Miracle-dz/UniFAR-FTUs huggingface dataset:
Continuous Electroencephalogram Monitoring in the Intensive Care Unit

Because of recent technical advances, it is now possible to record and monitor the continuous digital electroencephalogram (EEG) of many critically ill patients simultaneously. Continuous EEG monitoring (cEEG) provides dynamic information about brain function that permits early detection of changes in neurologic status, which is especially useful when the clinical examination is limited. Nonconvulsive seizures are common in comatose critically ill patients and can have multiple negative effects on the injured brain. The majority of seizures in these patients cannot be detected without cEEG. cEEG monitoring is most commonly used to detect and guide treatment of nonconvulsive seizures, including after convulsive status epilepticus. In addition, cEEG is used to guide management of pharmacological coma for treatment of increased intracranial pressure. An emerging application for cEEG is to detect new or worsening brain ischemia in patients at high risk, especially those with subarachnoid hemorrhage. Improving quantitative EEG software is helping to make it feasible for cEEG (using full scalp coverage) to provide continuous information about changes in brain function in real time at the bedside and to alert clinicians to any acute brain event, including seizures, ischemia, increasing intracranial pressure, hemorrhage, and even systemic abnormalities affecting the brain, such as hypoxia, hypotension, acidosis, and others. Monitoring using only a few electrodes or using full scalp coverage, but without expert review of the raw EEG, must be done with extreme caution as false positives and false negatives are common. Intracranial EEG recording is being performed in a few centers to better detect seizures, ischemia, and peri-injury depolarizations, all of which may contribute to secondary injury. When cEEG is combined with individualized, physiologically driven decision making via multimodality brain monitoring, intensivists can identify when the brain is at risk for injury or when neuronal injury is already occurring and intervene before there is permanent damage. The exact role and cost-effectiveness of cEEG at the current time remains unclear, but we believe it has significant potential to improve neurologic outcomes in a variety of settings.
Sarcopenia as a Useful Predictor for Long-Term Mortality in Cirrhotic Patients with Ascites

This study aimed to assess and compare sarcopenia with other prognostic factors for predicting long-term mortality in cirrhotic patients with ascites. Clinical data of 65 among 89 patients with measurement of all parameters were consecutively collected. Sarcopenia was evaluated as right psoas muscle thickness measurement divided by height (PMTH) (mm/m). During a mean follow-up of 20 (range: 1-49) months, 19 (29.2%) of 65 patients died. The values of the area under the receiver operating characteristics curve (AUROC) of Child-Pugh score, Model for End-Stage Liver Disease (MELD) score, MELD-Na, and PMTH for predicting 1-yr mortality were 0.777 (95% CI, 0.635-0.883), 0.769 (95% CI, 0.627-0.877), 0.800 (95% CI, 0.661-0.900), and 0.833 (95% CI, 0.699-0.924), whereas hepatic venous pressure gradient was not significant (AUROC, 0.695; 95% CI. 0.547-0.818, P=0.053). The differences between PMTH and other prognostic variables were not significant (all P>0.05). The best cut-off value of PMTH to predict long-term mortality was 14 mm/m. The mortality rates at 1-yr and 2-yr with PMTH>14 mm/m vs. PMTH≤14 mm/m were 2.6% and 15.2% vs. 41.6% and 66.8%, respectively (P<0.001). The mortality in cirrhotic patients with PMTH≤14 mm/m was higher than those with PMTH>14 mm/m (HR, 5.398; 95% CI, 2.111-13.800, P<0.001). In conclusion, sarcopenia, evaluated by PMTH, is an independent useful predictor for long-term mortality in cirrhotic patients with ascites. Graphical Abstract
Optimizing and Visualizing Deep Learning for Benign/Malignant Classification in Breast Tumors

Breast cancer has the highest incidence and second highest mortality rate for women in the US. Our study aims to utilize deep learning for benign/malignant classification of mammogram tumors using a subset of cases from the Digital Database of Screening Mammography (DDSM). Though it was a small dataset from the view of Deep Learning (about 1000 patients), we show that currently state of the art architectures of deep learning can find a robust signal, even when trained from scratch. Using convolutional neural networks (CNNs), we are able to achieve an accuracy of 85% and an ROC AUC of 0.91, while leading hand-crafted feature based methods are only able to achieve an accuracy of 71%. We investigate an amalgamation of architectures to show that our best result is reached with an ensemble of the lightweight GoogLe Nets tasked with interpreting both the coronal caudal view and the mediolateral oblique view, simply averaging the probability scores of both views to make the final prediction. In addition, we have created a novel method to visualize what features the neural network detects for the benign/malignant classification, and have correlated those features with well known radiological features, such as spiculation. Our algorithm significantly improves existing classification methods for mammography lesions and identifies features that correlate with established clinical markers.
Pre-Existing Albuminuria Predicts Aids and Non-Aids Mortality in Women Initiating Antiretroviral Therapy

Background We previously reported an increased risk of all-cause and AIDS mortality among HIV-infected women with albuminuria (proteinuria or microalbuminuria) enrolled in the Women's Interagency HIV Study (WIHS) prior to the introduction of HAART. Methods The current analysis includes 1,073 WIHS participants who subsequently initiated HAART. Urinalysis for proteinuria and semi-quantitative testing for microalbuminuria from two consecutive study visits prior to HAART initiation were categorized as follows: confirmed proteinuria (both specimens positive for protein), confirmed microalbuminuria (both specimens positive with at least one microalbuminuria), unconfirmed albuminuria (one specimen positive for proteinuria or microalbuminuria), or negative (both specimens negative). Time from HAART initiation to death was modelled using proportional hazards analysis. Results Compared with the reference group of women with two negative specimens, the hazard ratio (HR) for all-cause mortality was significantly increased for women with confirmed microalbuminuria (HR 1.9, 95% CI 1.2–2.9). Confirmed microalbuminuria was also independently associated with AIDS death (HR 2.3, 95% CI 1.3–4.3), whereas women with confirmed proteinuria were at increased risk for non-AIDS death (HR 2.4, 95% CI 1.2–4.6). Conclusions In women initiating HAART, pre-existing microalbuminuria independently predicted increased AIDS mortality, whereas pre-existing proteinuria predicted increased risk of non-AIDS death. Urine testing may identify HIV-infected individuals at increased risk for mortality even after the initiation of HAART. Future studies should consider whether these widely available tests can identify individuals who would benefit from more aggressive management of HIV infection and comorbid conditions associated with mortality in this population.
Development and regulation of substance P expression in neurons of the tadpole optic tectum

Activity-dependent synaptic plasticity is characteristic of developing visual systems. Using the frog retinotectal system, we investigated the extent to which afferent input affects neurotransmitter expression in a target structure. We have concentrated on a particular subpopulation of tectal cells that is immunoreactive to substance P (SP). Early in development, SP expression in tectal neurons was restricted to the anterior lateral region of the tectum. As tadpoles developed, this expression expanded into progressively more posterior and medial regions in a manner that closely followed the gradient of tectal maturation. At all times, however, anterior and lateral tectal regions had a greater percent of SP-like immunoreactive (SP-ir) cells than posterior and medial ones. Horseradish peroxidase (HRP) labeling of the retinal ganglion cell projection in conjunction with SP immunocytochemistry demonstrated that innervation by retinal ganglion cell terminals preceded the expression of SP by tectal cells. This suggested that the optic nerve may influence SP differentiation and/or expression. In support of this idea, transection of the optic nerve resulted in a decrease in SP expression in the deafferented tectal lobe of tadpoles. This result, opposite to that seen previously in the adult, also indicates that optic nerve–dependent regulation of SP expression in the developing and mature systems occurs through different pathways.
Cellular interface morphologies in directional solidification. III. The effects of heat transfer and solid diffusivity.

The shape and stability of two-dimensional finite-amplitude cellular interfaces arising during directional solidification are compared for several solidification models that account differently for latent heat released at the interface, unequal thermal conductivities of melt and solid, and solute diffusivity in the solid. Finite-element analysis and computer-implemented perturbation methods are used to analyze the families of steadily growing cellular forms that evolve from the planar state. In all models a secondary bifurcation between different families of finite-amplitude cells exists that halves the spatial wavelength of the stable interface. The quantitative location of this transition is very dependent on the details of the model. Large amounts of solute diffusion in the solid retard the growth of large-amplitude cells.
Nonpharmacological Treatments for Musculoskeletal Pain

Background: Several types of physical therapy are used in the management of painful musculoskeletal disorders. These treatment modalities can be broadly categorized as electrotherapy modalities (e.g., transcutaneous electrical nerve stimulation), acupuncture, thermal modalities (e.g., moist heat, ultrasound), manual therapies (e.g., manipulation or massage), or exercise. Within each of these broad categories significant variations in treatment parameters are possible. Objective: To consider the evidence base for each of these main categories of physical therapy in the management of musculoskeletal pain. Method: To consider the available evidence related to clinical effectiveness and then to review evidence from basic science studies evaluating potentially therapeutic effects of the various therapies. Results: There seems to be evidence from basic science research to suggest that many of the therapies could have potentially therapeutic effects. However, there appears to be limited high-quality evidence from randomized clinical trials to support the therapeutic effectiveness of several of the therapies. Conclusions: There is some preliminary evidence to support the use of manual therapies, exercise, and acupuncture in the management of some categories of musculoskeletal pain. Limitations of the existing research base are discussed and recommendations for areas of future research are provided.
Computer-mediated communication for intellectual teamwork: a field experiment in group writing

To work together on complex projects, people must agree on a set of shared goals, coordinate the actions of contributors, and weave the components they have created independently into a unified whole. These activities are the basic components of intellectual teamwork—people working together over substantial periods of time to create information-intensive products. Intellectual teamwork demands extensive information sharing and coordination, but these communication needs vary over time and over tasks. These projects typically involve an initial phase during which group members settle on an interpretation of the problem, define their goals and plan their work, an execution phase during which group members may work independently to carry out the various tasks associated with the project, and an integration phase during which group members must bring their individual inputs together to create a final product [Biks90; Finh90; Krau88; McGr90). These variations suggest that different communication modalities may be useful at successive stages in the life of a long-term project. A relatively static medium such as writing may be sufficient for exchanging information, but tasks that involve ambiguous goals, multiple perspectives, and information that is susceptible to multiple interpretations—characteristics of the planning and integrative phases of intellectual teamwork—are typically associated with high levels of direct, informal, face-to-face communication [Daft81; Daft87; Tush78, Tush79; Vand76]. Face-to-face interaction can support the rich communication required for integrative work, but creating the conditions to support face-to-face communication can be expensive, and sometimes, logistically impossible. Of course, other forms of communication—telephones, for instance—are available to counter these disadvantages. Telephones permit easy communication across both short and long distances, and they support naturalistic interaction embodying many of the features of Face-to-Face conversation. Nevertheless, as anyone who has ever played an extended game of “telephone tag” knows, they require the sender and the receiver to be simultaneously available. This limitation is inconsistent with current communication needs in business and science, both of which are becoming, on the one hand, more geographically and temporally distributed, and, on the other, more interconnected.
MR Imaging of the Cervical Spine in Nonaccidental Trauma: A Tertiary Institution Experience

BACKGROUND AND PURPOSE: Cervical MR imaging has demonstrated a utility for detecting soft tissue injury in nonaccidental trauma. The purpose of this study was to identify the incidence and types of cervical spine injury on MR imaging in nonaccidental trauma and to correlate cervical spine injury with parenchymal injury on brain MR imaging and findings on head CT. MATERIALS AND METHODS: A retrospective review of children diagnosed with nonaccidental trauma in a tertiary referral pediatric hospital over 8 years was performed. Inclusion criteria were children younger than 5 years of age, a confirmed diagnosis of nonaccidental trauma, and cervical spine MR imaging within 1 week of presentation. Brain and cervical spine MR imaging, head CT, cervical radiographs, and skeletal surveys were reviewed. RESULTS: There were 89 patients included in this study (48 males; mean age, 9.1 months [range, 1–59 months]). Cervical spine injury on MR imaging was found in 61 patients (69%). Ligamentous injury was seen in 60 patients (67%), with interspinous ligaments being most commonly involved. Abnormal capsular fluid (atlanto-occipital and atlantoaxial) was present in 28 patients (32%). Cervical spine injury on MR imaging was significantly associated with parenchymal restricted diffusion on brain MR imaging and parenchymal injury on head CT (P = .0004 and P = .0104, respectively). Children with restricted diffusion on brain MR imaging were 6.22 (point estimate) times more likely to have cervical spine injury on MR imaging. CONCLUSIONS: There is a high incidence of cervical spine injury in pediatric nonaccidental trauma. Positive findings may affect management and suggest a traumatic etiology.
Comparison of virtual cystoscopy, multiplanar reformation, and source CT images with contrast material-filled bladder for detecting lesions.

OBJECTIVE The objective of our study was to compare the diagnostic accuracy of virtual cystoscopy, multiplanar reformation, and source CT images for lesion detection in the contrast material-filled bladder. SUBJECTS AND METHODS Two observers independently evaluated 47 patients (28 men and 19 women; mean age +/- SD, 59 +/- 16 years) with virtual cystoscopy, multiplanar reconstruction, and source CT images acquired with contrast material-filled bladder using an MDCT scanner (detector array, 4 x 1.25 mm; beam pitch, 0.75). Agreement between the two observers was evaluated for the three reconstruction methods using kappa statistics. Using the conventional cystoscopic findings as a reference, we compared the results of the three reconstruction techniques both by bladder site and by patient using the McNemar test. RESULTS The interobserver agreement for the number of positive sites was excellent for virtual cystoscopy (kappa = 0.816), fair for multiplanar reconstruction (kappa = 0.461), and good for source CT images kappa = 0.676). For both observers, the sensitivity for lesion detection by bladder site was significantly greater with virtual cystoscopy (observer 1, 95%; observer 2, 90%) than with multiplanar reconstruction (78% and 60%) and source CT (68% and 65%) images (p < 0.05), whereas the specificity by bladder site and the sensitivity and specificity by patient did not differ with the three methods (p > 0.05). For determining the presence or absence of lesion at each site, virtual cystoscopy was more accurate than multiplanar reconstruction and source CT images for both observers (p < 0.05). CONCLUSION Virtual cystoscopy is more accurate than multiplanar reconstruction and source CT images for the detection of lesions in the bladder.
Ventilatory effects of medical antishock trousers in healthy volunteers.

The ventilatory effects of medical antishock trousers (MAST) were investigated using 10 healthy volunteers. Use of the MAST (60-80 mm Hg) decreased forced expiratory volume (-8% +/- 4%, p less than 0.01), vital capacity (-8% +/- 5%, p less than 0.01), and functional residual capacity (-12% +/- 6%, p less than 0.01) and induced a significant decrease in tidal volume (-30% +/- 17%, p less than 0.05), but minute ventilation was unmodified because of a concomitant increase in respiratory rate (+17% +/- 8%, p less than 0.001). The MAST modified the breathing pattern: the abdominal contribution to ventilation was markedly decreased (-57% +/- 22%, p less than 0.001), suggesting a decrease in the diaphragmatic contribution to ventilation. The MAST increased both the end-expiratory (+131% +/- 115%, p less than 0.01) and inspiratory variation (delta Pgas: +42% +/- 40%, p less than 0.05) of gastric pressure, whereas the end-expiratory and inspiratory variation of esophageal pressure remained unchanged. Because of a higher delta Pgas, the dynamic compliance of the abdominal compartment markedly fell (-77% +/- 10%, p less than 0.001). Transdiaphragmatic pressure (Pdi: +28% +/- 30%, p less than 0.05) significantly increased and the pressure-time index of the diaphragm significantly increased (+32% +/- 32%, p less than 0.05) after inflation of the MAST, suggesting an increase in the diaphragmatic cost of breathing. Inspiratory activity of the parasternal intercostal muscles significantly increased after the MAST was inflated. Computerized tomography showed that the MAST induced a cephalad shift of the diaphragm, which reduced pulmonary height. (ABSTRACT TRUNCATED AT 250 WORDS)
Nonindigenous Plant Advantage in Native and Exotic Australian Grasses under Experimental Drought, Warming, and Atmospheric CO2 Enrichment

A general prediction of ecological theory is that climate change will favor invasive nonindigenous plant species (NIPS) over native species. However, the relative fitness advantage enjoyed by NIPS is often affected by resource limitation and potentially by extreme climatic events such as drought. Genetic constraints may also limit the ability of NIPS to adapt to changing climatic conditions. In this study, we investigated evidence for potential NIPS advantage under climate change in two sympatric perennial stipoid grasses from southeast Australia, the NIPS Nassella neesiana and the native Austrostipa bigeniculata. We compared the growth and reproduction of both species under current and year 2050 drought, temperature and CO2 regimes in a multifactor outdoor climate simulation experiment, hypothesizing that NIPS advantage would be higher under more favorable growing conditions. We also compared the quantitative variation and heritability of growth traits in populations of both species collected along a 200 km climatic transect. In contrast to our hypothesis we found that the NIPS N. neesiana was less responsive than A. bigeniculata to winter warming but maintained higher reproductive output during spring drought. However, overall tussock expansion was far more rapid in N. neesiana, and so it maintained an overall fitness advantage over A. bigeniculata in all climate regimes. N. neesiana also exhibited similar or lower quantitative variation and growth trait heritability than A. bigeniculata within populations but greater variability among populations, probably reflecting a complex past introduction history. We found some evidence that additional spring warmth increases the impact of drought on reproduction but not that elevated atmospheric CO2 ameliorates drought severity. Overall, we conclude that NIPS advantage under climate change may be limited by a lack of responsiveness to key climatic drivers, reduced genetic variability in range-edge populations, and complex drought-CO2 interactions.
Albumin concentrations plus neutrophil lymphocyte ratios for predicting overall survival after curative resection for gastric cancer

Background In patients with gastric cancer (GC), survival is poor, given the late diagnosis. Risk-stratifying these patients earlier could help improve care. We determined whether combining preoperative albumin concentration and the neutrophil lymphocyte ratio (COA-NLR) could predict overall survival (OS) better than other prognostic indexes. Methods We calculated the COA-NLR and other prognostic indexes with data obtained within 1 week before surgery in a retrospective analysis of patients with GC undergoing curative resection between September 2000 and November 2012. Patients with concentrations of hypoalbuminemia above 35 g/L and an NLR value of 2.3 or higher were given a score of 2. Patients with one of these conditions or neither were allocated scores of 1 or 0, respectively. Patients were monitored until July 2014. Results OS in the 873 eligible patients was 44.9% in patients with a COA-NLR score of 0, 29.8% in patients with a score of 1, and 20.3% in patients with a score of 2 (P<0.001). The COA-NLR score was independently associated with OS (hazard ratio, 1.35; 95% confidence interval, 1.12 to 1.63; P=0.002). Moreover, the area under the receiver operating characteristics curve was 0.62 for the COA-NLR, which was significantly higher (<0.001) than that of the NLR ratio (0.60), the Glasgow prognostic score (0.58), and the platelet lymphocyte ratio (0.54). The COA-NLR was especially accurate for patients with stage I–II GC and the three values (0, 1, and 2) divided patients into subgroups more accurately than did the other indexes (area under the curve value: 0.66, P<0.001). Conclusion The preoperative COA-NLR index is useful for predicting postoperative OS in patients with GC and can be used to guide targeted therapy.