Miracle-dz/UniFAR-FTUs huggingface dataset:
Clinicians’ Role in the Adoption of an Oncology Decision Support App in Europe and Its Implications for Organizational Practices: Qualitative Case Study

Background Despite the existence of adequate technological infrastructure and clearer policies, there are situations where users, mainly physicians, resist mobile health (mHealth) solutions. This is of particular concern, bearing in mind that several studies, both in developed and developing countries, showed that clinicians’ adoption is the most influential factor in such solutions’ success. Objective The aim of this study was to focus on understanding clinicians’ roles in the adoption of an oncology decision support app, the factors impacting this adoption, and its implications for organizational and social practices. Methods A qualitative case study of a decision support app in oncology, called ONCOassist, was conducted. The data were collected through 17 in-depth interviews with clinicians and nurses in the United Kingdom, Ireland, France, Italy, Spain, and Portugal. Results This case demonstrates the affordances and constraints of mHealth technology at the workplace, its implications for the organization of work, and clinicians’ role in its constant development and adoption. The research findings confirmed that factors such as app operation and stability, ease of use, usefulness, cost, and portability play a major role in the adoption decision; however, other social factors such as endorsement, neutrality of the content, attitude toward technology, existing workload, and internal organizational politics are also reported as key determinants of clinicians’ adoption. Interoperability and cultural views of mobile usage at work are the key workflow disadvantages, whereas higher efficiency and performance, sharpened practice, and location flexibility are the main workflow advantages. Conclusions Several organizational implications emerged, suggesting the need for some actions such as fostering a work culture that embraces new technologies and the creation of new digital roles for clinicians both on the hospitals or clinics and on the development sides but also more collaboration between health care organizations and digital health providers to enable electronic medical record integration and solving of any interoperability issues. From a theoretical perspective, we also suggest the addition of a fourth step to Leonardi’s methodological guidance that accounts for user engagement; embedding the users in the continuous design and development processes ensures the understanding of user-specific affordances that can then be made more obvious to other users and increase the potential of such tools to go beyond their technological features and have a higher impact on workflow and the organizing process.
Optimization of photocrosslinked gelatin/hyaluronic acid hybrid scaffold for the repair of cartilage defect

There is no therapy currently available for fully repairing articular cartilage lesions. Our laboratory has recently developed a visible light‐activatable methacrylated gelatin (mGL) hydrogel, with the potential for cartilage regeneration. In this study, we further optimized mGL scaffolds by supplementing methacrylated hyaluronic acid (mHA), which has been shown to stimulate chondrogenesis via activation of critical cellular signalling pathways. We hypothesized that the introduction of an optimal ratio of mHA would enhance the biological properties of mGL scaffolds and augment chondrogenesis of human bone marrow‐derived mesenchymal stem cells (hBMSCs). To test this hypothesis, hybrid scaffolds consisting of mGL and mHA at different weight ratios were fabricated with hBMSCs encapsulated at 20 × 106 cells/ml and maintained in a chondrogenesis‐promoting medium. The chondrogenenic differentiation of hBMSCs, within different scaffolds, was estimated after 8 weeks of culture. Our results showed that mGL/mHA at a 9:1 (%, w/v) ratio resulted in the lowest hBMSC hypertrophy and highest glycosaminoglycan production, with a slightly increased volume of the entire construct. The applicability of this optimally designed mGL/mHA hybrid scaffold for cartilage repair was then examined in vivo. A full‐thickness cylindrical osteochondral defect was surgically created in the rabbit femoral condyle, and a three‐dimensional cell–biomaterial construct was fabricated by in situ photocrosslinking to fully fill the lesion site. The results showed that implantation of the mGL/mHA (9:1) construct resulted in both cartilage and subchondral bone regeneration after 12 weeks, supporting its use as a promising scaffold for repair and resurfacing of articular cartilage defects, in the clinical setting.
Nivolumab plus ipilimumab in non-small-cell lung cancer.

Nivolumab and ipilimumab, two therapeutic immune checkpoint inhibitor antibodies that block PD-1 and CTLA-4, respectively, have indications in cancer as single agents and in combination. In this review, we examine the potential role of dual immune checkpoint inhibition with nivolumab plus ipilimumab in the management of patients with previously untreated advanced non-small-cell lung cancer, based on results from the Phase III CheckMate 227 study. Immunotherapies with indications in the first-line treatment of non-small-cell lung cancer include pembrolizumab alone and combined with chemotherapy, and atezolizumab combined with bevacizumab and chemotherapy. CheckMate 227 is the first Phase III study evaluating first-line chemotherapy-sparing combination immunotherapy and including tumor mutational burden as a biomarker for patient selection.
Comparative power law analysis for the spatial heterogeneity scaling of the hot‐spring microbiomes

Spatial heterogeneity is a fundamental property of any natural ecosystems, including hot spring and human microbiomes. Two important scales that spatial heterogeneity exhibits are population and community scales, and Taylor's power law (PL) and its extensions (PLEs) offer ideal quantitative models to assess population‐ and community‐level heterogeneities. Here we analyse 165 hot spring microbiome samples at the global scale that cover a wide range of temperatures (7.5–99°C) and pH levels (3.3–9). We explore a question of fundamental importance for measuring the spatial heterogeneity of the hot‐spring microbiome and further discuss their ecological implications: How do critical environmental factors such as temperature and pH influence the scaling of community spatial heterogeneity? We are particularly interested in the existence of a universal scaling model that is independent of environmental gradients. By applying PL and PLEs, we were able to obtain such scaling parameters of the hot spring at both community and population levels, which are temperature‐ and pH‐invariant. These findings suggest that while the hot‐spring microbiomes located at different regions may have different environmental conditions, they share a fundamental heterogeneity scaling parameter, analogically similar to the gravitational acceleration on Earth, which may vary slightly depending on altitude and latitude, but is invariant overall. In contrast, similar to the physics of the Moon and Earth, which have different gravitational accelerations, the hot spring and human microbiomes can have different scaling parameters as demonstrated in this study.
Molecular Detection and Epidemiological Features of Selected Bacterial, Viral, and Parasitic Enteropathogens in Stool Specimens from Children with Acute Diarrhea in Thi-Qar Governorate, Iraq

Knowledge of etiology causes of diarrheal illness is essential for development and implementation of public health measures to prevent and control this disease syndrome. There are few published studies examining diarrhea in children aged <5 years in Iraq. This study aims to investigate the occurrences and epidemiology of selected bacterial (Salmonella spp. and Campylobacter spp.), viral (adenovirus, norovirus GI and GII, and astrovirus), and parasitic (Entamoeba spp. and Giardia spp.) agents in stool samples from 155 child diarrheal cases enrolled between March and August 2017, in a hospital-based cross-sectional study in Thi-Qar, southeastern Iraq. Using molecular techniques and sequence-based characterization, adenovirus was the most frequently detected enteropathogen (53/155 (34.2%)), followed by Salmonella spp. (23/155 (14.8%)), Entamoeba spp. (21/155 (13.5%)), and Campylobacter spp. (17/155 (10.9%)). Mixed infection with Salmonella spp. and Campylobacter spp. was evident, and the same was revealed between various enteric viruses, particularly adenovirus and norovirus. The most frequent co-infection pattern was between adenovirus and Campylobacter spp. , in seven cases (7/155 (4.5%)). Whole-genome sequencing-derived typing data for Salmonella isolates (n = 23) revealed that sequence type 49 was the most prevalent in this sample set (15/23 (65.2%)). To the best of our knowledge, this study provides the first report on detection and identification of floR, blaCARB-2, and mphA antimicrobial resistance genes in Salmonella isolated from children in the Middle East region. Logistic regression analysis pointed to few enteropathogen-specific correlations between child age, household water source, and breastfeeding patterns in relation to the outcome of detection of individual enteropathogens. This study presents the first published molecular investigation of multiple enteropathogens among children <5 years of age in Iraq. Our data provide supporting evidence for planning of childhood diarrhea management programs. It is important to build on this study and develop future longitudinal case-control research in order to elaborate the epidemiology of enteropathogens in childhood diarrhea in Iraq.
Information Management in Cancer Registries: Evaluating the Needs for Cancer Data Collection and Cancer Research

Cancer registry data collection involves, at a minimum, collecting data on demographics, tumor characteristics, and treatment. A common, identified, and standardized set of data elements is needed to share data quickly and efficiently with consumers of this data. This project highlights the fact that, there is a need to develop common data elements; Surveys were developed for central cancer registries (CCRs) and cancer researchers (CRs) at NCI-designated Cancer Centers, in order to understand data needs. Survey questions were developed based on the project focus, an evaluation of the research registries and database responses, and systematic review of the literature. Questions covered the following topics: 1) Research, 2) Data collection, 3) Database/ repository, 4) Use of data, 5) Additional data items, 6) Data requests, 7) New data fields, and 8) Cancer registry data set. A review of the surveys indicates that all cancer registries’ data are used for public health surveillance, and 96% of the registries indicate the data are also used for research. Data are available online in interactive tables from over 50% of CRs and 87% of CCRs. Some other survey responses indicate that CCR treatment data are not complete for example treatment data, however cancer researchers are interested in treatment variables from CCRs. Cancer registries have many data available for review, but need to examine what data are needed and used by different entities. Cancer Registries can further enhance usage through collaborations and partnerships to connect common interests in the data by making registries visible and accessible.
Comparison of haloperidol, non-haloperidol antipsychotics, and no pharmacotherapy for the management of delirium in an inpatient geriatric palliative care population

Abstract Antipsychotics are frequently used for treatment of delirium, although little evidence exists that they improve delirium outcomes. Our objective was to evaluate haloperidol (HAL) compared to non-haloperidol antipsychotics (NHAP) or no pharmacologic treatment (NP) in the management of delirium in older adults under the care of a palliative care consult service across a large, integrated health care system. A retrospective chart review examined data from September 2014-September 2015. All hospitalized patients ≥65 years old with a diagnosis of delirium during palliative care consultation were included (n = 304). Primary outcome was length of stay after delirium diagnosis. Secondary outcomes included delirium symptom length, sedation, and QTc prolongation. Univariate statistical tests, analysis of covariance, and multiple regression methods were used to compare groups. Post-delirium length of stay in the HAL, NHAP, and NP groups were 8.5, 7.0, and 6.8 days, respectively (p = 0.19). Delirium duration in the HAL, NHAP, and NP groups were 6.7, 6.0, and 4.9 days, respectively (p = 0.05). Safety outcomes were statistically different than the reference group (NHAP). Congruent with existing literature in other generalized patient populations, no significant difference in post-delirium length of stay existed in geriatric, palliative care population.
Efficient Dithering in MASH Sigma-Delta Modulators for Fractional Frequency Synthesizers

The digital multistage-noise-shaping (MASH) ΣΔ modulators used in fractional frequency synthesizers are prone to spur tone generation in their output spectrum. In this paper, the state of the art on spur-tone-magnitude reduction is used to demonstrate that an M -bit MASH architecture dithered by a simple M-bit linear feedback shift register (LFSR) can be as effective as more sophisticated topologies if the dither signal is properly added. A comparison between the existent digital ΣΔ modulators used in fractional synthesizers is presented to demonstrate that the MASH architecture has the best tradeoff between complexity and quantization noise shaping, but they present spur tones. The objective of this paper was to significantly decrease the area of the circuit used to reduce the spur tone magnitude for these MASH topologies. The analysis is validated with a theoretical study of the paths where the dither signal can be added. Experimental results of a digital M -bit MASH 1-1-1 ΣΔ modulator with the proposed way to add the LFSR dither are presented to make a hardware comparison.
Comparison of Proteome Composition of Serum Enriched in Extracellular Vesicles Isolated from Polycythemia Vera Patients and Healthy Controls

Extracellular vesicles (EVs), e.g., exosomes and microvesicles, are one of the main networks of intercellular communication. In myeloproliferative neoplasms, such as polycythemia vera (PV), excess of EVs originating from overabundant blood cells can directly contribute to thrombosis through their procoagulant activity. However, the proteomic composition of these vesicles in PV patients has not been investigated before. In this work, we examined the proteomic composition of serum EVs of PV patients in comparison to healthy controls. We processed EV-enriched serum samples using the Multiple Enzyme Filter Aided Sample Preparation approach (MED-FASP), conducted LC-MS/MS measurements on a Q-Exactive HF-X mass spectrometer, and quantitatively analyzed the absolute concentrations of identified proteins by the Total Protein Approach (TPA). Thirty-eight proteins were present at statistically significant different concentrations between PV patients’ study group and healthy controls’ group. The main protein components deregulated in PV were primarily related to excessive amounts of cells, increased platelet activation, elevated immune and inflammatory response, and high concentrations of procoagulant and angiogenic agents. Our study provides the first quantitative analysis of the serum EVs’ proteome in PV patients. This new knowledge may contribute to a better understanding of the secondary systemic effects of PV disease and further development of diagnostic or therapeutic procedures.
Annexin II upregulates cellular levels of p 11 protein by a post-translational mechanism

Annexin II (p36) and p11, which belong to two different families of calcium-binding proteins, are able to form a heterotetrameric protein complex (p36) # (p11) # called calpactin I. As these proteins were detectable only in the presence of each other in a variety of cell lines, we studied the mechanisms of regulation of cellular levels of annexin II and p11. In cells expressing p11 messenger RNA, p11 protein is undetectable unless annexin II is also expressed. As an example, the hepatoblastoma HepG2 cell line displays no detectable annexin II nor p11 protein, although it
Frontoparietal Traffic Signals: A Fast Optical Imaging Study of Preparatory Dynamics in Response Mode Switching

Coordination between networks of brain regions is important for optimal cognitive performance, especially in attention demanding tasks. With the event-related optical signal (a measure of changes in optical scattering because of neuronal activity) we can characterize rapidly evolving network processes by examining the millisecond-scale temporal correlation of activity in distinct regions during the preparatory period of a response mode switching task. Participants received a precue indicating whether to respond vocally or manually. They then saw or heard the letter “L” or “R,” indicating a “left” or “right” response to be implemented with the appropriate response modality. We employed lagged cross-correlations to characterize the dynamic connectivity of preparatory processes. Our results confirmed coupling of frontal and parietal cortices and the trial-dependent relationship of the right frontal cortex with response preparation areas. The frontal-to-modality-specific cortex cross-correlations revealed a pattern in which first irrelevant regions were deactivated, and then relevant regions were activated. These results provide a window into the subsecond scale network interactions that flexibly tune to task demands.
Mycobacterium paratuberculosis cultured from milk and supramammary lymph nodes of infected asymptomatic cows

Milk and supramammary lymph node samples were obtained from asymptomatic cows infected with Mycobacterium paratuberculosis at the time of slaughter. Of 81 supramammary lymph node samples, 22 (27%) were culture positive for M. paratuberculosis. Of 77 milk samples, 9 (11.6%) were culture positive. The prevalence of supramammary lymph node or milk infection was highest with heavy fecal shedding of M. paratuberculosis and lowest with light shedding. The serologic status of the cow was not useful for predicting the risk of supramammary lymph node or milk infection. Shedding of M. paratuberculosis occurs in the milk of asymptomatic infected cows but, apparently, less frequently than previously reported for symptomatic cows.
Validating a Self-Report Measure of Student Athletes’ Perceived Stress Reactivity: Associations With Heart-Rate Variability and Stress Appraisals

Student athletes experience multiple stressors relating to both their sporting and academic commitments. Individual differences play a significant role in how well student athletes cope with the demands they face. When assessing individual differences in stress reactivity, there are a lack of valid alternatives to costly and time-consuming lab-based physiological methods (e.g., cortisol sampling, cardiac variables). This paper aims to further validate a self-report measure of adolescent athletes’ individual differences in perceived stress reactivity, by comparing to a psycho-physiological measure of emotion regulation (heart-rate variability) assessed during a socially evaluated cold pressor test. 30 student athletes and 31 student non-athletes completed a measure of perceived stress reactivity and took part in the socially evaluated cold pressor test while their heart-rate variability was assessed, along with their self-reported appraisals of stress, pain, and unpleasantness experienced during the procedure. Controlling for gender and athleticism, individual differences in perceived stress reactivity showed no associations with tonic or phasic levels of heart-rate variability. However, perceived stress reactivity was associated with levels of self-reported stress, pain, and unpleasantness experienced during the socially evaluated cold pressor test. These findings therefore suggest that perceived stress reactivity is associated with cognitive responses to stress (i.e., stress appraisals). However, further research is needed to confirm its relationship with physiological measures and responses. This further adds to the understanding of perceived stress reactivity, and validity of the perceived stress reactivity scale for adolescent athletes.
An Empirical Study of a Pedagogical Agent as an Adjunct to an eHealth Self-Management Intervention: What Modalities Does It Need to Successfully Support and Motivate Users?

Prior research has shown that the more patients know about their disease, health, and lifestyle the better the health outcomes are. Patients who are suffering from either a physical disease with mental consequences or from mental illnesses can contribute to their own feeling of mental well-being by following evidence-based online, self-guided therapeutic interventions. These self-guided therapeutic interventions during which there is no contact with a care provider have shown high effectiveness. However, users (patients) of self-guided eHealth interventions have difficulties fulfilling the entire trajectory as is mirrored in high non-adherence rates. Users have reported a need for support, that is traditionally provided by human care providers. This study investigates the opportunities from within the technology to increase its support level toward the user. We deployed a pedagogical agent acting as an adjunct to a self-guided positive psychology psycho-education intervention. This agent provided instructions and user support in between and explicitly not during the online learning modules as to mitigate the risk of distraction. By setting up a between-subjects design and deploying three versions of a pedagogical agent (also known as Embodied Conversational Agent), varying the features of animation, speech, and visibility we investigated whether users felt more supported than by a fourth text-only control condition. All four conditions provided similar task-related support and emotion-related support to the user. Our results showed that our pedagogical agent made users feel guided and supported with respect to fulfilling their tasks. However, no effects were found of emotion-related support resulting in higher user motivation and an improved learning experience. Significant effects of visibility and voice were found, but animation of our pedagogical agent had no effect. On the feedback outcome variable, we found a gender effect. Male participants graded the visible Embodied Conversational Agent (ECA) higher than female participants and graded the non-visible ECA lower than female participants. In our view, ECA’s should not necessarily be deployed with the ambition to compete with the profound human potential to deliver support and guidance. Exploring ECA capabilities merits further attention, from the stance that the technology itself can support users and potentially make them adhere.