Miracle-dz/UniFAR-FTUs huggingface dataset:
Self-Attentive Spatial Adaptive Normalization for Cross-Modality Domain Adaptation

Despite the successes of deep neural networks on many challenging vision tasks, they often fail to generalize to new test domains that are not distributed identically to the training data. The domain adaptation becomes more challenging for cross-modality medical data with a notable domain shift. Given that specific annotated imaging modalities may not be accessible nor complete. Our proposed solution is based on the cross-modality synthesis of medical images to reduce the costly annotation burden by radiologists and bridge the domain gap in radiological images. We present a novel approach for image-to-image translation in medical images, capable of supervised or unsupervised (unpaired image data) setups. Built upon adversarial training, we propose a learnable self-attentive spatial normalization of the deep convolutional generator network’s intermediate activations. Unlike previous attention-based image-to-image translation approaches, which are either domain-specific or require distortion of the source domain’s structures, we unearth the importance of the auxiliary semantic information to handle the geometric changes and preserve anatomical structures during image translation. We achieve superior results for cross-modality segmentation between unpaired MRI and CT data for multi-modality whole heart and multi-modal brain tumor MRI (T1/T2) datasets compared to the state-of-the-art methods. We also observe encouraging results in cross-modality conversion for paired MRI and CT images on a brain dataset. Furthermore, a detailed analysis of the cross-modality image translation, thorough ablation studies confirm our proposed method’s efficacy.
Recent advances of targeted therapy in relapsed/refractory acute myeloid leukemia

Despite advances in the understanding of disease pathobiology, treatment for relapsed or refractory acute myeloid leukemia (R/R AML) remains challenging. The prognosis of R/R AML remains extremely poor despite chemotherapy and bone marrow transplants. Discoveries on recurrent and novel genetic mutations, such as FLT3-ITD and IDH1/IDH2, critical signaling pathways, and unique molecular markers expressed on the surface of leukemic cells have been under investigation for the management of R/R AML. Other than monoclonal antibodies, diabodies, and triabodies are new targeted therapies developed in recent years and will be the new direction of immunotherapy. Targeted agents combined intensive regimens can be viable options for salvage therapy and as bridges to allogeneic transplant. Future directions will focus on novel, efficient and targeted combinations, low-toxicity maintenance, and individualized precision strategies. Here, we review the major recent advances of targeted therapies in the treatment of R/R AML.
Preanesthetic nebulized ketamine vs preanesthetic oral ketamine for sedation and postoperative pain management in children for elective surgery

Abstract Preoperative anxiety is a major problem in children leading to a poor outcome. Preanesthetic oral ketamine is generally used in children but has less bioavailability due to the first-pass effect. Even ketamine has an unpleasant taste. Preanesthetic inhaled ketamine is also reported effective and safe in children. The objectives of the study were to compare the effectiveness and safety of preanesthetic nebulized ketamine against preanesthetic oral ketamine for sedation and postoperative pain management in children. Children received 10 mg/kg oral ketamine (children received preanesthetic oral ketamine [OK cohort], n = 142), or nebulized with 3 mg/kg ketamine (children were preanesthetic nebulized with ketamine [NK cohort], n = 115), or received apple juice (children suspectable to preoperative ketamine and received apple juice only [OA cohort], n = 126) before anesthesia for elective surgery. Data regarding preoperative hemodynamic parameters, sedation score measurements, postoperative pain management, postoperative nausea and vomiting management, and postoperative complications were collected and analyzed. Preoperative hemodynamic parameters for oral and nebulized ketamine administration were stable. Nebulized ketamine was provided higher sedation than apple juice (P = .002, q = 4.859) and oral ketamine (P = .002, q = 3.526). Children of NK cohort had required fewer fentanyl consumption until discharge than those of OA (55.45 ± 7.19 μG/ child vs 65.15 ± 15.24 μG/ child, P < .0001, q = 9.859) and OK (55.45 ± 7.19 μG/child vs 60.19 ± 8.12 μG/child, P < .0001, q = 4.953) cohorts. Children of the NK cohort had consumed higher ondansetron syrup than those of the OA cohort but fewer than those of the OK cohort until discharge. Gastrointestinal side effects were reported in the OK cohort, and nose irritation and drowsiness were reported in the NK cohort. Like preanesthetic oral ketamine, preanesthetic inhaled ketamine also has safety for children. Preanesthetic inhaled ketamine can provide effective sedation in low doses during operation than preanesthetic oral ketamine. Level of evidence: III.
Investigating Health Equity and Healthcare Needs among Immigrant Women Using the Association Rule Mining Method

Equitable access to healthcare services is a major concern among immigrant women. Thus, this study investigated the relationship between socioeconomic characteristics and healthcare needs among immigrant women in Taiwan. The secondary data was obtained from “Survey of Foreign and Chinese Spouses’ Living Requirements, 2008”, which was administered to 5848 immigrant women by the Ministry of the Interior, Taiwan. Additionally, descriptive statistics and significance tests were used to analyze the data, after which the association rule mining algorithm was applied to determine the relationship between socioeconomic characteristics and healthcare needs. According to the findings, the top three healthcare needs were providing medical allowances (52.53%), child health checkups (16.74%), and parental knowledge and pre- and post-natal guidance (8.31%). Based on the association analysis, the main barrier to the women’s healthcare needs was “financial pressure”. This study also found that nationality, socioeconomic status, and duration of residence were associated with such needs, while health inequality among aged immigrant women was due to economic and physical factors. Finally, the association analysis found that the women’s healthcare problems included economic, socio-cultural, and gender weakness, while “economic inequality” and “women’s health” were interrelated.
Food insecurity is associated with mental health problems among Canadian youth

Background Research has linked food insecurity to mental health problems, though little is known about this relationship among Canadian youth. We investigate the association between food insecurity severity and mental illnesses in a nationally representative youth sample. Methods We sampled 55 700 youth 12–24 years from recent cycles of Canadian Community Health Survey. Household food insecurity was measured using a standard 18-item questionnaire. We fitted Poisson regressions on self-rated mental health and diagnosed mood and anxiety disorders, controlling for sociodemographic confounders. Clinical assessments of emotional distress, major depression and suicidal ideation were examined in subsamples with available data. We stratified the sample by gender, age and survey cycle to test potential demographic heterogeneity. Results One in seven youth lived in marginal (5.30%), moderate (8.08%) or severe (1.44%) food insecurity. Results showed that food insecurity was associated with higher likelihood of every mental health problem examined. The association was graded, with more severe food insecurity linked to progressively worse mental health. Notably, marginal, moderate and severe food insecurity were associated with 1.77, 2.44 and 6.49 times higher risk of suicidal thoughts, respectively. The corresponding relative risk for mood disorders were 1.57, 2.00 and 2.89; those for anxiety disorders were 1.41, 1.65 and 2.58. Moderate food insecurity was more closely associated with mental health problems in 18–24 year olds than in 12–17 year olds. Conclusions Food insecurity severity was associated with poorer mental health among Canadian youth independent of household income and other socioeconomic differences. Targeted policy intervention alleviating food insecurity may improve youth mental health.
A history of cigarette smoking is associated with faster functional decline and reduction of entorhinal cortex volume in mild cognitive impairment

Little is known about the longitudinal association of cigarette smoking with Alzheimer’s Disease (AD) related markers in subjects with mild cognitive impairment (MCI). In this study, we aimed to examine the effect of a history of cigarette smoking on change in global cognition, verbal memory, functional performance, hippocampal volume, entorhinal cortex volume, brain glucose metabolism, and CSF AD pathologies over time in MCI subjects. At baseline, there were 870 subjects with MCI, including 618 non-smokers (no history of smoking) and 252 smokers (any lifetime history of smoking). Linear mixed models were fitted for each outcome with adjustment of several covariates. The major findings were: (1) Among older people with MCI, smokers showed faster decline in functional performance compared to non-smokers; (2) Smokers demonstrated steeper decline in entorhinal cortex volume than non-smokers; (3) A history of cigarette smoking was not associated with change in CSF Aβ42, t-tau or p-tau levels over time in MCI subjects. In conclusion, we found that a history of cigarette smoking was associated with faster decline in functional performance and entorhinal cortex volume over time at the prodromal stage of dementia.
Statistical Considerations in the Evaluation of Continuous Biomarkers

Discovery of biomarkers has been steadily increasing over the past decade. Although a plethora of biomarkers has been reported in the biomedical literature, few have been sufficiently validated for broader clinical applications. One particular challenge that may have hindered the adoption of biomarkers into practice is the lack of reproducible biomarker cut points. In this article, we attempt to identify some common statistical issues related to biomarker cut point identification and provide guidance on proper evaluation, interpretation, and validation of such cut points. First, we illustrate how discretization of a continuous biomarker using sample percentiles results in significant information loss and should be avoided. Second, we review the popular “minimal-P-value” approach for cut point identification and show that this method results in highly unstable P values and unduly increases the chance of significant findings when the biomarker is not associated with outcome. Third, we critically review a common analysis strategy by which the selected biomarker cut point is used to categorize patients into different risk categories and then the difference in survival curves among these risk groups in the same dataset is claimed as the evidence supporting the biomarker’s prognostic strength. We show that this method yields an exaggerated P value and overestimates the prognostic impact of the biomarker. We illustrate that the degree of the optimistic bias increases with the number of variables being considered in a risk model. Finally, we discuss methods to appropriately ascertain the additional prognostic contribution of the new biomarker in disease settings where standard prognostic factors already exist. Throughout the article, we use real examples in oncology to highlight relevant methodologic issues, and when appropriate, we use simulations to illustrate more abstract statistical concepts.
Twin Differences in Harsh Parenting Predict Youth’s Antisocial Behavior

In the current study, we leveraged differences within twin pairs to examine whether harsh parenting is associated with children’s antisocial behavior via environmental (vs. genetic) transmission. We examined two independent samples from the Michigan State University Twin Registry. Our primary sample contained 1,030 families (2,060 twin children; 49% female; 6–10 years old) oversampled for exposure to disadvantage. Our replication sample included 240 families (480 twin children; 50% female; 6–15 years old). Co-twin control analyses were conducted using a specification-curve framework, an exhaustive modeling approach in which all reasonable analytic specifications of the data are interrogated. Results revealed that, regardless of zygosity, the twin experiencing harsher parenting exhibited more antisocial behavior. These effects were robust across multiple operationalizations and informant reports of both harsh parenting and antisocial behavior with only a few exceptions. Results indicate that the association between harsh parenting and children’s antisocial behavior is, to a large degree, environmental in origin.
A shift in ontogenetic timing produced the unique sauropod skull

Sauropod dinosaurs include the largest terrestrial vertebrates that have ever lived. Virtually every part of the sauropod body is heavily modified in association with gigantic size and associated physiological alterations. Sauropod skulls are no exception: they feature elongated, telescoped facial regions connected to tilted neurocrania and reoriented jaw adductor muscles. Several of these cranial features have been suggested to be adaptations for feeding on the one hand and the result of paedomorphic transformation near the base of Sauropoda on the other. However, the scarcity of sauropodomorph ontogenetic series has impeded further investigation of these hypotheses. We re‐evaluated the cranial material attributed to the early sauropodomorph Anchisaurus, which our phylogenetic analyses confirm to be closely related to sauropods. Digital assembly of μCT‐scanned skulls of the two known specimens, a juvenile and an adult, permitted us to examine the detailed ontogeny of cranial elements. The skull anatomy of Anchisaurus is distinguished by a mosaic of ancestral saurischian and sauropod‐like characters. Sauropod‐like characters of the braincase and adductor chamber appear late in ontogeny, suggesting that these features first evolved by the developmental mechanism of terminal addition. Shape analyses and investigation of allometric evolution demonstrate that cranial characters that appear late in the ontogeny of sauropodomorphs closely related to sauropods are already present in the embryos and juveniles of sauropods, suggesting a predisplacement‐type shift in developmental timing from the ancestral anchisaurian condition. We propose that this developmental shift relaxed prior constraints on skull morphology, allowing sauropods to explore a novel range of phenotypes and enabling specializations of the feeding apparatus. The shift in timing occurred in concert with the evolution of gigantism and physiological and locomotory innovations.
Assessing Suitability of Sorghum to Alleviate Sub-Saharan Nutritional Deficiencies through the Nutritional Water Productivity Index in Semi-Arid Regions

Lack of cereal nutritional water productivity (NWP) information disadvantages linkages of nutrition to water–food nexus as staple food crops in Sub-Saharan Africa (SSA). This study determined the suitability of sorghum (Sorghum bicolor L. Moench) genotypes to alleviate protein, Zn and Fe deficiency under water-scarce dryland conditions through evaluation of NWP. Sorghum genotypes (Macia, Ujiba, PAN8816, IsiZulu) NWP was quantified from three planting seasons for various sorghum seed nutrients under dryland semi-arid conditions. Seasons by genotypes interaction highly and significantly affected NWPStarch, Ca, Cu, Fe, and significantly affected NWPMg, K, Na, P, Zn. Genotypic variations highly and significantly affected sorghum NWPProtein, Mn. Macia exhibited statistically superior NWPprotein (13.2–14.6 kg·m−3) and NWPZn (2.0–2.6 g·m−3) compared to other tested genotypes, while Macia NWPFe (2.6–2.7 g·m−3) was considerably inferior to that of Ujiba and IsiZulu landraces under increased water scarcity. Excellent overall NWPprotein, Fe and Zn under water scarcity make Macia a well-rounded genotype suitable to alleviating food and nutritional insecurity challenges in semi-arid SSA; however, landraces are viable alternatives with limited NWPprotein and Zn penalty under water-limited conditions. These results underline genotype selection as a vital tool in improving “nutrition per drop” in semi-arid regions.
The Risk of Resurgence in Vaccine Preventable Infections Due to COVID-Related Gaps in Immunization

Abstract Nationally, immunization delivery has decreased significantly during COVID-19. Internationally, over 60 national vaccine programs have been disrupted or suspended. As a result of these immunization declines, the global community is at risk for a resurgence in vaccine preventable infections including measles, pertussis and polio; all highly contagious diseases that result in significant morbidity and mortality in children. Measles outbreaks have already occurred in many countries who suspended their vaccination programs. Outbreaks in the United States are likely to occur when social distancing stops and children return to school. Health care providers have acted quickly to institute multiple risk mitigation strategies to restore vaccine administration. However, childhood immunization rates remain below pre-COVID levels. Partnerships between healthcare providers, community leaders and local, state, regional and national public health departments are needed to reassure families that vaccine delivery during COVID is safe and to identify and catch-up those children who are under-immunized.
Correlation study of CYP2C19 gene polymorphism and clopidogrel resistance in Han Chinese patients with cerebral infarction in Guizhou region

Abstract This study conducts a correlation exploration of CYP2C19 gene polymorphism and clopidogrel resistance in Han Chinese patients with cerebral infarction in Guizhou Region. A total of 270 Han Chinese patients with cerebral infarction, who were hospitalized in our hospital from January 2016 to January 2018, are selected. These patients were divided into 2 groups, clopidogrel resistance group (n = 60) and clopidogrel sensitive group (n = 210). According to the TEG results, the CYP2C19 gene polymorphism detection was carried out by using the PCR-RFLP method, while IL-6 level in the patient's blood was measured by using the ELISA method. The resistance group occupies 22.22%. The platelet inhibition ratio of the resistance group was 23 ± 7%, which was significantly lower than that of the sensitive group (65 ± 13%), and the difference was statistically significant (P < .05). The Logisitic regression analysis revealed that the history of diabetes, history of high blood pressure, increase in low density lipoprotein and CYP2C19 mutant gene were independent risk factors of clopidogrel resistance. After treatment, the serum IL-6 level of patients in the resistance group was 17.21 ± 0.98 ng/L, which was significant higher than that of patients in the sensitive group (11.21 ± 0.68 ng/L), and the difference was statistically significant (P < .05). Patients with cerebral infarction in Guizhou region have a higher occurrence rate of clopidogrel resistance. Clopidogrel resistance not only will weaken the anti-inflammatory action of the drug, but also correlates with the patient's CYP2C19 mutant gene and blood lipid level.
Beneficial effect of lipoic acid on nicotine-induced vascular endothelial damage in rabbits -

This study has been designed to investigate the effect of alpha lipoic acid (ALA) in nicotine-induced vascular endothelial dysfunction (VED) in rabbits. Nicotine (7.5 mg/kg/day, sc, 6 weeks) was administered to produce VED in rabbits. The development of VED was assessed by employing aortic histopathology and estimating serum concentration of nitrite/nitrate (NOx). Further, serum lipid profile was assessed. Moreover, the oxidative stress was assessed by estimating serum thiobarbituric acid reactive substances (TBARS) reduced glutathione (GSH) and superoxide dismutase (SOD) generation. The administration of nicotine produced VED by impairing the integrity of vascular endothelium and subsequently decreasing serum concentration of NOx. Further, nicotine produced oxidative stress, which was assessed in terms of increase in serum TBARS and decreased GSH and SOD levels. However, treatment with ALA (20 mg/kg/day, orally) markedly prevented nicotine-induced VED and oxidative stress by improving the integrity of vascular endothelium, increasing the concentration of serum NOx, decreasing serum TBARS and normalizing SOD and GSH activities. Thus, it may be concluded that ALA reduces the oxidative stress and consequently improves the integrity of vascular endothelium and enhances the generation of nitric oxide to prevent nicotine-induced experimental VED.
A randomized comparative study of the efficacy of topical latanoprost versus topical betamethasone diproprionate lotion in the treatment of localized alopecia areata.

BACKGROUND Topical corticosteroids are the standard therapy for the treatment of alopecia areata. Recently, topical latanoprost has been found effective in the treatment of eyelash alopecia areata. OBJECTIVES The objective of this study was to compare the efficacy of topical latanoprost ophthalmic solution (group 1) with that of topical betamethasone diproprionate lotion (group 2) in the treatment of localized alopecia areata. METHODS This was a single-centre, randomized, two-armed, parallel-group efficacy trial. Fifty consecutive patients with localized alopecia areata were randomized in a 1:1 ratio to receive either topical latanoprost 0.005% ophthalmic solution or topical betamethasone diproprionate 0.05% lotion. Of these 50 patients, 44 patients (21 in group 1 and 23 in group 2) completed the treatment protocol. RESULTS The percentage reduction in area involved with alopecia areata at 16 weeks (primary outcome) was lower in latanoprost vs. betamethasone group (median [interquartile range], 11.1 [0-99.1] vs. 100% [13.6-100], P = 0.02). Significantly lesser patients in the latanoprost group had a complete response to treatment as compared to the betamethasone group (6 [24%] vs. 14 [56%], P = 0.02). The median (interquartile range) hair regrowth score was significantly lower in the latanoprost vs. the betamethasone group (1 [0-4.5] vs. 5 [1-5], P = 0.02). Subjects in the betamethasone group showed a more rapid reduction in the involved area. LIMITATIONS Short duration of treatment and follow-up were limitations of this study. CONCLUSION Our results suggest that topical latanoprost 0.005% ophthalmic solution is less effective but safer than topical betamethasone dipropionate 0.05% lotion in the treatment of localized alopecia areata (clinicaltrials.gov: NCT02350023).
Template-Assisted Plasmonic Nanogap Shells for Highly Enhanced Detection of Cancer Biomarkers

We present a template-assisted method for synthesizing nanogap shell structures for biomolecular detections based on surface-enhanced Raman scattering. The interior nanogap-containing a silver shell structure, referred to as a silver nanogap shell (Ag NGS), was fabricated on silver nanoparticles (Ag NPs)-coated silica, by adsorbing small aromatic thiol molecules on the Ag NPs. The Ag NGSs showed a high enhancement factor and good signal uniformity, using 785-nm excitation. We performed in vitro immunoassays using a prostate-specific antigen as a model cancer biomarker with a detection limit of 2 pg/mL. To demonstrate the versatility of Ag NGS nanoprobes, extracellular duplex surface-enhanced Raman scattering (SERS) imaging was also performed to evaluate the co-expression of cancer biomarkers, human epidermal growth factor-2 (HER2) and epidermal growth factor receptor (EGFR), in a non-small cell lung cancer cell line (H522). Developing highly sensitive Ag NGS nanoprobes that enable multiplex biomolecular detection and imaging can open up new possibilities for point-of-care diagnostics and provide appropriate treatment options and prognosis.