Miracle-dz/UniFAR-FTUs huggingface dataset:
Characterizing Resident Preferences for Faculty Involvement and Support in Disclosing Medical Errors to Patients.

Background Residents may be commonly involved with medical errors and need faculty support when disclosing these to patients. Objective We characterized residents' preferences for faculty involvement and support during the error disclosure process. Methods We surveyed residents from internal medicine, pediatrics, emergency medicine, general and orthopedic surgery, and obstetrics and gynecology residency programs at the University of Toronto in 2014-2015 about their preferences for faculty involvement across a variety of different error scenarios (ie, error type, severity, and proximity) and for elements of support they perceive to be most helpful during the disclosure process. Results Over 90% of the 192 respondents (N = 538, response rate 36%) wanted direct involvement in the error disclosure process, irrespective of type or severity of the error. Residents were relatively comfortable disclosing prescription and communication errors without direct faculty involvement but preferred faculty involvement when disclosing diagnostic and management errors. When errors were severe, many residents still wanted to be involved but preferred having faculty lead the disclosure. Residents particularly wanted to participate in the process when they felt responsible for the error. Residents highly valued receiving faculty advice on how to manage consequences and how to prevent future errors in preparing for disclosure, as well as receiving postdisclosure feedback and personal support. Conclusions Residents are willing participants in the error disclosure process and have specific preferences for faculty involvement and support. These findings can inform faculty development to ensure appropriate support and supervision for residents when disclosing errors to patients.
Production , Manufacturing and Logistics When remanufacturing meets product quality improvement : The impact of production cost

Remanufacturing as well as quality improving innovations are important activities to improve sustainability. However, when coexisting in one company, their interaction is not clear. On the one hand, past research found a positive impact of remanufacturing on product quality. On the other hand, remanufacturing was shown to be negatively affected by an industry’s technology trajectory of quality improve-
Deterministic Annealing for Hybrid Beamforming Design in Multi-Cell MU-MIMO Systems

This work deals with hybrid beamforming (HBF) for the MIMO Interfering Broadcast Channel (IBC), i.e. the Multi-Input Multi-Output (MIMO) Multi-User (MU) Multi-Cell downlink channel. HBF is a low complexity alternative to fully digital precoding in Massive MIMO systems. Hybrid architectures involve a combination of digital and analog processing that enables both beamforming and multiplexing gains. We consider BF design by maximizing the Weighted Sum Rate (WSR) for the case of Perfect Channel State Information at the Transmitter (CSIT). We optimize the WSR using minorization and alternating optimization, the result of which is observed to converge fast. We furthermore propose a deterministic annealing based approach to avoid issues of local optima that plague phase shifter constrained analog beamformers. Simulation results indicate that the proposed deterministic annealing based approach performs significantly better than state of the art Weighted Sum Mean Squared Error (WSMSE) or WSR based solutions. We also propose a closed form solution for the analog BF in case the number of RF chains equals or exceeds the total number of multipath components and the antenna array responses are phasors.
A high‐protein diet or combination exercise training to improve metabolic health in individuals with long‐standing spinal cord injury: a pilot randomized study

We compared the effects of an 8‐week iso‐caloric high‐protein (HP) diet versus a combined exercise regimen (Comb‐Ex) in individuals with long‐standing spinal cord injury (SCI). Effects on metabolic profiles, markers of inflammation, and signaling proteins associated with glucose transporter 4 (GLUT‐4) translocation in muscles were evaluated. Eleven participants with SCI completed the study (HP diet: n = 5; Comb‐Ex: n = 6; 46 ± 8 years; C5‐T12 levels; American Spinal Injury Association Impairment Scale A or B). The Comb‐Ex regimen included upper body resistance training (RT) and neuromuscular electrical stimulation‐induced‐RT for paralytic quadriceps muscles, interspersed with high‐intensity (80–90% VO2 peak) arm cranking exercises 3 days/week. The HP diet included ~30% total energy as protein (carbohydrate to protein ratio <1.5, ~30% energy from fat). Oral glucose tolerance tests and muscle biopsies of the vastus lateralis (VL) and deltoid muscles were performed before and after the trial. Fasting plasma glucose levels decreased in the Comb‐Ex (P < 0.05) group compared to the HP‐diet group. A decrease in areas under the curve for insulin and TNF‐α concentrations was observed for all participants regardless of group assignment (time effect, P < 0.05). Although both groups exhibited a quantitative increase in insulin sensitivity as measured by the Matsuda Index, the change was clinically meaningful only in the HP diet group (HP diet: pre, 4.6; post, 11.6 vs. Comb‐Ex: pre, 3.3; post, 4.6). No changes were observed in proteins associated with GLUT‐4 translocation in VL or deltoid muscles. Our results suggest that the HP‐diet and Comb‐Ex regimen may improve insulin sensitivity and decrease TNF‐α concentrations in individuals with SCI.
Back-Translation Sampling by Targeting Difficult Words in Neural Machine Translation

Neural Machine Translation has achieved state-of-the-art performance for several language pairs using a combination of parallel and synthetic data. Synthetic data is often generated by back-translating sentences randomly sampled from monolingual data using a reverse translation model. While back-translation has been shown to be very effective in many cases, it is not entirely clear why. In this work, we explore different aspects of back-translation, and show that words with high prediction loss during training benefit most from the addition of synthetic data. We introduce several variations of sampling strategies targeting difficult-to-predict words using prediction losses and frequencies of words. In addition, we also target the contexts of difficult words and sample sentences that are similar in context. Experimental results for the WMT news translation task show that our method improves translation quality by up to 1.7 and 1.2 Bleu points over back-translation using random sampling for German-English and English-German, respectively.
Balancing Computation Speed and Quality: A Decentralized Motion Planning Method for Cooperative Lane Changes of Connected and Automated Vehicles

This paper focuses on the multi-vehicle motion planning (MVMP) problem for cooperative lane changes of connected and automated vehicles (CAVs). The predominant decentralized MVMP methods can hardly explore and utilize the cooperation capability of a multi-vehicle team, thus they usually lead to low-quality solutions. This paper proposes a two-stage MVMP framework to find high-quality online solutions. Concretely, at stage 1, the CAV platoon transfers from its original formation to a sufficiently sparse formation; at stage 2, all the CAVs simultaneously change lanes with collision avoidance implicitly ensured. The CAVs only involve longitudinal rather than lateral motions at stage 1, thus the collision-avoidance constraints can be easily handled. Since stage 2 begins with a sparse formation, the implicitly ensured collision avoidance can be completely omitted then. Through this, the proposed method avoids directly handling the challenging collision avoidance conditions, thereby being able to compute fast. As the vehicles run cooperatively and simultaneously at either stage, the obtained solutions are near-optimal. The completeness, effectiveness, and quality of the proposed two-stage MVMP method are validated through theoretical analysis and comparative simulations.
Chronic administration of the angiotensin type 2 receptor agonist C21 improves insulin sensitivity in C57BL/6 mice.

The renin–angiotensin system modulates insulin action. Angiotensin type 1 receptor exerts a deleterious effect, whereas the angiotensin type 2 receptor (AT2R) appears to have beneficial effects providing protection against insulin resistance and type 2 diabetes. To further explore the role of the AT2R on insulin action and glucose homeostasis, in this study we administered C57Bl/6 mice with the synthetic agonist of the AT2R C21 for 12 weeks (1 mg/kg per day; ip). Vehicle‐treated animals were used as control. Metabolic parameters, glucose, and insulin tolerance, in vivo insulin signaling in main insulin‐target tissues as well as adipose tissue levels of adiponectin, and TNF‐α were assessed. C21‐treated animals displayed decreased glycemia together with unaltered insulinemia, increased insulin sensitivity, and increased glucose tolerance compared to nontreated controls. This was accompanied by a significant decrease in adipocytes size in epididymal adipose tissue and significant increases in both adiponectin and UCP‐1 expression in this tissue. C21‐treated mice showed an increase in both basal Akt and ERK1/2 phosphorylation levels in the liver, and increased insulin‐stimulated Akt activation in adipose tissue. This positive modulation of insulin action induced by C21 appeared not to involve the insulin receptor. In C21‐treated mice, adipose tissue and skeletal muscle became unresponsive to insulin in terms of ERK1/2 phosphorylation levels. Present data show that chronic pharmacological activation of AT2R with C21 increases insulin sensitivity in mice and indicate that the AT2R has a physiological role in the conservation of insulin action.
Tunable, Ultrafast Fiber-Laser Between 1.15 and 1.35 μm for Harmonic Generation Microscopy in Human Skin

We demonstrate a fiber-optic ultrafast tunable source for harmonic generation microscopy (HGM) in human skin. The source is based on a 31-MHz Er-fiber laser followed by self-phase modulation enabled spectral selection (SESS). The resulting pulses are tunable between 1.15 and 1.35 μm with up to >10-nJ pulse energy and ∼100-fs pulse duration. We employ this source to drive a scanning microscope for HGM imaging of ex vivo human skin. A systematic investigation on imaging depth versus excitation wavelength reveals that excitation wavelengths in the 1.15–1.25 μm range exhibit low optical attenuation within the tissue and allows larger imaging depth for HGM in human skin. HGM driven by fiber-based SESS sources constitutes an enabling tool for noninvasive virtual skin biopsy in clinical applications.
Estimation of Power Plant Emissions With Unscented Kalman Filter

Emissions from power plants constitute a major part of air pollution and should be adequately estimated. In this paper, we consider the problem of estimating nitrogen dioxide (NO<inline-formula><tex-math notation="LaTeX">$_X$ </tex-math></inline-formula>) emission of power plants by developing an inverse method to integrate satellite observations of atmospheric pollutant column concentrations with species concentrations and direct sensitivities predicted by a regional air quality model, in order to discern biases in the emissions of the pollutant precursors. Using this method, the emission fields are analyzed using a “bottom-up” approach, with an inversion performed by an unscented Kalman filter (UKF) to improve estimation profiles from emissions inventories data for the Sydney metropolitan area. The idea is to integrate information from the original inventories with tropospheric nitrogen dioxide (NO<inline-formula><tex-math notation="LaTeX">$_2$</tex-math></inline-formula>) emissions estimated during one month from the air pollution model-chemical transport model, and then, for validation, to compare the resulting model with satellite retrievals from the ozone monitoring instrument (OMI) above the region. The UKF-based estimation of NO<inline-formula><tex-math notation="LaTeX">$_2$</tex-math></inline-formula> emissions shows better agreement with OMI observations, implying a significant improvement in accuracy as compared with the original inventories. Therefore, the proposed method is a promising tool for estimation of air emissions in urban areas.
Setting the stage: reviewing current knowledge on the health of New Zealand immigrants—an integrative review

The growth of migrant communities continues to rise globally, creating unique and complex health challenges. Literature on immigrant health in New Zealand (NZ) remains scant. This integrative literature review was conducted drawing on peer-reviewed research articles on immigrant health in NZ published between 2012 and 2018. The objectives were to: (i) provide a critical overview of immigrant health in NZ; (ii) identify general trends in health research conducted in NZ on immigrants; (iii) compare, contrast, and evaluate the quality of the information; (iv) develop a summary of research results and; (v) identify priorities and recommendations for future research. A search yielded more than 130 articles with 28 articles constituting the foundation of the review. This review is timely following the rapid increase in the scale, speed, and spread of immigration and its potential for changing NZ’s national health patterns and priorities. This integrative review led to the four primary conclusions. Firstly, migration in NZ is a gendered phenomenon, as there has been more women and girls arriving as migrants in NZ and being at risk of poor health in comparison with their male counterparts. Secondly, studies on infectious diseases take precedence over other health problems. Thirdly, research methodologies used to collect data may not be relevant to the cultural and traditional customs of the migrant populations. Furthermore, a number of research findings implemented have failed to meet the needs of NZ migrants. Lastly, policy initiatives are inclined more towards supporting health practitioners and lack a migrant centred approach. What is already known about this topic? Despite NZ becoming more ethnically and linguistically diverse, there is limited literature on the health of migrants living in NZ. What this paper adds? This integrative literature review provides a critical overview of refugee and migrant health in NZ through reviewing and critiquing the current literature available. This paper identifies research trends, the general health of migrants in NZ, recommendations that could inform future migrant and refugee health research and health policies and initiatives to ensure effective and relevant health service provision to migrants.
A Variant of the Sciatic Nerve and its Clinical Implications

Variants of gluteal neural anatomy are important to consider, especially during surgical approaches to the hip. During the routine dissection of the gluteal region, a variant of the sciatic nerve was found where the nerve left the pelvis fully split into its tibial and common fibular components. Intrapelvically and extrapelvically, there was no splitting of the two components by the piriformis muscle. Distally, the two parts of the nerve were draped over the medial and lateral edges of the ischial tuberosity. To avoid iatrogenic injury to the sciatic nerve during invasive or surgical approaches to this region, all possible anatomical variations, such as the one presented herein, should be appreciated by the clinician.
Trends and Determinants of Child Growth Indicators in Malawi and Implications for the Sustainable Development Goals

Sustainable development goals (SGD) 2 links malnutrition, morbidity and child mortality to stunting, wasting and overweight among children under-5 years of age. Sub-Saharan Africa still registers high nutritionally insecure people. In particular, Malawi has made modest progress in improving nutritional outcomes; and still experiences a number of structural challenges leading to negative nutritional outcomes. We describe trends of under nutrition and how the effect of selected determinants of child nutrition affect Malawian children under-5 from 1992 to 2015–16; and examine the changing patterns of the effect of selected socio-demographic characteristics on stunting and underweight using data from demographic and health surveys (DHS). The analysis included 31,630 children under-5 years from 1992, 2000, 2004, 2010, and 2015–16 DHS. Our outcome measures are stunting (height/length-for-age) and underweight (weight-for-age) less than -2 SD (Z-score). We perform logistic regression to assess the relationship between selected socio-demographic characteristics with the stunting and underweight variables. Underweight decreased by 14.0% from 24.7% (1992) to 10.7% (2015–16). Stunting decreased by 23.0% from 55.6% (1992) to 32.6% (2015–16). Underweight was more prevalent among children from central and southern regions; among male children; and children above 6 months of age or more. Later surveys were associated with reduced likelihood of underweight than the earliest surveys. Similar trends were observed between socioeconomic factors and stunting. The observed underweight and stunting prevalence is 2.2% and 1.9% lower than expected, respectively. Despite modest declines in underweight and stunting among young children in Malawi, underweight and stunting remain significant public health challenges particularly in southern and central Malawi which constitute about 85% of the total population. Interventions to address the critical malnutrition challenges in Malawi are inevitable within the context of SDG 2 on health.
Health-Relevant Phenotypes in the Offspring of Mice Given CAR Activators Prior to Pregnancy

Hepatic induction in response to drugs and environmental chemicals affects drug therapies and energy metabolism. We investigated whether the induction is transmitted to the offspring. We injected 3-day- and 6-week-old F0 female mice with TCPOBOP, an activator of the nuclear receptor constitutive androstane receptor (CAR, NR1I3), and mated them 1–6 weeks afterward. We detected in the offspring long-lasting alterations of CAR-mediated drug disposition, energy metabolism, and lipid profile. The transmission to the first filial generation (F1) was mediated by TCPOBOP transfer from the F0 adipose tissue via milk, as revealed by embryo transfer, crossfostering experiments, and liquid chromatography–mass spectrometry analyses. The important environmental pollutant PCB153 activated CAR in the F1 generation in a manner similar to TCPOBOP. Our findings indicate that chemicals accumulating and persisting in adipose tissue may exert liver-mediated, health-relevant effects on F1 offspring simply via physical transmission in milk. Such effects may occur even if treatment has been terminated far ahead of conception. This should be considered in assessing developmental toxicity and in the long-term follow-up of offspring of mothers exposed to both approved and investigational drugs, and to chemicals with known or suspected accumulation in adipose tissue.
Contending Worldviews in the Clinical Encounter: An Empirical Study of Complementary and Alternative Medicine Deliberations in Contemporary Medical Oncology.

OBJECTIVE In this article, the authors characterize the different ways patients and clinicians discuss complementary and alternative medicine (CAM) during routine cancer care. METHODS Over a period of two years, the authors audio-recorded clinical interactions between 37 medical oncology clinicians and a sample of 327 oncology patients at an academic cancer center in the Midwest United States. Recordings of conversations that included any discussion of CAM were transcribed and analyzed using a qualitative content analysis approach. RESULTS Out of 327 conversations, CAM was mentioned and/or discussed in only 31 encounters. Communication dynamics between clinician and patient involve several factors: the condition of the patient and his or her knowledge about and experience with CAM, the clinician's knowledge and values about CAM, perceived assumptions and stereotypes about CAM, and institutional response to the integration of CAM in cancer care. CONCLUSION Addressing the difficult and sensitive topic of CAM in cancer care requires hearing patients in a manner meaningful to them. In that sense, CAM can serve as an important marker and test case in the march toward shared decision-making and patient-centered communication generally.
Prevalence and risk factors of impaired fasting glucose and diabetes among Chinese children and adolescents: a national observational study

Abstract The prevalence of impaired fasting glucose (IFG) and diabetes mellitus (DM) has reportedly increased significantly among Chinese children and adolescents. We aimed to examine the prevalence of IFG and DM, the disparities in sex and region and related risk factors among Chinese children and adolescents. A total of 16 434 Chinese children aged 6–17 years were selected from a national cross-sectional survey, and fasting glucose was measured for all participants. Overall, mean fasting plasma glucose (FPG) concentration was (4·64 (sd 0·51)) mmol/l, and the prevalence of DM and IFG was 0·10 and 1·89 %, respectively. Compared with girls, boys had higher FPG concentration (4·69 v. 4·58 mmol/l, r 0·107, P<0·001) and IFG prevalence (2·67 v. 1·07 %, r φ 0·059, P<0·001). Compared with rural children and adolescents, urban children and adolescent had higher FPG concentration (4·65 v. 4·62 mmol/l, r 0·029, P<0·001) and DM prevalence (0·15 v. 0·05 %, r φ 0·016, P<0·01). In addition, self-reported fried foods intake and overweight/obesity were positively associated with IFG, and the proportion of consuming fried foods more than or equal to once per week and overweight/obesity prevalence in boys and urban children and adolescents were significantly higher than girls and rural children and adolescents, respectively (P<0·05). Although the prevalence of IFG and DM was relatively low in Chinese children and adolescents, sex and region disparities were observed, which may be associated with differences in overweight/obesity prevalence and dietary factors.