Miracle-dz/UniFAR-FTUs huggingface dataset:
Evaluation of discovered clinical pathways using process mining and joint agent-based discrete-event simulation

The analysis of clinical pathways from event logs provides new insights about care processes. In this paper, we propose a new methodology to automatically perform simulation analysis of patients' clinical pathways based on a national hospital database. Process mining is used to build highly representative causal nets, which are then converted to state charts in order to be executed. A joint multi-agent discrete-event simulation approach is used to implement models. A practical case study on patients having cardiovascular diseases and eligible to receive an implantable defibrillator is provided. A design of experiments has been proposed to study the impact of medical decisions, such as implanting or not a defibrillator, on the relapse rate, the death rate and the cost. This approach has proven to be an innovative way to extract knowledge from an existing hospital database through simulation, allowing the design and test of new scenarios.
Characterization of serial order encoding in the monkey anterior cingulate sulcus

In a previous report we showed that neurons in the anterior cingulate cortex might encode the serial order of the three components (first, second and third) of motor sequences, irrespective of which component is performed, and irrespective of the component that precedes or follows. Here we further explore these data by comparing the magnitude of cell activity at the different ranks. We also compare the activity recorded in the motor sequences and in tasks with only one motor component. We finally discuss functional hypotheses, which may account for the serial order encoding.
The adoption of student-centered teaching materials as a professional development experience for college faculty

ABSTRACT Efforts to promote the use of student-centered learning environments in STEM education have been tempered by a lack of professional development strategies that help faculty overcome common barriers to reform. This study investigated the impact that adopting a suite of student-centered teaching materials had on the teaching practices and beliefs of eight geoscience faculty at a variety of US institutions. Each instructor adopted 18 class lessons that were developed as part of the InTeGrate (Interdisciplinary Teaching about the Earth for a Sustainable Future) project into a semester-long course. The Teaching Practices Inventory (TPI) and Reformed Teaching Observation Protocol (RTOP) were used to collect data on teaching practices whereas instructor beliefs were captured with the Teacher Beliefs Interview (TBI). Data were collected over three semesters, a control semester using traditional materials, a pilot semester using the new materials, and a final treatment semester. While the TPI survey showed no self-reported changes in the practices, RTOP observations recorded the incorporation of more student-centered teaching practices. TBI results confirm that most of the instructors also made at least moderate shifts toward more student-centered beliefs about teaching and learning. These findings demonstrate that the adoption of well-crafted, student-centered instructional materials can have a positive impact on both the teaching practices and beliefs of college faculty.
Creating and enabling opportunities for increased student participation in experience based learning in professional practice

This paper explores models for enabling increased participation in experience based learning in legal professional practice. Legal placements as part of “for-credit” units offer students the opportunity to develop their professional skills in practice, reflect on their learning and job performance and take responsibility for their career development and planning. In short, work integrated learning (WIL) in law supports students in making the transition from university to practice. Despite its importance, WIL has traditionally taken place in practical legal training courses (after graduation) rather than during undergraduate law courses. Undergraduate WIL in Australian law schools has generally been limited to legal clinics which require intensive academic supervision, partnerships with community legal organisations and government funding. This paper will propose two models of WIL for undergraduate law which may overcome many of the challenges to engaging in WIL in law (which are consistent with those identified generally by the WIL Report). The first is a virtual law placement in which students use technology to complete a real world project in a virtual workplace under the guidance of a workplace supervisor. The second enables students to complete placements in private legal firms, government legal offices, or community legal centres under the supervision of a legal practitioner. The units complement each other by a) creating and enabling placement opportunities for students who may not otherwise have been able to participate in work placement by reason of family responsibilities, financial constraints, visa restrictions, distance etc; and b) enabling students to capitalise on existing work experience. This paper will report on the pilot offering of the units in 2008, the evaluation of the models and changes implemented in 2009. It will conclude that this multi-pronged approach can be successful in creating opportunities for, and overcoming barriers to participation in experiential learning in legal professional practice.
Does Physical Activity Increase Life Expectancy? A Review of the Literature

Physical activity reduces many major mortality risk factors including arterial hypertension, diabetes mellitus type 2, dyslipidemia, coronary heart disease, stroke, and cancer. All-cause mortality is decreased by about 30% to 35% in physically active as compared to inactive subjects. The purpose of this paper was to synthesize the literature on life expectancy in relation to physical activity. A systematic PubMed search on life expectancy in physically active and inactive individuals was performed. In addition, articles comparing life expectancy of athletes compared to that of nonathletes were reviewed. Results of 13 studies describing eight different cohorts suggest that regular physical activity is associated with an increase of life expectancy by 0.4 to 6.9 years. Eleven studies included confounding risk factors for mortality and revealed an increase in life expectancy by 0.4 to 4.2 years with regular physical activity. Eleven case control studies on life expectancy in former athletes revealed consistently greater life expectancy in aerobic endurance athletes but inconsistent results for other athletes. None of these studies considered confounding risk factors for mortality. In conclusion, while regular physical activity increases life expectancy, it remains unclear if high-intensity sports activities further increase life expectancy.
Screening of Trace Elements in Hair of the Female Population with Different Types of Cancers in Wielkopolska Region of Poland

Background. Cancer constitutes a major health problem worldwide. Thus, search for reliable and practical markers of the disease process remains the key issue of the diagnostic process. Objectives. The study aims at linking the trace element status of an organism, assessed by hair analysis, with the occurrence of cancer diseases. Material and Methods. Hair samples were collected from 299 patients with cancer diseases confirmed by a histopathological test and from 100 controls. Cancer patients were divided into three groups, depending on cancer type: hormone-dependent cancer, cancer of the alimentary tract, and cancer with high glycolytic activity. Mineral element analysis of hair was performed using an atomic emission spectrophotometer with inductively coupled plasma (ICP-OES) and inductively coupled plasma mass spectrometry (ICP-MS). Results. Statistically significantly lower concentrations of selenium, zinc, copper, germanium and boron, iron, and magnesium were observed in the three groups of cancer patients. Disturbance in the axis glucose-insulin and changes in concentrations of heavy metals and toxic elements were also noted. Conclusions. It seems safe to conclude that our results confirmed usefulness of hair element analysis in screening tests for the assessment of the biomarker of various cancer diseases in a female population.
Basel III, Ownership Concentration, Risk-Taking, and Capital Stability: Evidence from Asia

This study investigates the associations among bank risk-taking, ownership concentration, and the recently-proposed standard for capital stability (Basel III). Consistent with theory, the evidence shows that a rise in ownership concentration by one standard deviation increases the extent of risk-taking by as much as 6-8%. Although Basel III does not start taking effect until 2013, we hypothetically apply the capital stability standard on a sample of East Asian banks in the period 2005-2009. Our results suggest that an improvement in capital stability by one standard deviation diminishes the extent of risk-taking by 5.37% (as measured by the bank’s Z-score). We also find that the standard for capital stability would have been more effective in countries with better economic development. Our results provide insights into the likely effects of Basel III and should be useful to a wide range of audiences, including policymakers, regulators, bankers, as well as practitioners and researchers.
Pop-Out Without Awareness

Visual pop-out occurs when a unique visual target (e.g., a feature singleton) is present in a set of homogeneous distractors. However, the role of visual awareness in this process remains unclear. In the experiments reported here, we showed that even though subjects were not aware of a suppressed pop-out display, their subsequent performance on an orientation-discrimination task was significantly better at the pop-out location than at a control location. These results indicate that conscious visual awareness of a feature singleton is not necessary for it to attract attention. Furthermore, the subliminal pop-out effect disappeared when subjects diverted their attention toward a rapid sequential visual presentation task while presented with the same subliminal pop-out display. These results suggest that top-down attention is necessary for the subliminal pop-out effect and that the cognitive processes underlying attention and awareness are somewhat independent.
Fixed points in two-neuron discrete time recurrent networks: stability and bifurcation considerations

The position, number and stability types of xed points of a two{neuron recurrent network with nonzero weights are investigated. Using simple geometrical arguments in the space of derivatives of the sigmoid transfer functionwith respect to the weighted sum of neuron inputs, we partition the network state space into several regions corresponding to stability types of the xed points. If the neurons have the same mutual interaction pattern, i.e. they either mutually inhibit or mutually excite themselves, a lower bound on the rate of convergence of the attractive xed points towards the saturation values, as the absolute values of weights on the self{loops grow, is given. The role of weights in location of xed points is explored through an intuitively appealing characterization of neurons according to their inhibition/excitation performance in the network. In particular, each neuron can be of one of the four types: greedy, enthusiastic, altruistic or depressed. Both with and without the external inhibition/excitation sources, we investigate the position and number of xed points according to character of the neurons. When both neurons self-excite themselves and have the same mutual interaction pattern, the mechanism of creation of a new attractive xed point is shown to be that of saddle node bifurcation. 2
Cold snare polypectomy for non-pedunculated colon polyps greater than 1 cm

Abstract Background and study aims Colonic polyps > 1 cm in size are commonly managed using hot polypectomy techniques. The most frequent adverse events (delayed bleeding, post-polypectomy syndrome, and perforation) are related to electrocautery-induced injury. We hypothesized that cold resection of large polyps may have similar efficacy and improved safety compared to hot polypectomy. Our aims were to evaluate efficacy and safety of piecemeal cold snare resection of colonic polyps > 1 cm. Patients and methods Patients undergoing lift and piecemeal cold snare polypectomy of non-pedunculated colon polyps > 1 cm from October 2013 to September 2015 were identified retrospectively. Efficacy was defined by the absence of residual adenomatous tissue at endoscopic follow-up. Adverse events (AEs), including post-procedural bleeding, bowel perforation, or post-procedural pain requiring hospitalization were assessed by chart review and telephone follow-up. Results Seventy-three patients underwent piecemeal cold snare polypectomy for 94 colon polyps > 1 cm with 56 of 73 patients completing follow-up on 72 polyps. Residual or recurrent adenoma was found in 7 cases (9.7 %). Median polyp size was significantly greater in those with residual/recurrent adenoma (37.1 vs. 19.1 mm, P < .0001). There were no AEs among all 73 patients enrolled. Conclusions Piecemeal cold snare resection of colon polyps > 1 cm is feasible, safe and efficacious when compared to published hot polypectomy data. Additional observational and randomized comparative effectiveness studies are necessary to demonstrate comparable adenoma eradication and improved safety advantage over existing hot snare polypectomy techniques.
Preoperative evaluation value of aortic arch lesions by multidetector computed tomography angiography in type A aortic dissection

AbstractThe purpose of this study was to preoperatively evaluate the value of aortic arch lesions by multidetector computed tomography (MDCT) angiography in type A aortic dissection (AD). From January 2013 to December 2015, we enrolled 42 patients with type A AD who underwent MDCT angiography in our hospital. The institutional database of patients was retrospectively reviewed to identify MDCT angiography examinations for type A AD. Surgical corrections were conducted in all patients to confirm diagnostic accuracy.In this study, the diagnostic accuracy of MDCT angiography was 100% in all 42 patients. The intimal tear site locations that were identified in patients included the ascending aorta (n = 25), aortic arch (n = 12), and all other sites (n = 5). Compared with the control group, there were significant differences in the aortic arch anatomy among the cases. Regarding the distance between the left common carotid and left subclavian arteries, compared with the control group, most cases with type A AD had a significant variation.MDCT angiography plays an important role in detecting aortic arch lesions of type A AD, especially in determining the location of the intimal entry site and change of branch blood vessels. Surgeons can formulate an appropriate operating plan, according to the preoperative MDCT diagnosis information.
Involvement of the CD95 (APO-1/Fas) receptor/ligand system in multiple sclerosis brain

Immunohistochemical methods were used to search for Fas receptor/Fas ligand system involvement in multiple sclerosis (MS) white matter brain lesions. We found large numbers of Fas ligand (Fas-L)-bearing cells present in two acute lesions and 12 of 16 chronic MS lesions, and very few positive cells in non-inflammatory controls. Four of six brains from non-MS neuropathologic conditions associated with inflammation and white matter disease were, however, also positive for Fas-L. Double staining with cell-specific markers revealed that the pattern of ligand- positive cells in chronic MS lesions was complex and composed of several different cell types which were primarily resident glial cells with a small overlay of macrophages. Fas/APO 1 (CD95) receptor expression in MS tissue was also evaluated and marked upregulation of the receptor was found. In addition, Fas receptor was induced, but to a lesser extent, in numerous control brains. The observations that TUNEL- positive dying cells were present in MS lesions and showed excellent co- localization with Fas-L, indicate that the Fas death system may contribute to plaque pathogenesis and could lead to the development of a new category of therapeutic agents for MS.
Curcumin Blocks Small Cell Lung Cancer Cells Migration, Invasion, Angiogenesis, Cell Cycle and Neoplasia through Janus Kinase-STAT3 Signalling Pathway

Curcumin, the active component of turmeric, has been shown to protect against carcinogenesis and prevent tumor development. However, little is known about its anti-tumor mechanism in small cell lung cancer (SCLC). In this study, we found that curcumin can inhibit SCLC cell proliferation, cell cycle, migration, invasion and angiogenesis through suppression of the STAT3. SCLC cells were treated with curcumin (15 µmol/L) and the results showed that curcumin was effective in inhibiting STAT3 phosphorylation to downregulate of an array of STAT3 downstream targets ,which contributed to suppression of cell proliferation, loss of colony formation, depression of cell migration and invasion. Curcumin also suppressed the expression of proliferative proteins (Survivin, Bcl-XL and Cyclin B1), and invasive proteins (VEGF, MMP-2, MMP-7 and ICAM-1). Knockdown of STAT3 expression by siRNA was able to induce anti-invasive effects in vitro. In contrast, activation of STAT3 upstream of interleukin 6 (IL-6) leads to the increased cell proliferation ,cell survival, angiogenesis, invasion, migration and tumor growth. Our findings illustrate the biologic significance of IL-6/JAK/STAT3 signaling in SCLC progression and providenovel evidence that the pathway may be a new potential target for therapy of SCLC. It was concluded that curcumin is a potent agent in the inhibition of STAT3 with favorable pharmacological activity,and curcumin may have translational potential as an effective cancer therapeutic or preventive agent for SCLC.
Rapid Transition from Inhaled Iloprost to Inhaled Treprostinil in Patients with Pulmonary Arterial Hypertension

Background Inhaled treprostinil is a prostacyclin analog approved for the treatment of pulmonary arterial hypertension (PAH) that may provide a more convenient treatment option for patients receiving inhaled iloprost while maintaining the clinical benefit of inhaled prostacyclin therapy. Aims In this open-label safety study, 73 PAH patients were enrolled with primarily World Health Organization Class II (56%) or III (42%) symptoms. At baseline, most patients (93%) were receiving 5 μg of iloprost per dose but 38% of patients reported a dosing frequency below the labeled rate of 6–9 times daily. Patients initiated inhaled treprostinil at 3 breaths four times daily (qid) at the immediate next scheduled iloprost dose. The primary objective was to assess the safety of rapid transition from iloprost to inhaled treprostinil; clinical status and quality of life were also assessed. Results Most patients (84%) achieved the target treprostinil dose of 9 breaths qid and remained on study until transition to commercial therapy (89%). The most frequent adverse events (AEs) were cough (74%), headache (44%), and nausea (30%), and five patients prematurely discontinued study drug due to AE (n = 3), disease progression (n = 1), or death (n = 1). At week 12, the time spent on daily treatment activities was reduced compared to baseline, with a mean total savings of 1.4 h per day. Improvements were also observed at week 12 for 6-min walk distance (+16.0; P < 0.001), N-terminal pro-B-type natriuretic peptide (−74 pg/mL; P = 0.001), and the Cambridge Pulmonary Hypertension Outcome Review (all domains P < 0.001). Conclusions Pulmonary arterial hypertension patients can be safely transitioned from inhaled iloprost to inhaled treprostinil while maintaining clinical status.
Working memory in children with mild to borderline intellectualdisabilities: A systematic review of strengths and weaknesses

BACKGROUND: Limitations in Working Memory (WM) appear to play a crucial role in the development of learning problems and behavioral problems in children with Mild to Borderline Intellectual Disabilities (MBID). Increasing our understanding about WM strengths and weaknesses in this vulnerable population, offer more insight into what type of support is best for these children. METHOD: This review employed a systematic literature review (N=11) to investigate whether WM in children (aged 4 to 18) with MBID (IQ range 50-85) differs compared to (1) typically developing children of the same Chronological Age (CA) and (2) younger, typically developing children with the same Mental Age (MA). CONCLUSION: The visuospatial WM system is a relatively strong aspect, in particular for those higher functioning MBID children (IQ range between 70-85). In contrast to this, verbal WM performance appears to be rather weak in this group. This verbal WM deficiency contributes to problems with reading, writing and numeracy. It is, therefore, important to stimulate WM both at home and at school from an early age. Additionally, training programs could be initiated that focus not only on enhancing WM but also on acquiring memory strategies to increase generalizability to daily activities.
Unpacking Organizational Ambidexterity: Dimensions, Contingencies, and Synergistic Effects

Significant ambiguity remains in the literature regarding the conceptualization of organizational ambidexterity. We unpack this construct into one with two dimensions we term the balance dimension of ambidexterity (BD) and the combined dimension of ambidexterity (CD). BD corresponds to a firm's orientation to maintain a close relative balance between exploratory and exploitative activities, whereas CD corresponds to their combined magnitude. We reason that these dimensions are conceptually distinct, and rely on different causal mechanisms to enhance firm performance. We find that over and above their independent effects, concurrent high levels of BD and CD yield synergistic benefits. We also find that BD is more beneficial to resource-constrained firms, whereas CD is more beneficial to firms having greater access to internal and/or external resources. These results indicate that managers in resource-constrained contexts may benefit from a focus on managing trade-offs between exploration and exploitation demands, but for firms that have access to sufficient resources, the simultaneous pursuit of exploration and exploitation is both possible and desirable.
Stretching rates and equivalent length near the tropopause

[1] Diagnostics of mixing in the upper troposphere/lower stratosphere region reveal interesting seasonal and interannual variability and illustrate how the subtropical tropopause can be identified with a region of minimum mixing, a partial barrier to the transport of air between the troposphere and stratosphere. Both the strength and the location of this barrier show substantial seasonal variability, with a stronger barrier and weaker mixing observed during winter. The interannual variability of the mixing intensity near the tropopause on the 350 K isentropic surface suggests a correlation with the phase of the El Nino-Southern Oscillation, with weaker mixing occurring during strong El Nino years. The diagnostics are based on the analyses and reanalyses from the European Centre for Medium-Range Weather Forecasts over the 21 year period 1979–2000 and include the exponential stretching rates of material contours and Nakamura's [1996] modified Lagrangian mean effective diffusivity/equivalent length. As well as providing information about the spatial and temporal distribution of mixing intensity, the diagnostics also indicate sensitivity to changes in the analyses/reanalyses data sets. In particular, a stronger seasonal cycle and greater interannual variability is found in the more recent (1994–2000) analyses than in the earlier (1979–1993) reanalyses.