Miracle-dz/UniFAR-FTUs huggingface dataset:
Self-awareness of computed tomography ordering in the emergency department.

OBJECTIVES Physician variation in the use of computed tomography (CT) is concerning due to the risks of ionizing radiation, cost, and downstream effects of unnecessary testing. The objectives of this study were to describe variation in CT-ordering rates among emergency physicians (EPs), to measure correlation between perceived and actual CT-ordering rates, to assess attitudes that influence decisions to order imaging tests, and to identify EP attitudes associated with higher CT utilization. METHODS This study was a retrospective review of imaging and administrative billing records at two emergency department sites of a tertiary care adult teaching hospital. The study also included a cross-sectional survey of EPs at this hospital. We asked physicians about their perceived ordering behaviour, and what factors influenced their decision to order a CT. We examined correlations between perceived and actual CT-ordering rates. We adjusted ordering rates for shift distribution using a logistic regression model and identified outlier physicians whose ordering rate was significantly lower or higher than expected. We used multivariable regression analysis to determine which survey responses predicted higher CT utilization. RESULTS During the study period, 59 EPs saw 45,854 patients, and ordered 6,609 CTs - a mean ordering rate of 14.4% (standard deviation (SD)=4.3%). The ordering rate for individual physicians ranged from 5.9% to 25.9%. Of the 59 EPs, 13 EPs were low-ordering outliers; 12 were high-ordering outliers. Forty-five EPs (76.3%) completed the survey. Mean perceived ordering rate was 12.6%, and was weakly correlated with actual ordering (r=0.19, p=0.21). 42 EPs (93.3%) believed they ordered "about the same" or "fewer" CTs than their peers. Of the 17 EPs in the two highest ordering quintiles, only 3 (18%) knew they were high orderers. In the multivariable analysis, higher ordering was associated with increasing strength of response to the following predictors: medico-legal risk (relative risk [RR]=1.18, 95% CI: 1.03-1.21), risk of contrast (RR=1.14, 95% CI: 1.07-1.22), what colleagues would do (RR=1.09, 95% CI: 0.99-1.19), risk of missing a diagnosis (RR=1.08, 95% CI: 0.98-1.21), and patient wishes (RR=1.07, 95% CI: 0.97-1.17). CONCLUSIONS There is large variation in CT ordering among EPs. Physicians' self-reported ordering rate correlates poorly with actual ordering. High CT orderers were rarely aware that they ordered more than their colleagues. Higher rates of ordering were observed among physicians who reported increased concern with 1) risk of missing a diagnosis, 2) medico-legal risk, 3) risk of contrast, 4) patient wishes, and 5) what colleagues would do.
Association Between Prescription Drug Insurance and Health Care Utilization Among Medicare Beneficiaries

Medicare Part D was associated with reduced hospitalizations, yet little is known whether these effects varied across patients and how Part D was associated with length of stay and inpatient expenditures. We used Medicare claims and the Medicare Current Beneficiary Survey from 2002 to 2010 and an instrumental variables approach. Gaining drug insurance through Part D was associated with a statistically significant 8.0% reduction in likelihood of admission across conditions examined. Reductions were generally greater for younger, healthier, and male individuals. Across all conditions, mean length of stay decreased by 3.2% from a baseline of 5.1 days. Part D was associated with a 3.5% reduction in expenditures per admission, reflecting a decrease of $844 from a mean charge of $24,124 per admission prior to Part D. Thus, Part D was associated with statistically and clinically significant reductions in the probability of admission and length of stay for several common conditions.
Language constructs for context-oriented programming: an overview of ContextL

ContextL is an extension to the Common Lisp Object System that allows for Context-oriented Programming. It provides means to associate partial class and method definitions with layers and to activate and deactivate such layers in the control flow of a running program. When a layer is activated, the partial definitions become part of the program until this layer is deactivated. This has the effect that the behavior of a program can be modified according to the context of its use without the need to mention such context dependencies in the affected base program. We illustrate these ideas by providing different UI views on the same object while, at the same time, keeping the conceptual simplicity of object-oriented programming that objects know by themselves how to behave, in our case how to display themselves. These seemingly contradictory goals can be achieved by separating class definitions into distinct layers instead of factoring out the display code into different classes.
Role of the Frontal Sinus in Mediating Ocular Vestibular-Evoked Myogenic Potentials by Bone Vibration Stimuli Applied to the Forehead

This study investigated ocular vestibular-evoked myogenic potential (oVEMP) tests via Fpz and Fz taps to assess the role of the frontal sinus in mediating oVEMP elicitation. Forty healthy subjects and 80 patients with Ménière disease (MD) underwent a series of oVEMP tests via a minishaker tapping at the Fpz and Fz sites in a randomized order. Response rates of oVEMP test via various tapping sites were compared. Dimensions of the frontal sinus were measured via CT scan. A significantly negative correlation between the age and height of the frontal sinus was noted, and the cutoff age for discriminating present and absent Fpz oVEMPs in MD patients was 52 years. Additionally, oVEMPs by Fpz tapping were more efficiently presented in males than females, likely because of the greater resonance by the larger height of the frontal sinus in males (3.88 ± 0.68 cm) than females (3.42 ± 0.67 cm). In conclusion, the height of the frontal sinus plays a role in mediating the elicitation of oVEMPs. The oVEMPs could be easily elicited by the first-order bone vibration (Fpz/Fz tapping) coupled with the second-order resonance effect (with a high extent of the frontal sinus). Thus, initial tapping at the Fpz site is suggested. If it fails, try the Fz site for screening the oVEMPs.
Outer Periarteriolar Lymphoid Sheath Arrest and Subsequent Differentiation of Both Naive and Tolerant Immunoglobulin Transgenic B Cells Is Determined by B Cell Receptor Occupancy

T-dependent B cell responses in the spleen are initiated in the outer periarteriolar lymphoid sheath (PALS) and culminate in the generation of proliferative foci and germinal center reactions. By pulsing anti–hen egg lysozyme (HEL) immunoglobulin transgenic (IgTg) B cells with various concentrations of HEL in vitro before adoptive transfer into normal recipients, it was shown that a critical number of B cell receptors (BCRs) must be ligated for B cells to undergo arrest in the outer PALS. T cell help was manipulated independently of the BCR stimulus by incubating B cells expressing the appropriate major histocompatibility complex class II antigen with a peptide recognized by CD4+ TCR Tg T cells. B cells which either failed to arrest in the outer PALS due to a subthreshold BCR stimulus, or arrested only transiently due to the brevity of the BCR stimulus, underwent an abortive response within the follicles when provided with T cell help. In contrast, naive B cells stimulated by a sustained, suprathreshold concentration of either foreign or self-antigen and given T cell help, proliferated in the outer PALS and then differentiated. Outer PALS arrest was not influenced by the nature of the B cells occupying the follicle, but appeared to be determined solely by the magnitude of BCR stimulation. Thus antigen-pulsed B cells arrested in the outer PALS in an identical manner irrespective of whether the follicles comprised a population of normal B cells with multiple specificities, a monoclonal naive population, or a monoclonal population of tolerant B cells. In addition, tolerant B cells were found to relocate from the follicles to the outer PALS of HEL/anti-HEL double Tg mice in which the concentration of soluble self-antigen had been increased by zinc feeding. Similarly, when anti-HEL Tg mice were crossed with a second HEL Tg strain expressing a higher concentration of soluble HEL, the tolerant anti-HEL Tg B cells were located constitutively in the outer PALS. Thus, subtle variations in antigen concentration resulted in dramatic changes in positioning of B cells within the spleen. A series of mixed bone marrow chimeras in which the effective antigen concentration was inversely related to the number of self-reactive B cells due to absorption of antigen by transgene-encoded membrane and secreted Ig, was used to confirm that alteration in B cell position previously attributed to changes in follicular composition could be explained on the basis of available antigen concentration, rather than the diversity of the repertoire.
Glasses-type wearable computer displays: usability considerations examined with a 3D glasses case study

Abstract This study presents usability considerations and solutions for the design of glasses-type wearable computer displays and examines their effectiveness in a case study. Design countermeasures were investigated by a four-step design process: (1) preliminary design analysis; (2) design idea generation; (3) final design selection; and (4) virtual fitting trial. Three design interventions were devised from the design process: (1) weight balance to reduce pressure concentrated on the nose, (2) compliant temples to accommodate diverse head sizes and (3) a hanger mechanism to help spectacle users hang their wearable display on their eye glasses. To investigate their effectiveness, in the case study, the novel 3D glasses adopting the three interventions were compared with two existing 3D glasses in terms of neck muscle fatigue and subjective discomfort rating. While neck muscle fatigue was not significantly different among the three glasses (p = 0.467), the novel glasses had significantly smaller discomfort ratings (p = 0.009). Relevance to Industry: A four-step design process identified usability considerations and solutions for the design of glasses-type wearable computer displays. A novel 3D glasses was proposed through the process and its effectiveness was validated. The results identify design considerations and opportunities relevant to the emerging wearable display industry.
The Space-Time Continuum of Cortical Dysplasia

Somatic Mutations Activating the mTOR Pathway in Dorsal Telencephalic Progenitors Cause a Continuum of Cortical Dysplasias D’Gama AM, Woodworth MB, Hossain AA, Bizzotto S, Hatem NE, LaCoursiere CM, Najm I, Ying Z, Yang E, Barkovich AJ, Kwiatkowski DJ, Vinters HV, Madsen JR, Mathern GW, Blümcke I, Poduri A, Walsh CA. Cell Rep. 2017;21:3754-3766. Focal cortical dysplasia (FCD) and hemimegalencephaly (HME) are epileptogenic neurodevelopmental malformations caused by mutations in mTOR pathway genes. Deep sequencing of these genes in FCD/HME brain tissue identified an etiology in 27 (41%) of 66 cases. Radiographically indistinguishable lesions are caused by somatic activating mutations in AKT3, MTOR, and PIK3CA and germline loss-of-function mutations in DEPDC5, NPRL2, and TSC1/2, including TSC2 mutations in isolated HME demonstrating a “two-hit” model. Mutations in the same gene cause a disease continuum from FCD to HME to bilateral brain overgrowth, reflecting the progenitor cell and developmental time when the mutation occurred. Single-cell sequencing demonstrated mTOR activation in neurons in all lesions. Conditional Pik3ca activation in the mouse cortex showed that mTOR activation in excitatory neurons and glia, but not interneurons, is sufficient for abnormal cortical overgrowth. These data suggest that mTOR activation in dorsal telencephalic progenitors, in some cases specifically the excitatory neuron lineage, causes cortical dysplasia.
Essentially No Barriers in Neural Network Energy Landscape

Training neural networks involves finding minima of a high-dimensional non-convex loss function. Knowledge of the structure of this energy landscape is sparse. Relaxing from linear interpolations, we construct continuous paths between minima of recent neural network architectures on CIFAR10 and CIFAR100. Surprisingly, the paths are essentially flat in both the training and test landscapes. This implies that neural networks have enough capacity for structural changes, or that these changes are small between minima. Also, each minimum has at least one vanishing Hessian eigenvalue in addition to those resulting from trivial invariance.
Local Bond Stress-Slip Models for Reinforcing Bars and Prestressing Strands in High-Peformance Fiber- Reinforced Cement Composites

This paper discusses previous studies that use pullout-type tests comprising monotonic, unidirectional cyclic, and reversed cyclic loads have shown that bond between reinforcing bars/prestressing strands and concrete can be significantly enhanced by replacing the conventional concrete with high-performance fiber-reinforced cement composites (HPFRCCs). This can be attributed to the fact that, compared to plain concrete and conventional fiber-reinforced concrete (FRC), HPFRCCs exhibit a strain-hardening response under tension up to large strains, thereby preventing the concrete from deterioration under bond action. Pullout test results provide the bond stress versus slip relationship that can be considered the constitutive property of the steel-to-HPFRCC interface. Since the post-cracking tensile stress and strain of fiber-reinforced cement composites are the fundamental characteristics that distinguish them from conventional concrete, the HPFRC tensile stress-strain response obtained from direct tensile tests was used to derive the local bond stress-slip models presented in this paper. This paper shows that the proposed models are more concise than previous models suggested for FRC and give good agreement with test results.
The HANS KAI Project: a community-based approach to improving health and well-being through peer support.

INTRODUCTION HANS KAI is a unique health promotion intervention to improve participants' health by focussing on interrelated chronic disease prevention behaviours through peer support and strengthening of social support networks. The study objective was to determine the effectiveness of HANS KAI in an urban Canadian setting. METHODS We used a mixed methods intervention research design that involved multiple sites from November 2010 to April 2015. Data was obtained from participant surveys as well as in-person interviews at zero, 6, 12 and 24 months. Participants met in groups at least once a month during the research period, to self-monitor health indicators, prepare and share a healthy snack, participate in a physical activity, set a healthy lifestyle goal (optional) and socialize. RESULTS There were statistically significant mental health improvements from pre- to post-program, and 66% of the participants described specific behaviour changes as a result of HANS KAI participation. Additional positive health impacts included peer support; acquiring specific health knowledge; inspiration, motivation or accountability; the empowering effect of monitoring one's own health indicators; overcoming social isolation and knowing how to better access services. CONCLUSION The need to identify innovative ways to address chronic disease prevention and management has been the driver for implementing and evaluating HANS KAI. While further research will be required to validate the present findings, it appears that HANS KAI may be an effective approach to create environments that empower community members to support each other while promoting healthy lifestyle choices and detecting early changes in health status.
On the Cutting Performance of Segmented Diamond Blades when Dry-Cutting Concrete

The objective of the present study is to analyze and compare the cutting performance of segmented diamond blades when dry-cutting concrete. A cutting criteria is proposed to characterize the wear of the blades by measuring the variation of the external diameter and the weight loss of the blade. The results exhibit the cutting blade SB-A, which has twice the density of diamonds and large contact area, exhibits less wear even though the material removal rate is higher compared with the other two cutting blades. Additionally, the surface topography of the different blades is evaluated to examine the impact of wear depending on the surface profile and the distribution of the diamonds in the blade’s matrix. Large number of diamonds pull-out are found in blades type SB-C, which additionally shows the worst wear resistant capability. As a conclusion, the cutting efficiency of the blade is found to be related to the density of embedded diamonds and the type of the surface profile of the cutting blade after reaching the stop criteria.
Wear and machinability properties of AS series magnesium alloys

This study investigates the effect of the amount of Al amount in AS series magnesium alloys on wear resistance and machinability. Changes in mechanical properties, wear resistance, and machinability were studied depending on the Al amount in magnesium alloys containing 1% Si. Therefore, AS series magnesium alloys (AS11, AS21, AS41, AS61, and AS91) (containing Al in various degrees ranging from 1% to 9%) were used in this study. It was observed that the hardness of intermetallic phases in the microstructure of AS series magnesium alloys affected wear resistance and machinability depending on the increase in Al amount. Mg2Si intermetallic phase in the microstructure of AS91 alloy was established to reduce machinability while increasing hardness and wear resistance.
Anaerobic Ammonium-Oxidizing Bacteria in Cow Manure Composting.

Composting is widely used to transform waste into valuable agricultural organic fertilizer. Anaerobic ammonium-oxidizing (anammox) bacteria play an important role in the global nitrogen cycle, but their role in composting remains poorly understood. In the present study, the community structure, diversity, and abundance of anammox bacteria were analyzed using cloning and sequencing methods by targeting the 16S rRNA gene and the hydrazine oxidase gene (hzo) in samples isolated from compost produced from cow manure and rice straw. A total of 25 operational taxonomic units were classified based on 16S rRNA gene clone libraries, and 14 operational taxonomic units were classified based on hzo gene clone libraries. The phylogenetic tree analysis of the 16S rRNA gene and deduced HZO protein sequences from the corresponding encoding genes indicated that the majority of the obtained clones were related to the known anammox bacteria Candidatus "Brocadia," Candidatus "Kuenenia," and Candidatus "Scalindua. " The abundances of anammox bacteria were determined by quantitative PCR, and between 2.13 × 105 and 1.15 × 106 16S rRNA gene copies per gram of compost were found. This study provides the first demonstration of the existence of anammox bacteria with limited diversity in cow manure composting.
A 3-Year Randomized Trial of Lifestyle Intervention for Cardiovascular Risk Reduction in the Primary Care Setting: The Swedish Björknäs Study

Background Successfully transferring the findings of expensive and tightly controlled programmes of intensive lifestyle modification to the primary care setting is necessary if such knowledge is to be of clinical utility. The objective of this study was to test whether intensive lifestyle modification, shown previously in tightly-controlled clinical trials to be efficacious for diabetes risk-reduction among high-risk individuals, can reduce cardiovascular risk factor levels in the primary care setting. Methodology / Principal Findings The Swedish Björknäs study was a randomized controlled trial conducted from 2003 to 2006 with follow-up on cardiovascular risk factors at 3, 12, 24 and 36 months. A total of 151 middle-aged men and women at moderate- to high-risk of cardiovascular disease from northern Sweden were randomly assigned to either an intensive lifestyle intervention (n = 75) or control (n = 76) group. The intervention was based broadly on the protocol of the Diabetes Prevention Program. The three-month intervention period was administered in the primary care setting and consisted of supervised exercise sessions and diet counselling, followed by regular group meetings during three years. The control group was given general advice about diet and exercise and received standard clinical care. Outcomes were changes in anthropometrics, aerobic fitness, self-reported physical activity, blood pressure, and metabolic traits. At 36 months post-randomisation, intensive lifestyle modification reduced waist circumference (−2.2 cm: p = 0.001), waist-hip ratio (−0.02: p<0.0001), systolic blood pressure (−4.9 mmHg: p = 0.036), and diastolic blood pressure (−1.6 mmHg: p = 0.005), and improved aerobic fitness (5%; p = 0.038). Changes in lipid or glucose values did not differ statistically between groups. At 36 months, self-reported time spent exercising and total physical activity had increased more in the intervention group than in the control group (p<0.001). Conclusion / Significance A program of intensive lifestyle modification undertaken in the primary health care setting can favourably influence cardiovascular risk-factor profiles in high-risk individuals. Trial Registration ClinicalTrials.gov NCT00486941
Mechanisms Promoting the Long-Term Persistence of a Wolbachia Infection in a Laboratory-Adapted Population of Drosophila melanogaster

Intracellular bacteria of the genus Wolbachia are widespread endosymbionts across diverse insect taxa. Despite this prevalence, our understanding of how Wolbachia persists within populations is not well understood. Cytoplasmic incompatibility (CI) appears to be an important phenotype maintaining Wolbachia in many insects, but it is believed to be too weak to maintain Wolbachia in Drosophila melanogaster, suggesting that Wolbachia must also have other effects on this species. Here we estimate the net selective effect of Wolbachia on its host in a laboratory-adapted population of D. melanogaster, to determine the mechanisms leading to its persistence in the laboratory environment. We found i) no significant effects of Wolbachia infection on female egg-to-adult survival or adult fitness, ii) no reduced juvenile survival in males, iii) substantial levels of CI, and iv) a vertical transmission rate of Wolbachia higher than 99%. The fitness of cured females was, however, severely reduced (a decline of 37%) due to CI in offspring. Taken together these findings indicate that Wolbachia is maintained in our laboratory environment due to a combination of a nearly perfect transmission rate and substantial CI. Our results show that there would be strong selection against females losing their infection and producing progeny free from Wolbachia.
Effect of Crude Oil Pollution on some Soil Physical Properties

The release of crude oil into the environment by oil spills is receiving worldwide attention due to the potential risks posed to the ecosystem. The effect of crude oil pollution on soil physical properties was investigated at Effunrun, Warri, Delta State, Nigeria. Soil samples in three replicates were collected from a polluted area and control (unpolluted) sites at three soil depths of 0-5 cm, 0-10 cm and 10-15 cm and analyzed for soil physical properties. Sand particles was significantly (p<0.05) reduced by 4.4 % at 10-15cm depth when compared with 0-5 cm depth. In contrast, clay content was significantly (p<0.05) lower at 0-5cm depth than 5- 10 cm and 10-15 cm respectively, by 26.0 % and 30.7 %. Clay content increased with soil depth. Soil total porosity and macroporosity were 7.84 % and 17.6 %, respectively being higher in unpolluted soil than polluted soil howbeit, the results were similar. The study revealed that crude oil can have effect on pore spaces within the soil. Consequently, this may impair aeration and infiltration of water into the soil and inhibit plant growth.