Miracle-dz/UniFAR-FTUs huggingface dataset:
Recommendations for integrating peer mentors in hospital-based addiction care

Abstract Legislators and health systems have recently begun to explore the use of peer mentors as part of hospital-based addiction teams. Integrating peers into hospitals is a complex undertaking still in its infancy. Peers’ lived experience of addiction and its consequences, combined with their distance from medical culture and hierarchy, is at the core of their power – and creates inherent challenges in integrating peers into hospital settings. Successful integration of peers in hospitals has unique challenges for individual providers, health systems, and the peers themselves. We have included peers as part of a hospital-based addiction medicine team at our hospital since 2015. In this article, we outline some unique challenges, share lessons learned, and provide recommendations for integrating peers into hospital-based SUD care. Challenges include the rigid professional hierarchy of hospitals which contrasts with peers’ role, which is built on shared life experience and relationship; different expectations regarding professional boundaries and sharing personal information; the intensity of the hospital environment; and, illness severity of hospitalized people which can be emotionally draining and increase peers’ own risk for relapse. Recommendations focus on establishing a way to finance the peer program, clearly defining the peer role, creating a home base within hospital settings, creating a collaborative and structured process for hiring and retaining peers, identifying peers who are likely to succeed, providing initial and ongoing training to peers that extends beyond typical peer certification, ways to introduce peer program to hospital staff, and providing regular, meaningful supervision. We hope that our recommendations help other hospital systems capitalize on the practical lessons learned from our experience.
Heart failure awareness in the Korean general population: Results from the nationwide survey

Background For a better heart failure outcome, it is fundamental to improve the awareness of heart failure at the general population level. We conducted this study to identify the current status of awareness of heart failure in the Korean general population. Methods This cross-sectional nationwide survey recruited a total of 1,032 participants aged 30 years or older, based on a stratification systematic sampling method. A 23-item questionnaire was surveyed through telephone interviews. Results Although 80% of the participants had heard of heart failure, 47% exactly defined what heart failure is. A minority of participants correctly recognized the lifetime risk of developing heart failure (21%) as well as the mortality (16%) and readmission risk (18%) of heart failure and the cost burden of heart failure admission (28%). Regarding preferred treatment options, 71% of the participants chose a treatment option that could improve the quality of life. Approximately two-thirds of the participants agreed that current medical treatment could reduce mortality and improve the quality of life. More than half of the participants (59%) thought that heart failure patients should live quietly and reduce all physical activities. Across survey items, we found a lower awareness state in the elderly groups and people at lower income and educational levels. Conclusions The current awareness status of heart failure in the Korean general population is still low. Proactive educational efforts should be made to improve public awareness with special attention to individuals with lower disease awareness.
Predictors of Obesity among Gut Microbiota Biomarkers in African American Men with and without Diabetes

Gut microbiota and their biomarkers may be associated with obesity. This study evaluated associations of body mass index (BMI) with circulating microbiota biomarkers in African American men (AAM) (n = 75). The main outcomes included fecal microbial community structure (16S rRNA), gut permeability biomarkers (ELISA), and short-chain fatty acids (SCFAs, metabolome analysis). These outcomes were compared between obese and non-obese men, after adjusting for age. The results showed that lipopolysaccharide-binding protein (LBP), the ratio of LBP to CD14 (LBP/CD14), and SCFAs (propionic, butyric, isovaleric) were higher in obese (n = 41, age 58 years, BMI 36 kg/m2) versus non-obese (n = 34, age 55 years, BMI 26 kg/m2) men. BMI correlated positively with LBP, LBP/CD14 (p < 0.05 for both) and SCFAs (propionic, butyric, isovaleric, p < 0.01 for all). In the regression analysis, LBP, LBP/CD14, propionic and butyric acids were independent determinants of BMI. The study showed for the first time that selected microbiota biomarkers (LBP, LBP/CD14, propionic and butyric acids) together with several other relevant risks explained 39%–47% of BMI variability, emphasizing that factors other than microbiota-related biomarkers could be important. Further research is needed to provide clinical and mechanistic insight into microbiota biomarkers and their utility for diagnostic and therapeutic purposes.
Too fast to stay on track? Shorter time to first anti-retroviral regimen is not associated with better retention in care in the French Dat’AIDS cohort

Background Rapid antiretroviral therapy (ART) initiation has been proven beneficial for patients and the community. We aimed to analyze recent changes in timing of ART initiation in France and consequences of early start. Methods We selected from a prospective nationwide cohort, on 12/31/2017, patients with HIV-1 infection diagnosed between 01/01/2010 and 12/31/2015. We described time from (1) diagnosis to first specialized medical encounter, (2) from this encounter to ART initiation, (3) from diagnosis to first undetectable HIV viral load (VL). We analyzed the determinants of measured temporal trends. A multivariate logistic regression was performed to assess characteristics related with 1-year retention in care. Results In the 7 245 included patients, median time (1) from HIV diagnosis to first medical encounter was 13 (IQR: 6–32) days, (2) to ART initiation was 27 (IQR: 9–91) days, decreasing from 42 (IQR: 13–272) days in 2010 to 18 (IQR: 7–42) in 2015 (p<0.0001), (3) to first undetectable VL was 257 (IQR: 151–496) days, decreasing from 378 (IQR: 201–810) days in 2010 to 169 (IQR: 97–281) in 2015. After one year, proportion of patients alive and still in care was significantly lower in those in the lower quartile of time from first encounter to ART (<9 days) than those in the higher quartile (>90 days), 79.9% and 85.2%, respectively (p<0.0001). Conclusions In a country with unrestricted rapid access to ART, keeping recently diagnosed HIV infected patients in care remains challenging. Starting ART rapidly did not seem to be profitable for all and every patient.
Transversus Abdominis Plane Block in Laparoscopic Colorectal Surgery: A Systematic Review.

BACKGROUND Multimodal analgesia is important for postoperative recovery in laparoscopic colorectal surgery. Multiple randomized controlled trials have investigated the use of transversus abdominis plane local anesthetic infiltration as a method of decreasing postoperative pain and opioid consumption, with variable results. OBJECTIVE This study aimed to examine the overall effect of transversus abdominis plane block in postoperative pain, opioid use, and speed of recovery in laparoscopic colorectal surgery. DATA SOURCES A literature search was done with PubMed, EMBASE, Web of Knowledge, and Cochrane Library. Only randomized controlled trials were selected for review. INTERVENTIONS Transversus abdominis plane local anesthetic infiltration versus no intervention, saline, or other techniques in laparoscopic colorectal surgeries was investigated. MAIN OUTCOME MEASURES The primary outcome measured was postoperative pain on day 1, at rest or with activity. The secondary outcomes measured were postoperative pain beyond day 1, consumptions of opioid, and length of hospital stay. RESULTS Eight clinical trials including 649 patients between 2013 and 2018 were included. Resting pain scores within 2 hours (standardized mean difference, -0.53; p = 0.01), 4 hours (standardized mean difference, -0.42; p = 0.004), and 6 hours (standardized mean difference, -0.47; p = 0.03) showed statistically significant reduction. Six studies including 413 patients demonstrated lower cumulative opioid consumption within 24 hours after surgery (standardized mean difference, -0.82; p = 0.01). Five studies including 357 patients did not show a significant difference in length of stay (standardized mean difference, -0.04; p = 0.82). LIMITATIONS Local anesthetic used in block varied in type and quantity across different studies. There were heterogeneities in pain score measurements and opioid consumption. Patient populations may be different among studies. CONCLUSIONS Transversus abdominis block can lead to a lower pain score at rest within the first 6 hours and reduce opioid consumption within the first 24 hours. See Video Abstract at http://links.lww. com/DCR/A997.
Comparison between grip strength and grip strength divided by body weight in their relationship with metabolic syndrome and quality of life in the elderly

Strength measures should be normalized by body mass; however, the definition of sarcopenia includes only simple grip strength. Thus, we compared the relationship of grip strength and grip strength divided by body weight or body mass index to two major consequences of sarcopenia, namely metabolic syndrome and poor quality of life. Data from the participants (aged 60 years or older) of the Sixth Korea National Health and Nutrition Examination were analyzed. Metabolic syndrome was defined according to the Adult Treatment Panel III guidelines with some modifications appropriate for Koreans. Quality of life was assessed using the EuroQoL Five-dimension questionnaire. Multiple logistic regression models were used to evaluate the association of grip strength and grip strength divided by body weight with metabolic syndrome and quality of life. A total of 1273 men and 1436 women were included in the analyses. Grip strength was not related to metabolic syndrome, whereas grip strength divided by body weight and grip strength normalized by body mass index revealed a dense dose-response relationship. All measures showed a similar correlation with quality of life. Grip strength divided by body weight can be superior to simple grip strength and grip strength normalized by body mass index in representing the metabolic aspects of sarcopenia.
Interspecific Covariation in Courtship Displays, Iridescent Plumage, Solar Orientation, and Their Interactions in Hummingbirds

Many animals communicate using multiple signals. Historically, most attention was paid to how multiple signals evolve and function in isolation, but recent work has focused on how they may interact with one another and produce unique signal interaction properties. These interaction properties vary within species, but little is known about how they vary among species, especially in regard to how the expression of particular signals may drive different signal interaction mechanisms. We studied the evolutionary relationships between iridescent plumage, courtship (shuttle) displays, solar environment, and male color appearance during a display (i.e., the signal interaction property) among six species of North American bee hummingbirds. We found that color appearances covary with behavioral and plumage properties, which themselves negatively covary, such that species with more exaggerated displays appeared flashier during courtship, while species with more exaggerated plumage appeared brighter/more colorful with minimal color changes. By understanding how signal interaction properties covary with signals, we were able to discover the complex multilayered evolutionary relationships underlying these traits and uncover new potential drivers of signal evolution. Our results highlight how studying the interaction properties between animal signals provides a richer understanding of how those traits evolved and diversified.
Antipruritic Placebo Effects by Conditioning H1-antihistamine

Supplemental digital content is available in the text. ABSTRACT Objective Allergic rhinitis symptoms can be reduced by behaviorally conditioning antihistamine. It is unclear whether these findings extend to histamine-induced itch or work when participants are informed about the conditioning procedure (open-label conditioning). The current study aims to investigate the efficacy of (open-label) antipruritic behavioral conditioning for histamine-induced itch. Methods Healthy participants (n = 92; 84% female) were randomized to I) an open-label conditioned, II) closed-label conditioned, III) conditioned-not-evoked control, or IV) nonconditioned control group. A two-phase conditioning paradigm was used. During acquisition, a conditioned stimulus (CS; distinctively tasting beverage) was repeatedly paired with the H1-antihistamine levocetirizine (groups I–III). During evocation, the CS was paired with placebo (I, II), or instead of the CS, water was paired with placebo (III). The nonconditioned control group (IV) received CS with placebo in both phases. Itch after histamine iontophoresis and physiological data (i.e., spirometry, heart rate, skin conductance) were assessed. Combined conditioned and combined control groups were first compared, and analyses were repeated for separate groups. Results Marginally lower itch was reported in the combined conditioned compared with the control groups (F(1,88) = 2.10, p = . 076, η2partial = 0.02); no differences between separate groups were found. No effects on physiological data were found, except for heart rate, which reduced significantly and consistently for control groups, and less consistently for conditioned groups (group by time interaction: F(7,80) = 2.35, p = . 031, η2partial = 0.17). Conclusion Limited support was found for the efficacy of antipruritic behavioral conditioning, regardless of whether participants were informed about the conditioning procedure. The application of open-label conditioning in patient populations should be further researched. Trial Registration: www.trialregister. nl; ID NTR5544.
New approaches to tumor therapy with siRNA-decorated and chitosan-modified PLGA nanoparticles

Abstract Objective: In this study, we aimed to develop a candidate modifited polymeric nanoparticle (NP) system that will kill cancer cells by facilitated to apoptosis and also reduce pain. Significance: The primary goal of treatment, especially for metastatic cancers, is to control the growth of the cancer and to alleviate the symptoms. Pain is one of the commonest symptoms of cancer. In cancer treatment, directing cancer cells to death while simultaneously relieving pain will be a new approach. Methods: Chitosan-modified PLGA NPs were prepared using an nanoprecipitation technique. The NPs were loaded with flurbiprofen and decorated with folic acid. STAT3-siRNA was adsorbed to these polymeric NPs using antisense technology. Results: The NPs were small in size (176.9–220.3 nm) with positive zeta potential (+14.1 mV to +27.2 mV). They had high loading capacity and prolonged release properties over 144 hours. Cytotoxicity studies performed with siRNA showed effective electrostatic interaction due to the positively charged NPs. Folic acid facilitated entry into cancer cells and helped to kill them. Conclusion: The formulation we developed is a potential carrier system for both treatment of cancer and prevention of pain, especially for metastatic cancers.
Concept mapping as a Tool for Learning and Assessment in Problem-based Learning

The knowledge structure of medical experts and successful learners is characterized by comprehensive integrated frameworks of related concepts. The development of this knowledge structure can facilitate clinical problem solving and other higher cognitive activities. Concept mapping is a learning tool which can depict the representation of knowledge structure of learners. Concept maps are built on learning theory concepts which complement problem-based learning (PBL). Students studying in PBL programs can construct concept maps centered on PBL cases and integrating the basic sciences and community concepts related to the case they study. Furthermore, concept maps can be used in PBL tutorial sessions for enhancing discussion, identifying learning gaps, generation of learning objectives, promoting learning integration and assessment of learning. Other uses of concept mapping in PBL could be in large group sessions in Seminars or team-based learning sessions to facilitate interactions and relevance of different concepts to the PBL case. However, challenges to concept mapping use in medical education include the development of tools with reliability and validity-evidence.
The Three Spaces Model for Online CPD

- a model for designing assignments for online courses in Continuing Professional Development The paper explores the challenges of designing assignments for online learning environments and looks into the use of models as analytic thinking tools for course designers. The paper opens with a discussion on challenges central to designing assignments for online learning environments in higher education. Subsequently, two widely used models for course design, Salmon’s five-stage-model (2002, 2003) and Ryan & Ryan’s TARL model (2013), are explored with the aim of evaluating their usefulness in Continuing Professional Development (CPD) for teachers and pre-school teachers, a context which has received relatively little attention in terms of research on course design. A number of assignments that have been used in online CPD courses for (pre-)school teachers are analysed with the aim of identifying design patterns, i.e. examples of how recurring pedagogical problems can be solved and, on the basis of this, a new model that can support CPD course designers in designing assignments, the Three Spaces Model For Online CPD, is presented and discussed.
T-cell-mediated suppression of hematopoiesis.

Eight years ago, Hoffman and co-workers reported in the Journal that peripheral-blood lymphocytes from patients with aplastic anemia could suppress the growth of erythroid colonies from normal marrow.1 Concurrently, it was shown that removal of lymphocytes from aplastic marrow by treatment with antithymocyte globulin and complement or by gravity sedimentation partially restored the growth of granulocyte progenitors.2 These studies suggested that some cases of marrow failure were due to inhibition of marrow progenitor-cell growth by "autoreactive suppressor" T lymphocytes. However, it was also suggested that the observed inhibitory effects of lymphocytes from patients with aplastic anemia were due to allosensitization .
The Effect of Instructors’ Immediate Behaviors and Clarity on Student Writing Apprehension

The demand for writing skills is becoming increasingly prevalent within the U.S. job market. Yet, the biggest barrier to developing successful writing skills, writing apprehension, has received very little attention from scholars in the past 30 years. The present study sought to identify the influence of instructional communicative behaviors on business students’ writing apprehension. Specifically, the study tested a model in which instructors’ immediate behaviors and clarity indirectly influenced students’ writing apprehension through the mediation of perceived immediacy. The data were consistent with the hypothesized model.
INTERNET OF THINGS UNIFIED PROTOCOL STACK

The Internet of Things (IoT) is a paradigm aimed at connecting everyday objects to the Internet. Given the character of IoT devices, the most popular way of connecting them is using wireless technologies. However, unlike traditional (legacy) networks, the IoT has unique traffic characteristics with specific demands on the used communication protocols. Together with the constrained nature of IoT devices and the diversity in IoT application domains, there is no one network technology that meets all requirements. IoT solutions are based on a variety of protocols that yield concerns about interoperability and mutual compatibility. This article provides a high-level overview of the most popular IoT network technologies and compares them in one unified protocol stack consisting of five layers. The proposed protocol stack is intended to highlight the similarities and differences among IoT network technologies and to provide their compatibility possibilities at different layers.
Modeling Dynamic Processes with Deep Neural Networks: A Case Study with a Gas-fired Absorption Heat Pump

Deriving mathematical models for the simulation of dynamic processes is costly and time-consuming. This paper examines the possibilities of deep neural networks (DNNs) as a means to facilitate and accelerate this step in development. DNNs are machine learning models that have become a state-of-the-art solution to a wide range of data analysis and pattern recognition tasks. Unlike mathematical modeling approaches, DNN approaches require little to no domain-specific knowledge. Given a sufficient amount of data, a model of the complex nonlinear input-to-output relations of a dynamic system can be learned autonomously. To validate this DNN based modeling approach, we use the example of a gas-fired absorption heat pump. The DNN is learned based on several measurement series recorded during a hardware-in-the-loop (HiL) simulation of the heat pump. A mathematical reference model of the heat pump that was tested in the same HiL environment is used for a comparison of a mathematical and a DNN based modeling approach. Our results show that DNNs can yield models that are comparable to the reference model. The presented methodology covers the data preprocessing, the learning of the models and their validation. It can be easily transferred to more complex dynamic processes.
Deep Execution - Value and Policy Based Reinforcement Learning for Trading and Beating Market Benchmarks

In this article we introduce the term "Deep Execution" that utilize deep reinforcement learning (DRL) for optimal execution. We demonstrate two different approaches to solve for the optimal execution: (1) the deep double Q-network (DDQN), a value-based approach and (2) the proximal policy optimization (PPO) a policy-based approach, for trading and beating market benchmarks, such as the time-weighted average price (TWAP). We show that, firstly, the DRL can reach the theoretically derived optimum by acting on the environment directly. Secondly, the DRL agents can learn to capitalize on price trends (alpha signals) without directly observing the price. Finally, the DRL can take advantage of the available information to create dynamic strategies as an informed trader and thus outperform static benchmark strategies such as the TWAP.
AN ALGORITHM FOR CONSTRUCTION OF A PORTFOLIO WITH A FUNDAMENTAL CRITERION

The classical models for construction of investment portfolio do not take into account fundamental values of considered companies. In our approach we extend the portfolio choice by adding this dimension to the classical criteria of profitability and risk. It is assumed that an investor selects stock according to their attractiveness, measured by some fundamental values of companies. In this approach portfolios are assessed according to three criteria: their profitability, risk (measured by variance of returns) and fundamental value (measured by some indicators of fundamental value). In this article we consider earnings to price ratio as the measure of the fundamental value of a company. In the paper we consider an algorithm for constructing portfolios with fundamental criterion based on analytical solutions for appropriate optimization problems. In the optimization problem we consider minimizing variance with constrains on expected return and attractiveness of investment, measured with some indicators of fundamental values of companies in a portfolio. We also present empirical examples of calculating effective portfolios of stocks listed on the Warsaw Stock Exchange.