Miracle-dz/UniFAR-FTUs huggingface dataset:
Morphological and Hemodynamic Analysis of Mirror Posterior Communicating Artery Aneurysms

Background and Purpose Hemodynamic factors are commonly believed to play an important role in the pathogenesis, progression, and rupture of cerebral aneurysms. In this study, we aimed to identify significant hemodynamic and morphological parameters that discriminate intracranial aneurysm rupture status using 3-dimensional-angiography and computational fluid dynamics technology. Materials and Methods 3D-DSA was performed in 8 patients with mirror posterior communicating artery aneurysms (Pcom-MANs). Each pair was divided into ruptured and unruptured groups. Five morphological and three hemodynamic parameters were evaluated for significance with respect to rupture. Results The normalized mean wall shear stress (WSS) of the aneurysm sac in the ruptured group was significantly lower than that in the unruptured group (0.52±0.20 versus 0.81±0.21, P = .012). The percentage of the low WSS area in the ruptured group was higher than that in the unruptured group (4.11±4.66% versus 0.02±0.06%, P = .018). The AR was 1.04±0.21 in the ruptured group, which was significantly higher than 0.70±0.17 in the unruptured group (P = .012). By contrast, parameters that had no significant differences between the two groups were OSI (P = .674), aneurysm size (P = .327), size ratio (P = .779), vessel angle (P = 1.000) and aneurysm inclination angle (P = 1.000). Conclusions Pcom-MANs may be a useful disease model to investigate possible causes of aneurysm rupture. The ruptured aneurysms manifested lower WSS, higher percentage of low WSS area, and higher AR, compared with the unruptured one. And hemodynamics is as important as morphology in discriminating aneurysm rupture status.
Double inverse nanotapers for efficient light coupling to integrated photonic devices.

Efficient light coupling to integrated photonic devices is of key importance to a wide variety of applications. "Inverse nanotapers" are widely used, in which the waveguide width is reduced to match an incident mode. Here, we demonstrate novel "double inverse" tapers, in which we reduce both the waveguide height and width. We demonstrate >45% chip-through coupling efficiency for both the transverse electric and transverse magnetic polarizations in Si3N4 tapers of >500 nm width, in comparison to regular inverse tapers that necessitate <100 nm width. The double inverse tapers show polarization-independent coupling and allow the fabrication using photolithography, relevant for applications at near-infrared and visible wavelengths, e.g., supercontinuum and soliton microcomb generation.
The Role of Cognitive Emotion Regulation Strategies in Problem Gaming Among Adolescents: A Nationally Representative Survey Study

Explanatory theoretical models have proposed an association between problematic online gaming and abilities or strategies in alleviating distress or negative emotions in times of stress as proximal non-gaming-related personality factors. However, there is little research that has targeted how emotion regulation relates to problematic online gaming—especially during adolescence when gaming behavior is most prevalent. In emotion regulation research, there has been a particular emphasis on rumination because it is strongly associated with overall psychopathology. However, it is unknown whether this putatively maladaptive strategy relates to problematic online gaming and whether it is a gender-dependent association. Consequently, the present study examined how emotion regulation strategies, and particularly rumination, related to problem gaming and tested whether gender moderated this relationship in adolescents. In a national representative adolescent sample, 46.9% of the participants (N = 1,646) reported online gaming in the past 12 months and provided information on problematic gaming, and it was these data that were used for further analysis. Their data concerning problematic online gaming and emotion regulation strategies were analyzed, including rumination along with other putatively maladaptive (e.g., catastrophizing) and adaptive (e.g., positive reappraisal) strategies, while controlling for age, gender, and game genre preference. Results of linear regression analyses showed that all the putatively maladaptive emotion regulation strategies (including self-blame, other blame, catastrophizing, and rumination) were positively related to problematic online gaming. Positive reappraisal proved to be a protective factor; it was inversely related to problematic online gaming. In addition, the relationship between rumination and online gaming was moderated by gender (i.e., the relationship was stronger among boys). Based on the results, it is argued that emotion regulation is a useful framework to study problematic online gaming. The present study highlighted that the relative predictive value of rumination for problematic online gaming varied for boys and girls, suggesting that trait rumination might be a gender-specific vulnerability factor for problematic online gaming, but this requires further investigation and replication.
Safety and Efficacy of Resident-Performed Functional Upper Eyelid Blepharoplasty.

PURPOSE To determine the safety and efficacy of resident-performed functional upper eyelid blepharoplasty. METHODS The authors retrospectively looked at functional upper eyelid blepharoplasty surgery performed on 836 eyes of 448 patients under the supervision of one oculoplastic surgery attending at the University of California Davis Eye Center from January 1, 2013, to December 31, 2017. The primary surgeon was a resident on 427 eyes and was an attending on 409 eyes. Patients (73.5%) were female, and the mean age was 66.0 ± 10.0. All patients had at least 2 postoperative visits, and eyes that underwent other concurrent upper eyelid or brow procedures were excluded. The authors looked at major and minor complications, percentage of initially dissatisfied patients, and percentage of cases that required a revision procedure within 6 months. Chi-square tests were used for statistical analysis. RESULTS There were no major complications in either group. There was no difference in the rate of minor complications (10.8% vs. 7.6%, p = 0.11), percentage of patients who were initially dissatisfied with the procedure (3.5% vs. 2.0%, p = 0.17), or percentage of patients requiring a revision procedure (5.2% vs. 3.2%, p = 0.15). The most common minor complications were inclusion cysts (45, 5.4%), wound dehiscence (9, 1.1%), and hypertrophic scars (9, 1.1%), and the most common revision procedures were removal of inclusion cyst(s) (17, 2.0%) and suturing or placement of topical skin adhesive for wound dehiscence (9, 1.1%). CONCLUSIONS Ophthalmology residents can perform functional upper eyelid blepharoplasty safely and effectively under the supervision of an attending physician.
External validation of a five-variable clinical prediction rule for identifying children at very low risk for intra-abdominal injury after blunt abdominal trauma

BACKGROUND A clinical prediction rule was previously developed by the Pediatric Surgery Research Collaborative (PedSRC) to identify patients at very low risk for intra-abdominal injury (IAI) and intra-abdominal injury receiving an acute intervention (IAI-I) who could safely avoid abdominal computed tomography (CT) scans after blunt abdominal trauma (BAT). Our objective was to externally validate the rule. METHODS The public-use dataset was obtained from the Pediatric Emergency Care Applied Research Network (PECARN) Intra-abdominal Injury Study. Patients 16 years of age and younger with chest x-ray, completed abdominal history and physical examination, aspartate aminotransferase (AST), and amylase or lipase collected within 6 hours of arrival were included. We excluded patients who presented greater than 6 hours after injury or missing any of the five clinical prediction variables from the PedSRC prediction rule. RESULTS We included 2,435 patients from the PECARN dataset, with a mean age of 9.4 years. There were 235 patients with IAI (9.7%) and 60 patients with IAI-I (2.5%). The clinical prediction rule had a sensitivity of 97.5% for IAI and 100% for IAI-I. In patients with no abnormality in any of the five prediction rule variables, the rule had a negative predictive value of 99.3% for IAI and 100.0% for IAI-I. Of the “very low-risk” patients identified by the rule, 46.8% underwent abdominal CT imaging. CONCLUSIONS A highly sensitive clinical prediction rule using history and abdominal physical examination, laboratory values, and chest x-ray was successfully validated using a large public-access dataset of pediatric BAT patients. LEVEL OF EVIDENCE Epidemiologic/prognostic study, level III; therapeutic care/management study, level IV.
Willingness to trade-off: An intermediate factor in patient decision-making regarding escalating care

This study aimed to evaluate treatment necessity, treatment concern, and willingness to engage in decisional trade-offs in the context of treatment escalation decision-making. Participants (n = 147) recruited online were randomized to read a vignette about escalating care in psoriasis in a 2 (high treatment concern vs moderate treatment concern) × 2 (high perceived treatment necessity vs moderate perceived treatment necessity) design. High treatment concern was associated with choosing to defer treatment escalation and being unwilling to engage in decisional trade-offs if disease risk changed. Results highlight the importance of treatment concern and willingness trade-off in treatment escalation decision-making.
Nature and Science of Sleep Dovepress Sleep Estimates in Children: Parental versus Actigraphic Assessments

Background: In the context of increasing awareness about the need for assessment of sleep duration in community and clinical settings, the use of questionnaire-based tools may be fraught with reporter bias. Conversely, actigraphy provides objective assessments of sleep patterns. In this study, we aimed to determine the potential discrepancies between parentally-based sleep logs and concurrent actigraphic recordings in children over a one-week period. Methods: We studied 327 children aged 3–10 years, and included otherwise healthy, nonsnoring children from the community who were reported by their parents to be nonsnorers and had normal polysomnography, habitually-snoring children from the community who completed the same protocol, and children with primary insomnia referred to the sleep clinic for evaluation in the absence of any known psychiatric illness. Actigraphy and parental sleep log were concomitantly recorded during one week. Results: Sleep logs displayed an average error in sleep onset after bedtime of about 30 minutes (P , 0.01) and of a few minutes before risetime in all groups. Furthermore, subjective parental reports were associated with an overestimated misperception of increased sleep duration of roughly one hour per night independent of group (P , 0.001). Conclusion: The description of a child's sleep by the parent appears appropriate as far as symptoms are concerned, but does not result in a correct estimate of sleep onset or duration. We advocate combined parental and actigraphic assessments in the evaluation of sleep complaints, particularly to rule out misperceptions and potentially to aid treatment. Actigraphy provides a more reliable tool than parental reports for assessing sleep in healthy children and in children with sleep problems.
High Oct4 predicted worse prognosis of right-sided colon cancer patients.

AIM This present study was aimed to compare the role of Oct4 in left-sided colon cancer (LCC) with right-sided colon cancer (RCC). PATIENTS & METHODS One hundred and fifty one pathology specimens, 68 frozen-thawed tumors and cell lines were used to evaluate the role of Oct4 in LCC and RCC through immunohistochemistry, western blot and real-time quantitative PCR. RESULTS In LCC, positive expression of Oct4 was positively related to differentiation and Dukes stage (p < 0.01). Only in RCC, Oct4 expression was also positively related to lymphatic invasion and survival rates of 'negative group' were significantly higher. CONCLUSION In summary, Oct4 was related to tumor differentiation and later Dukes stage in colon cancer, and was correlated with invasion of lymphatic only in RCC. In addition, Oct4 was a potential prognostic indicator in RCC.
Pre-diagnostic biomarkers of metabolic dysregulation and cancer mortality

INTRODUCTION The obesogenic milieu is a pro-tumorigenic environment that promotes tumor initiation, angiogenesis and metastasis. In this prospective cohort, we examined the association between pre-diagnostic metabolic biomarkers, plasma adiponectin, resistin, leptin and lipoprotein (a), and the risk of cancer mortality. METHODS Prospective data was obtained from the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort of Blacks and Whites followed from 2003 through 2012 for cancer mortality. We determined the association between metabolism biomarkers (log-transformed and tertiles) and risk of cancer mortality using Cox Proportional Hazards models with robust sandwich estimators to calculate the 95% confidence intervals (CIs), and adjusted for baseline covariates, including age, gender, income, education, physical activity, BMI, smoking status, alcohol use, and comorbidity score. RESULTS Among 1764 participants with available biomarker data, each SD higher log-leptin was associated with a 54% reduced risk of total cancer mortality (HR: 0.46, 95% CI: 0.23 – 0.92) and obesity-related cancer mortality (HR: 0.55, 95% CI: 0.39-0.79). Among Blacks only, each SD higher log-resistin was associated with a nearly 7-fold increased risk of cancer mortality (adjusted HR: 6.68, 95% CI: 2.10 – 21.21). There were no significant associations of adiponectin or Lp(a) and cancer mortality. CONCLUSIONS Leptin is involved in long-term regulation of energy balance, while resistin is involved in chronic inflammation and LDL production. These findings highlight the biological mechanisms linking metabolic dysregulation with cancer mortality, and the influence of resistin on cancer mortality only among Blacks suggests that this hormone may be a useful biomarker of racial differences in cancer mortality that deserves further study. IMPACT Our observed increased risk of cancer mortality associated with higher serum resistin levels among Blacks suggests that if validated in larger cohorts, clinical strategies focused on resistin control may be a promising cancer prevention strategy.
Processing of interaural phase differences in components of harmonic and mistuned complexes in the inferior colliculus of the Mongolian gerbil

Harmonicity and spatial location provide eminent cues for the perceptual grouping of sounds. In general, harmonicity is a strong grouping cue. In contrast, spatial cues such as interaural phase or time difference provide for strong grouping of stimulus sequences but weak grouping for simultaneously presented sounds. By studying the neuronal basis underlying the interaction of these cues in processing simultaneous sounds using van Rossum spike train distance measures, we aim at explaining the interaction observed in psychophysical experiments. Responses to interaural phase differences imposed on single components of harmonic and mistuned complex tones as well as noise delay functions were recorded as multiunit responses from the inferior colliculus of Mongolian gerbils. Results revealed a better representation of interaural phase differences if imposed on a harmonic rather than a mistuned frequency component of a complex tone. The representation of interaural phase differences was better for long integration‐time windows approximately reflecting firing rates rather than short integration‐time windows reflecting the temporal pattern of the stimulus‐driven response. We found only a weak impact of interaural phase differences if combined with mistuning of a component in a harmonic tone complex.
Alternative Model of Personality Disorders (DSM-5) Predicts Dropout in Inpatient Psychotherapy for Patients With Personality Disorder

Objective Criterion A serves as the fundamental diagnostic criterion of the Alternative Model of Personality Disorders in section III of the Diagnostic and Statistical Manual 5. Consisting of a self- and an interpersonal dimension, it defines the construct of personality functioning as a general and dimensional factor of personality disorders. This study aimed to explore criterion A along with well-established treatment dropout predictors, e.g., sociodemographic factors, personality disorder diagnosis, symptom severity, and the therapeutic alliance. Methods The sample consisted of 132 patients diagnosed with personality disorder in a psychotherapeutic inpatient treatment. Cox proportional hazard regression models and a lasso model were applied. Results 28% of the sample prematurely discontinued treatment. The risk for dropout was 2.3 times higher for patients with high impairments in self-functioning as assessed with criterion A. Moreover, a positive therapist-rated therapeutic alliance was associated with a lower dropout risk. Conclusion The study suggests criterion A is a useful clinical indicator by identifying patients with personality disorder with a higher risk for dropout. An individualized therapeutic approach for such patients might be required.
Regression of hepatitis C virus‐associated membranoproliferative glomerulonephritis with direct‐acting antiviral therapy after liver transplantation

A 64-year-old woman with hepatitis C virus (HCV)-related cirrhosis underwent living-donor, ABO-compatible liver transplantation. She received immunosuppressive therapy with prednisolone, tacrolimus and mycophenolate mofetil. In a couple of months after transplantation, HCV-RNA (genotype 1b) levels increased up to 6.2 log IU/mL, together with elevated liver transaminases. Liver biopsy was consistent with recurrence of HCV hepatitis, and prednisolone was discontinued. Meanwhile, proteinuria and haematuria became apparent and oedema gradually developed. Five months after transplantation, she was referred to our department because of marked nephrotic-range proteinuria (15.9 g/gCr) along with low serum albumin (2.1 g/dL). Although her renal function remained normal (serum creatinine, 0.76 mg/dL), complement levels were around the lower limit, and cryoglobulinemia was marginally detected (Fig. 1a). Renal biopsy revealed mesangial proliferation, endocapillary hypercellularity and duplication of the glomerular basement membrane (Fig. 1b). In immunofluorescence staining, deposition of IgM and IgA was
Weaning of moderately preterm infants from the incubator to the crib: a randomized clinical trial

Commentary on: Shankaran S, Bell EF, Laptook AR, Saha S, Newman NS, Kazzi SNJ, Barks J, Stoll BJ, Bara R, Gabrio J, Childs K, Das A, Higgins RD, Carlo WA, S anchez PJ, Carlton DP, Pavageau L, Malcolm W, D’Angio CT, Ohls RK, Poindexter BB, Sokol GM, Van Meurs KP, Colaizy TT, Khmour A, Puopolo KM, Garg M, Walsh M for the Eunice Kennedy Shriver National Institute of Child Health, and Human Development Neonatal Research Network. J Pediatr 2019; 204:96–102. PMID 30337189
Resolutions of length four which are differential graded algebras

Let $P$ be a commutative Noetherian ring and $F$ be a self-dual acyclic complex of finitely generated free $P$-modules. Assume that $F$ has length four and $F_0$ has rank one. We prove that $F$ can be given the structure of a Differential Graded Algebra with Divided Powers; furthermore, the multiplication on $F$ exhibits Poincare duality. This result is already known if $P$ is a local Gorenstein ring and $F$ is a minimal resolution. The purpose of the present paper is to remove the unnecessary hypotheses that $P$ is local, $P$ is Gorenstein, and $F$ is minimal.
Effect of Aerobic Training on Heart Rate Recovery in Patients with Established Heart Disease; a Systematic Review

Background Although a delayed decrease in heart rate during the first minute after graded exercise has been identified as a powerful predictor of overall mortality in cardiac patients, the potential to influence this risk factor by aerobic training remains to be proven. Objective The aim was to study the relationship between aerobic training and Heart Rate Recovery (HRR) in patients with established heart disease. Methods (Quasi) randomized clinical trials on aerobic exercise training in adults with established heart disease were identified through electronic database and reference screening. Two reviewers extracted data and assessed the risk of bias and therapeutic validity. Methodological validity was evaluated using an adapted version of the Cochrane Collaboration’s tool for assessing risk of bias and the therapeutic validity of the interventions was assessed with a nine-itemed, expert-based rating scale (CONTENT). Scores range from 0 to 9 (score ≥ 6 reflecting therapeutic validity). Results Of the 384 articles retrieved, 8 studies (449 patients) were included. Three of the included studies demonstrated adequate therapeutic validity and five demonstrated low risk of bias. Two studies showed both adequate therapeutic validity and a low risk of bias. For cardiac patients aerobic exercise training was associated with more improvement in HRR compared to usual care. Conclusion The present systematic review shows a level 1A evidence that aerobic training increases HRR in patients with established heart disease.
Provably Correct Learning Algorithms in the Presence of Time-Varying Features Using a Variational Perspective

Features in machine learning problems are often time-varying and may be related to outputs in an algebraic or dynamical manner. The dynamic nature of these machine learning problems renders current higher order accelerated gradient descent methods unstable or weakens their convergence guarantees. Inspired by methods employed in adaptive control, this paper proposes new algorithms for the case when time-varying features are present, and demonstrates provable performance guarantees. In particular, we develop a unified variational perspective within a continuous time algorithm. This variational perspective includes higher order learning concepts and normalization, both of which stem from adaptive control, and allows stability to be established for dynamical machine learning problems where time-varying features are present. These higher order algorithms are also examined for provably correct learning in adaptive control and identification. Simulations are provided to verify the theoretical results.