Miracle-dz/UniFAR-FTUs huggingface dataset:
Comparison of Machine Learning Optimal Classification Trees With the Pediatric Emergency Care Applied Research Network Head Trauma Decision Rules.

Importance Computed tomographic (CT) scanning is the standard for the rapid diagnosis of intracranial injury, but it is costly and exposes patients to ionizing radiation. The Pediatric Emergency Care Applied Research Network (PECARN) rules for identifying children with minor head trauma who are at very low risk of clinically important traumatic brain injury (ciTBI) are widely used to triage CT imaging. Objective To examine whether optimal classification trees (OCTs), which are novel machine-learning classifiers, improve on PECARN rules' predictive accuracy. Design, Setting, and Participants A secondary analysis of prospective, publicly available data on emergency department visits for head trauma used by the PECARN group to develop their tool was conducted to derive OCT-based prediction rules for ciTBI in a development cohort and compare their predictive performance vs the PECARN rules in a validation cohort among children who were younger than 2 years and 2 years or older. Data on 42 412 children with head trauma and without severely altered mental status who were examined between June 1, 2004, and September 30, 2006, were gathered from 25 emergency departments in North America participating in PECARN. Data analysis was conducted from September 15, 2016, to December 18, 2018. Main Outcomes and Measures The outcome was ciTBI, with predictive performance measured by estimating the sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio for the OCT and the PECARN rules. The OCT and PECARN rules' performance was compared by estimating ratios for each measure. Results Of the 42 412 children (15 996 [37.7%] girls) included in the analysis, 10 718 were younger than 2 years (25.3%; mean [SD] age, 11.6 [0.6] months) and 31 694 were 2 years or older (74.7%; age, 9.1 [4.9] years). Compared with PECARN rules, OCTs misclassified 0 vs 1 child with ciTBI in the younger and 10 vs 9 children with ciTBI in the older cohort, and correctly identified more children with very low risk of ciTBI in the younger (7605 vs 5701) and older (20 594 vs 18 134) cohorts. In the validation cohorts, compared with the PECARN rules, the OCTs had statistically significantly better specificity (in the younger cohort: 69.3%; 95% CI, 67.4%-71.2% vs 52.8%; 95% CI, 50.8%-54.9%; in the older cohort: 65.6%; 95% CI, 64.5%-66.8% vs 57.6%; 95% CI, 56.4%-58.8%), positive predictive value (odds ratios, 1.54; 95% CI, 1.36-1.74 and 1.23; 95% CI, 1.17-1.30, in younger and older children, respectively), and positive likelihood ratio (risk ratios, 1.54; 95% CI, 1.36-1.74 and 1.23; 95% CI, 1.17-1.30, in younger and older children, respectively). There were no statistically significant differences in the sensitivity, negative predictive value, and negative likelihood ratio between the 2 sets of rules. Conclusions and Relevance If implemented, OCTs may help reduce the number of unnecessary CT scans, without missing more patients with ciTBI than the PECARN rules.
Ethnic/Racial Variations in Blood Pressure Awareness, Treatment, and Control

Understanding the impact of patient factors on blood pressure (BP) management is an important step to developing interventions to improve cardiovascular health. The National Health and Nutrition Examination Survey (NHANES) 1999–2002 was used to identify predictors of hypertension awareness, treatment, and control. An estimated 63.3 million (31.0%) US adults currently have BP exceeding 140/90 mm Hg, and prevalence is higher for blacks than for other racial/ethnic subgroups. Among antihypertensive medication‐treated patients, 51.3% are controlled. Treated blacks and Mexican Americans have the lowest rates of BP control. Mexican Americans are 0.62 times as likely to be aware and 0.61 times as likely to be treated as white persons with hypertension. Compared with whites, treated Mexican Americans are 0.71 times as likely and treated blacks 0.59 times as likely to achieve BP control. Hypertension treatment and BP control in the United States remain suboptimal, and significant racial/ethnic disparities persist. Effective interventions targeting Mexican Americans and blacks as well as whites are essential to improving hypertension management.
Demographics of healthcare professionals' knowledge and attitude toward deceased organ donation: Survey of critical care areas in a tertiary hospital.

INTRODUCTION Organ donation rate in Malaysia is amongst the lowest in the World. Healthcare professionals (HCPs) working in critical care areas play an important role in the deceased organ donation (DOD) process. This study seeks to identify the demographics of HCPs working in the critical care areas and their knowledge and attitudes toward the DOD process. METHOD A cross-sectional survey on the demographics, knowledge and attitudes of the doctors and nurses working in critical care areas was undertaken by the random sampling method, using a validated, structured questionnaire. HCP's knowledge and attitudes towards brain death (BD), DOD, organ transplantation (OT), and possession of organ donor card were compared against their demographics. RESULTS Four hundred and twelve (72.9%) out of the total 565 HCPs in critical care areas responded of whom 163 (39.6%) were doctors and 249 (60.4%) were nurses. After adjusting for other factors, department of work and profession were highly correlated with the overall knowledge score (p<0.001 and p=0.003 respectively) and knowledge about BD (p<0.001 and p=0.013 respectively). HCPs from the neurosurgical intensive care unit (p<0.001) and doctors (p<0.001) had higher mean knowledge scores compared to their counterparts. Profession was most significantly correlated with having a positive attitude towards BD (p<0.001) and OT (p<0.001). CONCLUSION Department, profession and ethnicity were the demographic characteristics that correlated with knowledge and attitudes of HCPs on organ donation. Efforts to improve DOD rates in Malaysia should include targeted interventions to address the knowledge and attitudes of HCPs working in critical care areas.
Genetic epidemiology and Mendelian randomization for informing disease therapeutics: Conceptual and methodological challenges

The past decade has been proclaimed as a hugely successful era of gene discovery through the high yields of many genome-wide association studies (GWAS). However, much of the perceived benefit of such discoveries lies in the promise that the identification of genes that influence disease would directly translate into the identification of potential therapeutic targets (1-4), but this has yet to be realised at a level reflecting expectation. One reason for this, we suggest, is that GWAS to date have generally not focused on phenotypes that directly relate to the progression of disease, and thus speak to disease treatment.
Strong attractions and repulsions mediated by monovalent salts

Significance The physical properties of proteins and polyions in electrolyte solutions are of crucial importance for understanding biological processes and for controlling biotechnological processes. The concentration of salt controls the range and strength of the interactions in these complex electrolytes. Here, multiscale coarse-grained molecular dynamics simulations reveal long-range interactions between nanoparticles in aqueous solutions at high monovalent salt concentrations. The simulations explain the crystallization of nanoparticles even when they are strongly charged and explain the reentrant attractive to repulsive to attractive interactions as the nanoparticle charge density increases in high monovalent salt-concentration conditions. Controlling interactions between proteins and nanoparticles in electrolyte solutions is crucial for advancing biological sciences and biotechnology. The assembly of charged nanoparticles (NPs) and proteins in aqueous solutions can be directed by modifying the salt concentration. High concentrations of monovalent salt can induce the solubilization or crystallization of NPs and proteins. By using a multiscale coarse-grained molecular dynamics approach, we show that, due to ionic correlations in the electrolyte, NPs pairs at high monovalent salt concentrations interact via remarkably strong long-range attractions or repulsions, which can be split into three regimes depending on the surface charge densities of the NPs. NPs with zero-to-low surface charge densities interact via a long-range attraction that is stronger and has a similar range to the depletion attraction induced by polymers with radius of gyrations comparable to the NP diameter. On the other hand, moderately charged NPs with smooth surfaces as well as DNA-functionalized NPs with no possibility of hybridization between them interact via a strong repulsion of range and strength larger than the repulsion predicted by models that neglect ionic correlations, including the Derjaguin–Landau–Vervey–Overbeek (DLVO) model. Interactions between strongly charged NPs (>2 e/nm2), both types smooth and DNA-functionalized NPs, show an attractive potential well at intermediate-to-high salt concentrations, which demonstrates that electrolytes can induce aggregation of strongly charged NPs. Our work provides an improved understanding of the role of ionic correlations in NP assembly and design rules to utilize the salting-out process to crystallize NPs.
Universal linear optics

Complex quantum optical circuitry Encoding and manipulating information in the states of single photons provides a potential platform for quantum computing and communication. Carolan et al. developed a reconfigurable integrated waveguide device fabricated in a glass chip (see the Perspective by Rohde and Dowling). The device allowed for universal linear optics transformations on six wave-guides using 15 integrated Mach-Zehnder interferometers, each of which was individually programmable. Functional performance in a number of applications in optics and quantum optics demonstrates the versatility of the device's reprogrammable architecture. Science, this issue p. 711; see also p. 696 A reconfigurable optical circuit provides a platform for a photonically-based quantum computer. [Also see Perspective by Rohde and Dowling] Linear optics underpins fundamental tests of quantum mechanics and quantum technologies. We demonstrate a single reprogrammable optical circuit that is sufficient to implement all possible linear optical protocols up to the size of that circuit. Our six-mode universal system consists of a cascade of 15 Mach-Zehnder interferometers with 30 thermo-optic phase shifters integrated into a single photonic chip that is electrically and optically interfaced for arbitrary setting of all phase shifters, input of up to six photons, and their measurement with a 12-single-photon detector system. We programmed this system to implement heralded quantum logic and entangling gates, boson sampling with verification tests, and six-dimensional complex Hadamards. We implemented 100 Haar random unitaries with an average fidelity of 0.999 ± 0.001. Our system can be rapidly reprogrammed to implement these and any other linear optical protocol, pointing the way to applications across fundamental science and quantum technologies.
Accuracy of a Fourth-Generation Subcutaneous Continuous Glucose Sensor

Abstract Background: This study evaluated the accuracy and performance of a fourth-generation subcutaneous glucose sensor (Guardian™ Sensor 3) in the abdomen and arm. Methods: Eighty-eight subjects (14–75 years of age, mean ± standard deviation [SD] of 42.0 ± 19.1 years) with type 1 or type 2 diabetes participated in the study. Subjects wore two sensors in the abdomen that were paired with either a MiniMed™ 640G insulin pump, or an iPhone® or iPod® touch® running a glucose monitoring mobile application (Guardian Connect system) and a third sensor in the arm, which was connected to a glucose sensor recorder (GSR). Subjects were also asked to undergo in-clinic visits of 12–14 h on study days 1, 3, and 7 for frequent blood glucose sample testing using a Yellow Springs Instrument (YSI) reference. Results: The overall mean absolute relative difference (MARD ± SD) between abdomen sensor glucose (SG) and YSI reference values was 9.6% ± 9.0% and 9.4% ± 9.8% for the MiniMed 640G insulin pump and Guardian Connect system, respectively; and 8.7% ± 8.0% between arm SG and YSI reference values. The percentage of SG values within 20% agreement of the YSI reference value (for YSI >80 mg/dL) was 90.7% with the MiniMed 640G insulin pump, 91.8% with the Guardian Connect system, and 93.1% for GSR-connected arm sensors. Mean functional sensor life, when calibrating 3–4 times/day, was 145.9 ± 39.3 h for sensors paired with the MiniMed 640G insulin pump, 146.1 ± 41.6 h for sensors paired with the Guardian Connect system, and 147.6 ± 40.4 h for sensors connected to the GSR. Responses to survey questions regarding sensor comfort and ease of use were favorable. Conclusions: The Guardian Sensor 3 glucose sensor, whether located in abdomen or the arm, provided accurate glucose readings when compared with the YSI reference and demonstrated functional life commensurate with the intended 7-day use. ClinicalTrials.gov: NCT02246582
Can a Regional Trade Agreement Benefit a Nonmember Country Without Compensating it?

RTAs are generally formed without any tariff concessions or transfers to nonmember countries. Can such an RTA benefit nonmembers' welfare? In a two-good three-country competitive equilibrium model in the absence of an entrepot, an RTA without concessions to a nonmember will hurt nonmembers' welfare when goods are normal. If one of the member countries is an entrepot, however, it definitely improves nonmembers' welfare. In a three-good three-country model, an RTA without concessions damages the nonmember's welfare, provided that all the goods are normal and substitutes, and that initial tariff levels are small.
Cytogenetic Characterization of Two Metynnis Species (Characiformes, Serrasalmidae) Reveals B Chromosomes Restricted to the Females

Karyotypes and chromosomal characteristics with focus on B chromosomes of 2 species of the serrasalmid genus Metynnis, namely M. lippincottianus and M. maculatus, were examined using conventional (C-banding) and molecular (FISH mapping of minor and major rDNAs and Rex1, Rex3, and Rex6 retrotransposable elements) protocols. Both species possessed a diploid chromosome number of 2n = 62 and karyotypes composed of 32 metacentric + 28 submetacentric + 2 subtelocentric and 32 metacentric + 26 submetacentric + 4 subtelocentric, respectively; one small B element was found in the female genome of M. lippincottianus. C-banding revealed heterochromatin in the pericentromeric and terminal portions of all chromosomes of both species; the B chromosome was entirely heterochromatic. FISH showed 18S rDNA sites in 2 chromosome pairs in both species (pairs 19 and 22), and a large block in the B chromosome, while 5S rDNA signals were detected in the first pair of subtelocentric chromosomes in both species, moreover in M. maculatus an additional labeled pair 4 was observed. Mapping of the Rex1, Rex3, and Rex6 retrotransposable elements in the genomes of M. lippincottianus and M. maculatus indicated that they were dispersed throughout nearly all the chromosomes of the complement, except for the B chromosome of M. lippincottianus.
The Role School Counselors Believe They Should Adopt in Dropout Prevention.

The ASCA National Model’s theme and element definitions were used to investigate the school counselor’s role in dropout prevention. The domains recommended by the What Works Clearinghouse (staying-in-school, progressing-in-school, and completing-school) were used to determine how accountability should be assessed. Results indicate that counselors view delivery system as the primary role they should adopt followed in order by advocacy and collaboration, systemic change, and leadership. Counselors did not indicate a preference for any one assessment domain except when comparing the completing-school and progressing-in-school domains. In that comparison, the progressing-in-school domain was the preferred method of demonstrating accountability in dropout prevention.
Construction of a Benchmark for the User Experience Questionnaire (UEQ)

Questionnaires are a cheap and highly efficient tool for achieving a quantitative measure of a product’s user experience (UX). However, it is not always easy to decide, if a questionnaire result can really show whether a product satisfies this quality aspect. So a benchmark is useful. It allows comparing the results of one product to a large set of other products. In this paper we describe a benchmark for the User Experience Questionnaire (UEQ), a widely used evaluation tool for interactive products. We also describe how the benchmark can be applied to the quality assurance process for concrete projects.
Old Voters, New Voters, and the Personal Vote

We provide new estimates of the size of the personal vote in U.S. House elections from 1872 to 1990. We take advantage of the "natural experiment" that attends decennial redistricting: every ten years, most incumbents are given new districts that contain a combination of old and new territory. By contrasting an incombent's vote in the new part of the district with his or her vote in the old part of the district, we can estimate the magnitude of the personal vote-the vote that the incumbent receives because he or she represented the voters in the past. Our estimates confirm prior work that shows that a large fraction of the incumbency advantage owes to the personal vote, as opposed to challenger quality. Unlike past research, we are able to estimate the relationship between district partisanship and the personal vote. We find a significant interaction which shows that incumbents develop larger personal votes in areas where they are electorally most vulnerable. here is no doubt that incumbents today have a substantial advantage over nonincumbents in U.S. House elections. The overall size of this advantage has been fairly well established, as has the fact that incumbents' electoral strength has increased dramatically over the postwar period. Measured in terms of vote share, the overall incumbency advantage grew from a modest 1-3 percentage point edge in the 1940s and early 1950s to a 7-10 percentage point edge in the 1980s and early 1990s.1 There is much less agreement about the sources of the incumbency advantage and the causes of its growth. Congressional scholars have identified a variety of factors that may be responsible, which can be grouped into three broad categories. The first, and the focus of this paper, is electoral advantage that stems from a legislator's homestyle. Members of the House are reputedly very responsive to their constituents; in turn, their constituents reward them with their votes. Mayhew (1974b), Fenno (1974), and others detail the sorts of activities that legislators do to build a widely known and respected name, including casework, frequent visits to the district, position-taking on issues, and securing federal benefits. A second source of the incumbency advantage is candidate quality. Incumbents may win because they are the best candidates running, and they do noticeably worse when they face state legislators and other experienced challengers. Finally, incumbency may simply act as a voting cue, a label which voters rely on because party has become less relevant. Assessing the importance of these different factors has significant implications for our normative evaluations of the modern congress and our understanding
Effect of exercise combined with glucagon‐like peptide‐1 receptor agonist treatment on cardiac function: A randomized double‐blind placebo‐controlled clinical trial

In patients with type 2 diabetes, both supervised exercise and treatment with the glucagon‐like peptide‐1 (GLP‐1) receptor agonist (GLP‐1RA) liraglutide may improve cardiac function. We evaluated cardiac function before and after 16 weeks of treatment with the GLP‐1RA liraglutide or placebo, combined with supervised exercise, in 33 dysregulated patients with type 2 diabetes on diet and/or metformin. Early diastolic myocardial tissue velocity was improved by exercise in the placebo group (mean ± standard deviation [s.d.] −7.1 ± 1.6 to −7.7 ± 1.8 cm/s, P = .01), but not in the liraglutide group (−7.1 ± 1.4 to −7.0 ± 1.4 cm/s, P = .60; between groups, P = .02). Similarly, the mean ± s.d. ratio of early and atrial mitral annular tissue velocities improved in the placebo group (1.0 ± 0.4 to 1.2 ± 0.4, P = .003), but not in the liraglutide group (1.0 ± 0.3 to 1.0 ± 0.3, P = .87; between groups, P = .03). We found no significant differences in heart rate, left ventricular (LV) structure or function within or between the groups. In conclusion, the addition of liraglutide to exercise in sedentary patients with dysregulated type 2 diabetes may blunt the suggested beneficial effect of exercise on LV diastolic function.
Impact of a Student-Run Clinic on Emergency Department Utilization.

BACKGROUND AND OBJECTIVES Student-run clinics (SRCs) provide primary care access to low-income patients who would otherwise pursue more expensive care, such as visits to emergency departments (ED). Decreasing inappropriate ED utilization offers an opportunity to create value in the health care system. However, to date, no SRC has rigorously studied this. This study examines whether increased access to ambulatory care through an SRC, the Crimson Care Collaborative (CCC), is associated with decreased ED utilization, providing value to payers and providers, and justifying investment in SRCs. METHODS We conducted a 5-year retrospective analysis of 796 patients to determine if ED utilization changed after patients enrolled in CCC. We used patient-level ED visit data to estimate the average change in ED utilization. A regression analysis examined the impact of demographic and clinical variables on changes in ED utilization. RESULTS Average per-patient ED utilization significantly (P<0.001) decreased by 23%, 50%, and 48% for patients enrolling in CCC from 2013 to 2015, respectively. Following enrollment in CCC, average ED utilization decreased by 0.39 visits per patient per year. This translates to 62.01 avoided ED visits annually, and estimated payer savings of $84,148, representing 68% of the clinic's direct operating costs. CONCLUSIONS CCC created value to payers and providers from 2013-2015 by providing a lower-cost source of care and increasing ED capacity for more emergent and appropriate care. This study suggests that SRCs can create financial value for both payers and providers while also providing an avenue to teach value-based care in medical education.
Genetics of complex traits: prediction of phenotype, identification of causal polymorphisms and genetic architecture

Complex or quantitative traits are important in medicine, agriculture and evolution, yet, until recently, few of the polymorphisms that cause variation in these traits were known. Genome-wide association studies (GWAS), based on the ability to assay thousands of single nucleotide polymorphisms (SNPs), have revolutionized our understanding of the genetics of complex traits. We advocate the analysis of GWAS data by a statistical method that fits all SNP effects simultaneously, assuming that these effects are drawn from a prior distribution. We illustrate how this method can be used to predict future phenotypes, to map and identify the causal mutations, and to study the genetic architecture of complex traits. The genetic architecture of complex traits is even more complex than previously thought: in almost every trait studied there are thousands of polymorphisms that explain genetic variation. Methods of predicting future phenotypes, collectively known as genomic selection or genomic prediction, have been widely adopted in livestock and crop breeding, leading to increased rates of genetic improvement.