. Rescue therapy with Arestin was allowed at Days 180 and 270 at any site exhibiting an increase in PPD>or=2 mm from the previous visit. The following clinical parameters were recorded at four sites/implant at Day 0, 10, 30, 60, 90, 180, 270 and 360: PPD, clinical attachment level (CAL), bleeding on probing (BOP) and plaque index (PlI). RESULTS Six implants in six subjects were either rescued or exited because of persisting active peri-implantitis. Successful implants showed a statistically significant reduction in both PPD and percentage of sites with BOP between baseline and Day 360 (P<0.05). At mesial implant sites, the mean PPD reduction amounted to 1.6 mm (95% CI: 0.9-2.2 mm, P<0.001) and was accompanied by a statistically significant reduction of the BOP value (P<0.001). Binary regression analysis showed that the clinical parameters and smoking history could not discriminate between successfully treated and rescued or exited implants at any observation time point. CONCLUSION Non-surgical mechanical treatment of peri-implantitis lesions with adjunctive local delivery of microencapsulated minocycline led to positive effects on clinical parameters up to 12 months.
Socio-economic disparities in the diet of French children and adolescents: a multidimensional issue

Abstract Objective The present research aimed to study the multidimensionality of the link between dietary intake and socio-economic position (SEP) in a representative sample of French children and adolescents, using a variety of SEP indicators. Design Data from the second French national food consumption survey (INCA2) were used. Information on food consumption was collected using a 7d food record and SEP data (occupation, education, income, household wealth indices) using questionnaires. Multivariable linear regression analyses were performed separately in children and adolescents to assess the relationships between dietary components (food groups and macronutrients) and each dimension of SEP. Setting The INCA2 survey, France. Subjects A representative sample of French children (3–10 years of age; n 574) and adolescents (11–17 years of age; n 881). Results Compared with children from a higher SEP, those from a lower SEP had lower intakes of fruit and vegetables, yoghurts and confectionery and higher intakes of starchy foods, meat, milk, sugar-sweetened beverages and pizzas/sandwiches. Similar results were observed in adolescents for fruit and vegetables, yoghurts and sugar-sweetened beverages. Adolescents also had lower intakes of cakes/pastries and higher intakes of processed meat and dairy desserts. Neither energy nor protein intake was associated with SEP. Adolescents from a lower SEP had higher carbohydrate and lower lipid intakes. Overall, these findings were consistent across the various dimensions of SEP, but the gradient was steeper depending on the caregiver’s educational level. Conclusions This research highlights the need for specific messages to help poorly educated families adopt good eating habits.
Explaining variation in maternal care in a cooperatively breeding mammal

Because of the necessity of lactation, mammalian mothers must perform at least a minimum amount of infant care. In cooperatively breeding species, other group members aid in all other aspects of infant care. However, some mothers continue to carry and nurse their infants more than others. The golden lion tamarin, Leontopithecus rosalia, is a small, communally breeding primate in the family Callitrichidae. We studied hormonal, individual, historical and social factors hypothesized to contribute to variation in levels of maternal care. We used neonatal weight as a measure of prenatal care, and carrying and nursing as measures of postnatal care. Greater neonatal weight was associated with smaller litter size, lower prepartum levels of oestrogen conjugates, and higher prepartum cortisol levels. Higher rates of carrying during weeks 2 and 3 were associated with higher maternal weight, larger litter size and smaller numbers of helpers per infant. Higher rates of nursing in weeks 2 and 3 were predicted by smaller group size and provisioning of the mother. The most important factors affecting postnatal maternal care were maternal weight, group size, litter size and provisioning status of the mother. Thus, females that display higher levels of maternal care do so either because they have to (they have fewer helpers) or because they can (they are in better condition).
Elevated Soluble Vascular Cell Adhesion Molecule-1 Is Associated With Cerebrovascular Resistance and Cognitive Function

Background Elevated plasma soluble vascular cell adhesion molecule-1 (sVCAM-1) is a presumed marker of endothelial dysfunction, both in the brain and systemic circulation. Impairments in memory and cognition have been associated with cardiovascular diseases, but little is known about their relationships to abnormal cerebral endothelial function. Methods We studied the cross-sectional association between sVCAM-1 and markers of cerebrovascular hemodynamics and cognitive function in 680 community-dwelling participants in the MOBILIZE Boston Study, aged 65 years and older. Cognitive function was assessed using the Hopkins Verbal Learning Memory Test and Trail Making Tests (TMTs) A and B. Global cognitive impairment was defined as Mini-Mental State Examination (MMSE) score less than 24. sVCAM-1 was measured by ELISA assay. Beat-to-beat blood flow velocity (BFV) and cerebrovascular resistance (CVR = mean arterial pressure / BFV) in the middle cerebral artery were assessed at rest by transcranial Doppler ultrasound. Results sVCAM-1 concentrations were higher among participants with an MMSE score <24 versus ≥24 (1,201±417 vs 1,122±494ng/mL). In regression models adjusted for sociodemographic characteristics and health conditions, increasing levels of sVCAM-1 were linearly associated with higher resting CVR (p = .006) and lower performance on the Hopkins Verbal Learning Memory (immediate recall and delayed recall) and adjusted TMT B tests (p < .05). Higher levels of sVCAM-1 were also associated with global cognitive impairment on the MMSE (odds ratio = 3.9; 95% confidence interval: 1.4-10.9; p = .011). Conclusions In this cohort of elderly participants, we observed a cross-sectional association between elevated sVCAM-1 levels and both cognitive impairment and increased cerebrovascular resistance. Longitudinal studies are needed to determine whether elevated sVCAM-1 is a cause or consequence of cerebrovascular damage.
Strategies for and Outcome of Repeat Revascularization Surgery for Moyamoya Disease: An American Institutional Series

BACKGROUND: Revascularization for moyamoya disease (MMD) effectively prevents future ischemic events. However, small subsets of patients with persistent or new symptoms due to inadequate collateralization require repeat revascularizations. OBJECTIVE: To investigate the clinical and radiological outcome of repeat revascularization in MMD patients with previous indirect or direct bypasses. METHODS: Single institution, retrospective analysis of a prospective MMD database. RESULTS: From 1991 to 2014, this institution performed 1244 revascularization bypasses (1107 direct, 137 indirect) in 765 patients, of whom 57 were repeat revascularizations (38 indirect, 19 direct bypass). When initially performed at the institution, the repeat revascularization rate was 4% for indirect and 1% for direct bypasses (P = .03). Cohorts with previous indirect vs direct bypass were slightly younger (mean age 23 vs 30 yr), with fewer females (61% vs 84%, P = .08), and a similar mean duration between initial bypass and repeat revascularization (49 vs 47 mo). Both groups had similar repeat revascularization due to transient ischemic attacks (66% vs 63%). One acute graft occlusion in the previous direct bypass group was revised within 1 wk postoperatively. Over 50% of the repeat revascularizations in both groups were direct bypasses; the major difference being that the repeat bypass in the direct group was to augment another vascular territory. At nearly 5 yr mean follow‐up, over 80% of patients in both groups are well, free from stroke/transient ischemic attack symptoms, with excellent radiological results. CONCLUSION: Repeat revascularization can safely and effectively prevent future ischemic events. Indirect bypass has a higher rate of repeat revascularization than direct bypass.
Surgical Technique and Clinically Relevant Resection Cavity Dynamics Following Implantation of Cesium-131 Brachytherapy in Patients With Brain Metastases

BACKGROUND: Cesium-131 (Cs-131) brachytherapy is used to reduce local recurrence of resected brain metastases. To ensure dose homogeneity and reduce risk of radiation necrosis, interseed distance and cavity volume must remain stable during delivery. OBJECTIVE: To investigate the efficacy of the “seeds-on-a-string” technique with intracavitary fibrin glue in achieving cavity volume stability. METHODS: We placed intraoperative Cs-131 brachytherapy in 30 cavities postresection of brain metastases. Seeds-on-a-string were placed like barrel staves within the cavity with fibrin glue. Serial magnetic resonance imaging occurred postoperatively. Preoperative tumor volumes were compared with postoperative cavity volumes to evaluate volume stability. Thirty patients who underwent postresective stereotactic radiosurgery (SRS) were used as a control group for volumetric comparison. RESULTS: Cs-131 and SRS patients exhibited consistent cavity shrinkage over the median 110-day follow-up (P < .001), with total median shrinkage of 56.5% (Cs-131) and 84.8% (SRS). During the first month when ≈88% of Cs-131 dosage is delivered, however, there was nonsignificant volume decrease in the Cs-131 group (median 22.0%; P = .06), whereas SRS patients showed significantly more shrinkage (46.7%; P = .042). No events of radiation necrosis occurred in either group. CONCLUSION: Cs-131 patients exhibited significantly less cavity shrinkage than SRS patients during the first critical month with 88% Cs-131 dose delivery. This significant difference in shrinkage suggests that the intracavitary seeds-on-a-string technique facilitates increased cavity stability, promoting more homogenous dose delivery. ABBREVIATIONS: Cs-131, Cesium-131 FLAIR, fluid-attenuated inversion recovery I-125, Iodine-125 SRS, stereotactic radiosurgery WBRT, whole brain radiotherapy
Performance of AHEAD Score in an Asian Cohort of Acute Heart Failure With Either Preserved or Reduced Left Ventricular Systolic Function

Background AHEAD (A: atrial fibrillation; H: hemoglobin; E: elderly; A: abnormal renal parameters; D: diabetes mellitus) score has been related to clinical outcomes of acute heart failure. However, the prognostic value of the AHEAD score in acute heart failure patients with either reduced or preserved left ventricular ejection fraction (HFrEF and HFpEF) remain to be elucidated. Methods and Results The study population consisted of 2143 patients (age 77±12 years, 68% men, 38% HFrEF) hospitalized primarily for acute heart failure with a median follow‐up of 23.75 months. The performance of the AHEAD score (atrial fibrillation, hemoglobin <13 mg/dL for men and 12 mg/dL for women, age >70 years, creatinine >130 μmol/L, and diabetes mellitus) was evaluated by Cox's regression analysis for predicting cardiovascular and all‐cause mortality. The mean AHEAD scores were 2.7±1.2 in the total study population, 2.6±1.3 in the HFrEF group, and 2.7±1.1 in the HFpEF group. After accounting for sex, sodium, uric acid, and medications, the AHEAD score remained significantly associated with all‐cause and cardiovascular mortality (hazard ratio and 95% CI: 1.49, 1.38–1.60 and 1.48, 1.33–1.64), respectively. The associations of AHEAD score with mortality remained significant in the subgroups of HFrEF (1.63, 1.47–1.82) and HFpEF (1.34, 1.22–1.48). Moreover, when we calculated a new AHEAD‐U score by considering uric acid (>8.6 mg/dL) in addition to the AHEAD score, the net reclassification was improved by 19.7% and 20.1% for predicting all‐cause and cardiovascular mortality, respectively. Conclusions The AHEAD score was useful in predicting long‐term mortality in the Asian acute heart failure cohort with either HFrEF or HFpEF. The new AHEAD‐U score may further improve risk stratification.
Deformed Quantum Field Theory, Thermodynamics at Low and High Energies, and Gravity. II. Deformation Parameter

The principal objective of this paper is to show that deformation of the General Relativity within the scope of both the Generalized Uncertainty Principle (UV-cutoff) and the Extended Uncertainty Principle (IR-cutoff) in the cases when the corresponding gravitational equations have a thermodynamic interpretation may be studied in terms of a small parameter introduced in previous works of the author. From this viewpoint the parameter is though to be universal. Consideration is given to the possibility for extension of the obtained results to more general cases. Possible generalization of the uncertainty relation for the pair (cosmological constant, "space-time volume"), where the cosmological constant is regarded as a dynamic quantity at high and low energies, is analyzed. This paper is devoted to the 70-th Anniversary of Professor Nikolai Maksi- movich Shumeiko, Director of the Belarusian Particles and High Energy Physics National Centre.
Effects of fucoidan on diabetic rat testicular tissue

Abstract Increased reactive oxygen species (ROS) resulting from hyperglycemia and inadequate endogenous antioxidant systems are responsible for the complications of diabetes. ROS accumulate in the cell and stimulate apoptosis, which compromises sperm quality and function. We investigated the possible effects of fucoidan, a potent antioxidant with a regulatory effect on blood glucose homeostasis, on the testicular tissues of rats with experimental diabetes. Diabetes was induced by administering 40 mg/kg streptozotocin (STZ) on five consecutive days. Twenty-four Wistar albino male rats were divided into four groups: group 1, control group (CG); group 2, diabetes group (DG); group 3, early fucoidan group (EFG) treated with 50 mg/kg fucoidan after diabetes induction; group 4, late fucoidan group (LFG) treated with the same dose of fucoidan 15 days after diabetes induction. Fucoidan was administered intraperitoneally every two days for four weeks. Basement membrane thickness and Johnsen scores were higher in the DG than in the CG; no difference was found for either the EFG or LFG compared to the CG. Seminiferous tubule diameters of EFG were significantly greater than for the DG. Apoptotic tubule and apoptotic cell indexes were significantly greater in the DG and significantly less in the EFG and LFG groups compared to the CG. Early use of fucoidan in diabetic individuals may minimize damage to testicular tissue.
Awareness and Knowledge Among Internal Medicine Resident Trainees for Dose Adjustment of Analgesics and Neuropsychotropic Medications in CKD

Objectives Errors in drug dosing lead to poor patient outcomes and are common in patients with chronic kidney disease (CKD). Because the majority of patients with CKD are being treated by physicians specializing in internal medicine, we studied the awareness and knowledge that internal medicine resident trainees (IMRTs) have regarding the correct dosage of commonly used analgesic and neuropsychotropic medications for patients with CKD. Methods We surveyed 353 IMRTs about their awareness of whether a medication needs dose adjustment in patients with CKD and knowledge for medication adjustment by level of glomerular filtration rate. Results There were high percentages for lack of awareness and knowledge. For analgesics, this lack of awareness/knowledge was highest for acetaminophen (awareness 83.0%, knowledge 90.9%). For neuropsychotropics, this was highest for paroxetine (awareness 74.5%, knowledge 91.5%). Analyses for postgraduate year (PGY) -1 trainees and PGY-2 trainees for analgesics showed higher odds for lack of awareness for tramadol (PGY-1 odds ratio [OR] 2.37, 95% confidence interval [CI] 1.2–4.62, P < 0.05; PGY-2 OR 2.34, 95% CI 1.16–4.72, P < 0.05) and for lack of knowledge for meperedine (PGY-1 OR 4.01, 95% CI 1.81–8.89, P < 0.05; PGY-2 OR 3.30, 95% CI 1.44–7.59, P < 0.05). Nephrology residency rotation for the neuropsychotropic medication of gabapentin showed lower odds for both lack of awareness (OR 0.56, 95% CI 0.32–0.97, P < 0.05) and knowledge (OR 0.52, 95% CI 0.27–0.997, P < 0.05). Conclusions Awareness and knowledge are poor among IMRTs for dose adjustments of analgesics and neuropsychotropic medication classes in patients with CKD. There should be a renewed focus during IMRTs’ residency on additional nephrology exposure and formal didactic educational training to help them better manage complex treatment regimens to prevent medication dosing errors.
Intermittent Exposure to Cigarette Smoke Increases Lung Tumors and the Severity of Emphysema More than Continuous Exposure

&NA; Lung cancer and chronic obstructive pulmonary disease are leading causes of morbidity and mortality worldwide, and cigarette smoking is a main risk factor for both. The presence of emphysema, an irreversible lung disease, further raises the risk of lung cancer in patients with chronic obstructive pulmonary disease. The mechanisms involved in smoke‐induced tumorigenesis and emphysema are not fully understood, attributable to a lack of appropriate animal models. Here, we optimized a model of cigarette smoke (CS)‐induced lung cancer and emphysema in A/J mice treated with 4‐(methylnitrosamino)‐1‐(3‐pyridyl)‐1‐butanone, a potent carcinogen. We investigated whether variations in CS exposure patterns with the same total amount and duration of exposure affect tumorigenesis and/or development of emphysema. Continuous CS exposure for 3 months significantly suppressed 4‐(methylnitrosamino)‐1‐(3‐pyridyl)‐1‐butanone‐induced development of adenomas and adenocarcinomas; however, emphysema independently developed during this period. Surprisingly, intermittent CS exposure increased the severity of emphysema and resulted in a higher incidence of adenocarcinomas. Furthermore, intermittent CS exposure elicited a marked increase in M2‐polarized macrophages within and near the developed tumors. By employing a CS exposure protocol with repeated cycles of cessation and relapse, we provide evidence that intermittent CS exposure enhances tumorigenesis and emphysema progression more than that of continuous CS exposure.
Advanced Materials for Health Monitoring with Skin‐Based Wearable Devices

Skin‐based wearable devices have a great potential that could result in a revolutionary approach to health monitoring and diagnosing disease. With continued innovation and intensive attention to the materials and fabrication technologies, development of these healthcare devices is progressively encouraged. This article gives a concise, although admittedly non‐exhaustive, didactic review of some of the main concepts and approaches related to recent advances and developments in the scope of skin‐based wearable devices (e.g. temperature, strain, biomarker‐analysis werable devices, etc.), with an emphasis on emerging materials and fabrication techniques in the relevant fields. To give a comprehensive statement, part of the review presents and discusses different aspects of these advanced materials, such as the sensitivity, biocompatibility and durability as well as the major approaches proposed for enhancing their chemical and physical properties. A complementary section of the review linking these advanced materials with wearable device technologies is particularly specified. Some of the strong and weak points in development of each wearable material/device are highlighted and criticized. Several ideas regarding further improvement of skin‐based wearable devices are also discussed.