Miracle-dz/UniFAR-FTUs huggingface dataset:
Association of acute kidney injury and chronic kidney disease with processes of care and long-term outcomes in patients with acute myocardial infarction

Aims To examine the association of acute kidney injury (AKI) with long-term outcomes after myocardial infarction (MI), and evaluate whether effect modification is present according to baseline chronic kidney disease (CKD) status. Methods and results ACTION Registry records from 2008 to 2012 were linked to Medicare claims data, creating a cohort of 76 500 acute MI patients aged ≥ 65 years who survived to hospital discharge. Mild, moderate, and severe AKI were defined as changes in creatinine from baseline to peak of 0.3 to < 0.5, 0.5 to < 1.0, and ≥ 1.0 mg/dL, respectively. Stage 3, Stage 4, and Stage 5 CKD were defined as estimated glomerular filtration rates of 30-59, 15-29, and <15 mL/min/m2, respectively. Cox proportional hazards modelling was used to examine associations of AKI with long-term outcomes. The prevalence of baseline CKD was: Stage 3 (41.2%), Stage 4 (6.7%), and Stage 5 (1.0%). The incidence of AKI was: mild (7.5%), moderate (6.0%), and severe (3.0%). A significant interaction of AKI with baseline CKD was observed for 1-year mortality (Pinteraction <0.001). Acute kidney injury was associated with worse multivariable-adjusted 1-year mortality among individuals without CKD: mild AKI [hazard ratio (HR): 1.33, 95% confidence interval (CI): 1.22-1.49], moderate AKI (HR:1.66, 95% CI: 1.46-1.89), and severe AKI (HR: 2.87, 95% CI: 2.41-3.43). An attenuation of this effect was noted with advancing stages of baseline CKD such that among patients with Stage 5 CKD, AKI was not associated with 1-year mortality. Conclusion Acute kidney injury is associated with worse long-term outcomes after MI. This effect is modified by baseline CKD status.
Importance of comorbidities in the treatment of primary care patients with heart failure—Baseline results of the observational RECODE-HF Study

Background Both non-cardiac and cardiac comorbidities are related to the prognosis of chronic heart failure (HF), but so far little is known about the impact of comorbidities on treatment difficulties in routine care. Objectives To investigate which comorbidities are associated with treatment difficulties in primary care. We hypothesized that somatic comorbidities as well as psychosocial distress are associated with treatment difficulties. Methods In this baseline analysis of data of the observational RECODE-HF study, HF patients were recruited via primary care practices in two German sites. They received a questionnaire by mail to measure psychosocial distress. Each patient's GP was interviewed by phone regarding the patient's comorbidities and treatment difficulties. Logistic regression analyses controlled for GP cluster effects were calculated to investigate the association between comorbidities/psychosocial distress and treatment difficulties. Results The 3282 patients of 285 GPs included in the analysis were aged 74.2 (±10.1) years and had a mean number of 4.6 (±2.4) comorbidities. GPs reported treatment difficulties in 32.5% of the patients. Allergies/drug intolerance [odds ratio (ORs)=2.0], asthma/chronic obstructive pulmonary disease (ORs=1.4), renal insufficiency (ORs=1.3), atherosclerosis/peripheral arterial occlusive disease (ORs=1.3) and cardiac arrhythmias (ORs=1.2) as well as patient-reported psychosocial distress (ORs=1.2), HF severity (ORs=3.7-1.6) and age (ORs=0.98) were associated with treatment difficulties. Conclusion Five somatic comorbidity groups as well as patient-reported psychosocial distress were significantly associated with a higher risk of GP-reported treatment difficulties. Further efforts to address comorbidities in clinical guidelines could be built on these results.
Minimizing Attack Graph Data Structures

— An attack graph is a data structure representing how an attacker can chain together multiple attacks to expand their influence within a network (often in an attempt to reach some set of goal states). Restricting attack graph size is vital for the execution of high degree polynomial analysis algorithms. However, we find that the most widely-cited and recently-used ‘condition/exploit’ attack graph representation has a worst-case quadratic node growth with respect to the number of hosts in the network when a linear representation will suffice. In 2002, a node linear representation in the form of a ‘condition’ approach was published but was not significantly used in subsequent research. In analyzing the condition approach, we find that (while node linear) it suffers from edge explosions: the creation of unnecessary complete bipartite sub-graphs. To address the weaknesses in both approaches, we provide a new hybrid ‘condition/vulnerability’ representation that regains linearity in the number of nodes and that removes unnecessary complete bipartite sub-graphs, mitigating the edge explosion problem. In our empirical study modeling an operational 5968-node network, our new representation had 94 % fewer nodes and 64 % fewer edges than the currently used condition/exploit approach.
Similar acute physiological responses from effort and duration matched leg press and recumbent cycling tasks

The present study examined the effects of exercise utilising traditional resistance training (leg press) or ‘cardio’ exercise (recumbent cycle ergometry) modalities upon acute physiological responses. Nine healthy males underwent a within session randomised crossover design where they completed both the leg press and recumbent cycle ergometer conditions. Conditions were approximately matched for effort and duration (leg press: 4 × 12RM using a 2 s concentric and 3 s eccentric repetition duration controlled with a metronome, thus each set lasted 60 s; recumbent cycle ergometer: 4 × 60 s bouts using a resistance level permitting 80–100 rpm but culminating with being unable to sustain the minimum cadence for the final 5–10 s). Measurements included VO2, respiratory exchange ratio (RER), blood lactate, energy expenditure, muscle swelling, and electromyography. Perceived effort was similar between conditions and thus both were well matched with respect to effort. There were no significant effects by ‘condition’ in any of the physiological responses examined (all p > 0.05). The present study shows that, when both effort and duration are matched, resistance training (leg press) and ‘cardio’ exercise (recumbent cycle ergometry) may produce largely similar responses in VO2, RER, blood lactate, energy expenditure, muscle swelling, and electromyography. It therefore seems reasonable to suggest that both may offer a similar stimulus to produce chronic physiological adaptations in outcomes such as cardiorespiratory fitness, strength, and hypertrophy. Future work should look to both replicate the study conducted here with respect to the same, and additional physiological measures, and rigorously test the comparative efficacy of effort and duration matched exercise of differing modalities with respect to chronic improvements in physiological fitness.
Design of polar self-assembling lactic acid derivatives possessing submicrometre helical pitch

Several new lactic acid derivatives containing the keto linkage group far from the chiral part and short alkyl chains have been synthesized and characterised by polarising optical microscopy, differential scanning calorimetry, as well as electro-optic and dielectric spectroscopy. The materials possess a self-assembling behaviour on the nanoscale level as they form polar smectic liquid crystalline mesophases, namely the orthogonal paraelectric SmA* and the tilted ferroelectric SmC* phases, in a broad temperature range down to room temperature. A short helical pitch (≈120–320 nm), relatively high spontaneous polarisation (≈150 nC/cm2) and reasonable tilt angle values have been determined within the temperature range of the tilted ferroelectric SmC* phase. The obtained results make the new materials useful for the advanced mixture design and for further utilisation in electro-optic devices based on the deformed helix ferroelectric effect.
Parsimony, model adequacy and periodic correlation in time series forecasting

Summary The merits of the modelling philosophy of Box & Jenkins (1970) are illustrated with a summary of our recent work on seasonal river flow forecasting. Specifically, this work demonstrates that the principle of parsimony, which has been questioned by several authors recently, is helpful in selecting the best model for forecasting seasonal river flow. Our work also demonstrates the important of model adequacy. An adequate model for seasonal river flow must incorporate seasonal periodic correlation. The usual autoregressive-moving average (ARMA) and seasonal ARMA models are not adequate in this respect for seasonal river flow time series. A new diagnostic check, for detecting periodic correlation in fitted ARMA models is developed in this paper. This diagnostic check is recommended for routine use when fitting seasonal ARMA models. It is shown that this diagnostic check indicates that many seasonal economic time series also exhibit periodic correlation. Since the standard forecasting methods are inadequate on this account, it can be concluded that in many cases, the forecasts produced are sub-optimal. Finally, a limitation of the arbitrary combination of forecasts is also illustrated. Combining forecasts from an adequate parsimonious model with an inadequate model did not improve the forecasts whereas combining the two forecasts of two inadequate models did yield an improvement in forecasting performance. These findings also support the model building philosophy of Box & Jenkins. The non-intuitive findings of Newbold & Granger (1974) and Winkler & Makridakis (1983) that the apparent arbitrary combination of forecasts from similar models will lead to forecasting performance is not supported by our case study with river flow forecasting.
Endocytic vesicle scission by lipid phase boundary forces

Endocytosis in budding yeast is thought to occur in several phases. First, the membrane invaginates and then elongates into a tube. A vesicle forms at the end of the tube, eventually pinching off to form a “free” vesicle. Experiments show that actin polymerization is an active participant in the endocytic process, along with a number of membrane-associated proteins. Here we investigate the possible roles of these components in driving vesiculation by constructing a quantitative model of the process beginning at the stage where the membrane invagination has elongated into a tube encased in a sheath of membrane-associated protein. This protein sheath brings about the scission step where the vesicle separates from the tube. When the protein sheath is dynamin, it is commonly assumed that scission is brought about by the constriction of the sheath. Here, we show that an alternative scenario can work as well: The protein sheath acts as a “filter” to effect a phase separation of lipid species. The resulting line tension tends to minimize the interface between the tube region and the vesicle region. Interestingly, large vesicle size can further facilitate the reduction of the interfacial diameter down to a few nanometers, small enough so that thermal fluctuations can fuse the membrane and pinch off the vesicle. To deform the membrane into the tubular vesicle shape, the membrane elastic resistance forces must be balanced by some additional forces that we show can be generated by actin polymerization and/or myosin I. These active forces are shown to be important in successful scission processes as well.
Toward Precision and Reproducibility of Diffusion Tensor Imaging: A Multicenter Diffusion Phantom and Traveling Volunteer Study

BACKGROUND AND PURPOSE: Precision medicine is an approach to disease diagnosis, treatment, and prevention that relies on quantitative biomarkers that minimize the variability of individual patient measurements. The aim of this study was to assess the intersite variability after harmonization of a high-angular-resolution 3T diffusion tensor imaging protocol across 13 scanners at the 11 academic medical centers participating in the Transforming Research and Clinical Knowledge in Traumatic Brain Injury multisite study. MATERIALS AND METHODS: Diffusion MR imaging was acquired from a novel isotropic diffusion phantom developed at the National Institute of Standards and Technology and from the brain of a traveling volunteer on thirteen 3T MR imaging scanners representing 3 major vendors (GE Healthcare, Philips Healthcare, and Siemens). Means of the DTI parameters and their coefficients of variation across scanners were calculated for each DTI metric and white matter tract. RESULTS: For the National Institute of Standards and Technology diffusion phantom, the coefficients of variation of the apparent diffusion coefficient across the 13 scanners was <3.8% for a range of diffusivities from 0.4 to 1.1 × 10−6 mm2/s. For the volunteer, the coefficients of variations across scanners of the 4 primary DTI metrics, each averaged over the entire white matter skeleton, were all <5%. In individual white matter tracts, large central pathways showed good reproducibility with the coefficients of variation consistently below 5%. However, smaller tracts showed more variability, with the coefficients of variation of some DTI metrics reaching 10%. CONCLUSIONS: The results suggest the feasibility of standardizing DTI across 3T scanners from different MR imaging vendors in a large-scale neuroimaging research study.
A No-Reference Modular Video Quality Prediction Model for H.265/HEVC and VP9 Codecs on a Mobile Device

We propose a modular no-reference video quality prediction model for videos that are encoded with H.265/HEVC and VP9 codecs and viewed on mobile devices. The impairments which can affect video transmission are classified into two broad types depending upon which layer of the TCP/IP model they originated from. Impairments from the network layer are called the network QoS factors, while those from the application layer are called the application/payload QoS factors. Initially we treat the network and application QoS factors separately and find out the 1 : 1 relationship between the respective QoS factors and the corresponding perceived video quality or QoE. The mapping from the QoS to the QoE domain is based upon a decision variable that gives an optimal performance. Next, across each group we choose multiple QoS factors and find out the QoE for such multifactor impaired videos by using an additive, multiplicative, and regressive approach. We refer to these as the integrated network and application QoE, respectively. At the end, we use a multiple regression approach to combine the network and application QoE for building the final model. We also use an Artificial Neural Network approach for building the model and compare its performance with the regressive approach.
Stress-Rupture of Simple S-Glass/Epoxy Composites *

The stress-rupture of S-glass/epoxy composites has been studied. A 40 ksi increase in stress reduces the life of an S-glass/epoxy composite by a factor of 10. An empirical extrapolation of 15,000 hours of testing implies that S-glass/epoxy composites can sustain an equivalent fiber stress of 200 ksi for 10 years. The S-glass/epoxy stress-rupture distributions from over 1300 tests are described by an exponential model and are related to the applied stress by a power law in time.
Controlling range expansion in habitat networks by adaptively targeting source populations

Controlling the spread of invasive species, pests, and pathogens is often logistically limited to interventions that target specific locations at specific periods. However, in complex, highly connected systems, such as marine environments connected by ocean currents, populations spread dynamically in both space and time via transient connectivity links. This results in nondeterministic future distributions of species in which local populations emerge dynamically and concurrently over a large area. The challenge, therefore, is to choose intervention locations that will maximize the effectiveness of the control efforts. We propose a novel method to manage dynamic species invasions and outbreaks that identifies the intervention locations most likely to curtail population expansion by selectively targeting local populations most likely to expand their future range. Critically, at any point during the development of the invasion or outbreak, the method identifies the local intervention that maximizes the long‐term benefit across the ecosystem by restricting species’ potential to spread. In so doing, the method adaptively selects the intervention targets under dynamically changing circumstances. To illustrate the effectiveness of the method we applied it to controlling the spread of crown‐of‐thorns starfish (Acanthaster sp.) outbreaks across Australia's Great Barrier Reef. Application of our method resulted in an 18‐fold relative improvement in management outcomes compared with a random targeting of reefs in putative starfish control scenarios. Although we focused on applying the method to reducing the spread of an unwanted species, it can also be used to facilitate the spread of desirable species through connectivity networks. For example, the method could be used to select those fragments of habitat most likely to rebuild a population if they were sufficiently well protected.
Immunolocalization of CD163+ Tumor-Associated Macrophages and Symmetric Proliferation of Ki-67 as Biomarkers to Differentiate New Different Grades of Laryngeal Dysplasia

Objectives To evaluate CD163+ tumor-associated macrophages (TAMs), Ki-67, and cyclin D1 to differentiate laryngeal dysplasia in the 2017 World Health Organization classification. Methods Immunohistochemistry for CD163, Ki-67, and cyclin D1 was performed using paraffin-embedded specimens. CD163+ TAMs infiltrating the epithelium were estimated. Ki-67 and cyclin D1 were evaluated in four parts of the epithelium-basal, parabasal, middle third, and upper third layers. Results In total, 133 specimens were analyzed, including low-grade dysplasia (n = 31), high-grade dysplasia (n = 49), carcinoma in situ (n = 23), and normal mucosa (n = 30). CD163+ TAMs infiltrating the epithelium were significantly higher in high-grade dysplasia than in low-grade dysplasia. In the basal layer, Ki-67+ and cyclin D1+ cells were overexpressed in high-grade dysplasia (P < .0001). The area under the curve was 0.958 for Ki-67 and 0.909 for CD163+ TAMs (P < .0001). Conclusions CD163+ TAMs infiltrating the epithelium and Ki-67 overexpression in the basal layer may serve as biomarkers to differentiate low-grade dysplasia from high-grade dysplasia of the larynx. A symmetric proliferative pattern was observed during laryngeal carcinogenesis following Ki-67 overexpression.
Ongoing haemolytic uraemic syndrome (HUS) outbreak caused by sorbitol-fermenting (SF) Shiga toxin-producing Escherichia coli (STEC) O157, Germany, December 2016 to May 2017

We report an ongoing, protracted and geographically dispersed outbreak of haemolytic uraemic syndrome (HUS) and gastroenteritis in Germany, involving 30 cases since December 2016. The outbreak was caused by the sorbitol-fermenting immotile variant of Shiga toxin-producing (STEC) Escherichia coli O157. Molecular typing revealed close relatedness between isolates from 14 cases. One HUS patient died. Results of a case–control study suggest packaged minced meat as the most likely food vehicle. Food safety investigations are ongoing.
The Regularization Effects of Anisotropic Noise in Stochastic Gradient Descent

Understanding the generalization of deep learning has raised lots of concerns recently, where the learning algorithms play an important role in generalization performance, such as stochastic gradient descent (SGD). Along this line, we particularly study the anisotropic noise introduced by SGD, and investigate its importance for the generalization in deep neural networks. Through a thorough empirical analysis, it is shown that the anisotropic diffusion of SGD tends to follow the curvature information of the loss landscape, and thus is beneficial for escaping from sharp and poor minima effectively, towards more stable and flat minima. We verify our understanding through comparing this anisotropic diffusion with full gradient descent plus isotropic diffusion (i.e. Langevin dynamics) and other types of position-dependent noise.
Trends in Racial-Ethnic Disparities in Access to Mental Health Care, 2004-2012.

OBJECTIVE This study compared trends in racial-ethnic disparities in mental health care access among whites, blacks, Hispanics, and Asians by using the Institute of Medicine definition of disparities as all differences except those due to clinical appropriateness, clinical need, and patient preferences. METHODS Racial-ethnic disparities in mental health care access were examined by using data from a nationally representative sample of 214,597 adults from the 2004-2012 Medical Expenditure Panel Surveys. The main outcome measures included three mental health care access measures (use of any mental health care, any outpatient care, and any psychotropic medication in the past year). RESULTS Significant disparities were found in 2004-2005 and in 2011-2012 for all three racial-ethnic minority groups compared with whites in all three measures of access. Between 2004 and 2012, black-white disparities in any mental health care and any psychotropic medication use increased, respectively, from 8.2% to 10.8% and from 7.6% to 10.0%. Similarly, Hispanic-white disparities in any mental health care and any psychotropic medication use increased, respectively, from 8.4% to 10.9% and 7.3% to 10.3%. CONCLUSIONS No reductions in racial-ethnic disparities in access to mental health care were identified between 2004 and 2012. For blacks and Hispanics, disparities were exacerbated over this period. Clinical interventions that improve identification of symptoms of mental illness, expansion of health insurance, and other policy interventions that remove financial barriers to access may help to reduce these disparities.
Factors influencing risk‐based care of the childhood cancer survivor in the 21st century

The population of adult survivors of childhood cancer continues to grow as survival rates improve. Although it is well established that these survivors experience various complications and comorbidities related to their malignancy and treatment, this risk is modified by many factors that are not directly linked to their cancer history. Research evaluating the influence of patient‐specific demographic and genetic factors, premorbid and comorbid conditions, health behaviors, and aging has identified additional risk factors that influence cancer treatment‐related toxicity and possible targets for intervention in this population. Furthermore, although current long‐term follow‐up guidelines comprehensively address specific therapy‐related risks and provide screening recommendations, the risk profile of the population continues to evolve with ongoing modification of treatment strategies and the emergence of novel therapeutics. To address the multifactorial modifiers of cancer treatment‐related health risk and evolving treatment approaches, a patient‐centered and risk‐adapted approach to care that often requires a multidisciplinary team approach, including medical and behavioral providers, is necessary for this population. CA Cancer J Clin 2018;68:133‐152. © 2018 American Cancer Society.