Miracle-dz/UniFAR-FTUs huggingface dataset:
Polypharmacy-an Upward Trend with Unpredictable Effects.

BACKGROUND Guideline-oriented treatments can lead to polypharmacy, i.e., the simultaneous long-term use of multiple drugs. Polypharmacy mainly affects elderly patients. The goal of this review is to survey the current scientific evidence about polypharmacy, focusing on clinical endpoints, and to point out implications for medical practice and research. METHODS This selective literature review is based on pertinent publications that were retrieved by a selective search in PubMed employing the terms "polypharmacy AND general practice. " Selected references were considered as well. RESULTS In Germany, polypharmacy currently affects approximately 42% of persons over age 65, with an ongoing upward trend. 20-25% of these patients receive potentially inappropriate drugs. Approximately 86% of the daily doses of drugs taken by persons over age 65 are prescribed by general practitioners. There is inconsistent evidence on the question whether polypharmacy affects clinical endpoints such as mortality. It cannot be determined with certainty whether polypharmacy itself, or the underlying multimorbidity, is the reason for worse clinical outcomes. Lists, instruments, and guidelines such as PRISCUS (a list of potentially inappropriate drugs for elderly patients), FORTA (Fit fOR The Aged), MAI (the Medication Appropriateness Index), and the Hausärztliche Leitlinie Multimedikation (a German-language guideline on polypharmacy for general practitioners) can help physicians take care of patients who are taking multiple drugs. It has not yet been proven, however, that their use has any effect on clinical outcomes. CONCLUSION The decision whether to keep giving a drug or to discontinue it must always be made individually on the basis of current treatment goals; drug lists and a pertinent general practitioners' guideline can be useful aids in decision-making. Efforts to pay more attention to multimorbidity and polypharmacy in future studies and guidelines are deserving of support.
Monitoring Trail: A New Paradigm for Fast Link Failure Localization in WDM Mesh Networks

We consider optical layer monitoring schemes for fast link failure localization in WDM mesh networks. A new concept monitoring trail (m-trail) is proposed. It differs from the existing monitoring cycle (m-cycle) concept by removing the cycle constraint. As a result, m-trail provides a more flexible all-optical monitoring structure which includes simple, non-simple m-cycles and open trails as special cases. Aiming at minimizing the total monitoring cost, an integer linear program (ILP) is formulated for m-trail design. Numerical results show that the m-trail based scheme significantly outperforms its m-cycle based counterpart.
Contribution of Climate and Air Pollution to Variation in Coronary Heart Disease Mortality Rates in England

There are substantial geographic variations in coronary heart disease (CHD) mortality rates in England that may in part be due to differences in climate and air pollution. An ecological cross-sectional multi-level analysis of male and female CHD mortality rates in all wards in England (1999–2004) was conducted to estimate the relative strength of the association between CHD mortality rates and three aspects of the physical environment - temperature, hours of sunshine and air quality. Models were adjusted for deprivation, an index measuring the healthiness of the lifestyle of populations, and urbanicity. In the fully adjusted model, air quality was not significantly associated with CHD mortality rates, but temperature and sunshine were both significantly negatively associated (p<0.05), suggesting that CHD mortality rates were higher in areas with lower average temperature and hours of sunshine. After adjustment for the unhealthy lifestyle of populations and deprivation, the climate variables explained at least 15% of large scale variation in CHD mortality rates. The results suggest that the climate has a small but significant independent association with CHD mortality rates in England.
Progress Dissecting the Oral Microbiome in Caries and Health

Recent rapid advances in “-omics” technologies have yielded new insights into the interaction of the oral microbiome with its host. Associations of species that are usually considered to be acid-tolerant with caries have been confirmed, while some recognized as health-associated are often present in greater proportions in the absence of caries. In addition, some newly identified bacteria have been suggested as potential contributors to the caries process. In spite of this progress, two major challenges remain. The first is that there is a great deal of heterogeneity in the phenotypic capabilities of individual species of oral bacteria. The second is that the most abundant taxa in oral biofilms display remarkable phenotypic plasticity, i.e., the bacteria associated most strongly with health or with caries can morph rapidly in response to alterations in environmental pH, carbohydrate availability and source, and oxygen tension and redox environment. However, new technologic advances coupled with “old-fashioned microbiology” are starting to erode the barriers to a more complete understanding of oral biofilm physiology and ecology, and in doing so are beginning to provide insights for the creation of novel cost-effective caries control therapies.
The effects of smoking on treatment outcome in patients newly diagnosed with pulmonary tuberculosis.

SETTING Smoking is reported to be associated with tuberculosis (TB), but its effect on sputum smear conversion remains a matter for discussion. OBJECTIVE To assess the effects of smoking and smoking cessation on treatment outcomes in patients newly diagnosed with TB in Iran. DESIGN Newly diagnosed smear-positive TB patients were included in the study. All smokers participated in a smoking cessation programme. Sputum smear status was evaluated at the end of month 2, 5 and 6 of treatment, and smoking status was evaluated at the end of month 2. Differences in smear conversion rates were compared between the three groups, i.e., non-smokers, smokers and quitters. RESULTS A total of 183 smokers and 151 non-smokers were included. When smoking cessation was assessed after 2 months, 42.6% (78/183) of the smokers were found to have quit. The cure rate at the end of 6 months, precisely compatible with the conversion rate, was significantly higher among non-smokers (P = 0.004) and quitters at 2 months (P = 0.049) than among persisting smokers (83.4%, 80.8% and 67.6%, respectively). CONCLUSION Cure rates in patients newly diagnosed with pulmonary TB were higher in non-smokers and quitters at 2 months than in smokers. Smoking cessation advice should be included in TB control programmes.
Acceleration and heating of metal particles in condensed matter detonation

For condensed explosives, containing metal particle additives, interaction of the detonation shock and reaction zone with solid inclusions leads to high rates of momentum and heat transfer that consequently introduce non-ideal detonation phenomena. During the time scale of the leading detonation shock crossing a particle, the acceleration and heating of metal particles are shown to depend on the volume fraction of particles, dense packing configuration, material density ratio of explosive to solid particles and ratio of particle diameter to detonation reaction-zone length. Dimensional analysis and physical parameter evaluation are used to formalize the factors affecting particle acceleration and heating. Three-dimensional mesoscale calculations are conducted for matrices of spherical metal particles immersed in a liquid explosive for various particle diameter and solid loading conditions, to determine the velocity and temperature transmission factors resulting from shock compression. Results are incorporated as interphase exchange source terms for macroscopic continuum models that can be applied to practical detonation problems involving multi-phase explosives or shock propagation in dense particle-fluid systems.
Ultrahigh Strength and High Electrical Conductivity in Copper

Methods used to strengthen metals generally also cause a pronounced decrease in electrical conductivity, so that a tradeoff must be made between conductivity and mechanical strength. We synthesized pure copper samples with a high density of nanoscale growth twins. They showed a tensile strength about 10 times higher than that of conventional coarse-grained copper, while retaining an electrical conductivity comparable to that of pure copper. The ultrahigh strength originates from the effective blockage of dislocation motion by numerous coherent twin boundaries that possess an extremely low electrical resistivity, which is not the case for other types of grain boundaries.
Lateralizing language with magnetic source imaging: Validation based on the Wada test

Purpose: Magnetoencephalography (MEG)/magnetic source imaging (MSI) is a noninvasive functional neuroimaging procedure used to localize language‐specific regions in the brain. The Wada test, or intracarotid amobarbital procedure (IAP), is the gold standard in determining speech/language lateralization for presurgical planning, although it is invasive and associated with morbidity. The purpose of this study is to provide further validation on the use of MSI for presurgical language lateralization by comparing results against the IAP.
Antibiotic-induced gut microbiota disruption during human endotoxemia: a randomised controlled study

Objective The gut microbiota is essential for the development of the intestinal immune system. Animal models have suggested that the gut microbiota also acts as a major modulator of systemic innate immunity during sepsis. Microbiota disruption by broad-spectrum antibiotics could thus have adverse effects on cellular responsiveness towards invading pathogens. As such, the use of antibiotics may attribute to immunosuppression as seen in sepsis. We aimed to test whether disruption of the gut microbiota affects systemic innate immune responses during endotoxemia in healthy subjects. Design In this proof-of-principle intervention trial, 16 healthy young men received either no treatment or broad-spectrum antibiotics (ciprofloxacin, vancomycin and metronidazole) for 7 days, after which all were administered lipopolysaccharide intravenously to induce a transient sepsis-like syndrome. At various time points, blood and faeces were sampled. Results Gut microbiota diversity was significantly lowered by the antibiotic treatment in all subjects. Clinical parameters, neutrophil influx, cytokine production, coagulation activation and endothelial activation during endotoxemia were not different between antibiotic-pretreated and control individuals. Antibiotic treatment had no impact on blood leucocyte responsiveness to various Toll-like receptor ligands and clinically relevant causative agents of sepsis (Streptococcus pneumoniae, Klebsiella pneumoniae, Escherichia coli) during endotoxemia. Conclusions These findings suggest that gut microbiota disruption by broad-spectrum antibiotics does not affect systemic innate immune responses in healthy subjects during endotoxemia in humans, disproving our hypothesis. Further research is needed to test this hypothesis in critically ill patients. These data underline the importance of translating findings in mice to humans. Trial registration number ClinicalTrials.gov (NCT02127749; Pre-results).
Look on the Bright Side: Positivity Bias Modulates Interference Effects in the Simon Task

Negative faces are detected more quickly but categorized more slowly than positive faces. Using a Simon task, we examined stimulus- and response-related processes of this dissociation: If negative stimuli are both processed and responded to more quickly than positive ones, they should elicit reduced Simon effects. Conversely, if negative stimuli are processed more quickly but responded to more slowly, enlarged Simon effects should occur. Consistent with the first possibility, negative stimuli showed reduced Simon effects. Unexpectedly, this reduction transferred to neutral stimuli (arrows and pointing hands) requiring the same response as negative faces. This pattern suggests that spatial attention became biased toward the side associated with a positive-face response and away from the side associated with a negative-face response, demonstrating that, similar to higher level cognitive decision processes, even early attentional processes can be subject to a positivity bias (“Pollyanna effect”).
Microwave ablation of primary and secondary liver tumours: ex vivo, in vivo, and clinical characterisation

Abstract Purpose: The aim of this study was to compare the performance of a microwave ablation (MWA) apparatus in preclinical and clinical settings. Materials and method: The same commercial 2.45 GHz MWA apparatus was used throughout this study. In total 108 ablations at powers ranging from 20 to 130 W and lasting from 3 to 30 min were obtained on ex vivo bovine liver; 28 ablations at 60 W, 80 W and 100 W lasting 5 and 10 min were then obtained in an in vivo swine model. Finally, 32 hepatocellular carcinomas (HCCs) and 19 liver metastases in 46 patients were treated percutaneously by administering 60 W for either 5 or 10 min. The treatment outcome was characterised in terms of maximum longitudinal and transversal axis of the induced ablation zone. Results: Ex vivo ablation volumes increased linearly with deposited energy (r2 = 0.97), with higher sphericity obtained at lower power for longer ablation times. Larger ablations were obtained on liver metastases compared to HCCs treated with 60 W for 10 min (p < 0.003), as ablation diameters were 4.1 ± 0.6 cm for metastases and 3.7 ± 0.3 cm for HCC, with an average sphericity index of 0.70 ± 0.04. The results on the in vivo swine model at 60 W were substantially smaller than the ex vivo and clinical results (either populations). No statistically significant difference was observed between ex vivo results at 60 W and HCC results (p > 0.08). Conclusions: For the selected MW ablation device, ex vivo data on bovine liver was more predictive of the actual clinical performance on liver malignancies than an in vivo porcine model. Equivalent MW treatments yielded a significantly different response for HCC and metastases at higher deposited energy, suggesting that outcomes are not only device-specific but must also be characterised on a tissue-by-tissue basis.
The Dynamic Performance of Flexural Ultrasonic Transducers

Flexural ultrasonic transducers are principally used as proximity sensors and for industrial metrology. Their operation relies on a piezoelectric ceramic to generate a flexing of a metallic membrane, which delivers the ultrasound signal. The performance of flexural ultrasonic transducers has been largely limited to excitation through a short voltage burst signal at a designated mechanical resonance frequency. However, a steady-state amplitude response is not generated instantaneously in a flexural ultrasonic transducer from a drive excitation signal, and differences in the drive characteristics between transmitting and receiving transducers can affect the measured response. This research investigates the dynamic performance of flexural ultrasonic transducers using acoustic microphone measurements and laser Doppler vibrometry, supported by a detailed mechanical analog model, in a process which has not before been applied to the flexural ultrasonic transducer. These techniques are employed to gain insights into the physics of their vibration behaviour, vital for the optimisation of industrial ultrasound systems.
Hybrid Microgrid With Parallel- and Series-Connected Microconverters

In this paper, a hybrid microgrid with series- and parallel-connected microconverters is proposed. A few series-connected low voltage microconverters are used to build a string converter with rated output voltage magnitude. Then, the parallel operation of string converters increases the power rating and redundancy of the microgrid. To realize both grid-tied and islanding microgrid control with proper power sharing, a hierarchical power regulation method is developed with simultaneous point of common coupling (PCC) voltage and microconverter voltage control. First, the well-understood droop control is adopted to obtain PCC voltage reference for power sharing between parallel string converters. Second, a power balancing regulation through microconverter local voltage control is used to redistribute output power demand among series-connected microconverters in a string converter. As the string converter line current measured by all microconverters is the same, it is utilized to develop a novel synchronizer to interconnect the string converter central controller and the microconverter local controllers with only low bandwidth communications. Due to the coordination of string converter central control and microconverter local control, the proposed hybrid microgrid can operate in grid-tied and islanding modes with real and reactive power sharing for each microconverter.
The Best of Both Worlds: Asymptotically Efficient Mechanisms with a Guarantee on the Expected Gains-From-Trade

The seminal impossibility result of Myerson and Satterthwaite [1983] states that for bilateral trade, there is no mechanism that is individually rational (IR), incentive compatible (IC), weakly budget balanced, and efficient. This has led follow-up work on two-sided trade settings to weaken the efficiency requirement and consider approximately efficient simple mechanisms, while still demanding the other properties. The current state-of-the-art of such mechanisms for two-sided markets can be categorized as giving one (but not both) of the following two types of approximation guarantees on the gains from trade : a constant ex-ante guarantee, measured with respect to the second-best efficiency benchmark, or an asymptotically optimal ex-post guarantee, measured with respect to the first-best efficiency benchmark. Here the second-best efficiency benchmark refers to the highest gains from trade attainable by any IR, IC and weakly budget balanced mechanism, while the first-best efficiency benchmark refers to the maximum gains from trade (attainable by the VCG mechanism, which is not weakly budget balanced). In this paper, we construct simple mechanisms for double-auction and matching markets that simultaneously achieve both types of guarantees: these are ex-post IR, Bayesian IC, and ex-post weakly budget balanced mechanisms that 1) ex-ante guarantee a constant fraction of the gains from trade of the second-best, and 2) ex-post guarantee a realization-dependent fraction of the gains from trade of the first-best, such that this realization-dependent fraction converges to 1 (full efficiency) as the market grows large. We believe that mechanisms that not only provide a worst-case guarantee, but also provide a guarantee of performing very well on "easy instances" are appealing and more likely to be used. In our setting, we implement this agenda by postulating that "nice instances" are large-market instances, and we are able to achieve the best of both worlds: a guaranteed constant approximation on one hand, and asymptotic optimality when the markets are large on the other hand. We believe that presenting similar results in other settings is an interesting research direction.
Automated analysis of acute myeloid leukemia minimal residual disease using a support vector machine

We investigated the ability of support vector machines (SVM) to analyze minimal residual disease (MRD) in flow cytometry data from patients with acute myeloid leukemia (AML) automatically, objectively and standardly. The initial disease data and MRD review data in the form of 159 flow cytometry standard 3.0 files from 36 CD7-positive AML patients in whom MRD was detected more than once were exported. SVM was used for training with setting the initial disease data to 1 as the flag and setting 15 healthy persons to set 0 as the flag. Based on the two training groups, parameters were optimized, and a predictive model was built to analyze MRD data from each patient. The automated analysis results from the SVM model were compared to those obtained through conventional analysis to determine reliability. Automated analysis results based on the model did not differ from and were correlated with results obtained through conventional analysis (correlation coefficient c = 0.986, P > 0.05). Thus the SVM model could potentially be used to analyze flow cytometry-based AML MRD data automatically, objectively, and in a standardized manner.
Mixed neuropathologies and associations with domain-specific cognitive decline

Objective: To test whether decline in specific cognitive domains associated with Alzheimer disease neuropathologic change (ADNC) is modified by co-occurrence of other neuropathologies such as Lewy body disease (LBD) or vascular brain injury (VBI). Methods: Data came from 1,603 autopsied participants evaluated at US Alzheimer's Disease Centers. Standardized z scores in memory, attention, language, and executive function were derived from neuropsychological test scores assessed at each annual visit. Multivariable linear mixed-effects models assessed associations between neuropathologies and longitudinal trajectories of domain scores. Results: Compared to other participants, those with ADNC + LBD generally had worse cognitive trajectories, particularly lower initial executive function and faster attention decline. Participants with ADNC + VBI typically had less impairment and slower decline. Interactions were significant between LBD and ADNC for memory (p = 0.046) and between VBI and ADNC for language (p = 0.03); decline was slower than expected if these neuropathologies acted additively on the rate of decline. In secondary models, these interactions were limited to those with high ADNC (but not intermediate ADNC). In a subset of 260 participants with data on microinfarct location, cortical and subcortical microinfarcts were associated with decline in memory, language, and executive function in those without ADNC, but this effect was reduced among those with ADNC. Conclusions: ADNC + LBD (but not ADNC + VBI) was associated with poorer executive function and attention compared to other pathology groupings. However, the effect of co-occurring pathologies on cognitive trajectories may depend on the severity of ADNC. Future studies using antemortem biomarkers should seek to replicate these neuropathologic observations.
Wood defects during industrial-scale production of thermally modified Norway spruce and Scots pine

Abstract This research investigates wood defects, particularly the formation of surface cracks, during the production of thermally modified wood and its exposure to cyclic moisture changes. Boards of Norway spruce and Scots pine originating from different steps within the production of ThermoWood® were collected and wood defects were investigated at macroscopic and microscopic scale. Subsequently, the wood was exposed to capillary wetting cycles to record its sensitivity towards cracking. After the modification process, typical anatomical defects of conventional kiln-drying became more frequent and severe, with the magnitude being to some extent depending on the presence of defects in the raw material. At microscopic scale, damages to ray parenchyma and epithelial cells as well as longitudinal cracks within the cell walls of earlywood tracheids were evident in thermally modified wood. Despite a lower water uptake and higher dimensional stability, thermally modified wood was more sensitive to surface cracking during wetting cycles than unmodified wood, i.e. at the outside face of outer boards (near bark). For limiting surface cracking of thermally modified wood during service life, the use of high-quality raw material, the exposure of the inside face of the boards (near pith) and the application of a surface coating are considered beneficial.