Miracle-dz/UniFAR-FTUs huggingface dataset:
Retrospective Assessment of Deep Neural Networks for Skin Tumor Diagnosis

BACKGROUND: The aim of this study was to validate the performance of algorithm (http://rcnn.modelderm.com) for the diagnosis of benign and malignant skin tumors. METHODS: With external validation dataset (43 disorders; 40,435 clinical images from 10,450 patients; January 1, 2008 - March 31, 2019), we compared the prediction of algorithm with the clinical diagnosis of 65 attending physicians at the time of biopsy request. RESULTS: For binary-task classification of determining malignancy, the AUC of the algorithm was 0.863(95% CI 0.852-0.875) with unprocessed clinical photographs. The sensitivity/specificity/positive predictive value/negative predictive value of the algorithm at the predefined high-sensitivity and high-specificity threshold were 79.1%(76.8-81.3)/77.0%(76.1-77.8)/31.3%(30.3-32.3)/96.5%(96.2-96.9) and 62.6%(59.9-65.2)/90.0%(89.4-90.6)/45.3%(43.5-47.2)/94.8%(94.4-95.1), respectively. The sensitivity/specificity calculated by the clinical diagnosis of attending physicians were 88.1%/83.8% (Top-3) and 70.2%/95.6% (Top-1), which were superior to the algorithm. For multi-task classification, the mean Top-1,2,3 accuracies of the algorithm were 42.6{+/-}20.7%, 56.1{+/-}22.8%, 61.9{+/-}22.9%, and those of clinical diagnosis were 65.4{+/-}17.7%, 73.9{+/-}16.6%, 74.7{+/-}16.6%, respectively. CONCLUSIONS: The performance of the algorithm was lower than that of dermatologists in real practice. Not only image information, but also clinical information should be integrated for more accurate prediction.
Financing Vaccines for Global Health Security

Recent outbreaks of infectious pathogens such as Zika, Ebola, and COVID-19 have underscored the need for the dependable availability of vaccines against emerging infectious diseases (EIDs). The cost and risk of R&D programs and uniquely unpredictable demand for EID vaccines have discouraged vaccine developers, and government and nonprofit agencies have been unable to provide timely or sufficient incentives for their development and sustained supply. We analyze the economic returns of a portfolio of EID vaccine assets, and find that under realistic financing assumptions, the expected returns are significantly negative, implying that the private sector is unlikely to address this need without public-sector intervention. We have sized the financing deficit for this portfolio and propose several potential solutions, including price increases, enhanced public-private partnerships, and subscription models through which individuals would pay annual fees to obtain access to a portfolio of vaccines in the event of an outbreak.
Does a non-targeted publicly-funded health care voucher system for the elderly improve access to optometry services?

ABSTRACT Objective To study how a non-targeted publicly-funded health care voucher system for the elderly impact on access to optometry services from the perspective of service users and service providers Design Cross-sectional study Setting 19 elderly community centers Participants 1176 people, aged 65 years or above, and 389 optometrists Primary and secondary outcome measures Usage characteristics of optometry services by eligible service users of the voucher scheme Perspectives of eligible service users on access barriers to optometry services Perspectives of service providers on voucher scheme Results In total, 1156 valid questionnaires were collected from a cohort of eligible service users. Results showed that 53.7% of subjects had used optometry services within the past 2 years, while 22% had not used optometry services before. Lack of familiarity with services provided, professional fees and prices of prescription spectacles were the main barriers to using optometry services. Of those subjects who had used the voucher for optometry service before, 80.4% had eye examination in the past 2 years, versus 64.1% among subjects who had not use health care voucher on the optometry service. 'Insufficient voucher value' was a commonly quoted reason for not using the health care vouchers for optometry services. Over 80% of optometrists agreed that the voucher scheme improved the awareness of major eye conditions and enabled the elderly to have prescription spectacles when necessary. Conclusion The health care voucher for the elderly improved access to optometry services. Access could be improved further by promoting awareness optometry services, location of service providers, price transparency of professional services and prescription spectacles. Responses from optometry services providers are supportive of the view that the voucher scheme improved access to and utilization of preventive care services. Article Summary Strengths and limitations of this study - High representativeness of community dwelling older population in Hong Kong. - The mixed method approach provided a more in-depth investigation of the population. - One limitation is the generalizability of the results with older people who are members in the community centers.
Communicative hand gestures as an implicit measure of artificial limb embodiment and daily usage

When people talk, they move their hands to enhance meaning. Here we ask whether people spontaneously use their artificial limbs (prostheses) to gesture, and whether prosthesis gesture behaviour relates to everyday prosthesis use and perceived embodiment. One-handed participants with congenital and acquired hand loss and two-handed controls participated in gesture-facilitating tasks, measured using acceleration monitors and further validated with offline video coding. Everyday functional prosthesis use and perceived prosthesis embodiment were assessed using questionnaires. Perhaps surprisingly, one- and two-handed participants did not differ in the amount of gestures they produced. However, they did differ in their gesture profile. One-handers performed more, and bigger, movements with their intact hand while gesturing relative to their prosthesis, whereas two-handers produced more equal movements across hands. Importantly, one-handers who incorporated their prosthesis more into gesturing, that is - produced gestures that were more similar to their two-handed counterparts - also showed more frequent prosthesis use in day-to-day life. Although as a group, one-handers only marginally agreed that their prosthesis feels like a body-part, people reporting positive embodiment also showed great prosthesis habits, both for communication and daily function. We propose that measuring gesture behaviour in prosthesis-users can be used as an implicit and objective clinical tool to monitor and assess successful prosthesis adoption.
Social Isolation as a predictor for mortality: Implications for COVID-19 prognosis

The health benefits of social support have been widely documented. However, the social distancing practices from the COVID-19 pandemic is causing social disruption on a grand scale, potentially causing poor health outcomes. Through Google Trends analysis, we found a COVID-19-related surge in interest surrounding loneliness. We assessed if social isolation and loneliness increase the risk for all-cause and cardiovascular disease (CVD) mortality (ICD-10: I00-I99) and used the data to create a conceptual framework. Using the 10-year overall and cardiovascular mortality follow-up data (n = 12,019) from the National Health and Nutrition Examination Survey (1999-2008), we conducted survival analyses and found that individuals who experience social isolation or loneliness have a significantly higher likelihood of overall and CVD mortality than those without support. These effects generally remained strong with further adjustment for NHANES-detected health and demographic differences showing the need to address COVID-19 related loneliness through increasing social nearing.
State-level variation of initial COVID-19 dynamics in the United States

During an epidemic, metrics such as R0, doubling time, and case fatality rates are important in understanding and predicting the course of an epidemic. However, if collected over country or regional scales, these metrics hide important smaller-scale, local dynamics. We examine how commonly used epidemiological metrics differ for each individual state within the United States during the initial COVID-19 outbreak. We found that the case number, and trajectory of cases, differs considerably between states. We show that early non-pharmaceutical, government actions, were the most important determinant of epidemic dynamics. In particular, restricting restaurant operations was correlated with increased doubling times. Although individual states are clearly not independent, they can serve as small, natural experiments in how different demographic patterns and government responses can impact the course of an epidemic.
Rôle de la protéine MtSNF4b dans la post maturation de graines de Medicago truncatula

La Sucrose non-fermenting Related Kinase (SnRK1), en interaction avec ses deux sous unites : b et g (SNF4), est un important regulateur du metabolisme et des reponses aux stress chez les plantes. Le but de cette these est d'etudier le role de MtSNF4b, une sous unite g specifique des graines de Medicago truncatula, pendant l'imbibition en relation avec la germination. Une analyse physiologique de la germination des graines RNAi MtSNF4b au cours de la post maturation a sec montre que les graines n'exprimant pas MtSNF4b perdent leur dormance plus rapidement que les graines de type sauvage. Une analyse transcriptomique comparative entre des embryons RNAi MtSNF4b et types sauvages montre que la plupart des genes sont reprimes dans les graines RNAi MtSNF4b et sont lies au stress biotiques. Ces genes codent des pathogenesis related proteines de type PR-10, des chitinases ou des facteurs de transcription de type WRKY et des enzymes impliquees dans le metabolisme secondaire, notamment les voies metaboliques des phenylpropanoides et des isoflavonoides pour la biosynthese de la medicarpine. Cependant, aucune difference dans la sensibilite des semences imbibees de type sauvage et RNAi MtSNF4b a deux souches de Xanthomonas par l'analyse de dynamiques de tailles des populations bacteriennes n'a pu etre mise en evidence. Des resultats preliminaires d'une etude de double hybride mettent en evidence plusieurs candidats potentiellement impliques dans la regulation de ces genes. La proteine MtSNF4b semble connecter la post maturation a sec avec les mecanismes de defenses dans les graines dormantes de Medicago truncatula.
Basic estimation-prediction techniques for Covid-19, and a prediction for Stockholm

An important task during the current Covid-19 pandemic is to predict the remainder of the epidemic, both without preventive measures and with. In the current paper we address this question using a simple estimation-prediction method. The input is the observed initial doubling time and a known value of R0. The simple General epidemic model is then fitted, and time calibration to calendar time is done using the observed number of case fatalities, together with estimates of the time between infection to death and the infection fatality risk. Finally, predictions are made assuming no change of behaviour, as well as for the situation where preventive measures are put in place at one specific time-point. The overall effect of the preventive measures is assumed to be known, or else estimated from the observed increased doubling time after preventive measures are put in place. The predictions are highly sensitive to the doubling times without and with preventive measures, sensitive to R0, but less sensitive to the estimates used for time-calibration: observed number of case fatalities, typical time between infection and death, and the infection fatality risk. The method is applied to the urban area of Stockholm, and predictions show that the peak of infections appear in mid-April and infections start settling in May.
COVID-19 outbreak in Greece has passed its rising inflection point and stepping into its peak

Since the beginning of 2020, COVID-19 is the most urgent and challenging task for the international scientific community, in order to identify its behaviour, track its progress and plan effective mitigation policies. In this study, Greece is the main focus for assessing the national outbreak and estimating the general trends and outlook of it. Multiple data analytics procedures, spectral decomposition and curve-fitting formulations are developed based on the data available at hand. Standard SIEQRDP epidemic modelling is applied for Greece and for the general region around it, providing hints for the outbreak progression in the mid- and long-term, for various infections under-reporting rates. The overall short-term outlook for Greece seems to be towards positive, with a downward trend in infections rate daily increase (i.e., now beyond the exponential growth rate), a possible peak within a few days beyond April 14th, as well as the high availability level of ICU w.r. t. expected demand at peak. On the negative side, the fade-out period seems to be in the order of several months, with high probability of recurrent surges of the outbreak. The mitigation policies for the `next day' should be focused on close tracking of the epidemic via large-scale tests, strict border checking in international travelling and an adaptive plan for selective activation of mitigation measures when deemed necessary.
Time-variant strategies for optimizing the performance of non-pharmaceutical interventions (NPIs) in protecting lives and livelihoods during the COVID-19 pandemic

A stochastic Individual Contact Model (ICM) using SIR compartments allowing for time-variant parameters was used to simulate 100 non-pharmaceutical intervention (NPI) strategies and exit trajectories for a hypothetical population, and to collect epidemiological and non-epidemiological outcomes to measure the performance of these strategies over the course of a period of intervention (up to six months) for a total duration of one-year to allow the full implications of the strategy and endgame to manifest. We find that variations in the time dimension and intensity of various strategies can have vastly different performance outcomes: (i) the timing of NPIs can 'shrink the area under the curve' (cumulative infections) not just 'flatten the curve'; (ii) prolonged lockdowns have diminishing margins of returns; (iii) smooth, submaximal lockdowns perform better than pulsatile lockdowns; and (iv) the efficiency of various strategies incorporating both epidemiological and non-epidemiological outcomes vary substantially. Most sobering, none of the simulated strategies allow for an 'acceptable' path to exit within six months due to very large gaps in health system capacity.
Medication Errors Caused by Nurses and Physicians in a Swiss Acute Care Community Hospital: Frequency and Correlation to Nurses’ Reported Workload / Von Pflegefachpersonen und Ärzten/-innen verursachte Medikamentenfehler in einem Schweizer Akutspital: Häufigkeit und Korrelation zur Arbeitsbelastung 

Abstract Objectives This study was carried out in a Swiss acute care community hospital to investigate the frequency, type, causes and potential clinical consequences of medication errors (MEs) caused by nurses and physicians in all stages of a technology-supported medication process, the relationship between the nurses’ workload and the medication administration errors (MAEs) and their reason for workload. Methods In this descriptive cross-sectional study, a questionnaire, the adapted Medication Error Self Reporting Tool (A-MESRT), was used to identify MEs in all stages of the medication process and record nurses’ self-perceived workload during medication administration. Results A total of 1936 completed A-MESRTs were returned. A total of 751 (38.8%) respondents reported different MEs. The highest number of errors occurred during medication administration (43%), followed by errors during dispensing (34%) and physician ordering errors using a computerised physician order entry (CPOE) system (23%). Of the 768 (100%) handwritten orders, 232 (30.2%) were erroneous. Moreover, the greater the individual nurse’s workload during a shift, the higher was the relative probability of committing an MAE (χ2 = 85.479, df = 1, OR = 2.129, p < 0.001). Furthermore, the three main causes of high or very high workload were revealed: (1) many newly operated patients to monitor; (2) complex multimorbid patients, for example, those with delirium; and (3) patients with complications after surgery. Conclusion The A-MESRT showed that the highest rate of MEs caused by nurses and physicians is in the non-technologically supported steps, demonstrating the potential benefits of a technology-supported medication process. Moreover, this study revealed a statistically significant correlation between nurses’ workload and MAEs.
An Exciting New Tool to Detect Circulating Tumor Cells in Lung Cancer Patients

Circulating tumor cells (CTCs) are rare cells that originate from a malignancy and circulate freely in the peripheral blood. The ability to capture and study CTCs is an emerging field with implications for early detection, diagnosis, determining prognosis and monitoring of cancer, as well as for understanding the fundamental biology of the process of metastasis. Here, we review the development and initial clinical studies with a novel microfluidic platform for isolating these cells, the CTC-chip, and discuss its potential uses in the study of lung cancer.
Low-Dose Treatment

Accepted, March 27, 2003. OBJECTIVE: The results of radiosurgical treatment of acoustic neuromas have improved by reducing the tumor marginal doses. We report relatively long-term follow-up results ( 5 yr) for patients who underwent low-dose radiosurgery. METHODS: We treated and followed 51 consecutive patients with unilateral acoustic neuromas who were treated from January 1994 to December 1996 by gamma knife radiosurgery at low doses ( 12 Gy to the tumor margin). The average age of the patients was 55 years (range, 32–76 yr). The treatment volume was 0.7 to 24.9 cm (median, 3.6 cm). The marginal radiation dose was 8 to 12 Gy (median, 12 Gy), and the follow-up period ranged from 18 to 96 months (median, 60 mo). RESULTS: Clinical tumor growth control (without tumor resection) was achieved in 96% of patients, and the 5-year tumor growth control rate was 92%. Hearing was preserved in 59% of those with preradiosurgical hearing preservation (GardnerRobertson Classes 1–4), and improvements ( 20 dB of improvement) were noted in 9% of the patients with any hearing. Hearing was preserved at a useful level (Gardner-Robertson Classes 1 and 2) in 56% of patients. Although preexisting trigeminal neuropathy worsened in 4% of the patients, our patients did not experience new facial palsies or trigeminal neuropathies after radiosurgery. Facial spasm occurred in 6% of the patients, and intratumoral bleeding occurred in 4% of patients. CONCLUSION: Low-dose radiosurgery ( 12 Gy at the tumor margin) can achieve a high tumor growth control rate and maintain low postradiosurgical morbidity (including hearing preservation) for acoustic neuromas.
Mirror movement asymmetries in congenita1 hemiparesis

Mirror movements are seen in normal children in the first decade. The movements persist after age 10 in patients with congenital hemiparesis. At first, mirror movements are more prominent in the good hand (when the impaired hand attempts a unimanual task), but after age 10, mirroring diminishes in the good hand, and these movements are equally prominent in good and impaired hands. Maturational changes in callosally mediated inhibition of uncrossed motor pathways and reorganizational changes of the pyramidal motor system after early unilateral brain injury explain these age-dependent changes in asymmetries of mirror movements.
Restoring geometrical optics near caustics using sequenced metaplectic transforms

Geometrical optics (GO) is often used to model wave propagation in weakly inhomogeneous media and quantum-particle motion in the semiclassical limit. However, GO predicts spurious singularities of the wavefield near reflection points and, more generally, at caustics. We present a new formulation of GO, called metaplectic geometrical optics (MGO), that is free from these singularities and can be applied to any linear wave equation. MGO uses sequenced metaplectic transforms of the wavefield, corresponding to symplectic transformations of the ray phase space, such that caustics disappear in the new variables and GO is reinstated. The Airy problem and the quantum harmonic oscillator are described analytically using MGO for illustration. In both cases, the MGO solutions are remarkably close to the exact solutions and remain finite at cutoffs, unlike the usual GO solutions.
Probing Flavor Structure of Cosmic Ray $e^\mp$ Spectrum and Implications for Indirect Dark Matter Searches

Measuring high energy cosmic ray electrons/positrons (CRE) provides important means for probing the nearby galactic sources and for the dark matter (DM) indirect detection. In this work, we perform a systematical analysis of the flavor structure of DM annihilations into charged leptons based on the cosmic ray CRE spectra measured by DAMPE, Fermi-LAT, AMS-02, and CALET experiments. We study the annihilations of possible TeV scale DM particles in a nearby subhalo, which is proposed to explain the possible peak-like structure of the DAMPE CRE data. We pay special attention to the possible non-resonant excess (besides the possible peak-like structure) and demonstrate that such non-resonant excess can mainly arise from the decay of muons produced by the DM annihilations in the subhalo. With these we study the flavor composition of the lepton final states of $\chi\chi \to e^+e^-, \mu^+\mu^-, \tau^+\tau^-$ by fitting the CRE data. We further analyze the constraints on the lepton flavor composition using the Fermi-LAT $\gamma$-ray measurements. We find that the flavor composition (favored by the CRE data) is consistent with the Fermi-LAT data at relatively low Galactic latitudes, while the fraction of the final state $\tau^\pm$ is severely bounded.
Structured Mechanical Models for Robot Learning and Control

Model-based methods are the dominant paradigm for controlling robotic systems, though their efficacy depends heavily on the accuracy of the model used. Deep neural networks have been used to learn models of robot dynamics from data, but they suffer from data-inefficiency and the difficulty to incorporate prior knowledge. We introduce Structured Mechanical Models, a flexible model class for mechanical systems that are data-efficient, easily amenable to prior knowledge, and easily usable with model-based control techniques. The goal of this work is to demonstrate the benefits of using Structured Mechanical Models in lieu of black-box neural networks when modeling robot dynamics. We demonstrate that they generalize better from limited data and yield more reliable model-based controllers on a variety of simulated robotic domains.
Linear analytical approach to dispersive, external and intrinsic dissipative couplings in optomechanical systems

We present a theoretical study of optomechanical systems in which the mechanical resonator modulates both the resonant frequency (dispersive coupling) and the decay rates (dissipative coupling) of the optical cavity. We extend the generic dispersive framework to a more general case in which the dissipative coupling is split between its external and intrinsic contribution. We report a complete analysis of the influence of each kind of optical losses (intrinsic and external) on the three coupling mechanisms and highlight the interest of each external decay rate regime. The basic tools to experimentally identify the three couplings and their relative influence on the optical response are presented. We demonstrate the general expression of the optical spring effect and optomechanical damping. Comparison between experimental measurements in photonic crystal systems from the literature and our theoretical modal yields good agreement.