Miracle-dz/UniFAR-FTUs huggingface dataset:
Treatment of Kratom Dependence With Buprenorphine-Naloxone Maintenance

Introduction: Use of the unregulated herbal supplement kratom is on the rise in the United States. We present a case series of 2 patients who developed kratom dependence and withdrawal who were successfully transitioned to buprenorphine-naloxone maintenance. Case Summary: Two patients using kratom to self-treat chronic pain after prescription opioids were discontinued presenting to our clinic with evidence of kratom dependence and withdrawal. On examination, both patients showed signs of mild opioid withdrawal. Both patients were successfully transitioned to buprenorphine-naloxone maintenance via home initiation with control of both their opioid withdrawal and chronic pain. Conclusions: Kratom use is on the rise and with increasing evidence of developing opioid-type dependence due to chronic kratom use. This case series shows that buprenorphine can be used to treat kratom dependence and underlying chronic pain that drives it use.
Towards an Artificially Empathic Conversational Agent for Mental Health Applications: System Design and User Perceptions

Background Conversational agents cannot yet express empathy in nuanced ways that account for the unique circumstances of the user. Agents that possess this faculty could be used to enhance digital mental health interventions. Objective We sought to design a conversational agent that could express empathic support in ways that might approach, or even match, human capabilities. Another aim was to assess how users might appraise such a system. Methods Our system used a corpus-based approach to simulate expressed empathy. Responses from an existing pool of online peer support data were repurposed by the agent and presented to the user. Information retrieval techniques and word embeddings were used to select historical responses that best matched a user’s concerns. We collected ratings from 37,169 users to evaluate the system. Additionally, we conducted a controlled experiment (N=1284) to test whether the alleged source of a response (human or machine) might change user perceptions. Results The majority of responses created by the agent (2986/3770, 79.20%) were deemed acceptable by users. However, users significantly preferred the efforts of their peers (P<.001). This effect was maintained in a controlled study (P=.02), even when the only difference in responses was whether they were framed as coming from a human or a machine. Conclusions Our system illustrates a novel way for machines to construct nuanced and personalized empathic utterances. However, the design had significant limitations and further research is needed to make this approach viable. Our controlled study suggests that even in ideal conditions, nonhuman agents may struggle to express empathy as well as humans. The ethical implications of empathic agents, as well as their potential iatrogenic effects, are also discussed.
Are age and anti-Müllerian hormone good predictors of ovarian reserve and response in women undergoing IVF?

Objective Ovarian reserve evaluation has been the focus of substantial clinical research for several years. This study aimed to examine the associations between markers of ovarian reserve and ovarian response. Methods This prospective study included 132 infertile women aged 24-48 years undergoing routine exploration during unstimulated cycles prior to the start of assisted reproductive technology (ART) treatments at our center from July 2015 to January 2017. Descriptive parameters and patient characteristics were reported as mean (SD) or median (range) values depending on the data distribution pattern. Student’s t-test was performed for continuous variables; the Wilcoxon and Pearson’s test were used for data not following a normal distribution; and Fisher’s test was used for categorical variables. p<0.05 was considered statistically significant. Results At the time of the study, the patients had a mean age of 35.7±3.84 years. On day 3 of the cycle, the mean anti-Müllerian hormone (AMH) serum level was 2.84±1.57 ng/mL and the patients had 14.68±4.2 antral follicles (AFC). A significant correlation was observed between AMH and age (r=-0.34 p<.01), follicle stimulating hormone (FSH) serum levels (r=-0.32, p<.01), AFC (r=0.81, p<.00001), total dose of medication during ovarian stimulation (r=-0.28, p<.0003), and ongoing pregnancy rate (p<.05). Age was significantly correlated with FSH (r=0.46, p<.01), AFC (r=-0.34, p<.00001), total dose of medication during ovarian stimulation (r=0.43, p<.0003), and ongoing pregnancy rate (p<.04). Conclusion Serum AMH and age are independent predictors of ovarian reserve and ovarian stimulation outcome in infertile women. Age and serum AMH level may be used to advise subfertile couples of their pregnancy prospects.
Role of Nicotinic Acetylcholine Receptor α3 and α7 Subunits in Detrusor Overactivity Induced by Partial Bladder Outlet Obstruction in Rats

Purpose: To investigate the role of α3 and α7 nicotinic acetylcholine receptor subunits (nAChRs) in the bladder, using a rat model with detrusor overactivity induced by partial bladder outlet obstruction (BOO). Methods: Forty Sprague-Dawley rats were used: 10 were sham-operated (control group) and 30 were observed for 3 weeks after partial BOO. BOO-induced rats were further divided into 3 groups: Two groups of 10 rats each received intravesicular infusions with hexamethonium (HM group; n=10) or methyllycaconitine (MLC group; n=10), which are antagonists for α3 and α7 nAChRs, respectively. The remaining BOO-induced rats received only saline infusion (BOO group; n=10). Based on the contraction interval measurements using cystometrogram, the contraction pressure and nonvoiding bladder contractions were compared between the control and the three BOO-induced groups. Immunofluorescent staining and Western blotting were used to analyze α3 and α7 nAChRs levels. Results: The contraction interval of the MLC group was higher than that of the BOO group (P<0.05). Nonvoiding bladder contraction almost disappeared in the HM and MLC groups. Contraction pressure increased in the BOO group (P<0.05) compared with the control group and decreased in the HM and MLC groups compared with the BOO group (P<0.05). Immunofluorescence staining showed that the α3 nAChR signals increased in the urothelium, and the α7 nAChR signals increased in the urothelium and detrusor muscle of the BOO group compared with the control group. Western blot analysis showed that both α3 and α7 nAChR levels increased in the BOO group (P<0.05). Conclusions: Alpha3 and α7 nAChRs are associated with detrusor overactivity induced by BOO. Furthermore, nAChR antagonists could help in clinically improving detrusor overactivity.
Proportions of mammalian‐type and reptilian‐type nephrons in the kidneys of two passerine birds

We compared the proportions of mammalian‐type and reptilian‐type nephrons in the kidneys of two species of passerine birds. The desert house sparrow (Passer domesticus) is relatively well adapted for water conservation, whereas the white‐crowned sparrow (Zonotrichia leucophrys) is more mesic adapted. The two species do not differ in body mass, but the kidneys of P. domesticus are significantly smaller than those of Z. leucophrys. Associated with its smaller size, the house sparrow kidney has significantly fewer glomeruli (35,700 per kidney) than does the white‐crowned sparrow kidney (53,000 per kidney). The medullary cones, which contain the loops of Henle of the mammalian‐type nephrons, are significantly longer in house sparrows than in white‐crowned sparrows (2.2 vs. 1.9 mm). The number of medullary cones, the number of nephrons per medullary cone, and, hence, the number of mammalian‐type nephrons do not differ between the two species. The smaller number of nephrons in the kidney of the house sparrow therefore represents a smaller number of reptilian‐type nephrons. Desert house sparrows have 18% mammalian‐type nephrons, whereas white‐crowned sparrows have 10% mammaliantype nephrons. The relative reduction of reptilian‐type nephrons in P. domesticus may reduce the flow of dilute urine through the collecting ducts, thereby permitting a greater concentration gradient to be established along the length of the medullary cones.
Characteristics of interruptions during medication administration: An integrative review of direct observational studies

AIMS AND OBJECTIVES To synthesise and summarise data gathered by direct observation of the characteristics of interruptions in the context of nursing medication administration (MA) in hospital settings. BACKGROUND Interruptions are prevalent during the MA process performed by nurses in hospital settings and have been found to be associated with an increase in frequency and severity of nursing MA errors. In addition, interruptions decrease task efficiency, leading to longer MA completion times. DESIGN Integrative review. METHODS The electronic databases Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, PsycARTICLES and Google Scholar were searched using the terms "interruptions" AND "medication administration" AND "direct observation. " Nine articles met the inclusion criteria. RESULTS Interruptions are likely to occur at least once during nursing MA processes in hospital settings. This finding applies to medication administered to one patient, termed a medication pass, and medication administered to multiple patients, termed a medication round. Interruptions are most commonly caused by another nurse or staff member or are self-initiated, and last approximately 1 min in length. CONCLUSIONS A raised awareness among staff of the most common sources of interruptions may encourage changes that lead to a decrease in the occurrence of interruptions. In addition, nurse leaders can apply an understanding of the common characteristics of interruptions to guide research, policies and educational methods aimed at interruption management strategies. RELEVANCE TO CLINICAL PRACTICE The findings from this review can be used to guide the identification and development of targeted interventions and strategies that would have the most substantial impact to reduce and manage interruptions during MA. Interruption management strategies have the potential to lead to a decrease in medication errors and an increase in task efficiency.
Evaluation of age effects on doxorubicin-induced toxicity in mesenchymal stem cells

Background: Doxorubicin, by aggregating in bone marrow, causes genotoxic effects, and thus reduces the repair ability of cells. The present study was conducted as an in vitro evaluation of age effects on the cytotoxicity induced by doxorubicin in mesenchymal stem cells (MSCs). Methods: The MSCs of female BALB/c mice aged 1, 8, and 16 months were separated, characterized, and subsequently evaluated in cellular growth media. After 24 hours, exposure of the MSCs of the 3 groups of mice to doxorubicin (25, 50, 100, 200, 400, 800, 1200 nM) and cytotoxicity were assessed, and the sublethal dose was determined using flow cytometry technique and lactate dehydrogenase (LDH) release assay. Results: The IC50 values determined by flow cytometry for the separated MSCs of 1 young, 8 middle- aged, and 16 old mice were and respectively. Interestingly, the results of these 2 methods in determining cytotoxicity were in agreement, and a concentration of approximately 25 nM was considered to be the shared sublethal dose for different ages. Conclusion: The results indicated that MSCs of middle-aged mice were more resistant to the toxic effects of the drug. Besides, MSCs separated from the old mice were the most sensitive to chemotherapy and its side effects such as disruptions of cell proliferation and viability. These disruptions can be ascribed to the alteration of function and physiological processes with age. Determining proper concentration of doxorubicin drug to destruct cancerous cells based on age and individual sensitivity can minimize the amount of toxicity
Polymorphisms of TNF-α -308 G/A and IL-8 -251 T/A Genes Associated with Urothelial Carcinoma: A Case-Control Study

Cigarette smoking and exposure to environmental tobacco smoke are well-known risk factors for urothelial carcinoma (UC). We conducted a hospital-based case-control study involving 287 UC cases and 574 cancer-free controls to investigate the joint effects of cigarette smoking and polymorphisms of inflammatory genes on UC risk. Tumor necrosis factor alpha (TNF-α) -308 G/A and interleukin-8 (IL-8) -251 T/A polymorphisms were determined using a polymerase chain reaction-restriction fragment length polymorphism method. People who had ever smoked and those who were exposed to environmental tobacco smoke had significantly increased UC odds ratios (ORs) of 1.65 and 1.68, respectively. Participants who had smoked more than 18 pack-years had a significantly increased UC OR of 2.64. People who had ever smoked and who carried the A/A genotype of the TNF-α -308 G/A polymorphism had a significantly higher UC OR (10.25) compared to people who had never smoked and who carried the G/G or G/A genotype. In addition, people who had ever smoked and who carried the IL-8 -251 T/T genotype had a significantly increased UC OR (3.08) compared to people who had never smoked and who carried the T/A or A/A genotype. In a combined analysis of three major risk factors (cumulative cigarette smoking, the TNF-α -308 A/A genotype, and the IL-8 -251 T/T genotype), subjects with any one, any two, and all three risk factors experienced significantly increased UC ORs of 1.55, 2.89, and 3.77, respectively, compared to individuals with none of the risk factors. Conclusions. Our results indicate that the combined effects of cumulative cigarette exposure and the TNF-α -308 A/A genotype and/or the IL-8 -251 T/T genotype on UC OR showed a significant dose-response relationship.
Sericin enhances the developmental competence of heat‐stressed bovine embryos

We investigated the effects of sericin on the developmental competence of bovine embryos exposed to heat stress (HS). Putative zygotes were cultured with sericin and subjected to HS (40.5°C for 6 hr) on Day 2 or 7 followed by continuous culture at 38.5°C until Day 8. Day 2 HS significantly decreased blastocyst development on Day 8 as well as mitochondrial activity, and significantly increased the amount of intracellular reactive oxygen species and terminal deoxynucleotidyl transferase biotin‐dUTP nick end labeling (TUNEL)‐positive cells, whereas Day 7 HS only significantly decreased mitochondrial activity and increased the number of TUNEL‐positive cells in Day 8 blastocysts. These detrimental effects were neutralized by sericin supplementation. Next, to investigate the potential production of blastocysts with high viability in terms of thermotolerance, embryos were cultured with sericin until Day 7, and then exposed to HS in the sericin‐free medium. TUNEL‐positive cell numbers were significantly lower in blastocysts produced by sericin culture than in control blastocysts. Transcript abundance for HSPA1A and BAX was significantly decreased but IFNT2 levels were increased in blastocysts produced by sericin culture. In conclusion, these findings demonstrate the anti‐oxidative and anti‐apoptotic activities of sericin, and the potential use of sericin to produce embryos with high viability in vitro.
Many-Goals Reinforcement Learning

All-goals updating exploits the off-policy nature of Q-learning to update all possible goals an agent could have from each transition in the world, and was introduced into Reinforcement Learning (RL) by Kaelbling (1993). In prior work this was mostly explored in small-state RL problems that allowed tabular representations and where all possible goals could be explicitly enumerated and learned separately. In this paper we empirically explore 3 different extensions of the idea of updating many (instead of all) goals in the context of RL with deep neural networks (or DeepRL for short). First, in a direct adaptation of Kaelbling's approach we explore if many-goals updating can be used to achieve mastery in non-tabular visual-observation domains. Second, we explore whether many-goals updating can be used to pre-train a network to subsequently learn faster and better on a single main task of interest. Third, we explore whether many-goals updating can be used to provide auxiliary task updates in training a network to learn faster and better on a single main task of interest. We provide comparisons to baselines for each of the 3 extensions.
Postload Glycated Albumin as an Alternate Measure for Diabetes Screening in a Chinese Population

In previous epidemiological screening in China, glycated albumin (GA) was mostly detected during the fasting state. This strict restriction causes some problems with diabetes screening. It is unclear if GA could help improve the efficiency of screening for diabetes for subjects who are not in the fasting state. The present study analyzed the differences between fasting and postload (30, 60, 120, and 180 min) GA levels. A total of 691 participants were enrolled in the present study. The Bland-Altman difference plots revealed that 95.4, 94.8, 93.6, and 93.9% of data points were within the limits of agreement for each time point. The receiver operating characteristic curve showed that the areas under the curve (AUC) for baseline GA and postload GA for every time point were 0.822 (95% CI 0.791–0.849), 0.821 (95% CI 0.790–0.848), 0.833 (95% CI 0.803–0.860), 0.840 (95% CI 0.811–0.867), and 0.840 (95% CI 0.810–0.867), with sensitivities of 67.5, 68.1, 69.3, 71.6, and 69.3%, respectively. There was no difference between the baseline and postload GA levels in either AUC or sensitivity (all p > 0.05). In conclusion, postload serum GA levels were in good agreement with those at baseline, and thus, it may be reasonable to employ nonfasting measurements of GA levels for diabetes screening.
Learning atoms for materials discovery

Significance Motivated by the recent achievements of artificial intelligence (AI) in linguistics, we design AI to learn properties of atoms from materials data on its own. Our work realizes knowledge representation of atoms via computers and could serve as a foundational step toward materials discovery and design fully based on machine learning. Exciting advances have been made in artificial intelligence (AI) during recent decades. Among them, applications of machine learning (ML) and deep learning techniques brought human-competitive performances in various tasks of fields, including image recognition, speech recognition, and natural language understanding. Even in Go, the ancient game of profound complexity, the AI player has already beat human world champions convincingly with and without learning from the human. In this work, we show that our unsupervised machines (Atom2Vec) can learn the basic properties of atoms by themselves from the extensive database of known compounds and materials. These learned properties are represented in terms of high-dimensional vectors, and clustering of atoms in vector space classifies them into meaningful groups consistent with human knowledge. We use the atom vectors as basic input units for neural networks and other ML models designed and trained to predict materials properties, which demonstrate significant accuracy.
Quadratic Decomposable Submodular Function Minimization

We introduce a new convex optimization problem, termed quadratic decomposable submodular function minimization. The problem is closely related to decomposable submodular function minimization and arises in many learning on graphs and hypergraphs settings, such as graph-based semi-supervised learning and PageRank. We approach the problem via a new dual strategy and describe an objective that may be optimized via random coordinate descent (RCD) methods and projections onto cones. We also establish the linear convergence rate of the RCD algorithm and develop efficient projection algorithms with provable performance guarantees. Numerical experiments in semi-supervised learning on hypergraphs confirm the efficiency of the proposed algorithm and demonstrate the significant improvements in prediction accuracy with respect to state-of-the-art methods.
Nurses’ Experience With Health Information Technology: Longitudinal Qualitative Study

Background Nurses are the largest group of health information technology (HIT) users. As such, nurses’ adaptations are critical for HIT implementation success. However, longitudinal approaches to understanding nurses’ perceptions of HIT remain underexplored. Previous studies of nurses’ perceptions demonstrate that the progress and timing for acceptance of and adaptation to HIT varies. Objective This study aimed to explore nurses’ experience regarding implementation of HIT over time. Methods A phenomenological approach was used for this longitudinal qualitative study to explore nurses’ perceptions of HIT implementation over time, focusing on three time points (rounds) at 3, 9, and 18 months after implementation of electronic health records and bar code medication administration. The purposive sample was comprised of clinical nurses who worked on a medical-surgical unit in an academic center. Results Major findings were categorized into 7 main themes with 54 subthemes. Nurses reported personal-level and organizational-level factors that facilitated HIT adaptation. We also generated network graphs to illustrate the occurrence of themes. Thematic interconnectivity differed due to nurses’ concerns and satisfaction at different time points. Equipment and workflow were the most frequent themes across all three rounds. Nurses were the most dissatisfied approximately 9 months after HIT implementation. Eighteen months after HIT implementation, nurses’ perceptions appeared more balanced. Conclusions It is recommended that organizations invest in equipment (ie, wireless barcode scanners), refine policies to reflect nursing practice, and improve systems to focus on patient safety. Future research is necessary to confirm patterns of nurses’ adaptation to HIT in other samples.
Clinical validation of the nursing diagnosis of impaired memory in patients with a stroke.

To validate the clinical indicators for the nursing diagnosis of impaired memory among patients with a stroke. A sample of 123 patients who had been admitted with a stroke was evaluated by using a questionnaire that was designed to identify the presence of the clinical indicators for the diagnosis of impaired memory, according to the NANDA International taxonomy. Measures of sensitivity and specificity were calculated for each clinical indicator by using random-effects latent class analysis. The clinical indicators that demonstrated high levels of diagnostic accuracy included the following: an inability to learn new skills and an inability to retain new skills. The inability to learn new skills and the inability to carry out previously learned skills were identified as the clinical indicators with high sensitivity and specificity in the latent class model with adjustment for age. The inability to retain new skills indicator showed better diagnostic accuracy in individuals with lower educational levels. The clinical indicators of the impaired memory diagnosis were observed frequently in patients with a stroke; in these patients, impaired memory was characterized by the inability to learn or retain new skills and was influenced by the age and educational level.