Miracle-dz/UniFAR-FTUs huggingface dataset:
Interpregnancy weight changes and impact on pregnancy outcome in a cohort of women with a macrosomic first delivery: a prospective longitudinal study

Objective To determine the median interpregnancy maternal weight change between first and second pregnancies, and second and third pregnancies and to assess the impact of this weight change on pregnancy outcome in a cohort of women with a macrosomic first delivery. Study design Prospective longitudinal study conducted over three pregnancies from 2007 to 2015. Setting Tertiary referral maternity hospital, Dublin, Ireland. Participants Women were recruited if their first baby weighed >4.0 kg. Methods The pregnancy outcomes in the second and third pregnancies were analysed separately. Data were also analysed for both interpregnancy intervals comparing outcomes for those who gained any weight, or more weight than the median, with those who did not. Main outcome measures Recurrent fetal macrosomia ≥4.0 kg and gestational diabetes mellitus. Results There were 280 women who delivered a third baby between 2011 and 2015. There were no differences in pregnancy outcomes for the second pregnancy in women who gained interpregnancy weight compared with those who did not and those who gained more interpregnancy weight than the median compared with those who did not. There was a statistically significant increase in birth weight ≥4.0 kg (54.0% vs 39.6% p=0.03) in those women who gained any weight between the second and third pregnancies. In those women who gained more interpregnancy weight than the median (1.70 kg) between a second and third pregnancy, there was a significant increase in the rate of gestational diabetes (6.5% vs 1.4%, p=0.03). Conclusions This longitudinal study demonstrates that within this cohort maternal interpregnancy weight change between a second and third pregnancy is associated with an increase in birth weight ≥4.0 kg. Additionally, a gain of more weight than the median (1.70 kg) is associated with a higher rate of gestational diabetes.
Projected Coding Intensity In Medicare Advantage Could Increase Medicare Spending By $200 Billion Over Ten Years.

Over the past decade, the average risk score for Medicare Advantage (MA) enrollees has risen steadily relative to that for fee-for-service Medicare beneficiaries, by approximately 1.5 percent per year. The Centers for Medicare and Medicaid Services (CMS) uses patient demographic and diagnostic information to calculate a risk score for each beneficiary, and these risk scores are used to determine payment to MA plans. The increase in relative MA risk scores is largely the result of successful efforts by MA plans to identify additional diagnoses, also known as coding intensity, and not of changes in enrollees' true health. In this article I estimate the effects of coding intensity on Medicare spending over the next decade. Under the moderately conservative assumption that coding intensity will decelerate, Medicare expenditures are expected to increase by approximately $200 billion. CMS has implemented a variety of strategies since 2010 that lessened the impact of coding intensity on Medicare spending; it has a variety of policy responses at its disposal to mitigate the impact going forward. The problem could be largely solved if CMS adjusted for coding intensity using the principle that MA beneficiaries are no healthier and no sicker than demographically similar fee-for-service Medicare beneficiaries, returning to the budget-neutrality approach that was introduced in 2004 and later abandoned.
Outcome Predictors of Acute Stroke Patients in Need of Intensive Care Treatment

Background: The prognosis of stroke patients admitted to intensive care units (ICU) is commonly regarded to be poor. However, only limited data regarding outcome predictors are available. Patients and Methods: Out of 4,958 consecutive patients admitted to our stroke unit with the diagnosis of acute stroke, after analysis we identified 347 patients (164 male) in need of ICU management. In-hospital and post-rehabilitation mortality as well as functional outcome at discharge and after rehabilitation were analyzed. Results: Ischemic stroke was diagnosed in 252 patients (72.6%) and intracerebral hemorrhage occurred in 95 patients (27.4%). The mean age in our cohort was considerably high (70.8 years). One hundred patients were comatose at admission. The median NIHSS score at admission in the remaining patients was 12. Apart from stroke-related disturbances of consciousness (47.1%), the most common reasons for ICU treatment were cardiac (23.4%) and respiratory (12.1%) complications or interventional procedures requiring mechanical ventilation (11%). In all, 231/347 patients (66.6%) were mechanically ventilated (mean 84 h). In-hospital mortality (143/347; 41.2%) was associated with old age, poor NIHSS score at admission, intracerebral hemorrhage and mechanical ventilation (p < 0.001 in all). Further, admission to ICU because of stroke-related impairment of consciousness increased in-hospital mortality (p < 0.001). Similarly, poor outcome after rehabilitation was associated with old age (p = 0.029) and mechanical ventilation (p < 0.001). In patients ≥80 years with either intracerebral hemorrhage or need of mechanical ventilation, outcome was unfavorable in nearly any case. However, the overall post-rehabilitation outcome did not differ between patients with intracerebral hemorrhage and ischemic stroke (p = 0.275). Conclusion: The stroke population in our study was associated with an increased early mortality; however, given the same conditions, it was old with a high percentage of patients requiring mechanical ventilation. This did not result in increased in-hospital mortality rates compared to younger and less severely affected cohorts. Thus, ICU management is a life-saving initiative even among the elderly. However, the functional outcome was poor in older patients, thus limiting the benefits of ICU care in these patients.
Current incidence of venous thromboembolism and comparison with 1998: a community-based study in Western France

Summary In 1998 we estimated the incidence of venous thromboembolism (VTE) to be 1.8/1,000 per year. The aim of this study was to compare current VTE incidence to that observed in 1998. We prospectively recorded all cases of symptomatic pulmonary embolism (PE) and deep vein thrombosis (DVT) of the lower limbs diagnosed between March 1, 2013 and February 28, 2014 in hospitals and in the community, using the same method and geographic area than in 1998. The 2013 incidence rates of VTE were computed and compared with those of 1998 using age- and sex-specific standardised incidence ratios (SIRs). In 2013, we recorded 576 VTE cases (279 isolated DVT and 297 PE ± DVT). Among 367,911 inhabitants, the overall incidence of VTE was 1.57/1,000 (95 % CI 1.44–1.69). The overall VTE incidence was significantly lower in 2013 as compared with 1998: SIR 0.72 (95 % CI 0.67–0.79) as well as the incidence of isolated DVT: SIR 0.53 (95 % CI 0.47–0.60); conversely, the overall incidence of PE was unchanged: SIR 1.10 (95 % CI, 0.98–1.23) despite an increase in the incidence of isolated PE: SIR 1.29 (95 % CI, 1.10–1.52). In 1998, 4.4 % of PE cases were diagnosed using CTPA as compared with 73.7 % in 2013 (p < 0.001). In conclusion, between 1998 and 2013, the incidence of symptomatic DVT decreased. Conversely, we found no similar reduction in the incidence of symptomatic PE; whether this is due to changes in diagnostic tests and algorithms in the management of suspected PE requires further investigations. Supplementary Material to this paper is available online at www.thrombosis-online.com.
What are the Visual Features Underlying Human Versus Machine Vision?

Although Deep Convolutional Networks (DCNs) are approaching the accuracy of human observers at object recognition, it is unknown whether they leverage similar visual representations to achieve this performance. To address this, we introduce Clicktionary, a web-based game for identifying visual features used by human observers during object recognition. Importance maps derived from the game are consistent across participants and uncorrelated with image saliency measures. These results suggest that Clicktionary identifies image regions that are meaningful and diagnostic for object recognition but different than those driving eye movements. Surprisingly, Clicktionary importance maps are only weakly correlated with relevance maps derived from DCNs trained for object recognition. Our study demonstrates that the narrowing gap between the object recognition accuracy of human observers and DCNs obscures distinct visual strategies used by each to achieve this performance.
The impact of ‘Cash for Clunkers’ on greenhouse gas emissions: a life cycle perspective

One of the goals of the US Consumer Assistance to Recycle and Save (CARS) Act of 2009, more commonly known as ‘Cash for Clunkers’, was to improve the US vehicle fleet fuel efficiency. Previous studies of the program’s environmental impact have focused mainly on the effect of improved fuel economy, and the resulting reductions in fuel use and emissions during the vehicle use phase. We propose and apply a method for analyzing the net effect of CARS on greenhouse gas emissions from a full vehicle life cycle perspective, including the impact of premature production and retirement of vehicles. We find that CARS had a one-time effect of preventing 4.4 million metric tons of CO2-equivalent emissions, about 0.4% of US annual light-duty vehicle emissions. Of these, 3.7 million metric tons are avoided during the period of the expected remaining life of the inefficient ‘clunkers’. 1.5 million metric tons are avoided as consumers purchase vehicles that are more efficient than their next replacement vehicle would otherwise have been. An additional 0.8 million metric tons are emitted as a result of premature manufacturing and disposal of vehicles. These results are sensitive to the remaining lifetime of the ‘clunkers’ and to the fuel economy of new vehicles in the absence of CARS, suggesting important considerations for policymakers deliberating on the use of accelerated vehicle retirement programs as a part of the greenhouse gas emissions policy.
Petroleum Hydrocarbon Profiles of Water and Sediment of Algoa Bay, Eastern Cape, South Africa

Petroleum hydrocarbon profiles of water and sediment samples of Algoa Bay in the Eastern Cape Province of South Africa were assessed using standard analytical procedures. Water (from surface and bottom levels) and sediment samples were collected from five locations in the bay from February to June 2016. Extraction of the petroleum hydrocarbons from the water and sediment samples collected was achieved using liquid-liquid and Soxhlet extraction techniques, respectively, followed by column clean up. Target compounds were analytically determined with gas chromatography–flame ionization detector (GC-FID) and quantified by integrating the areas of both the resolved and unresolved components. Physicochemical properties of the water samples were also determined on site using a SeaBird 19plusV2 CTD SBE 55 device. Estimated limit of detection, limit of quantitation and relative standard deviation for the 35 n-alkane standards ranged from 0.06 to 0.13 μg/L, 0.30 to 0.69 μg/L and 3.61 to 8.32%, respectively. Results showed that total petroleum hydrocarbon (TPH) varied from 45.07 to 307 μg/L in the water and 0.72 to 27.03 mg/kg in the sediments. The mean concentrations of TPH in both the water and sediment samples from Algoa Bay revealed a slight level of pollution. The diagnostic indices used showed that the hydrocarbons in the area were from both biogenic and anthropogenic sources. Hence, there is need for adequate regulation and control of all activities contributing to the levels of petroleum hydrocarbon in the marine environment for the safety of human, aquatic and wild lives in the area.
Learning to Segment Affordances

The goal of this work is to densely predict a comparatively large set of affordances given only single RGB images. We approach this task by using a convolutional neural network based on the well-known ResNet architecture, which we blend with refinement modules recently proposed in the semantic segmentation literature. A novel cost function, capable of handling incomplete data, is introduced, which is necessary because we make use of segmentations of objects and their parts to generate affordance maps. We demonstrate both, quantitatively and qualitatively, that learning a dense predictor of affordances from an object part dataset is indeed possible and show that our model outperforms several baselines.
Hyperglycaemic preterm neonates exhibit insulin resistance and low insulin production

Objectives To explore and compare the relationships between postmenstrual age (PMA), insulin, C-peptide and blood glucose concentrations (BGC) in hyperglycaemic and euglycaemic preterm neonates (PMA <30 weeks). Design Observational. Setting Dunedin Hospital Neonatal Intensive Care Unit, New Zealand. Patients Preterm neonates were recruited and included nine insulin-treated hyperglycaemic and 20 euglycaemic neonates. Samples for euglycaemic neonates were obtained from leftover blood, and for insulin-treated neonates, additional blood was collected at the same time as the patients’ routine 4 hourly blood glucose test over a 24-hour period (six samples). Main outcome measures Blood samples were collected, plasma was analysed for insulin and C-peptide and was measured in temporal association with BGC. Results The euglycaemic neonates had a mean PMA (SD) of 28 (1.4) weeks and the insulin-treated neonates had 25.5 (1.8) weeks. C-peptide plasma concentrations were significantly lower (p<0.01) in the insulin-treated hyperglycaemic neonates (51.7 (100) pmol/L; 200(208) pmol/L) indicating lower insulin production. Insulin plasma concentrations (r=−0.38), BGC (r=−0.38), C-peptide plasma concentrations (r=0.36) and insulin/C-peptide ratios (r=−0.49) were all significantly affected by PMA (p<0.01). As expected, insulin plasma concentrations were higher in the insulin-treated hyperglycaemic neonates (156 (161) pmol/L; 93.2 (63.1) pmol/L, p<0.01) confirming that intravenous exogenous insulin reached these neonates. Conclusions This study demonstrates that preterm neonates exhibit insulin resistance, hyperglycaemic neonates have lower insulin production than euglycaemic neonates and treatment with exogenous insulin did not appear to suppress insulin production in these neonates.
The in‐hospital burden of hidradenitis suppurativa in patients with inflammatory bowel disease: a decade nationwide analysis from 2004 to 2014

Hidradenitis suppurativa (HS) is a chronic inflammatory disease that significantly affects the patient's quality of life. Multiple studies have shown a strong association between HS and inflammatory bowel disease (IBD). Our primary goal was to explore the in‐hospital burden of HS on patients with IBD. Our secondary goal was to establish unique baseline characteristics and comorbidities of IBD patients with HS.
Second trimester levels of maternal serum total activin A and placental inhibin/activin alpha and betaA subunit messenger ribonucleic acids in Down syndrome pregnancy.

OBJECTIVES Previous data have shown that inhibin A (alpha/betaA) is increased about twofold in maternal serum samples from Down syndrome pregnancy. Our objectives were to determine whether activin A (betaA/betaA) was similarly increased in maternal serum from pregnancies affected with fetal Down syndrome, and to investigate whether increased expression of each inhibin/activin subunit occurred in placental tissue from cases of fetal Down syndrome. DESIGN AND METHODS Maternal serum total activin A levels were measured in 20 cases of fetal Down syndrome and 100 unaffected pregnancy samples. In addition, analysis of inhibin/activin alpha and betaA subunit mRNA levels was performed in placental tissue extracts from six cases of fetal Down syndrome and six tissues with a normal karyotype. RESULTS The median total activin A level in the Down syndrome cases was 0.82 MoM (multiples of the median); values did not differ significantly (P = 0.36, Mann-Whitney U analysis) from those in unaffected pregnancies. The inhibin alpha subunit/GAPDH mRNA ratio, but not that of betaA subunit/GAPDH mRNA, was significantly greater (P < 0.01, ANOVA) in placental tissue from Down syndrome than in control placental tissue. CONCLUSIONS Unlike inhibin A, activin A is not significantly increased in Down syndrome relative to unaffected pregnancy. Furthermore, increased amounts of maternal serum inhibin A in Down syndrome pregnancy probably result from increased placental expression of inhibin alpha, but not betaA, subunit.
Controlled Synthesis of 3D Multi‐Compartmental Particles with Centrifuge‐Based Microdroplet Formation from a Multi‐Barrelled Capillary

Controlled synthesis of micro multi-compartmental particles using a centrifuge droplet shooting device (CDSD) is reported. Sodium alginate solutions introduced in a multi-barreled capillary form droplets at the capillary orifice under ultrahigh gravity and gelify in a CaCl(2) solution. The size, shape, and compartmentalization of the particles are controlled. Co-encapsulation of Jurkat cells and magnetic colloids into Janus particles is demonstrated. The Janus particles present sensitive reaction toward magnetic fields, while the viability of the encapsulated cells is 91%.
Biometric Relationship Between Inner Canthal Distance And Geometric Progression For The Prediction Of Maxillary Central Incisor Width.

Statement of problem One of the primary concerns in denture esthetics is the selection of appropriate mesiodistal width of maxillary central incisors. Aim To examine the relationship between inner canthal distance and maxillary central incisor mesiodistal width in terms of geometric progression popularly known a golden proportion. Materials and Method : Two hundred and fifty dentate Indian subjects (121 males 129 females; mean age 21.49 years) free from facial and dental deformities were examined. The mesiodistal width of each maxillary central incisor was measured between its interproximal contact points. The inner canthal distance was measured from medial angle to medial angle of the palpebral fissures of the eyes. The common ratios of geometric progression are 0.618 and 1.618 . The inner canthal distance of each subject was multiplied by a decreasing function value of the geometric progression term (0.618) to provide the combined width of two central incisors. The product was then divided by 2 to obtain the width of a single maxillary central incisor. A “t” test was used to identify any significant differences in the mesiodistal tooth width and inner canthal distance by gender. Agreement between the measured and calculated central incisor widths was evaluated with Pearson’s correlation coefficients as was intraexaminer reliability. Results : The mean inner canthal distance of male and female subjects was 29.85±1.47mm and 27.46±2.1mm, respectively. The mean maxillary central incisor width of male and female subjects was 9.18±0.51mm and 8.42±0.40mm, respectively. Difference between the mean values for both measurements was significant. The actual and calculated width of maxillary central incisors was found to be highly correlated (r=0.96). Conclusion : The results of the present study suggest that inner canthal distance and geometric progression may be a reliable predictor of the width of the maxillary central incisor. Interpretation and extrapolation of the results may be tempered, by an acknowledgement of the study limitation. Only one ethnic group (Indian) was evaluated, and subjects were chosen with a specific age range. It is possible that ethnic related difference in inner canthal distance may exist. Further research is necessary to validate the outcomes of this investigation.
Genomic analyses of Northern snakehead (Channa argus) populations in North America

Background The introduction of northern snakehead (Channa argus; Anabantiformes: Channidae) and their subsequent expansion is one of many problematic biological invasions in the United States. This harmful aquatic invasive species has become established in various parts of the eastern United States, including the Potomac River basin, and has recently become established in the Mississippi River basin in Arkansas. Effective management of C. argus and prevention of its further spread depends upon knowledge of current population structure in the United States. Methods Novel methods for invasive species using whole genomic scans provide unprecedented levels of data, which are able to investigate fine scale differences between and within populations of organisms. In this study, we utilize 2b-RAD genomic sequencing to recover 1,007 single-nucleotide polymorphism (SNP) loci from genomic DNA extracted from 165 C. argus individuals: 147 individuals sampled along the East Coast of the United States and 18 individuals sampled throughout Arkansas. Results Analysis of those SNP loci help to resolve existing population structure and recover five genetically distinct populations of C. argus in the United States. Additionally, information from the SNP loci enable us to begin to calculate the long-term effective population size ranges of this harmful aquatic invasive species. We estimate long-term Ne to be 1,840,000–18,400,000 for the Upper Hudson River basin, 4,537,500–45,375,000 for the Lower Hudson River basin, 3,422,500–34,225,000 for the Potomac River basin, 2,715,000–7,150,000 for Philadelphia, and 2,580,000–25,800,000 for Arkansas populations. Discussion and Conclusions This work provides evidence for the presence of more genetic populations than previously estimated and estimates population size, showing the invasive potential of C. argus in the United States. The valuable information gained from this study will allow effective management of the existing populations to avoid expansion and possibly enable future eradication efforts.
Gut Microbiota Metabolites and Risk of Major Adverse Cardiovascular Disease Events and Death: A Systematic Review and Meta‐Analysis of Prospective Studies

Background Gut microbial metabolites have been implicated as novel risk factors for cardiovascular events and premature death. The strength and consistency of associations between blood concentrations of the gut microbial metabolites, trimethylamine‐N‐oxide (TMAO) and its precursors, with major adverse cardiovascular events (MACE) or death have not been comprehensively assessed. We quantified associations of blood concentrations of TMAO and its precursors with risks of MACE and mortality. Methods and Results PubMed and Embase databases were searched up, and a total of 19 prospective studies from 16 publications (n=19 256, including 3315 incident cases) with quantitative estimates of the associations of TMAO with the development of MACE or death were included in our main analysis. Multivariate‐adjusted relative risks (RRs) were used when these were available. Elevated concentrations of TMAO were associated with a pooled RR of 1.62 (95% CI, 1.45, 1.80; P heterogeneity=0.2; I2=23.5%) for MACE compared with low TMAO levels, and 1 study of black participants influenced the heterogeneity of the association. After excluding the data of blacks, the RRs were not different according to body mass index, prevalence of diabetes mellitus, history of cardiovascular diseases, and kidney dysfunction. Furthermore, elevated TMAO concentrations were associated with a pooled RR of 1.63 (1.36, 1.95) for all‐cause mortality. Individuals with elevated concentrations of TMAO precursors (l‐carnitine, choline, or betaine) had an approximately 1.3 to 1.4 times higher risk for MACE compared to those with low concentrations. Conclusions Elevated concentrations of TMAO and its precursors were associated with increased risks of MACE and all‐cause mortality independently of traditional risk factors.