Miracle-dz/UniFAR-FTUs huggingface dataset:
Multi-Center Study of the 99th Percentile Value of High-Sensitivity Troponin I in A Normal Healthy Chinese Population

Background: The aim of this study was to establish the 99th percentile value for high sensitivity troponin I in a normal healthy Chinese population and to analyze the differences between different age groups and sex and regions. Methods and Findings: The study included 1,537 cases of normal healthy subjects who were chosen according to a strict inclusion criterion. They were recruited from different regions of China and separated in different age groups. All patients were carefully scanned for any diseases or factors that might influence cardiac troponin levels. The measurement of high-sensitivity cardiac troponin was standardized and tests were repeated several times and all results recorded. We used ARCHITECT-i2000 (Abbott Laboratories, Lake Bluff, Illinois, USA) for measurement of all high sensitivity cardiac troponins. The overall value of the 99th percentile value was 26.42 pg/ml. For the male group 99th percentile value was 29.40 pg/ml and for the female group 99th percentile value was 19.46 pg/ml. The difference in cardiac troponin 99th percentile value for the male and female normal group was statistically significant (P 65 years old had a higher level of high sensitivity cardiac troponin and the difference was statistically significant when compared with other groups. The 99th percentile value corresponded to an imprecision of less than 10%. Conclusions: We established the 99th percentile value for cardiac troponin in the Chinese population and the normal range for males and females and we evaluated the analytical performance of ARCHITECT high sensitivity troponin I assays.
Restoring Agency to the Human Actor

A cursory read of the social psychological literature suggests that when people find themselves in strong situations, they fail to display agency. The early classic studies of conformity, obedience, and bystander intervention, for example, are renowned for showing that when challenged by strong situational pressures, participants acquiesced—even if it meant abandoning their moral principles or disregarding their own sensory data. Later studies of learned helplessness, ego depletion, and stereotype threat echoed this “power of the situation” theme, demonstrating that exposure to (or the expectation of) a frustrating or unpleasant experience suppressed subsequent efforts to actualize goals and abilities. Although this work has provided many valuable insights into the influence of situational pressures, it has been used to buttress an unbalanced and misleading portrait of human agency. This portrait fails to recognize that situations are not invariably enemies of agency. Instead, strong situational forces often allow for, and may even encourage, expressions of human agency. We examine the nature, causes, and consequences of this phenomenon. We endorse a broader approach that emphasizes how responding to situational pressure can coexist with agency. This new emphasis should create greater convergence between social psychological models and the experience of agency in everyday life.
Persistent Memcached: Bringing Legacy Code to Byte-Addressable Persistent Memory

We report our experience building and evaluating pmemcached, a version of memcached ported to byte-addressable persistent memory. Persistent memory is expected to not only improve overall performance of applications' persistence tier, but also vastly reduce the "warm up" time needed for applications after a restart. We decided to test this hypothesis on memcached, a popular key-value store. We took the extreme view of persisting memcached's entire state, resulting in a virtually instantaneous warm up phase. Since memcached is already optimized for DRAM, we expected our port to be a straightforward engineering effort. However, the effort turned out to be surprisingly complex during which we encountered several non-trivial problems that challenged the boundaries of memcached's architecture. We detail these experiences and corresponding lessons learned.
c-Jun NH2-Terminal Kinase-Mediated Signaling Is Essential for Pseudomonas aeruginosa ExoS-Induced Apoptosis

ABSTRACT As an opportunistic bacterial pathogen, Pseudomonas aeruginosa mainly affects immunocompromised individuals as well as patients with cystic fibrosis. In a previous study, we showed that ExoS of P. aeruginosa, when injected into host cells through a type III secretion apparatus, functions as an effector molecule to trigger apoptosis in various tissue culture cells. Here, we show that injection of the ExoS into HeLa cells activates c-Jun NH2-terminal kinase (JNK) phosphorylation while shutting down ERK1/2 and p38 phosphorylation. Inhibiting JNK activation by expression of a dominant negative JNK1 or with a specific JNK inhibitor abolishes ExoS-triggered apoptosis, demonstrating the requirement for JNK-mediated signaling. Following JNK phosphorylation, cytochrome c is released into the cytosol, leading to the activation of caspase 9 and eventually caspase 3. Although c-Jun phosphorylation is also observed as a result of JNK activation, ongoing host protein synthesis is not essential for the apoptotic induction, suggesting that c-Jun- or other AP-1-driven activation of gene expression is dispensable in this process. Therefore, ExoS has opposing effects on different cellular pathways that regulate apoptosis: it shuts down host cell survival signal pathways by inhibiting ERK1/2 and p38 activation, and it activates proapoptotic pathways through activation of JNK1/2 leading ultimately to cytochrome c release and activation of caspases. These results highlight the modulation of host cell signaling by the type III secretion system during interaction between P. aeruginosa and host cells.
Racial disparities in completion rates from publicly funded alcohol treatment: economic resources explain more than demographics and addiction severity.

OBJECTIVES To assess racial and ethnic differences in rates of completion from publicly funded alcohol treatment programs, and to estimate the extent to which any identified racial differences in completion rates are related to differences in patient characteristics. DATA SOURCES Administrative intake and discharge records from all publicly funded outpatient and residential alcohol treatment recovery programs in Los Angeles County (LAC) during 1998-2000. Study participants (N=10,591) are African American, Hispanic, and white patients discharged from these programs, ages 18 or older, who reported alcohol as their primary substance abuse problem. STUDY DESIGN Bivariate tests identified racial and ethnic differences in rates of treatment completion and patient characteristics. Logistic regression models assessed the contribution of differences in patient characteristics to differences in completion. PRINCIPAL FINDINGS Significantly lower completion rates by African Americans (17.5 percent) relative to whites (26.7 percent) (odds ratio [OR]=0.58, 95 percent confidence interval [CI]: 0.50-0.68) are partially explained (40 percent) by differences in patient characteristics in outpatient care (adjusted OR=0.75, 95 percent CI: 0.63-0.90), mostly by indicators of economic resources (i.e., employment, homelessness, and Medi-Cal beneficiary). In residential care, only 7 percent of differences in completion (30.7 versus 46.1 percent) could be explained by the patient-level measures available (OR=0.52, 95 percent CI: 0.45-0.59; AOR=0.55, 95 percent CI: 0.47-0.65). Differences in completion rates between Hispanic and white patients were not detected. CONCLUSIONS Large differences in rates of outpatient and residential alcohol treatment completion between African American and white patients at publicly funded programs in LAC, the nation's second largest, publicly funded alcohol and drug treatment system, are partially because of economic differences among patients, but remain largely unexplained. These racial disparities merit additional investigation and the attention of health professionals.
Early syphilis: serological treatment response to doxycycline/tetracycline versus benzathine penicillin.

INTRODUCTION Benzathine penicillin G is the treatment of choice for syphilis, but doxycycline and tetracycline are effective second-line treatments. The objective of this study was to assess the serological response to treatment for early syphilis with benzathine penicillin compared with doxycycline or tetracycline. METHODOLOGY We examined rapid plasma regain (RPR) serological test results of all first-time early syphilis patients in Peking Union Medical College Hospital between 2000 and 2011, comparing treatment with two doses of penicillin to 14-day course of oral doxycycline (100 mg twice daily) or oral tetracycline (500 mg 4 times a day). RESULTS Of the 641 early syphilis cases with available treatment outcome data, 606 (94.5%) received penicillin and 35 (5.5%) received doxycycline/tetracycline. More than half (52.1%) had secondary syphilis, 13.4% had primary syphilis, and 34.5% had early latent syphilis. A statistically similar serological treatment success rate (p = 0.157) was observed in penicillin-treated patients 91.4% (554/606), when compared with patients treated with doxycycline/tetracycline 82.9% (29/35). CONCLUSION Doxycycline/tetracycline had a similar serological treatment success rate when compared to penicillin in the treatment of early syphilis.
A replication study and a meta-analysis of the association between the CDKN2A rs1333049 polymorphism and coronary heart disease.

AIM The aim of this study was to assess whether rs1333049 was associated with coronary heart disease (CHD) in Han Chinese. METHODS This case-control study was involved with 599 CHD patients and 591 non-CHD controls. Meanwhile, a comprehensive meta-analysis was also conducted to establish the contribution of rs1333049 to CHD. RESULTS Our results showed that rs1333049 increased the risk of CHD by 38% (OR=1.38, 95% CI=1.18-1.62). A breakdown analysis by gender further indicated that rs1333049 increased the risk of CHD in men by 29% (OR=1.29, 95% CI=1.05-1.58) and in women by 64% (OR=1.64, 95% CI=1.25-2.16). A follow-up subgroup analysis by age showed there was a significant association between rs1333049 and CHD in women younger than 65 (≤55 years: p=0.001, 55-65 years: p=0.008) and in men aged between 55 and 65 years (p=0.005). Our meta-analysis was involved with 21 studies (25 stages) among 20969 cases and 34114 controls. Our results showed that rs1333049 led to a significantly increased risk of CHD (OR=1.30, 95% CI=1.21-1.39). Further subgroup analyses by ethnicity showed rs1333049 increased the CHD risk by 30% in Europeans (OR=1.30, 95% CI=1.16-1.47) and 27% in Asians (OR=1.27, 95% CI=1.22-1.33). CONCLUSIONS Our case-control study and meta-analysis suggest that rs1333049 is a useful risk marker of CHD.
The Extracellular Component of a Transport Metabolon

Cytosolic carbonic anhydrase II (CAII) and the cytoplasmic C-terminal tails of chloride/bicarbonate anion exchange (AE) proteins associate to form a bicarbonate transport metabolon, which maximizes the bicarbonate transport rate. To determine whether cell surface-anchored carbonic anhydrase IV (CAIV) interacts with AE proteins to accelerate the bicarbonate transport rate, AE1-mediated bicarbonate transport was monitored in transfected HEK293 cells. Expression of the inactive CAII V143Y mutant blocked the interaction between endogenous cytosolic CAII and AE1, AE2, and AE3 and inhibited their transport activity (53 ± 3, 49 ± 10, and 35 ± 1% inhibition, respectively). However, in the presence of V143Y CAII, expression of CAIV restored full functional activity to AE1, AE2, and AE3 (AE1, 101 ± 3; AE2, 85 ± 5; AE3, 108 ± 1%). In Triton X-100 extracts of transfected HEK293 cells, resolved by sucrose gradient ultracentrifugation, CAIV recruitment to the position of AE1 suggested a physical interaction between CAIV and AE1. Gel overlay assays showed a specific interaction between CAIV and AE1, AE2, and AE3. Glutathione S-transferase pull-down assays revealed that the interaction between CAIV and AE1 occurs on the large fourth extracellular loop of AE1. We conclude that AE1 and CAIV interact on extracellular loop 4 of AE1, forming the extracellular component of a bicarbonate transport metabolon, which accelerates the rate of AE-mediated bicarbonate transport.
Cost-effectiveness of Gene Expression Classifier Testing of Indeterminate Thyroid Nodules Utilizing a Real Cohort Comparator

Objective To predict the cost-effectiveness of implementing routine gene expression classifier testing for thyroid nodules with indeterminate fine-needle aspiration cytology, by utilizing a real cohort of patients as a comparator. Study Design Cost-effectiveness analysis of a retrospective cohort compared with a simulated cohort. Setting Tertiary academic medical center. Subjects and Methods We reviewed the records of all patients who underwent ultrasound-guided fine-needle aspiration from 2010 to 2014 at a tertiary academic medical center. All patients with Bethesda class III or IV cytopathology had the details of their management catalogued over the subsequent 2 years of care. These patients were assigned to the standard-of-care arm of the study. We compared the third-party payer costs of care and the proportion of patients who underwent surgery with a simulated cohort who underwent gene expression classifier testing after an initial indeterminate fine-needle aspiration (molecular test arm). Results The cost of managing 1 nodule over 2 years was $2399 higher (range, $397-$4399) for the molecular test group than the standard of care group. The molecular test group had a 13.1% decrease (base parameters; range, 0.73%-45.09%) in the number of patients undergoing surgery. Conclusion When applied to a real cohort of patients, routine gene expression classifier is predicted to reduce the number of patients undergoing surgery but will increase cost of care. Cost-effectiveness is heavily dependent on prevalence of malignancy and gene expression classifier specificity.
Economic and biophysical impacts on agriculture under 1.5 °C and 2 °C warming

The goal of limiting global mean warming to well below 2 °C, and possibly to 1.5 °C, emerged in the Paris Agreement, motivated by the belief that achieving these targets ‘would significantly reduce the risks and impacts of climate change’. Understanding the climate impacts of relatively low levels of warming, in particular whether there are substantial benefits to reducing emissions to limit warming to 1.5 °C rather than 2 °C, is important for informing climate policy, but such studies are scarce. Here we evaluate the difference in global biophysical and economic impacts related to agriculture between 1.5 °C–2 °C warming. Given the small difference in global average temperature, accounting for uncertainties is important, and we include key uncertainties in three main components of the analysis: climate system (regional climate variability), biophysical system (crop response to CO2 fertilization), and economic system (trade responsiveness). We are unable to meaningfully distinguish the regional agricultural impacts occurring with 1.5 °C warming from those occurring with 2 °C warming when accounting for these uncertainties. Under some assumptions 1.5°C implies benefits relative to 2 °C, while under others it implies costs. Results are most sensitive to the uncertainty in the effect of CO2 fertilization on crop yield.
Risk of hypoglycaemia in users of sulphonylureas compared with metformin in relation to renal function and sulphonylurea metabolite group: population based cohort study

Objective To determine the association between use of sulphonylureas and risk of hypoglycaemia in relation to renal function and sulphonylurea metabolic group compared with use of metformin. Design Population based cohort study using routinely collected data from general practices in England. Setting Clinical Practice Research Datalink (CPRD) database, 2004-12. Participants 120 803 new users of a non-insulin antidiabetic agent with at least one prescription and aged 18 years or more. The first prescription defined start of follow-up. Patients were followed until the end of data collection, a record for hypoglycaemia, or a blood glucose level of less than 3.0 mmol/L. Main outcome measures Associations between sulphonylurea dose, renal impairment, type of sulphonylurea used, and risk of hypoglycaemia, were determined using Cox proportional hazard models. Adjustments were made for age, sex, lifestyle, comorbidity, and drug use. Results The risk of hypoglycaemia in current users of sulphonylureas only was significantly increased compared with current users of metformin only (adjusted hazard ratio 2.50, 95% confidence interval 2.23 to 2.82). The higher risk in current users of sulphonylureas only was further increased in patients with an estimated glomerular filtration rate of less than 30 mL/min/1.73 m2 (4.96, 3.76 to 6.55). The risk of hypoglycaemia was also significantly higher in patients with a high sulphonylurea dose (3.12, 2.68 to 3.62) and in current users of glibenclamide (7.48, 4.89 to 11.44). Gliclazide, the sulphonylurea of first choice, showed a similar risk of hypoglycaemia compared with other sulphonylureas. Conclusions Sulphonylurea treatment in patients with a renal function of less than 30 mL/min/1.73 m2 should be considered with caution. Moreover, an increased risk of hypoglycaemic events was observed among all users of sulphonylureas. This contrasts with several guidelines that recommend gliclazide as first choice sulphonylurea, and therefore requires further investigation.
Understanding Intention to Spread Anti-Rumors of Natural Disasters in Social Media

The purpose of this study is to investigate users’ intention of spreading anti-rumors of natural disasters in social media. Adopted from Technology Acceptance Model, the theoretical model was constructed. 196 questionnaires were collected. Descriptive statistics and Structural Equation Model were employed as the research methods. The main findings are as followings. Attitude has a significant positive effect on intention of spreading anti-rumors of natural disasters. Reputation has a significant positive impact on attitude and intention of spreading natural disasters. Perceived ease of use has no significant impact on attitude toward spreading anti-rumors of natural disasters. Keywords—Rumors; Natural disasters; Rumor-dispelling; Social media
Vertebral Body Osteopenia Associated With Posterolateral Spine Fusion in Humans

Study Design Lateral dual‐energy x‐ray absorptiometry was used to examine isolated changes in vertebral body mineral density in humans after instrumented posterolateral lumbar fusion. Objectives To determine if device‐related osteopenia will occur in humans who undergo spinal fusion. Device‐related osteopenia is known to occur as a result of local stress shielding after instrumentation in the appendicular skeleton. This effect has not been observed, however, in humans after spine fusion. To evaluate such changes, the vertebral body mineral density was measured in eight patients who had instrumented lumbar fusion and in eight matched control patients who had lumbar surgery with no fusion. Summary of Background Data In previous studies of dogs, vertebral body osteopenia occurred as a result of instrumented spine fusions. Previous studies in humans, however, have been limited by the relative insensitivity of conventional photon absorptiometry to isolated changes in the vertebral body because of overlying posterior elements. Methods Absorptiometry was performed an average of 31.9 months after posterolateral fusion that bridged at least one level in the region of L2‐L4. To reduce the effects of individual variations in mineral metabolism, the vertebral values were standardized by using the ratio of vertebral body to femoral neck density for each patient. Results The mean density ratio for the group of patients who underwent spine fusion was 0.733. This value was significantly lower than the control ratio of 0.879 (P = 0.048). Conclusions Patients who have undergone instrumented posterolateral lumbar fusions have decreased vertebral body bone mineral density at the level of fusion compared with that of matched controls.
Arthrodesis With External Fixation in the Unstable or Misaligned Charcot Ankle in Patients With Diabetes Mellitus

The unstable or misaligned Charcot ankle with or without chronic foot ulceration is a major clinical challenge. When it cannot be accommodated with an ankle foot orthosis, surgical treatment is indicated in order to avoid leg amputation. This requires extensive soft tissue release and bony resection to realign the foot and arthrodesis with internal or external fixation. The guidance in the literature favors internal fixation. This article reports results with external fixation in 11 patients (12 feet) over a period of 12 years. External fixation was chosen as the surgical option because of the presence of foot ulcers with the attendent risk of infection. There were 7 tibio-talar and 5 tibio-calcaneal fusions. Compression was applied for 6 weeks with an external frame according to Charnley, followed by 6 weeks with total-contact cast. Weight bearing with a rigid leather brace was allowed after 12 weeks. In one case, transtibial amputation was required due to loosening of the distal pins from osteopenic disintegrating bone. In 11 cases (92%), the foot was successfully realigned and independent walking with a brace retained during the follow-up of median 48 months (10-102 months). Bony union took place in 5 out of 7 cases with tibio-talar fusion and in 1 out of 5 with tibio-calcaneal fusion. The functional result in cases with fibrous union was, however, satisfactory. Although meaningful comparisons of series are difficult to conduct and interpret from, the limb salvage rate was similar to results with internal fixation. The authors consider the results to be encouraging and to be used to develop a higher level of evidence.
An 8b 80MSample/s pipelined ADC with background calibration

Conventional pipelined ADCs with redundancy and digital correction have linearity limited by the gain accuracy of the interstage amplifiers or the linearity of the D/A subconversions. With a fully differential 1.5 b/stage architecture, the D/A subconverters can in principle be inherently linear, and the main limitation stems from the interstage gain accuracy. Besides the error caused by finite-op-amp gain and capacitor mismatch, the linear portion of the incomplete op-amp settling can also be modeled as an interstage gain error. One way to compensate for interstage gain errors is to adjust the reference voltage from each stage to the next so that the ratio of the reference in one stage to the corresponding value in the previous stage is equal to 1+/spl epsi/, where /spl epsi/ is the gain error between the stages. This pipelined ADC uses monolithic calibration to adjust the reference voltages of the first two stages in the background during normal ADC operation to compensate for gain errors in the first two interstage amplifiers. Calibration is potentially useful even at an 8b level because it allows the use of small capacitors and low op-amp gain, reducing power dissipation and the minimum required supply voltage and increasing the maximum speed in a given technology. The key contributions here are the use of background calibration to improve the linearity of a pipelined ADC and the implementation of these techniques with the ADC on one CMOS IC.