Miracle-dz/UniFAR-FTUs huggingface dataset:
Stakeholder Perspectives on Navigating Evidentiary and Decision Uncertainty in Precision Oncology

(1) Background: Precision oncology has the potential to improve patient health and wellbeing through targeted prevention and treatment. Owing to uncertain clinical and economic outcomes, reimbursement has been limited. The objective of this pan-Canadian qualitative study was to investigate barriers to precision oncology implementation from the perspectives of health system stakeholders. (2) Methods: We conducted 32 semi-structured interviews with health technology decision makers (n = 14) and clinicians (n = 18) experienced with precision oncology. Participants were recruited using a purposive sampling technique. Interviews were analyzed using thematic analysis. Recruitment continued until two qualitative analysts reached agreement that thematic saturation was reached. (3) Results: While cautiously optimistic about the potential for enhanced therapeutic alignment, participants identified multiple decisional challenges under conditions of evidentiary uncertainty. Decision makers voiced concern over resource requirements alongside small benefitting patient populations and limited evidence supporting patient and health system impacts. Clinicians were comparatively tolerant of evidentiary uncertainty guiding clinical decision-making practices. Clinicians applied a broader definition of patient benefit, focusing on the ability to assist patients making informed clinical decisions. (4) Conclusions: Sustainable precision oncology must balance demand with evidence demonstrating benefit. We show that clinicians and decision makers vary in their tolerance for evolving knowledge, suggesting a need to establish evidentiary standards supporting precision oncology reimbursement decisions.
Oxygen uptake efficiency slope in community-dwelling ambulant stroke survivors during walking and stair climbing: a cross-sectional study

ABSTRACT Background Oxygen uptake efficiency slope during submaximal tests has been proposed as a more appropriate measure of aerobic capacity after suffering a stroke, since some individuals cannot tolerate maximal exercise testing. However, it has not yet been investigated whether the oxygen uptake efficiency slope is able to differentiate between healthy individuals and those who have suffered a stroke. Objectives To compare the oxygen uptake efficiency slope during walking and stair climbing between stroke survivors and age- and sex-matched healthy controls. Methods This is a cross-sectional study in which 18 individuals who had suffered a stroke (stroke survivors) and 18 healthy controls matched for sex and age were included. Oxygen consumption and minute ventilation were collected breath-by-breath during walking (6-min Walk Test) and stair climbing. The oxygen uptake efficiency slope was estimated by the slope of the line obtained through linear regression. Results The stroke survivors had a lower oxygen uptake efficiency slope during the 6-min Walk Test than the healthy controls (MD 498, 95% CI 122 to 873, p = .01). The between-group difference for the Stair Test was smaller and not statistically significant (MD 349, 95%CI −73 to 772, p = .10). Conclusions Stroke survivors had lower oxygen uptake efficiency slope during the performance of the 6-min Walk Test when compared to sex- and age-matched healthy controls. This suggests that stroke survivors have worse cardiopulmonary capacity.
Early Prediction of Parkinson's Disease from Brain MRI Images Using Convolutional Neural Network

The early diagnosis of Parkinson’s Disease (PD) is a challenging practice for doctors. Currently, there are no separate diagnostics and tests to be done to predict onset PD. However, the PD can be predicted through repeated clinical trials and tests. Sometimes, early prediction of PD can become tedious based on trials and tests. The computer-aided prediction will help medical professionals predict PD accurately during one’s onset stages to improve the PD patients’ quality of life. Hence, early prediction of PD is essential. In this article, Convolution Neural Networks (CNN) is proposed to classify PD patients and healthy individuals. The brain MRI images are given as input for the proposed methodology. The CNN deep neural network will first extract the features from the images. Then, it will classify the PD patients and healthy individuals from the extracted features. The automatic feature extraction will improve the accuracy of the classifier and reduce human error. The brain MRI images are taken from the PPMI dataset for experimentation. The sensitivity, specificity, and accuracy are calculated to assess the performance of the proposed methodology. The loss is also calculated to verify the performance of the classifier. It is observed that the CNN classifier has produced a higher accuracy of more than 98% in classifying PD patients and healthy individuals when compared to multi-layer perceptron deep learning.
IMPLEMENTATION OF CORPORATE SOCIAL RESPONSIBILITY ON FINANCIAL PERFORMANCE OF MANUFACTURING COMPANIES IN INDONESIA

This study is aimed to analyze the influence of Corporate Social Responsibility of financial performance at manufacturing companies listed on the Indonesia Stock Exchange. The sampling period studied was 2014 to 2018. The independent variable in this study was Corporate Social Responsibility which was assessed based on GRI indicators, namely Environmental Disclosure. The dependent variable of this study is financial performance measured by ROA, ROE, Revenues, and Tobin's Q, and the control variables used are Size and Age. The data used in this study were obtained from the company's 2014-2018 financial statements. Determination of the sample using purposive sampling technique in order to obtain a sample of 97 companies. Data analysis methods used are regression and partial t test. The results of this study are that Corporate Social Responsibility effected on financial performance measured by Revenues and Tobin’s Q while Corporate Social Responsibility does not affected on financial performance measured by ROA and ROE.
A Non-Isolated High Step-Up DC-DC Converter Using Voltage Lift Technique: Analysis, Design, and Implementation

This paper presents a new structure for non-isolated and non-inverting DC-DC converters with high voltage gain harnessing the fundamentals of the voltage lift technique. The proposed topology is a suitable structure for low voltage applications. The operation principles, the steady-state relations, and different switching strategies to further improve the voltage gain performance of the proposed converter are described. A hybrid utilization of complementary switching approach and simultaneous switching of two switches is proposed to achieve the highest voltage gain in different duty cycles. Furthermore, a theoretical analysis of power losses is provided. The suggested DC-DC converter architecture features high voltage gain, high efficiency, and low stress on semiconductor devices. In order to demonstrate these advantages, the structure is compared with some recently-presented high step-up converters in terms of efficiency, voltage gain, and voltage stress. Moreover, A 200W laboratory prototype is developed with experiments carried out to validate the given theories and feasibility of the proposed converter topology.
EEG Dipole Source Localization using Deep Neural Network

Electroencephalography (EEG) inverse problem is a typical inverse problem, in which the electrical activity within the brain is reconstructed based on EEG data collected from the scalp electrodes. In this paper, the four-layer concentric head model is used for simulation firstly, four deep neural network models including a multilayer perceptron (MLP) model and three convolutional neural networks (CNNs) are adopted to solve EEG inverse problem based on equal current dipole (ECD) model. In the simulations, 100,000 samples are generated randomly, of which 60% are used for network training and 20% are used for cross-validation. Eventually, the generalization performance of the model using the optimal function is measured by the errors in the rest 20% testing set. The experimental results show that the absolute error, relative error, mean positioning error and standard deviation of the four models are extremely low. The CNN with 6 convolutional layers and 3 pooling layers (CNN-3) is the best model. Its absolute error is about 0.015, its relative error is about 0.005, and its dipole position error is 0.040±0.029 cm. Furthermore, we use CNN-3 for source localization of the real EEG data in Working Memory. The results are in accord with physiological experience. The deep neural network method in our study needs fewer calculation parameters, takes less time, and has better positioning results.
Association of Fecal and Plasma Levels of Short-Chain Fatty Acids With Gut Microbiota and Clinical Severity in Patients With Parkinson Disease

Background and Objectives Short-chain fatty acids (SCFAs) are gut microbial metabolites that promote the disease process in a rodent model of Parkinson disease (PD), but fecal levels of SCFAs in patients with PD are reduced. Simultaneous assessments of fecal and plasma SCFA levels, and their interrelationships with the PD disease process, are scarce. We aimed to compare fecal and plasma levels of different SCFA subtypes in patients with PD and healthy controls to delineate their interrelations and link to gut microbiota changes and clinical severity of PD. Methods A cohort of 96 patients with PD and 85 controls were recruited from National Taiwan University Hospital. Fecal and plasma concentrations of SCFAs were measured using chromatography and mass spectrometry. Gut microbiota was analyzed using metagenomic shotgun sequencing. Body mass index and medical comorbidities were evaluated and dietary information was obtained using a food frequency questionnaire. To assess motor and cognitive impairment, we used the Movement Disorder Society–Unified Parkinson's Disease Rating Scale (MDS-UPDRS) and the Mini-Mental Status Examination (MMSE). Results Compared with controls, patients with PD had lower fecal but higher plasma concentrations of acetate, propionate, and butyrate. After adjustment for age, sex, disease duration, and anti-PD medication dosage, MDS-UPDRS part III motor scores correlated with reduced fecal levels of acetate (ρ = −0.37, p = 0.012), propionate (ρ = −0.32, p = 0.036), and butyrate (ρ = −0.40, p = 0.004) and with increased plasma propionate concentrations (ρ = 0.26, p = 0.042) in patients with PD. MMSE scores negatively correlated with plasma levels of butyrate (ρ = −0.09, p = 0.027) and valerate (ρ = −0.032, p = 0.033) after adjustment for confounders. SCFAs-producing gut bacteria correlated positively with fecal levels of SCFAs in healthy controls but revealed no association in patients with PD. In the PD patient group, the abundance of proinflammatory microbes, such as Clostridiales bacterium NK3B98 and Ruminococcus sp AM07-15, significantly correlated with decreased fecal levels and increased plasma levels of SCFAs, especially propionic acid. Discussion Reductions in fecal SCFAs but increased plasma SCFAs were observed in patients with PD and corelated to specific gut microbiota changes and the clinical severity of PD. Classification of Evidence This study provides Class III evidence that gut metabolite SCFAs distinguish between patients with PD and controls and are associated with disease severity in patients with PD.
Injectable decellularized nucleus pulposus tissue exhibits neuroinhibitory properties

Chronic low back pain (LBP) is a leading cause of disability, but treatments for LBP are limited. Degeneration of the intervertebral disc due to loss of neuroinhibitory sulfated glycosaminoglycans (sGAGs) allows nerves from dorsal root ganglia to grow into the core of the disc. Treatment with a decellularized tissue hydrogel that contains sGAGs may inhibit nerve growth and prevent disc‐associated LBP.
Difference between bone age at the hand and elbow at the onset of puberty

Abstract In the pubertal period, bone age advances rapidly in conjunction with growth spurts. Precise bone-age assessments in this period are important, but results from the hand and elbow can be different. We aimed to compare the bone age between the hand and elbow around puberty onset and to elucidate the chronological age confirming puberty onset according to elbow-based bone age. A total of 211 peripubertal subjects (127 boys and 84 girls) who underwent hand and elbow radiographs within 2 months was enrolled. Two radiologists and a pediatric orthopedic surgeon assessed bone age. Hand bone age was graded using the Greulich–Pyle (GP) method, and elbow bone age was determined using the Sauvegrain method. The correlation of 2 methods was evaluated by Demining regression analysis, and the mean absolute difference (MAD) with chronological age was compared between pre-pubertal and pubertal subjects. Receiver-operating characteristic curve analysis was performed to determine the chronological age confirming puberty onset. There was a statistically significant difference in bone age revealed by the GP and Sauvegrain methods in the pubertal group. In the pubertal group, the MAD was 1.26 ± 0.90 years with the GP method and 0.61 ± 0.47 years with the Sauvegrain method in boys (P < .001), while in girls, the MAD was 0.84 ± 0.60 years and 0.53 ± 0.36 years with the same 2 methods (P = .033). The chronological age for confirming puberty onset using the elbow was 12.2 years in boys and 10.3 years in girls. The bone ages of hand and elbow were different at puberty, and the elbow was a more reliable location for bone-age assessment at puberty. Puberty onset according to elbow occurred slightly earlier than expected.
Saturation‐prolongated and inhomogeneity‐mitigated chemical exchange saturation transfer imaging with parallel transmission

Chemical exchange saturation transfer (CEST) imaging benefits from a longer saturation duration and a higher saturation duty cycle. Dielectric shading effects occur when the radiofrequency (RF) wavelength approaches the object size. Here, we proposed a simultaneous parallel transmission‐based CEST (pTx‐CEST) sequence to prolongate the saturation duration at a 100% duty cycle and improve the RF saturation homogeneity in CEST imaging. The simultaneous pTx‐CEST sequence was implemented by switching the CEST saturation module from the non‐pTx to pTx mode, using the pTx functionality with both transmit channels being driven simultaneously (instead of time‐interleaved). The optimization of amplitude ratio and phase difference settings between RF channels for best B1 homogeneity was performed in phantoms of two different sizes mimicking the human brain and abdomen. The optimal amplitude and phase settings generating the best B1 homogeneity in the phantoms were used in pTx‐CEST scans of the human study. The comparison of the maximum achievable saturation duration between the non‐pTx‐CEST and pTx‐CEST sequences was performed in a protein phantom, healthy volunteers, and a metastatic brain tumor patient. The optimal amplitude ratio and phase difference setting between transmit channels manifested circular and elliptical polarization in the head‐sized and abdomen‐sized phantoms. In the brain, the maximum saturation durations achieved at a 100% duty cycle using the simultaneous pTx‐CEST sequence were prolonged to 2240, 3220, and 4200 ms compared with 980 ms using the non‐pTx‐CEST sequence at repetition times of 3, 4, and 5 s, respectively. The longer saturation duration helped improve the image contrast between the tumor and the normal tissue in the patient. The optimized elliptical polarization mode saturation pulses yielded improved uniformity of CEST signals acquired from the human abdomen. The proposed simultaneous pTx‐CEST sequence enabled essentially arbitrarily long saturation duration at a 100% duty cycle and helped reduce the dielectric shading effects with the optimized RF setting.
Pre-Existing Lymphopenia Increases the Risk of Hospitalization and Death after SARS-CoV-2 Infection

There is limited information regarding the severity of COVID-19 in immunocompromized patients. We conducted a retrospective cohort study considering the period from 1 March 2020 to 31 December 2020 to determine whether previously existing lymphopenia increases the risk of hospitalization and death after SARS-CoV-2 infection in the general population. The laboratory and hospital discharge databases of the Azienda Sanitaria Universitaria Friuli Centrale were used, and 5415 subjects infected with SARS-CoV-2 and with at least one recent absolute lymphocyte count determination before SARS-CoV-2 positivity were included. In total, 817 (15.1%) patients had severe COVID-19. Patients developing severe COVID-19 were more frequently males (44.9% of the severe COVID-19 group vs. 41.5% in the non-severe COVID-19 group; p < 0.0001) and were older (73.2 ± 13.8 vs. 58.4 ± 20.3 years; p < 0.0001). Furthermore, 29.9% of the lymphopenic patients developed severe COVID-19 vs. 14.5% of the non-lymphopenic patients (p < 0.0001). In a logistic regression model, female sex remained a protective factor (OR = 0.514, 95%CI 0.438–0.602, p < 0.0001), while age and lymphopenia remained risk factors for severe COVID-19 (OR = 1.047, 95%CI 1.042–1.053, p < 0.0001 for each additional year of age; OR = 1.715, 95%CI 1.239–2.347, p = 0.0011 for lymphopenia). This provides further information to stratify the risk of COVID-19 severity, which may be an important element in the management of immunosuppressive therapies.
A Home Away from Home: Migration, Identity and ‘Sojourning’ in the Life of Uzbekistanis in Japan

Abstract Using interview data, the article demonstrates that Uzbekistani residents of Japan understand and explain their stay in Japan largely as temporary, in line with the concept of ‘sojourning’. In contrast to previous studies that operationalise sojourning according to legal status or ‘preparations to return home’, this article claims that such ‘sojourning’ needs to be treated as a constantly changing socially shaped discursive category employed by respondents to mitigate challenges such as economic hardship, discrimination and cultural assimilation. Additionally, male expatriates may describe their sojourning in culturally specific religious terms, as wanderers (musofir) in search of life experience abroad.
Trends in the Incidence and Treatment of Early-Onset Pancreatic Cancer

Simple Summary Pancreatic cancer is being diagnosed more frequently in younger individuals. However, limited insight exists into the magnitude of this increase, which subgroups are most affected, and which treatments are utilized in this population. In our study, we aimed to characterize which, and how, subgroups in the United States were affected by pancreatic cancer from 2000 to 2016. Additionally, we aimed to show which therapies were used to treat young patients with pancreatic cancer. Our findings provide valuable information regarding which subgroups face higher rates of this disease and what therapies have historically been used for treatment. Clinicians, scientists, policymakers, and the general population can use this information to develop programs to educate and identify individuals who are at risk for developing pancreatic cancer at an early age, as well as to study whether younger patients should be treated differently than older patients. Abstract Background: Early-onset pancreatic cancer (EOPC) is relatively uncommon. It is unclear if the incidence of EOPC is evolving and how these patients are treated. Methods: We conducted a retrospective, population-based study using SEER 2004–2016. We evaluated annual age-adjusted incidence rate (AAIR), stage at presentation, and race/ethnicity among 7802 patients plus treatment patterns in 7307 patients (excluding neuroendocrine tumors) younger than 50. Results: The AAIR was higher in males while the rate increased faster in females. The AAIR was highest in Non-Hispanic Black patients and increased for all races/ethnicities over time. The percentage of patients diagnosed with distant-stage disease decreased over time but increased for localized-stage disease. Hispanic patients made up a larger proportion of patients over time compared to other groups. For localized-stage disease, primary surgery alone was the most utilized modality of therapy. For regional-stage disease, chemotherapy with radiation was the most utilized modality from 2004–2010, whereas chemotherapy alone was the most utilized from 2011–2016. For distant-stage disease, chemotherapy alone was the most utilized and used increasingly over time. Patients with EOPC received radiation and chemotherapy at similar rates to, and underwent surgery more frequently, than patients 50–69. Conclusions: The AAIR of EOPC increased over time, faster so in females. Groups who experience a higher burden of pancreatic cancer, particularly African Americans, experienced a higher burden of EOPC. Treatment of localized and regional-stage disease did not follow standard treatment guidelines for pancreatic cancer. Our findings indicate that EOPC patients received more treatment than their older counterparts.
The silent expansion of internationalisation: exploring the adoption of the International Baccalaureate in Madrid

ABSTRACT The growth of the International Baccalaureate (IB) worldwide is part of a global trend towards the internationalisation of education (IE). Its implementation, nonetheless, takes different forms depending on national and local contexts. This paper examines the recent expansion of the IB in Madrid, drawing upon the sociology of education policy enactments and recontextualisations and the Cultural Political Economy approach. Combining in-depth interviews, document analysis and secondary quantitative data, this paper shows why Madrid has led the expansion of IB schools in Spain in the last decade, an expansion, which has nonetheless remained relatively unnoticed. Our findings suggest that the growth and penetration of private international education initiatives such as the IB may be related to particular social factors, education system characteristics and education policy ensembles, with a particularly intense manifestation in decentralised systems where neoliberal and neoconservative policies foster autonomy, competition, internationalisation and ‘excellence’.
Age and sex-based differences in functional strength of adults participating in Special Olympics

: Muscular strength is a critical component of physical health. The aim of this cross-sectional study was to examine age-and sex-based differences in functional strength and rates of referral for education in a large international sample of Special Olympics athletes. A total of 30,358 (male = 19,661) adult (20 – 69 years old) athlete functional strength records were utilized from the Special Olympics Healthy Athletes database. Descriptive statistics were computed for the following tests: timed sit to stand, partial sit-up, grip strength, and seated push-up. Analyses of variance with Fisher-Hayter pairwise comparisons generally supported age-related decreases in strength among both males and females in this study. Overall, male participants were stronger than the female participants. However, significantly fewer women were referred for education based on their grip strength scores. The rates of referral for education are a concern regarding core-and leg strength for more than one-third of athletes over the age of 30. These findings suggest that a substantial proportion of Special Olympics athletes would benefit from additional strength and conditioning training.