Miracle-dz/UniFAR-FTUs huggingface dataset:
Feasibility of Synchronous Online Focus Groups of Rural Breast Cancer Survivors on Web-Based Distress Self-Management.

PURPOSE To obtain rural breast cancer survivors' perceptions of CaringGuidance™ After Breast Cancer Diagnosis, a web-based, psychoeducational, distress self-management program, and explore the feasibility of gathering survivors' perceptions about CaringGuidance using online focus groups (OFGs). PARTICIPANTS & SETTING 23 survivors of early-stage breast cancer, a mean of 2.5 years postdiagnosis, living in rural Nebraska. METHODOLOGIC APPROACH Participants reviewed the CaringGuidance program independently for an average of 12 days prior to their designated OFG. The extent of participants' pre-OFG review was verified electronically. Four synchronous, moderated OFGs were conducted. Demographic and OFG participation data were used to assess feasibility. Transcripts of OFGs were analyzed using directed content analysis. FINDINGS All enrolled women participated in their designated OFG. Five themes of the quality and usability of CaringGuidance were identified. Recommendations were used to modify CaringGuidance prior to the pilot efficacy trial. IMPLICATIONS FOR NURSING The findings contribute to nurses' knowledge and guide assessment and interventions pertaining to psychosocial needs of rural women with breast cancer, OFGs, and qualities rural women seek in web-based psychological interventions.
Kinematic and Dynamic Analysis of Magnetic Gear With Dual-Mechanical Port Using Block Diagrams

Magnetic gears with dual-mechanical port have several attractive features, such as reduced maintenance requirements and inherent overload protection, as compared with mechanical gears. However, it is difficult to obtain an intuitive analytical model because of its complicated magnetic flux interaction, and the dual-port transmission of this magnetic gear is rarely discussed. These difficulties actually limit the practical applications and increase the control difficulty. Therefore, this paper develops a modeling approach based on the block diagram. Both of the kinematic and dynamic characteristics for a dual-port transmission can be obtained in one unified description. This control-based approach also provides more flexibility and convenience, facilitating further control applications. The feasibility will be verified by finite element analysis simulation and experimental results.
A Novel Single-Phase Bidirectional Nine-Level Converter Employing Four Quadrant Switches

A novel bidirectional ac-dc multilevel converter based on four quadrant switches is proposed. This new converter can establish nine voltage levels downstream the coupling filter used to interface with the power grid, and, comparing with conventional two- or three-level converters, it operates with improved ac-side current, both for operation as active rectifier (on-grid), grid-tied inverter (on-grid) or voltage inverter (off-grid). A detailed description of the converter is exhibited, highlighting its main advantages according to the applications where it can be employed in smart grid scenarios. In order to confirm its viability, a considerable set of results is presented and discussed, establishing an overall comparison with conventional converters. Moreover, the proposed converter is validated operating as active rectifier, as grid-tied inverter, and as voltage inverter, controlled in closed-loop by current or voltage. The details ofthe proposed power converter hardware and the implementation of the digital algorithm, based on a fixed switching frequency structure, are clarified and discussed throughout the paper.
Medical services and health status in the northwest health region of British Columbia: a three year perspective

Providing efficient and effective health services to the residents of rural and remote regions of Canada has been the focus of much research since the implementation of universal medical care in 1967. A great deal research has been carried out by the individual provinces regarding physician supply and physician services utilisation, as well as attempts to determine an appropriate measure of population health status. While many of these measures have been assessed individually for several regions there are very few examples of integration of the measures to assess the degree to which they might influence one another. This thesis presents a descriptive analysis of measures of physician supply, physician services utilisation, and population health status, and includes a correlational analysis of the relationship between these variables. The focus of this study is specific to the Northwest Health Region of British Columbia and the eight Local Health Areas of which it is comprised since this area is characterised as having a shortage of physicians and their services, as well as having poor health status. Measures of physician supply are used to determine if there is an adequate supply of general practitioner and medical specialist practitioners in the Northwest compared to other Local Health Areas in the province and the provincial median. Utilisation of and accessibility to physician services is also examined to determine if there is reasonable access to physician services in the Northwest as compared to other areas in the province. A health status index is formulated from standardised mortality ratios and other rates in an attempt to describe the population health status of the 79 British Columbia Local Health Areas and, more specifically, of those in the Northwest Health Region. The values derived
Last Mile Delivery: Modes, Efficiencies, Sustainability, and Trends

In this article, the last mile delivery is concisely described. It has become an interested topic among logistics researchers and community because of the increasing of e-commerce and online shopping. The last mile delivery is divided into 5 modes: reception box, collection point, post office, attended home delivery, and unattended home delivery. Each mode is depicted and compared to each other in term of characteristics and efficiencies. The comparison is based on the perspective of stakeholders. Accordingly, they are interested in benefits of the last mile delivery differently. Then, we propose the trends of technologies, such as, internet of things, smart phone and its applications, social network, and drone which impact to the last mile delivery. These technologies could substantially improve the efficiency of last mile delivery. In addition, as the sustainability has become the key factor of today businesses, we also discuss the sustainability of all 5 modes.
LWA in 5G: State-of-the-Art Architecture, Opportunities, and Research Challenges

To cater to the exponential increase in wireless data demands under limited availability of licensed spectrum, the Federal Communications Commission has released extra bandwidth of 295 MHz in the 5 GHz unlicensed national information infrastructure bands for wireless communications. This free, unlicensed band has drawn considerable attention from academia and cellular operators worldwide. Several standards are being developed for flexible integration, aggregation, and interworking of this unlicensed band with licensed networks or spectrum. Of many candidate approaches, in this article, we introduce LTE WLAN aggregation (LWA). LWA, capable of leveraging the LTE and WLAN spectra simultaneously, has emerged as a prominent solution to increase network capacity and enhanced end users' quality of experience. Further, we present latest advances in this exciting technology by reviewing the state-of-the-art LWA architecture, and identify several opportunities and open challenges related to LWA design for future research.
Variable Precision in Visual Perception

Given the same sensory stimuli in the same task, human observers do not always make the same response. Well-known sources of behavioral variability are sensory noise and guessing. Visual short-term memory (STM) studies have suggested that the precision of the sensory noise is itself variable. However, it is unknown whether precision is also variable in perceptual tasks without a memory component. We searched for evidence for variable precision in 11 visual perception tasks with a single relevant feature, orientation. We specifically examined the effect of distractor stimuli: distractors were absent, homogeneous and fixed across trials, homogeneous and variable, or heterogeneous and variable. We first considered 4 models: with and without guessing, and with and without variability in precision. We quantified the importance of both factors using 6 metrics: factor knock-in difference, factor knock-out difference, and log factor posterior ratio, each based on AIC or BIC. According to all 6 metrics, we found strong evidence for variable precision in 5 experiments. Next, we extended our model space to include potential confounding factors: the oblique effect and decision noise. This left strong evidence for variable precision in only 1 experiment, in which distractors were homogeneous but variable. Finally, when we considered suboptimal decision rules, the evidence also disappeared in this experiment. Our results provide little evidence for variable precision overall and only a hint when distractors are variable. Methodologically, the results underline the importance of including multiple factors in factorial model comparison: Testing for only 2 factors would have yielded an incorrect conclusion.
Evaluating the adverse effects of melphalan formulations

Introduction For multiple myeloma patients who respond to primary therapy, autologous hematopoietic stem cell transplant (HSCT) is considered standard of care with high-dose melphalan for transplant candidates. There are now two different melphalan formulations available, including a propylene glycol containing (PG-MEL) product and a propylene glycol-free (PG-free MEL) product. Although considered bioequivalent, there remains limited literature directly evaluating the adverse events between the two agents. We seek to assess the tolerability and severity of side effects between the two formulations in a real-life practice setting. Methods A retrospective, descriptive analysis was conducted of multiple myeloma patients who received autologous stem cell conditioning with either melphalan formulation when dosed at 100 mg/m2/dose for two consecutive doses. The primary outcome was the assessment of tolerability and severity of side effects. Tolerability was split into four major categories including hematologic toxicity, gastrointestinal toxicity, renal toxicity, and highest recorded mucositis grade. Results There were a total of 78 patients who received a melphalan preparation during the study. The median time to myeloablation and neutrophil engraftment was five and seven days post-HSCT, respectively, for all patients. Patients who received PG-free MEL were less likely to develop mucositis, with 22 (56%) reported highest grade 0, defined by World Health Organization oral toxicity scale, compared to those who received PG-MEL (33%), p = 0.04. Conclusion There were minimal differences in tolerability or side effects observed between PG-free MEL and PG-MEL. These data may assist in better understanding the anticipated adverse effects of a high-dose melphalan conditioning therapy.
Testing Enhances Subsequent Learning in Older Adults

Interference susceptibility has been suggested to be a major factor for episodic memory impairment in healthy older adults. Previous work has shown that retrieval practice can reduce proactive interference and thus enhance learning and memory in younger adults, a finding referred to as the forward effect of testing in the literature. This study examined the late developmental trajectory of the forward effect in middle-aged and older adults (40 to 79 years of age). Participants studied three lists of items in anticipation of a final cumulative recall test. In the testing condition, participants were tested immediately on Lists 1 and 2 after initial study, whereas in the restudy condition, they restudied Lists 1 and 2. In both conditions, participants were tested immediately on List 3. The results of the immediate List-3 recall test showed a reliable forward effect of testing, with interim testing of Lists 1 and 2 enhancing List-3 recall and reducing the number of prior-list intrusions. Notably, this effect of testing was found independent of participants’ age. These results suggest that retrieval practice can reduce proactive interference in middle-aged and older adults. Together with recent findings on the presence of the backward effect of testing in older adults—that is, improved recall of studied material after retrieval versus restudy, these findings indicate that retrieval practice can be a very powerful tool to delimit memory impairment in older age.
Checklist of acanthocephalan parasites of South Africa

Abstract Twenty-one species of acanthocephalans, representative of thirteen genera from ten families of seven orders and three classes, are included in this updated checklist of acanthocephalans in South Africa. Although South Africa appears to have a less diverse acanthocephalan fauna compared to some other countries such as Iran in Asia, or Brazil in South America, this is probably an artefact of fewer parasitological surveys.
Anatomic and Histological Study of the Anterolateral Aspect of the Knee: A SANTI Group Investigation

Background: The structure and function of the anterolateral aspect of the knee have been significantly debated, with renewed interest in this topic since the description of the anterolateral ligament (ALL). Purpose: To define and describe the distinct structures of the lateral knee and to correlate the macroscopic and histologic anatomic features. Study Design: Descriptive laboratory study. Methods: Twelve fresh-frozen human cadavers were used for anatomic analysis. In the left knee, a layer-by-layer dissection and macroscopic analysis were performed. In the right knee, an en bloc specimen was obtained encompassing an area from the Gerdy tubercle to the posterior fibular head and extending proximally from the anterior aspect to the posterior aspect of the lateral femoral epicondyle. The en bloc resection was then frozen, sliced at the level of the joint line, and reviewed by a musculoskeletal pathologist. Results: Macroscopically, the lateral knee has 4 main layers overlying the capsule of the knee: the aponeurotic layer, the superficial layer including the iliotibial band (ITB), the deep fascial layer, and the ALL. Histologically, 8 of 12 specimens demonstrated 4 consistent, distinct structures: the ITB, the ALL, the lateral collateral ligament, and the meniscus. Conclusion: The lateral knee has a complex orientation of layers and fibers. The ALL is a distinct structure from the ITB and is synonymous to the previously described capsulo-osseous layer of the ITB. Clinical Relevance: Increasingly, lateral extra-articular procedures are performed at the time of anterior cruciate ligament reconstruction. Understanding the anatomic features of the anterolateral aspect of the knee is necessary to understand the biomechanics and function of the structures present and allows surgeons to attempt to replicate those anatomic characteristics when performing extra-articular reconstruction.
Building interpretable models for polypharmacy prediction in older chronic patients based on drug prescription records

Background Multimorbidity presents an increasingly common problem in older population, and is tightly related to polypharmacy, i.e., concurrent use of multiple medications by one individual. Detecting polypharmacy from drug prescription records is not only related to multimorbidity, but can also point at incorrect use of medicines. In this work, we build models for predicting polypharmacy from drug prescription records for newly diagnosed chronic patients. We evaluate the models’ performance with a strong focus on interpretability of the results. Methods A centrally collected nationwide dataset of prescription records was used to perform electronic phenotyping of patients for the following two chronic conditions: type 2 diabetes mellitus (T2D) and cardiovascular disease (CVD). In addition, a hospital discharge dataset was linked to the prescription records. A regularized regression model was built for 11 different experimental scenarios on two datasets, and complexity of the model was controlled with a maximum number of dimensions (MND) parameter. Performance and interpretability of the model were evaluated with AUC, AUPRC, calibration plots, and interpretation by a medical doctor. Results For the CVD model, AUC and AUPRC values of 0.900 (95% [0.898–0.901]) and 0.640 (0.635–0.645) were reached, respectively, while for the T2D model the values were 0.808 (0.803–0.812) and 0.732 (0.725–0.739). Reducing complexity of the model by 65% and 48% for CVD and T2D, resulted in 3% and 4% lower AUC, and 4% and 5% lower AUPRC values, respectively. Calibration plots for our models showed that we can achieve moderate calibration with reducing the models’ complexity without significant loss of predictive performance. Discussion In this study, we found that it is possible to use drug prescription data to build a model for polypharmacy prediction in older population. In addition, the study showed that it is possible to find a balance between good performance and interpretability of the model, and achieve acceptable calibration at the same time.
Holt-Oram Syndrome With Multiple Cardiac Abnormalities

Holt-Oram syndrome (HOS) is a rare monogenic disorder characterized by upper limb abnormalities, congenital heart defects and/or conduction abnormalities. It is determined by mutations of TBX5 gene and is inherited in an autosomal dominant manner. Penetrance is complete, but variable expressivity is present, which gives sometimes diagnostic difficulties. Our case is a young adult with a personal history of preaxial polydactyly operated in infancy, multiple cardiac malformations (atrial septal defect, bicuspid aortic valve, left ventricular non-compaction) and radiologic findings consistent with HOS. Family history is negative for HOS. In conclusion, we present a case of HOS diagnosed in the adult period to highlight the diagnostic problems for the proband and the family and the importance of an early diagnostic.
The antiangiogenic action of cisplatin on endothelial cells is mediated through the release of tissue inhibitor of matrix metalloproteinases-1 from lung cancer cells

In addition to suppressing cancer cell proliferation and tumor growth, cisplatin has been shown to inhibit tumor angiogenesis. However, the underlying mechanism remains a matter of debate. The present study addressed the impact of cisplatin on potential tumor-to-endothelial cell communication conferring an antiangiogenic effect. For this purpose, migration and tube formation of human umbilical vein endothelial cells (HUVECs) exposed to conditioned media (CM) from vehicle- or cisplatin-treated A549 and H358 lung cancer cells were quantified. Cancer cells were exposed to non-toxic concentrations of cisplatin to mimic low-dose treatment conditions. CM from cancer cells exposed to cisplatin at concentrations of 0.01 to 1 µM elicited a concentration-dependent decrease in HUVEC migration and tube formation as compared with CM from vehicle-treated cells. The viability of HUVECs was virtually unaltered under these conditions. siRNA approaches revealed cisplatin-induced expression and subsequent release of tissue inhibitor of matrix metalloproteinases-1 (TIMP-1) by lung cancer cells to be causally linked to a decrease in HUVEC migration and tube formation. Moreover, TIMP-1 upregulation and consequent inhibition of HUVEC migration by cisplatin was shown to be dependent on activation of p38 and p42/44 mitogen-activated protein kinases. Inhibition of angiogenic features was not observed when HUVECs were directly exposed to cisplatin. Similarly, antiangiogenic effects were not detectable in HUVECs exposed to CM from the cisplatin-challenged bronchial non-cancer cell line BEAS-2B. Collectively, the present data suggest a pivotal role of cisplatin-induced TIMP-1 release from lung cancer cells in tumor-to-endothelial cell communication resulting in a reduced cancer-associated angiogenic impact on endothelial cells.
A new tuskless walrus from the Miocene of Orange County, California, with comments on the diversity and taxonomy of odobenids

We describe Titanotaria orangensis (gen. et. sp. nov.), a new species of walrus (odobenid) from the upper Miocene Oso Member of the Capistrano Formation of Orange County, California. This species is important because: (1) It is one of the best-known and latest-surviving tuskless walruses; (2) It raises the number of reported odobenid taxa from the Oso Member to four species making it one of the richest walrus assemblages known (along with the basal Purisima of Northern California); (3) It is just the second record of a tuskless walrus from the same unit as a tusked taxon. Our phylogenetic analysis places T. orangensis as sister to a clade that includes Imagotaria downsi, Pontolis magnus, Dusignathus spp. , Gomphotaria pugnax, and Odobeninae. We propose new branch-based phylogenetic definitions for Odobenidae, Odobeninae, and a new node-based name (Neodobenia) for the clade that includes Dusignathus spp. , G. pugnax, and Odobeninae. A richness analysis at the 0.1 Ma level that incorporates stratigraphic uncertainty and ghost lineages demonstrates maximum peaks of richness (up to eight or nine coeval lineages) near the base of Odobenidae, Neodobenia, and Odobenini. A more conservative minimum curve demonstrates that standing richness may have been much lower than the maximum lineage richness estimates that are biased by stratigraphic uncertainty. Overall the odobenid fossil record is uneven, with large time slices of the record missing on either side of the Pacific Ocean at some times and biases from the preserved depositional environments at other times. We recognize a provisional timescale for the transition of East Pacific odobenid assemblages that include “basal odobenids” (stem neodobenians) from the Empire and older formations (>7 Ma), to a mixture of basal odobenids and neodobenians from the Capistrano and basal Purisima (7–5 Ma), and then just neodobenians from all younger units (<5 Ma). The large amount of undescribed material will add new taxa and range extensions for existing taxa, which will likely change some of the patterns we describe.
Increasing autophagy does not affect neurogenic muscle atrophy

Physiological autophagy plays a crucial role in the regulation of muscle mass and metabolism, while the excessive induction or the inhibition of the autophagic flux contributes to the progression of several diseases. Autophagy can be activated by different stimuli, including cancer, exercise, caloric restriction and denervation. The latter leads to muscle atrophy through the activation of catabolic pathways, i.e. the ubiquitin-proteasome system and autophagy. However, the kinetics of autophagy activation and the upstream molecular pathways in denervated skeletal muscle have not been reported yet. In this study, we characterized the kinetics of autophagic induction, quickly triggered by denervation, and report the Akt/mTOR axis activation. Besides, with the aim to assess the relative contribution of autophagy in neurogenic muscle atrophy, we triggered autophagy with different stimuli along with denervation, and observed that four week-long autophagic induction, by either intermitted fasting or rapamycin treatment, did not significantly affect muscle mass loss. We conclude that: i) autophagy does not play a major role in inducing muscle loss following denervation; ii) nonetheless, autophagy may have a regulatory role in denervation induced muscle atrophy, since it is significantly upregulated as early as eight hours after denervation; iii) Akt/mTOR axis, AMPK and FoxO3a are activated consistently with the progression of muscle atrophy, further highlighting the complexity of the signaling response to the atrophying stimulus deriving from denervation.