Miracle-dz/UniFAR-FTUs huggingface dataset:
The COPD assessment test (CAT): response to pulmonary rehabilitation. A multicentre, prospective study

Background The COPD (chronic obstructive pulmonary disease) assessment test (CAT) is a recently introduced, simple to use patient-completed quality of life instrument that contains eight questions covering the impact of symptoms in COPD. It is not known how the CAT score performs in the context of clinical pulmonary rehabilitation (PR) programmes or what the minimum clinically important difference is. Methods The introduction of the CAT score as an outcome measure was prospectively studied by PR programmes across London. It was used alongside other measures including the St George's Respiratory Questionnaire, the Chronic Respiratory Disease Questionnaire, the Clinical COPD Questionnaire, the Hospital Anxiety and Depression score, the Medical Research Council (MRC) dyspnoea score and a range of different walking tests. Patients completed a 5-point anchor question used to assess overall response to PR from ‘I feel much better’ to ‘I feel much worse’. Results Data were available for 261 patients with COPD participating in seven programmes: mean (SD) age 69.0 (9.0) years, forced expiratory volume in 1 s (FEV1) 51.1 (18.7) % predicted, MRC score 3.2 (1.0). Mean change in CAT score after PR was 2.9 (5.6) points, improving by 3.8 (6.1) points in those scoring ‘much better’ (n=162), and by 1.3(4.5) in those who felt ‘a little better’ (n=88) (p=0.002). Only eight individuals reported no difference after PR and three reported feeling ‘a little worse’, so comparison with these smaller groups was not possible. Conclusion The CAT score is simple to implement as an outcome measure, it improves in response to PR and can distinguish categories of response.
Robot-assisted Resection of Paraspinal Schwannoma

Resection of retroperitoneal tumors is usually perfomed using the anterior retroperitoneal approach. Our report presents an innovative method utilizing a robotic surgical system. A 50-yr-old male patient visited our hospital due to a known paravertebral mass. Magnetic resonance imaging showed a well-encapsulated mass slightly abutting the abdominal aorta and left psoas muscle at the L4-L5 level. The tumor seemed to be originated from the prevertebral sympathetic plexus or lumbosacral trunk and contained traversing vessels around the tumor capsule. A full-time robotic transperitoneal tumor resection was performed. Three trocars were used for the robotic camera and working arms. The da Vinci Surgical System® provided delicate dissection in the small space and the tumor was completely removed without damage to the surrounding organs and great vessels. This case demonstrates the feasibility of robotic resection in retroperitoneal space. Robotic surgery offered less invasiveness in contrast to conventional open surgery.
Advance care planning in motor neuron disease: A systematic review

Abstract Objective: Motor neuron disease (MND) is an incurable progressive illness, characterized by incessant deterioration of neuromuscular function. Timely commencement of advance care planning (ACP) may enable patients to participate in future care choices. The present systematic review aimed to summarize what is known about the prevalence, content, patient/caregiver benefits, healthcare professional (HCP) awareness/support, and healthcare outcomes associated with ACP in the MND setting. Method: Quantitative and qualitative studies were identified through database searches and eligibility assessed by one author and verified by her coauthor. Data extraction and quality assessments against standardized criteria were completed by the two authors. Results: Of the 422 studies identified, 16 were included. The research methods generally lacked rigor. Advance directive (AD) prevalence varied considerably across studies. Disease progression was the strongest predictor of AD completion. ACP processes may clarify patients' wishes and promote communication. HCP attitudes or lack of awareness may limit ACP processes. Varying patient preferences may make flexible approaches and timing necessary. Significance of results: Important benefits may be associated with ACP in the context of a motor neuron disease (e.g., feelings of control/relief and refusal of unwanted treatments). However, further evidence is required to verify findings and identify optimal streamlined approaches (e.g., use of decision aids) consistent with patients' (and caregivers') needs over time.
Cloud-Based Service Information System for Evaluating Quality of Life after Breast Cancer Surgery

Objective Although recent studies have improved understanding of quality of life (QOL) outcomes of breast conserving surgery, few have used longitudinal data for more than two time points, and few have examined predictors of QOL over two years. Additionally, the longitudinal data analyses in such studies rarely apply the appropriate statistical methodology to control for censoring and inter-correlations arising from repeated measures obtained from the same patient pool. This study evaluated an internet-based system for measuring longitudinal changes in QOL and developed a cloud-based system for managing patients after breast conserving surgery. Methods This prospective study analyzed 657 breast cancer patients treated at three tertiary academic hospitals. Related hospital personnel such as surgeons and other healthcare professionals were also interviewed to determine the requirements for an effective cloud-based system for surveying QOL in breast cancer patients. All patients completed the SF-36, Quality of Life Questionnaire (QLQ-C30) and its supplementary breast cancer measure (QLQ-BR23) at baseline, 6 months, 1 year, and 2 years postoperatively. The 95% confidence intervals for differences in responsiveness estimates were derived by bootstrap estimation. Scores derived by these instruments were interpreted by generalized estimating equation before and after surgery. Results All breast cancer surgery patients had significantly improved QLQ-C30 and QLQ-BR23 subscale scores throughout the 2-year follow-up period (p<0.05). During the study period, QOL generally had a negative association with advanced age, high Charlson comorbidity index score, tumor stage III or IV, previous chemotherapy, and long post-operative LOS. Conversely, QOL was positively associated with previous radiotherapy and hormone therapy. Additionally, patients with high scores for preoperative QOL tended to have high scores for QLQ-C30, QLQ-BR23 and SF-36 subscales. Based on the results of usability testing, the five constructs were rated on a Likert scale from 1–7 as follows: system usefulness (5.6±1.8), ease of use (5.6±1.5), information quality (5.4±1.4), interface quality (5.5±1.4), and overall satisfaction (5.5±1.6). Conclusions The current trend in clinical medicine is applying therapies and interventions that improve QOL. Therefore, a potentially vast amount of internet-based QOL data is available for use in defining patient populations that may benefit from therapeutic intervention. Additionally, before undergoing breast conserving surgery, patients should be advised that their postoperative QOL depends not only on the success of the surgery, but also on their preoperative functional status.
The Future of Microprocessors

The performance of microprocessors that power modern computers has continued to increase exponentially over the years for two main reasons. First, the transistors that are the heart of the circuits in all processors and memory chips have simply become faster over time on a course described by Moore’s law, and this directly affects the performance of processors built with those transistors. Moreover, actual processor performance has increased faster than Moore’s law would predict, because processor designers have been able to harness the increasing numbers of transistors available on modern chips to extract more parallelism from software.
Adaptation to marginal habitats: contrasting influence of the dispersal rate on the fate of alleles with small and large effects

The focus of this paper is the relationship between the dispersal rate and the conditions for invasion of a rare allele that improves performance in a marginal sink habitat at the expense of reducing fitness in the main source habitat. Classic multiple–niche population–genetic models predict that the conditions for the invasion of such an allele always become more favourable as the dispersal rate decreases. Precisely the opposite prediction was reached in demographic fitness–sensitivity studies. This study reconciles those contradictory predictions and identifies the assumptions responsible for the discrepancy. I show that whether a lower dispersal rate makes the conditions for the invasion of the allele more or less stringent depends on the magnitude of the effects of the allele. If the effect is large relative to the degree of maladaptedness of the original genotype to the marginal habitat, the conditions become less stringent with decreasing dispersal rate. The opposite is the case for mutations with very small effects. For a broad range of mutations with intermediate effects the conditions are most stringent under an intermediate dispersal rate.
Interference Alignment Techniques for MIMO Multi-Cell Interfering Broadcast Channels

The interference alignment (IA) is a promising technique to efficiently mitigate interference and to enhance capacity of a wireless communication network. This paper proposes an interference alignment scheme for a network with multiple cells and multiple multiple-input and multiple-output (MIMO) users under a Gaussian interference broadcast channel (IFBC) scenario. We first extend a grouping method already known in the literature to a multiple-cells scenario and jointly design transmit and receiver beamforming vectors using a closed-form expression without iterative computation. Then we propose a new approach using the principle of multiple access channel (MAC) - broadcast channel (BC) duality to perform interference alignment while maximizing capacity of users in each cell. The algorithm in its dual form is solved using interior point methods. We show that the proposed approach outperforms the extension of the grouping method in terms of capacity and basestation complexity. Finally, a rate balancing technique is introduced to maintain fairness among users.
An Evaluation of the MOOD Set of Object-Oriented Software Metrics

This paper describes the results of an investigation into a set of metrics for object-oriented design, called the MOOD metrics. The merits of each of the six MOOD metrics is discussed from a measurement theory viewpoint, taking into account the recognized object-oriented features which they were intended to measure: encapsulation, inheritance, coupling, and polymorphism. Empirical data, collected from three different application domains, is then analyzed using the MOOD metrics, to support this theoretical validation. Results show that (with appropriate changes to remove existing problematic discontinuities) the metrics could be used to provide an overall assessment of a software system, which may be helpful to managers of software development projects. However, further empirical studies are needed before these results can be generalized.
Preliminary evidence for the role of HTR2A variants in binge eating in young women

We examined the association between 15 single nucleotide polymorphisms (SNPs) in HTR2A and characteristics of disordered eating, including weight/shape concerns, binge eating (with or without loss of control), and compensatory behaviors (purging and nonpurging). Whether a lifetime history of major depressive disorder (MDD) moderated or mediated this association was also investigated. A sample of 1533 twin women of White descent that were part of the Missouri Adolescent Female Twin Study was used. Data were collected using self-report responses to a semistructured interview. Logistic regression analyses were used to examine the association between weight/shape concerns, binge eating, and compensatory behaviors and SNPs (where carriers of the minor allele were coded as 1). Two SNPs, rs6561333 and rs2296972, showed a protective influence against binge eating, with rs2296972 being significant at a trend level after application of the false discovery rate. The SNP was not associated with MDD nor did MDD moderate its putative relation with binge eating. Pending replication, our analyses provide preliminary evidence for intronic SNPs in HTR2A and their association with binge eating. Given the well-documented role of serotonergic dysfunction in eating psychopathology, this report warrants considerable further study.
The Covariation Between Burnout and Sick Leave Due to Mental Disorders Is Explained by a Shared Genetic Liability: A Prospective Swedish Twin Study With a Five-Year Follow-up

Background: This study aims to assess whether the associations between burnout and sick leave due to stress-related mental disorders, other mental disorders, and somatic conditions are influenced by familial (genetic and shared environmental) factors. Methods: In this prospective cohort study, 23,611 Swedish twins born between 1959 and 1985, who answered a web-based questionnaire, including the Pines Burnout Measure 2004–2006, were included. Registry data on sick leave spells from the response date until December 31, 2010 were obtained from the Swedish Social Insurance Agency. Logistic regression analysis was performed to assess odds ratios with 95% confidence intervals for the association between burnout and sick leave for the whole sample, while conditional logistic regression of the same-sex discordant twin pairs was used to estimate the association between burnout and sick leave, adjusting for familial confounding. The Bivariate Cholesky models were used to assess whether the covariation between burnout and sick leave was explained by common genetic and/or shared environmental factors. Results: Burnout was a risk factor for sick leave due to stress-related and other mental disorders, and these associations were explained by familial factors. The phenotypic correlation between burnout and sick leave due to somatic conditions was 0.07 and the association was not influenced by familial factors. The phenotypic correlations between burnout and sick leave due to stress-related (0.26) and other mental disorders (0.30) were completely explained by common genetic factors. Conclusions: The association between burnout and sick leave due to stress-related and other mental disorders seems to be a reflection of a shared genetic liability.
On the Placement of an Obstacle or a Well so as to Optimize the Fundamental Eigenvalue

We investigate how to place an obstacle B within a domain $\Omega$ in Euclidean space so as to maximize or minimize the principal Dirichlet eigenvalue for the Laplacian on $\Omega \setminus B$. The shape of B is fixed a priori (usually as a ball), and only its position varies. We establish that for a certain class of domains the minimizing B is in contact with $\partial \Omega$, while the maximizing B is in the interior, typically at the center (supposing that the domain is sufficiently symmetric for this statement to be meaningful). Under special circumstances we can characterize the optimizing configurations with multiple obstacles. Our method relies on the Hadamard perturbation formula and a moving plane analysis.Similar facts are proved when the hard obstacle is replaced by a central nonnegative potential function supported in B, and we consider the Schrodinger operator with this potential. Complementary facts are proved when the obstacle is replaced by a central nonpositive potential function.
Robust stability analysis of interconnected systems with uncertain time-varying time delays via IQCs

This paper presents a general modeling framework for interconnected LPV systems, that includes model classes like decomposable systems as special cases. The framework allows to consider arbitrary dynamic interconnection operators in the model. We propose to use integral quadratic constraints (IQCs) for robust stability analysis of such interconnected systems and provide convex sufficient conditions for the practically relevant case when communication between subsystems is delayed by an uncertain time-varying time delay. For that purpose, a survey of results on IQCs for time delay operators is presented. When analyzing robust stability, we distinguish between dynamic interconnection in- and output operators of the subsystems and a time-varying real valued interconnection topology, which may be switching arbitrarily fast under certain conditions.
Silent Cerebral Microbleeds on T2*-Weighted MRI: Correlation with Stroke Subtype, Stroke Recurrence, and Leukoaraiosis

Background and Purpose— Gradient-echo T2*-weighted MRI is uniquely sensitive to detect silent, old hemosiderin deposits, but the clinical significance of such “microbleeds” remains to be determined. Therefore, we investigated the incidence and the number of microbleeds among different stroke subtypes and the correlation with stroke recurrence and the severity of leukoaraiosis. Methods— This study consisted of 213 patients (73.5±9.1 years old, 104 men and 109 women), who were classified according to stroke subtypes into atherothrombotic infarction (24 patients), cardioembolic infarction (23 patients), lacunar infarction (66 patients), intracerebral hemorrhage (35 patients), and control (65 patients) groups. Gradient-echo T2*-weighted MRI was performed with a 1.5 T system, and asymptomatic microbleeds were located and counted. Results— The incidence and the number of microbleeds were significantly greater in patients with intracerebral hemorrhage (71.4% and 9.1±13.8, respectively) and lacunar infarction (62.1% and 7.4±16.1) compared with patients with cardioembolic infarction (30.4% and 2.5±5.6), atherothrombotic infarction (20.8% and 0.63±1.53), and controls (7.7% and 0.09±0.34). There was a correlation between the number of microbleeds and the severity of periventricular hyperintensity (r =0.626, P <0.0001). There was also a correlation between the number of microbleeds and the number of intracerebral hemorrhages (r =0.689, P <0.0001) or lacunar infarctions (r =0.514, P <0.0001). The locations of microbleeds were subcortical white matter (31.8%), thalamus (24.8%), basal ganglia (19.8%), brain stem (12.0%), and cerebellum (11.7%). Conclusions— The findings suggest that microbleeds on T2*-weighted MRI are an indicator of advanced small artery disease of the brain with an increased risk for bleeding. This result should be taken into consideration when treating patients with stroke, and further studies are required.
Variability of spirometry in chronic obstructive pulmonary disease: results from two clinical trials.

OBJECTIVE Our goal is to determine short-term intraindividual biologic and measurement variability in spirometry of patients with a wide range of stable chronic obstructive pulmonary disease severity, using datasets from the National Emphysema Treatment Trial (NETT) and the Lung Health Study (LHS). This may be applied to determine criteria that can be used to assess a clinically meaningful change in spirometry. METHODS A total of 5,886 participants from the LHS and 1,215 participants from the NETT performed prebronchodilator spirometry during two baseline sessions. We analyzed varying criteria for absolute and percent change of FEV(1) and FVC to determine which criterion was met by 90% of the participants. RESULTS The mean +/- SD FEV(1) for the initial session was 2.64 +/- 0.60 L (75.1 +/- 8.8% predicted) for the LHS and 0.68 +/- 0.22 L (23.7 +/- 6.5% predicted) for the NETT. The mean +/- SD number of days between test sessions was 24.9 +/- 17.1 for the LHS and 85.7 +/- 21.7 for the NETT. As the degree of obstruction increased, the intersession percent difference of FEV(1) increased. However, the absolute difference between tests remained relatively constant despite the severity of obstruction (0.106 +/- 0.10 L). Over 90% of participants had an intersession FEV(1) difference of less than 225 ml irrespective of the severity of obstruction. CONCLUSIONS Absolute changes in FEV(1) rather than percent change should be used to determine whether patients with chronic obstructive pulmonary disease have improved or worsened between test sessions.
Global Distribution of Rubella Virus Genotypes

Phylogenetic analysis of a collection of 103 E1 gene sequences from rubella viruses isolated from 17 countries from 1961 to 2000 confirmed the existence of at least two genotypes. Rubella genotype I (RGI) isolates, predominant in Europe, Japan, and the Western Hemisphere, segregated into discrete subgenotypes; intercontinental subgenotypes present in the 1960s and 1970s were replaced by geographically restricted subgenotypes after ~1980. Recently, active subgenotypes include one in the United States and Latin America, one in China, and a third that apparently originated in Asia and spread to Europe and North America, starting in 1997, indicating the recent emergence of an intercontinental subgenotype. A virus that potentially arose as a recombinant between two RGI subgenotypes was discovered. Rubella genotype II (RGII) showed greater genetic diversity than did RGI and may actually consist of multiple genotypes. RGII viruses were limited to Asia and Europe; RGI viruses were also present in most of the countries where RGII viruses were isolated.
A Combined Manifold Learning Analysis of Shape and Appearance to Characterize Neonatal Brain Development

Large medical image datasets form a rich source of anatomical descriptions for research into pathology and clinical biomarkers. Many features may be extracted from data such as MR images to provide, through manifold learning methods, new representations of the population's anatomy. However, the ability of any individual feature to fully capture all aspects morphology is limited. We propose a framework for deriving a representation from multiple features or measures which can be chosen to suit the application and are processed using separate manifold-learning steps. The results are then combined to give a single set of embedding coordinates for the data. We illustrate the framework in a population study of neonatal brain MR images and show how consistent representations, correlating well with clinical data, are given by measures of shape and of appearance. These particular measures were chosen as the developing neonatal brain undergoes rapid changes in shape and MR appearance and were derived from extracted cortical surfaces, nonrigid deformations, and image similarities. Combined single embeddings show improved correlations demonstrating their benefit for further studies such as identifying patterns in the trajectories of brain development. The results also suggest a lasting effect of age at birth on brain morphology, coinciding with previous clinical studies.
Horizontal gene transfer in the evolution of group A streptococcal emm‐like genes: gene mosaics and variation in Vir regulons

Most M type 5 group A streptococcal strains were found to contain a single emm‐like gene between virR and scpA (the Vir reguion), but two distinct emm‐like genes were identified in the Vir regulon of the MS strain NCTC8193. The complete sequences of both of these genes were determined. One, called emm5.8193, was shown to be a minor variant of the previously described emm5 gene from strain Manfredo. The second, designated enn5.8193, expresses an IgG‐binding protein when cloned in Escherichia coli. A comparison of enn5.8193 with emm‐like gene sequences from other strains indicated that it has a mosaic structure, consisting of distinct segments originating from emm‐like genes in different OF+ and OF−strains. These data provide the first clear evidence that the horizontal transfer of emm‐like sequences between distinct strains contributes to the evolution of group A streptococcal emm‐like genes and Vir regulons.