Miracle-dz/UniFAR-FTUs huggingface dataset:
Effectiveness of interventions for managing multiple high-burden chronic diseases in older adults: a systematic review and meta-analysis

INTRODUCTION: More than half of older adults (age ≥ 65 yr) have 2 or more high-burden multimorbidity conditions (i.e., highly prevalent chronic diseases, which are associated with increased health care utilization; these include diabetes [DM], dementia, depression, chronic obstructive pulmonary disease [COPD], cardiovascular disease [CVD], arthritis, and heart failure [HF]), yet most existing interventions for managing chronic disease focus on a single disease or do not respond to the specialized needs of older adults. We conducted a systematic review and meta-analysis to identify effective multimorbidity interventions compared with a control or usual care strategy for older adults. METHODS: We searched bibliometric databases for randomized controlled trials (RCTs) evaluating interventions for managing multiple chronic diseases in any language from 1990 to December 2017. The primary outcome was any outcome specific to managing multiple chronic diseases as reported by studies. Reviewer pairs independently screened citations and full-text articles, extracted data and assessed risk of bias. We assessed statistical and methodological heterogeneity and performed a meta-analysis of RCTs with similar interventions and components. RESULTS: We included 25 studies (including 15 RCTs and 6 cluster RCTs) (12 579 older adults; mean age 67.3 yr). In patients with [depression + COPD] or [CVD + DM], care-coordination strategies significantly improved depressive symptoms (standardized mean difference −0.41; 95% confidence interval [CI] −0.59 to −0.22; I2 = 0%) and reduced glycosylated hemoglobin (HbA1c) levels (mean difference −0.51; 95% CI −0.90 to −0.11; I2 = 0%), but not mortality (relative risk [RR] 0.79; 95% CI 0.53 to 1.17; I2 = 0%). Among secondary outcomes, care-coordination strategies reduced functional impairment in patients with [arthritis + depression] (between-group difference −0.82; 95% CI −1.17 to −0.47) or [DM + depression] (between-group difference 3.21; 95% CI 1.78 to 4.63); improved cognitive functioning in patients with [DM + depression] (between-group difference 2.44; 95% CI 0.79 to 4.09) or [HF + COPD] (p = 0.006); and increased use of mental health services in those with [DM + (CVD or depression)] (RR 2.57; 95% CI 1.90 to 3.49; I2 = 0%). INTERPRETATION: Subgroup analyses showed that older adults with diabetes and either depression or cardiovascular disease, or with coexistence of chronic obstructive pulmonary disease and heart failure, can benefit from care-coordination strategies with or without education to lower HbA1c, reduce depressive symptoms, improve health-related functional status, and increase the use of mental health services. Protocol registration: PROSPERO-CRD42014014489
Regulation of the NLRP3 inflammasome and macrophage pyroptosis by the p38 MAPK signaling pathway in a mouse model of acute lung injury

Acute lung injury and acute respiratory distress syndrome (ALI/ARDS) is characterized by uncontrolled progressive lung inflammation. Macrophages serve a key role in the pathogenesis of ALI/ARDS. Macrophage pyroptosis is a process of cell death releasing the proinflammatory cytokines interleukin (IL)-1β and IL-18. It was hypothesized that macrophage pyroptosis may partially account for the uncontrolled lung inflammation of ALI/ARDS. In the present study, greater macrophage pyroptosis in lipopolysaccharide (LPS)-treated macrophages and the ALI/ARDS mouse model was observed. The expression of nucleotide-binding domain, leucine-rich-containing family, pyrin domain-containing (NLRP)3 and IL-1β and cleavage of caspase-1 were significantly elevated following LPS treatment accompanied by greater activation of p38 mitogen-activated protein kinase (MAPK) signaling in vitro and in vivo. However, blocking p38 MAPK signaling through the inhibitor SB203580 significantly suppressed the acute lung injury and excessive lung inflammation in vivo, consistent with the reduced expression of the NLRP3 inflammasome and IL-1β and cleavage of caspase-1. Pretreatment of the rat NR8383 macrophage cell line with SB203580 significantly decreased the population of caspase-1+PI+ pyroptotic cells and expression of NLRP3/IL-1β. However, a larger population of Annexin V+PI- apoptotic cells was observed following blocking of the p38 MAPK signaling pathway. The results indicated that blockage of p38 MAPK signaling pathway skewed macrophage cell death from proinflammatory pyroptosis towards non-inflammatory apoptosis. These effects may contribute to attenuated acute lung injury and excessive inflammation in the SB203580-treated mice. The results may provide a novel therapeutic strategy for the treatment of uncontrolled lung inflammation in patients with ALI/ARDS.
PENGARUH SARANA PRASARANA DAN KUALITAS PELAYANAN TERHADAP KEPUASAN PASIEN (Studi Pada Pasien Rawat Jalan Unit Poliklinik IPDN Jatinangor)

Di tengah dinamika kegiatan pendidikan kedinasan IPDN kampus Jatinangor, Poliklinik IPDN mempunyai peran yang cukup penting dalam memberikan jasa pelayanan kesehatan kepada seluruh civitas akademika, dan seluruh lapisan petugas bertekad secara continue meningkatkan kepuasan pasien. Dengan maksimalisasi fungsi sarana prasarana yang telah ada serta didukung aksi pelayanan prima maka kepuasan pasien yang diharapkan akan dapat terwujud. Metode analisis data menggunakan analisis kuantitatif dengan alat analisis Regresi dan Korelasi dengan hasil sebagai berikut: Pengaruh sarana prasarana terhadap kepuasan pasien sebesar 59,20% artinya berpengaruh sedang. Hasil uji hipotesis menyatakan bahwa terdapat hubungan antara sarana prasarana dengan kepuasan pasien. Besarnya pengaruh kualitas pelayanan terhadap kepuasan pasien masuk pada kategori kuat (74,20%). Hasil uji hipotesis mengartikan bahwa pengaruh kualitas pelayanan terhadap kepuasan pasien adalah signifikan. Besarnya pengaruh sarana prasarana dan kualitas pelayanan terhadap kepuasan pasien masuk kategori kuat sebesar 77,90%. Kata kunci: Sarana Prasarana, Kualitas Pelayanan, Kepuasan Pasien.
Designing Web-based Forms for Users with Lower Literacy Skills

Previous research (Summers & Summers, 2003) has identified patterns of behavior and effective practices related to how lower literacy users interact with health-related Internet sites. However, prior research has not addressed how such users react to the unique challenges represented by interactive medical forms on health sites, such as interactive health quizzes, questionnaires, and registration forms. The goal of this four-month study was twofold: 1) to identify reading, writing, and navigational strategies of users with lower literacy skills when interacting with web-based forms in a medical context; 2) to develop design principles for making such web-based medical forms usable and accessible for lower-literacy adults. Eyetracking was used to gather data about how users interacted with a variety of web-based forms. Analysis of sessions with 26 low-literacy users (REALM score < 60) identified a variety of challenges users faced in completing forms. Based on these observations, proposed principles of effective form design were developed. Revised prototype forms were designed in accordance with these principles and iteratively tested with 14 users to verify improved usability.
Nanoparticle Enhanced Antibody and DNA Biosensors for Sensitive Detection of Salmonella

Bacteria-related pathogenic diseases are one of the major health problems throughout the world. Salmonella is a genus of rod-shaped Gram-negative enterobacteria of which more than 2600 serotypes have been identified. Infection with Salmonella can cause salmonellosis, a serious bacterial toxi-infection syndrome associated with gastroenteritis, and paralyphoid and typhoid fevers. Its rapid and sensitive detection is a key to the prevention of problems related to health. This paper describes the development of antibody and DNA sensors for Salmonella detection using a microfluidic-based electrochemical system. Commercial Salmonella typhimurium and Salmonella typhimurium from human stool samples were investigated using standard and nanomaterial-amplified antibody sensors. S. typhimurium could be detected down to 1 cfu mL−1. The specificity of immunoassay was tested by studying with non-specific bacteria including E. coli and S. aureus that revealed only 2.01% and 2.66% binding when compared to the target bacterium. On the other hand, the quantification of Salmonella DNA was investigated in a concentration range of 0.002–200 µM using the developed DNA biosensor that demonstrated very high specificity and sensitivity with a detection limit of 0.94 nM. Our custom-designed microfluidic sensor offers rapid, highly sensitive, and specific diagnostic assay approaches for pathogen detection.
Meta-Learning for Low-Resource Neural Machine Translation

In this paper, we propose to extend the recently introduced model-agnostic meta-learning algorithm (MAML, Finn, et al., 2017) for low-resource neural machine translation (NMT). We frame low-resource translation as a meta-learning problem where we learn to adapt to low-resource languages based on multilingual high-resource language tasks. We use the universal lexical representation (Gu et al., 2018b) to overcome the input-output mismatch across different languages. We evaluate the proposed meta-learning strategy using eighteen European languages (Bg, Cs, Da, De, El, Es, Et, Fr, Hu, It, Lt, Nl, Pl, Pt, Sk, Sl, Sv and Ru) as source tasks and five diverse languages (Ro,Lv, Fi, Tr and Ko) as target tasks. We show that the proposed approach significantly outperforms the multilingual, transfer learning based approach (Zoph et al., 2016) and enables us to train a competitive NMT system with only a fraction of training examples. For instance, the proposed approach can achieve as high as 22.04 BLEU on Romanian-English WMT’16 by seeing only 16,000 translated words (~600 parallel sentences)
Can Urban-Rural Patterns of Hospital Selection Be Changed Using a Report Card Program? A Nationwide Observational Study

Background: Guiding patients to choose high-quality healthcare providers helps ensure that patients receive excellent care and helps reduce health disparities among patients of different socioeconomic backgrounds. The purpose of this study was to examine and compare the effect of implementing a report-card program on the patterns of hospital selection in patients from different socioeconomic subgroups. Patients undergoing total knee replacement (TKR) surgery were used as the sample population. Methods: A patient-level, retrospective, observational and cross-sectional study design was conducted. Taiwan National Health Insurance claims data were used and all patients in this database who had received TKR between April 2007–March 2008 (prior to report-card program implementation) and between April 2009–March 2010 (after program implementation) were included. Those patients who were under 18 years of age or who lacked area-of-residence or National Health Insurance premium information were excluded. Travelling distance to the hospital and level of hospital performance were used to evaluate the effect of the report-card program. Results: A total of 32,821 patients were included in this study. The results showed that patterns of hospital selection varied based on the socioeconomic characteristics of patients. In terms of travelling distance and hospital selection, the performance of urban and higher income patients was shorter and better, respectively, than their rural and lower-income peers both before and after report-card-program implementation. Moreover, although the results of multivariate analysis showed that the urban-rural difference in travelling distance enlarged (by 4.75 km) after implementation of the report-card program, this increase was shown to not be significantly related to this program. Furthermore, the results revealed that implementation of the report-card program did not significantly affect the urban-rural difference in terms of level of hospital performance. Conclusions: A successful report-card program should ensure that patients in all socioeconomic groups obtain comprehensive information. However, the results of this study indicate that those in higher socioeconomic subgroups attained more benefits from the program than their lower-subgroup peers. Ensuring that all have equal opportunity to access high-quality healthcare providers may therefore be the next issue that needs to be addressed and resolved.
A Prospective Cohort Study of the Association Between Body Mass Index and Incident Bacterial Vaginosis

Some studies suggest that higher body mass index is associated with increased susceptibility to bacterial vaginosis (BV), but results are conflicting. Methods Female sex workers aged 16 to 45 years and participating in an open, prospective cohort study in Mombasa, Kenya between 2000 and 2014 were included in this analysis. Up to 2 years of follow-up were included per woman. Body mass index (BMI) was categorized as underweight (⩽18.5), normal (18.5–24.9), overweight (25–29.9), and obese (≥30). Bacterial vaginosis was assessed using Nugent scores. Generalized estimating equations were used to estimate relative risks of the association between BMI and BV. Results At baseline, 32.1% (n = 625) of 1946 women had BV. Half of women were overweight (31.1%, n = 606) or obese (20.1%, n = 391). Participants contributed 14,319 follow-up visits. Adjusting for age, compared to women with normal BMI, overweight (adjusted relative risk, 0.91; 95% confidence interval, 0.81–1.02) and obese (adjusted relative risk, 0.82; 95% confidence interval, 0.71–0.94) women were at lower risk for BV (joint P = 0.03). Conclusions Obese women had a nearly 20% lower risk of BV compared with women with normal BMI. Potential mechanisms for this effect, including possible effects of diet, obesity-associated changes in the gut microbiome, and systemic estrogen levels, should be explored.
Nowcasting the Stance of Social Media Users in a Sudden Vote: The Case of the Greek Referendum

Modelling user voting intention in social media is an important research area, with applications in analysing electorate behaviour, online political campaigning and advertising. Previous approaches mainly focus on predicting national general elections, which are regularly scheduled and where data of past results and opinion polls are available. However, there is no evidence of how such models would perform during a sudden vote under time-constrained circumstances. That poses a more challenging task compared to traditional elections, due to its spontaneous nature. In this paper, we focus on the 2015 Greek bailout referendum, aiming to nowcast on a daily basis the voting intention of 2,197 Twitter users. We propose a semi-supervised multiple convolution kernel learning approach, leveraging temporally sensitive text and network information. Our evaluation under a real-time simulation framework demonstrates the effectiveness and robustness of our approach against competitive baselines, achieving a significant 20% increase in F-score compared to solely text-based models.
LIGHT/TNFSF14 signaling attenuates beige fat biogenesis

The physiologic signals that regulate beige adipogenesis remain incompletely understood, especially those that limit browning and prevent overexpenditure of energy. In this study, the TNF family member cytokine lymphotoxin‐like inducible protein that competes with glycoprotein D for herpesvirus entry on T cells (LIGHT), also known as TNF super family protein 14 (TNFSF14), can inhibit adipose precursor differentiation into beige adipocytes. In acute cold stress, LIGHT deficiency in mice accelerated browning in the subcutaneous white adipose tissue (scWAT). Further experiments showed that LIGHT interacting with lymphotoxin‐β receptor (LTβR) on adipose precursors blocked beige fat biogenesis. LTβR signals attenuated the JNK pathway, which contributed to their antibeiging effect. Blocking JNK activation using a small molecular inhibitor prevented cold‐induced scWAT beiging. Furthermore, LIGHT/LTβR signals acted as an attenuator of white adipogenesis. LIGHT deficiency in mice promoted obesity during high‐fat diet feeding. These findings identify the LIGHT axis as a regulator of adipose tissue homeostasis and suggest that LIGHT signaling functions as a mechanism to divert energy in favor of immune activation. —Kou, Y. , Liu, Q. , Liu, W. , Sun, H. , Liang, M. , Kong, F. , Zhang, B. , Wei, Y. , Liu, Z. , Wang, Y. LIGHT/TNFSF14 signaling attenuates beige fat biogenesis. FASEB J. 33, 1595–1604 (2019). www.fasebj. org
Physical Activity Patterns and Risk of Type 2 Diabetes and Metabolic Syndrome in Middle-Aged and Elderly Northern Chinese Adults

The main aim of this study is to quantitatively describe the status of physical activity and evaluate its levels in a rural population and to investigate the association between the quantifiable physical activity and type 2 diabetes and metabolic syndrome. In total, 2076 participants aged over 40 years were included in a cross-sectional analysis. Physical activity status and the contributions of different types of activity were evaluated. The association between social behaviors and physical activities was analyzed. In addition, the impact of physical activities on type 2 diabetes mellitus and metabolic syndrome was also analyzed by logistic regression. Approximately half of the total activity in rural areas consisted of work-related activity (49.3%) followed by commuting (30.2%) and recreational activity (20.5%). In rural areas, the prevalence of physical activity levels was 28.6% for low levels, 47.3% for moderate levels, and 24.1% for high levels. Educational level showed a significant negative association with the physical activity level. Lower physical activity shows a strong and significant association with type 2 diabetes and metabolic syndrome. In conclusion, insufficient physical activity among rural people over 40 years old increases the risk of type 2 diabetes and metabolic syndrome. Population-wide and individualized guidelines for physical activities especially recreational physical activities should be developed.
Discriminative but Not Discriminatory: A Comparison of Fairness Definitions under Different Worldviews

We mathematically compare three competing definitions of group-level nondiscrimination: demographic parity, equalized odds, and predictive parity. Using the theoretical framework of Friedler et al., we study the properties of each definition under various worldviews, which are assumptions about how, if at all, the observed data is biased. We argue that different worldviews call for different definitions of fairness, and we specify the worldviews that, when combined with the desire to avoid a criterion for discrimination that we call disparity amplification, motivate demographic parity and equalized odds. In addition, we show that predictive parity is insufficient for avoiding disparity amplification because it allows an arbitrarily large inter-group disparity. Finally, we define a worldview that is more realistic than the previously considered ones, and we introduce a new notion of fairness that corresponds to this worldview.
Sampling depth of a diffuse reflectance spectroscopy probe for in-vivo physiological quantification of murine subcutaneous tumor allografts

Abstract. Diffuse reflectance spectroscopy (DRS) is a probe-based spectral biopsy technique used in cancer studies to quantify tissue reduced scattering (μs′) and absorption (μa) coefficients and vary in source–detector separation (SDS) to fine-tune sampling depth. In subcutaneous murine tumor allografts or xenografts, a key design requirement is ensuring that the source light interrogates past the skin layer into the tumor without significantly sacrificing signal-to-noise ratio (target of ≥15 dB). To resolve this requirement, a DRS probe was designed with four SDSs (0.75, 2.00, 3.00, and 4.00 mm) to interrogate increasing tissue volumes between 450 and 900 nm. The goal was to quantify percent errors in extracting μa and μs′, and to quantify sampling depth into subcutaneous Balb/c-CT26 colon tumor allografts. Using an optical phantom-based experimental method, lookup-tables were constructed relating μa,μs′, diffuse reflectance, and sampling depth. Percent errors were <10 % and 5% for extracting μa and μs′, respectively, for all SDSs. Sampling depth reached up to 1.6 mm at the first Q-band of hemoglobin at 542 nm, the key spectral region for quantifying tissue oxyhemoglobin concentration. This work shows that the DRS probe can accurately extract optical properties and the resultant physiological parameters such as total hemoglobin concentration and tissue oxygen saturation, from sufficient depth within subcutaneous Balb/c-CT26 colon tumor allografts. Methods described here can be generalized for other murine tumor models. Future work will explore the feasibility of the DRS in quantifying volumetric tumor perfusion in response to anticancer therapies.
Active-Site Conformational Fluctuations Promote the Enzymatic Activity of NDM-1

β-Lactam antibiotics are the mainstay for the treatment of bacterial infections. However, elevated resistance to these antibiotics mediated by metallo-β-lactamases (MBLs) has become a global concern. ABSTRACT β-Lactam antibiotics are the mainstay for the treatment of bacterial infections. However, elevated resistance to these antibiotics mediated by metallo-β-lactamases (MBLs) has become a global concern. New Delhi metallo-β-lactamase-1 (NDM-1), a newly added member of the MBL family that can hydrolyze almost all β-lactam antibiotics, has rapidly spread all over the world and poses serious clinical threats. Broad-spectrum and mechanism-based inhibitors against all MBLs are highly desired, but the differential mechanisms of MBLs toward different antibiotics pose a great challenge. To facilitate the design of mechanism-based inhibitors, we investigated the active-site conformational changes of NDM-1 through the determination of a series of 15 high-resolution crystal structures in native form and in complex with products and by using biochemical and biophysical studies, site-directed mutagenesis, and molecular dynamics computation. The structural studies reveal the consistency of the active-site conformations in NDM-1/product complexes and the fluctuation in native NDM-1 structures. The enzymatic measurements indicate a correlation between enzymatic activity and the active-site fluctuation, with more fluctuation favoring higher activity. This correlation is further validated by structural and enzymatic studies of the Q123G mutant. Our combinational studies suggest that active-site conformational fluctuation promotes the enzymatic activity of NDM-1, which may guide further mechanism studies and inhibitor design.
Why Self-Attention? A Targeted Evaluation of Neural Machine Translation Architectures

Recently, non-recurrent architectures (convolutional, self-attentional) have outperformed RNNs in neural machine translation. CNNs and self-attentional networks can connect distant words via shorter network paths than RNNs, and it has been speculated that this improves their ability to model long-range dependencies. However, this theoretical argument has not been tested empirically, nor have alternative explanations for their strong performance been explored in-depth. We hypothesize that the strong performance of CNNs and self-attentional networks could also be due to their ability to extract semantic features from the source text, and we evaluate RNNs, CNNs and self-attention networks on two tasks: subject-verb agreement (where capturing long-range dependencies is required) and word sense disambiguation (where semantic feature extraction is required). Our experimental results show that: 1) self-attentional networks and CNNs do not outperform RNNs in modeling subject-verb agreement over long distances; 2) self-attentional networks perform distinctly better than RNNs and CNNs on word sense disambiguation.