Miracle-dz/UniFAR-FTUs huggingface dataset:
Activation and Utilization of an Electronic Health Record Patient Portal at an Academic Medical Center—Impact of Patient Demographics and Geographic Location

The advent of the online electronic health record patient portal has provided an efficient and practical means for patients to become more involved in their health care. In this report, we analyze how demographic variables such as age, gender, race, and geographic location affect patient portal activation and usage at the University of Iowa Hospitals and Clinics, the sole academic medical center in the state of Iowa, a predominantly rural state. Our primary end points were activation of the patient portal (MyChart, Epic, Inc) and access of outpatient laboratory and radiology results, among the most commonly accessed and popular features of the patient portal. We thus analyzed data from 536 378 patients to determine rates of patient portal activation and data from 219 671 patient encounters to determine the frequency at which patients access their online diagnostic test results. Higher rates of patient portal activation and usage were associated with female gender, Caucasians/non-underrepresented minorities, geographic location in closer proximity to the medical center (Iowa City and neighboring cities/suburbs), and nonelderly adults. For underrepresented minority and rural patients, opportunities for improvement exist for both activation and more robust use of online patient portal accounts. Overall, these data highlight existing disparities with online patient portal usage and provide a base on which further studies and interventions can help to improve utilization of these systems.
Treatment With Tumor-infiltrating Lymphocytes in Advanced Melanoma: Evaluation of Early Clinical Implementation of an Advanced Therapy Medicinal Product

Tumor-infiltrating lymphocytes (TIL)-therapy in advanced melanoma is an advanced therapy medicinal product (ATMP) which, despite promising results, has not been implemented widely. In a European setting, TIL-therapy has been in use since 2011 and is currently being evaluated in a randomized controlled trial. As clinical implementation of ATMPs is challenging, this study aims to evaluate early application of TIL-therapy, through the application of a constructive technology assessment (CTA). First the literature on ATMP barriers and facilitators in clinical translation was summarized. Subsequently, application of TIL-therapy was evaluated through semistructured interviews with 26 stakeholders according to 6 CTA domains: clinical, economic, patient-related, organizational, technical, and future. In addition, treatment costs were estimated. A number of barriers to clinical translation were identified in the literature, including: inadequate financial support, lack of regulatory knowledge, risks in using live tissues, and the complex path to market approval. Innovative reimbursement procedures could particularly facilitate translation. The CTA survey of TIL-therapy acknowledged these barriers, and revealed the following facilitators: the expected effectiveness resulting in institutional support for an internal pilot, the results of which led to the inclusion of TIL-therapy in a national coverage with evidence development program, the availability of an in-house pharmacist, quality assurance expertise and a TIL-skilled technician. Institutional and national implementation of TIL-therapy remains complex. The promising clinical effectiveness is expected to facilitate the adoption of TIL-therapy, especially when validated through a randomized controlled trial. Innovative and conditional reimbursement procedures, together with the organization of knowledge transfer, could support and improve clinical translation of TIL and ATMPs.
Convolutional Neural Networks In Convolution

Currently, increasingly deeper neural networks have been applied to improve their accuracy. In contrast, We propose a novel wider Convolutional Neural Networks (CNN) architecture, motivated by the Multi-column Deep Neural Networks and the Network In Network(NIN), aiming for higher accuracy without input data transmutation. In our architecture, namely "CNN In Convolution"(CNNIC), a small CNN, instead of the original generalized liner model(GLM) based filters, is convoluted as kernel on the original image, serving as feature extracting layer of this networks. And further classifications are then carried out by a global average pooling layer and a softmax layer. Dropout and orthonormal initialization are applied to overcome training difficulties including slow convergence and over-fitting. Persuasive classification performance is demonstrated on MNIST.
The RHEB–mTOR axis regulates expression of Tf2 transposons in fission yeast

ABSTRACT The human TSC2 gene, mutations in which predispose individuals to the disease tuberous sclerosis complex (TSC), encodes a GTPase-activating protein for the GTPase RHEB. Loss of TSC2 results in constitutive activation of RHEB and its target mammalian target of rapamycin (mTOR). We have previously reported that fission yeast (Schizosaccharomyces pombe) Tf2 retrotransposons (hereafter Tf2s) are abnormally induced upon nitrogen starvation in cells lacking the tsc2+ gene (Δtsc2), a homolog of the human TSC2 gene, and in cells with a dominant-active mutation in the fission yeast RHEB GTPase (rhb1-DA4). We report here that induction of Tf2s in these mutants is suppressed upon overexpression of the cgs2+ gene, which encodes a cAMP-specific phosphodiesterase, or upon deletion of components in the glucose/cAMP signaling pathway, namely Cyr1, Pka1, Tor1 and the stress-activated transcription factor Atf1. The results suggest that the glucose/cAMP signaling pathway is downregulated when cells are starved for nitrogen. We also show that Tf2 proteins are degraded via autophagy, which is under control of Tor2, a homolog of human mTOR. It appears that failure in the two processes, downregulation of the glucose/cAMP signaling pathway and induction of autophagy, allows abnormal induction of Tf2s upon nitrogen starvation in Δtsc2 and rhb1-DA4 cells. Summary: Abnormal induction of the Tf2 retrotransposons upon nitrogen starvation in cells lacking the tsc2+ gene is due to defects in RHEB–mTOR and the glucose/cAMP signaling and induction of autophagy.
Operation Mechanism of a MoS2/BP Heterojunction FET

The electrical characteristics and operation mechanism of a molybdenum disulfide/black phosphorus (MoS2/BP) heterojunction device are investigated herein. Even though this device showed a high on-off ratio of over 1 × 107, with a lower subthreshold swing of ~54 mV/dec and a 1fA level off current, its operating mechanism is closer to a junction field-effect transistor (FET) than a tunneling FET. The off-current of this device is governed by the depletion region in the BP layer, and the band-to-band tunneling current does not contribute to the rapid turn-on and extremely low off-current.
Role of Hypoxic Stress in Regulating Tumor Immunogenicity, Resistance and Plasticity

Hypoxia, or gradients of hypoxia, occurs in most growing solid tumors and may result in pleotropic effects contributing significantly to tumor aggressiveness and therapy resistance. Indeed, the generated hypoxic stress has a strong impact on tumor cell biology. For example, it may contribute to increasing tumor heterogeneity, help cells gain new functional properties and/or select certain cell subpopulations, facilitating the emergence of therapeutic resistant cancer clones, including cancer stem cells coincident with tumor relapse and progression. It controls tumor immunogenicity, immune plasticity, and promotes the differentiation and expansion of immune-suppressive stromal cells. In this context, manipulation of the hypoxic microenvironment may be considered for preventing or reverting the malignant transformation. Here, we review the current knowledge on how hypoxic stress in tumor microenvironments impacts on tumor heterogeneity, plasticity and resistance, with a special interest in the impact on immune resistance and tumor immunogenicity.
Evaluation of Circulating MicroRNA Biomarkers in the Acute Pancreatic Injury Dog Model

This study aimed to evaluate the usefulness of four microRNAs (miRNAs) in an acute pancreatic injury dog model. Acute pancreatitis was induced by infusion of cerulein for 2 h (7.5 μg/kg/h). The levels of well-known miRNAs, microRNA-216a (miR-216a) and microRNA-375 (miR-375), and new candidates microRNA-551b (miR-551b), and microRNA-7 (miR-7), were measured at 0, 0.5, 1, 2, 6, 12, and 24 h with serum amylase and lipase, and histopathological examination was performed. Among the four miRNAs, miR-216a and miR-375, and serum enzymes were significantly increased by cerulein treatment. The expression levels of miRNAs and serum enzymes peaked at 2–6 h with a similar pattern; however, the overall increases in miR-216a and miR-375 levels were much higher than those of the serum enzyme biomarkers. Increased levels of miR-216a and miR-375 were most highly correlated to the degree of individual histopathological injuries of the pancreas, and showed much greater dynamic response than serum enzyme biomarkers. Twenty-four-hour time-course analysis in this study revealed time-dependent changes of miRNA expression levels, from initial increase to decrease by predose level in acute pancreatitis. Our findings demonstrate that, in dogs, miR-216a and miR-375 have the potential to sensitively detect pancreatitis and reflect well the degree of pancreatic injury, whereas miR-551b and miR-7 do not.
Critical Speed as a Measure of Aerobic Fitness for Male Rugby Union Players.

PURPOSE To compare critical speed (CS) derived from all-out testing (AOT) for linear and shuttle running with metrics from a graded exercise test, the Yo-Yo Intermittent Recovery Test Level 1 (YYIR1), and estimation of an 800-m-shuttle time trial. METHODS Twelve male rugby players completed a graded exercise test, the YYIR1, a linear AOT, shuttle AOTs of 25 and 50 m, and an 800-m-shuttle time trial consisting of 32 × 25-m shuttles. RESULTS Strong linear correlations were observed between maximum oxygen uptake ( V˙O2max ) and CS (m·s-1) derived from the linear AOT (3.68 [0.62], r = .90, P < .01) and 50-m-shuttle AOT (3.19 [0.26], r = .83, P < .01). Conversely, V˙O2max showed lower correlations with speeds evoking CS from 25-m AOT (2.86 [0.18], r = .42, P = .18) and YYIR1 (4.36 [0.11], r = .55, P = .07). The 800-m time trial (213.58 [15.84] s) was best predicted using parameters from the 25-m AOT (r = .93, SEE = 6.60 s, P < .001). CONCLUSIONS The AOT is a valuable method of assessing performance-specific fitness, with CS from linear and 50-m-shuttle AOTs being strong predictors of V˙O2max , rivaling metrics from the graded exercise test. The YYIR1 offered limited utility compared with the AOT method.
Uremia Impacts VE-Cadherin and ZO-1 Expression in Human Endothelial Cell-to-Cell Junctions

Endothelial dysfunction in uremia can result in cell-to-cell junction loss and increased permeability, contributing to cardiovascular diseases (CVD) development. This study evaluated the impact of the uremic milieu on endothelial morphology and cell junction’s proteins. We evaluated (i) serum levels of inflammatory biomarkers in a cohort of chronic kidney disease (CKD) patients and the expression of VE-cadherin and Zonula Occludens-1 (ZO-1) junction proteins on endothelial cells (ECs) of arteries removed from CKD patients during renal transplant; (ii) ECs morphology in vitro under different uremic conditions, and (iii) the impact of uremic toxins p-cresyl sulfate (PCS), indoxyl sulfate (IS), and inorganic phosphate (Pi) as well as of total uremic serum on VE-cadherin and ZO-1 gene and protein expression in cultured ECs. We found that the uremic arteries had lost their intact and continuous endothelial morphology, with a reduction in VE-cadherin and ZO-1 expression. In cultured ECs, both VE-cadherin and ZO-1 protein expression decreased, mainly after exposure to Pi and uremic serum groups. VE-cadherin mRNA expression was reduced while ZO-1 was increased after exposure to PCS, IS, Pi, and uremic serum. Our findings show that uremia alters cell-to-cell junctions leading to an increased endothelial damage. This gives a new perspective regarding the pathophysiological role of uremia in intercellular junctions and opens new avenues to improve cardiovascular outcomes in CKD patients.
Combined impact of risk factors on the subsequent development of hypertension.

OBJECTIVES This study aimed to develop a cumulative score composed of seven risk factors: age, resting heart rate, overweight or obesity, dyslipidemia, hyperuricemia, impaired glucose regulation, and impaired estimated glomerular filtration rate (eGFR), to evaluate the risk of new-onset hypertension. METHODS We retrospectively conducted a cohort study in 23 665 participants free from hypertension at baseline, who attended at least two annual health examinations between 2011 and 2016. We defined hypertension as SBP of 140 mmHg or less and/or DBP of at least 90 mmHg, according to the 2010 Chinese guidelines for the management of hypertension. We computed a composite, individual-level cumulative score incorporating all seven risk factors (no = 0 point; yes = 1 point; total range 0-7 points). Cox regression was used to analyze the association between cumulative score and risk of hypertension. RESULTS A total of 2305 participants developed hypertension during a median follow-up period of 3.6 years. Compared with participants with 0 points, the adjusted hazard ratios (95% confidence intervals) for the development of hypertension for those with 2, 3, and at least 4 points were 1.61 (1.29-2.02), 2.05 (1.64-2.57) and 2.77 (2.22-3.46), respectively (P trend < 0.001). This association was present after adjustment for sex and baseline blood pressure. CONCLUSION Age, resting heart rate, overweight or obesity, dyslipidemia, hyperuricemia, impaired glucose regulation, and impaired eGFR were associated with significant risk of new-onset hypertension and when combined there was an accumulation of risk.
Assessment of perceived stress and association with sleep quality and attributed stressors among 1st-year medical students: A cross-sectional study from Karwar, Karnataka, India

Objectives: The objective is to study the extent of perceived stress among 1st-year medical students using the Perceived Stress Scale-14 (PSS-14) and its association with sleep quality as assessed by the Pittsburgh Sleep Quality Index (PSQI) and attributed stressors. Materials and Methods: A cross-sectional study was conducted of 121 1st-year medical students at Karwar Institute of Medical Sciences, Karwar, Karnataka, India. The extent of their stress was assessed using the PSS-14 and their sleep quality was assessed using the PSQI. Graded stress exerted by the attributed stressors was also assessed. Results: A total of 33.8% of participants had perceived stress scores of >28. Among academic stressors, performance in examinations (34.7%), lack of time for recreation (30.6%), curriculum (24.8%), and frequency of examinations (24.8%) were the highest rated stressors. Quality of food in the mess (50.4%) and lack of entertainment in the institution (39.7%) were the highest rated psychosocial stressors. There was a positive correlation between the PSS-14 scores and various academic stressors and the global PSQI score. Conclusion: First-year medical students reported a high level of stress, including academic and psychosocial stressors. Effective changes in the curriculum and living conditions can reduce the level of stress among these students.
Early renal arterial rupture and arterial pseudoaneurysm in graft kidneys from the same deceased donor

Vascular complications are serious problems after kidney transplantation. An aneurysm or rupture in a graft artery is a rare but potentially devastating complication, which may lead to renal function impairment, graft loss, or even death. In this paper, we present two rare vascular complications in the early postoperative course after renal transplantation from the same deceased donor. In the first case, a 49-year-old woman who had spontaneous graft arterial rupture 13 days after kidney transplantation presented with sudden distension in the right lower abdomen. In the second case, a 56-year-old woman recipient with a graft renal arterial pseudoaneurysm presented with decreased urine output and deteriorating renal function 32 days after transplantation. Immediate surgical repair was performed, and fibrin sealant was applied to strengthen the fragile renal arterial wall. Although the function of both graft kidneys recovered well after surgery, the first graft kidney was removed 2 months later because of repeated fungal and bacterial infections. Aggressive surgical reconstruction may preserve graft kidneys in patients with vascular complications after kidney transplantation, but recovery of the graft condition remains a demanding challenge in renal transplantation.
Prognostic Value and Therapeutic Perspectives of Coronary CT Angiography: A Literature Review

Coronary stenosis severity is both a powerful and a still debated predictor of prognosis in coronary artery disease. Coronary computed tomographic angiography (CCTA) has emerged as a noninvasive technique that enables anatomic visualization of coronary artery disease (CAD). CCTA with newer applications, plaque characterization and physiologic/functional evaluation, allows a comprehensive diagnostic and prognostic assessment of otherwise low-intermediate subjects for primary prevention. CCTA measures the overall plaque burden, differentiates plaque subtypes, and identifies high-risk plaque with good reproducibility. Research in this field may also advance towards an era of personalized risk prediction and individualized medical therapy. It has been demonstrated that statins may delay plaque progression and change some plaque features. The potential effects on plaque modifications induced by other medical therapies have also been investigated. Although it is not currently possible to recommend routinely serial scans to monitor the therapeutic efficacy of medical interventions, the plaque modulation, as a part of risk modification, appears a feasible strategy. In this review we summarize the current evidence regarding vulnerable plaque and effects of lipid lowering therapy on morphological features of CAD. We also discuss the potential ability of CCTA to characterize coronary atherosclerosis, stratify prognosis of asymptomatic subjects, and guide medical therapy.
The Combination of Context Information to Enhance Simple Question Answering

With the rapid development of knowledge base, question answering based on knowledge base has become a hot research issue. In this paper, we focus on answering single-relation factoid questions based on knowledge base. We build a question answering system and study the effect of context information on fact selection, such as entity's notable type, out-degree. Experimental results show that context information can improve the result of simple question answering.
Development of a novel aortic dissection mouse model and evaluation of drug efficacy using in-vivo assays and database analyses

Objective: Aortic dissection is a life-threatening disease. At present, the only therapeutic strategies available are surgery and antihypertensive drugs. Moreover, the molecular mechanisms underlying the onset of aortic dissection are still unclear. We established a novel aortic dissection model in mice using pharmacologically induced endothelial dysfunction. We then used the Japanese Adverse Drug Event Report database to investigate the role of pitavastatin in preventing the onset of aortic dissection. Methods and results: To induce endothelial dysfunction, N&ohgr;-nitro-L-arginine methyl ester, a nitric oxide synthase inhibitor, was administered to C57BL/6 mice. Three weeks later, angiotensin II (Ang II) and &bgr;-aminopropionitrile (BAPN), a lysyl oxidase inhibitor, were administered with osmotic mini-pumps. False lumen formation was used as the pathological determinant of aortic dissection. The incidences of aortic dissection and death from aneurysmal rupture were significantly higher in the N&ohgr;-nitro-L-arginine methyl ester, Ang II, and BAPN (LAB) group than they were in the Ang II and BAPN (AB) group. Pitavastatin was administered orally to LAB mice. It significantly lowered the incidences of dissection and rupture. It also decreased inflammation and medial degradation, both of which were exacerbated in the LAB group. The Japanese Adverse Drug Event Report database analysis indicated that there were 113 cases of aortic dissection out of 95 090 patients (0.12%) not receiving statins but only six cases out of 16 668 patients receiving statins (0.04%) (odds ratio: 0.30; P = 0.0043). Conclusion: Our results suggest that endothelial dysfunction is associated with the onset of aortic dissection and pitavastatin can help prevent this condition.
Increased prevalence of obstructive sleep apnea in patients with pectus excavatum: A pilot study

Objective: Laryngomalacia is the most common congenital laryngeal anomaly and is associated with pectus excavatum (PE). Patients with laryngomalacia and patients with obstructive sleep apnea (OSA) both experience upper airway obstruction, and patients with laryngomalacia had been found to have a higher prevalence of PE. However, no studies have established the prevalence of OSA in patients with PE. We conducted this pilot study to evaluate the prevalence of OSA in patients with PE. Materials and Methods: A total of 42 patients ≥20 years old with PE who were admitted for Nuss surgery to correct PE in Taipei Tzu Chi Hospital between October 2015 and September 2016 were invited to participate in the study; 31 of the 42 patients agreed. All 31 patients completed an Epworth sleepiness scale questionnaire to evaluate excessive daytime sleepiness (EDS) and underwent overnight polysomnography to evaluate OSA before Nuss surgery. Results: The prevalence of snoring in the study participants was 100%. Ten of 31 patients (32.3%) reported EDS. The overall prevalence of OSA with an apnea/hypopnea index ≥5/h was 25.8%, and all patients with OSA were men. Conclusions: The prevalence of OSA in patients with PE seemed to be higher than that previously reported in the general population, implying that OSA might be a potential etiology or, at least, an aggravating factor for the development or progression of PE or might be responsible for the postoperative recurrence of PE in some patients. Further studies are needed to clarify this relationship.