Miracle-dz/UniFAR-FTUs huggingface dataset:
Stochastic tissue window normalization of deep learning on computed tomography

Abstract. Tissue window filtering has been widely used in deep learning for computed tomography (CT) image analyses to improve training performance (e.g., soft tissue windows for abdominal CT). However, the effectiveness of tissue window normalization is questionable since the generalizability of the trained model might be further harmed, especially when such models are applied to new cohorts with different CT reconstruction kernels, contrast mechanisms, dynamic variations in the acquisition, and physiological changes. We evaluate the effectiveness of both with and without using soft tissue window normalization on multisite CT cohorts. Moreover, we propose a stochastic tissue window normalization (SWN) method to improve the generalizability of tissue window normalization. Different from the random sampling, the SWN method centers the randomization around the soft tissue window to maintain the specificity for abdominal organs. To evaluate the performance of different strategies, 80 training and 453 validation and testing scans from six datasets are employed to perform multiorgan segmentation using standard 2D U-Net. The six datasets cover the scenarios, where the training and testing scans are from (1) same scanner and same population, (2) same CT contrast but different pathology, and (3) different CT contrast and pathology. The traditional soft tissue window and nonwindowed approaches achieved better performance on (1). The proposed SWN achieved general superior performance on (2) and (3) with statistical analyses, which offers better generalizability for a trained model.
The gaits of marsupials and the evolution of diagonal-sequence walking in primates.

OBJECTIVES Documenting the variety of quadrupedal walking gaits in a variety of marsupials (arboreal vs. terrestrial, with and without grasping hind feet), to aid in developing and refining a general theory of gait evolution in primates. MATERIALS AND METHODS Video records of koalas, ringtail possums, tree kangaroos, sugar gliders, squirrel gliders, wombats, numbats, quolls, a thylacine, and an opossum walking on a variety of substrates were made and analyzed to derive duty factors and diagonalities for symmetrical walking gaits. The resulting distributions of data points were compared with published data and theories. RESULTS Terrestrial marsupials' gaits overwhelmingly plot slightly below the theoretical "horse line" (Cartmill et al., Zoological Journal of the Linnean Society. 2002;136:401-420) typical of terrestrial mammals; arboreal marsupials' gaits overwhelmingly plot more decisively above it. Both distributions are roughly parallel to the horse line, but arboreal animals exhibit increased diagonality, so that their higher-speed walking gaits overlap with those of typical primates on the Hildebrand diagram of diagonality against duty factor. CONCLUSIONS Quadrupeds avoid gaits lying exactly on the (theoretically optimum) horse line, to avoid fore/hind limb interference ("forging"). This can be accomplished by either a slight reduction in diagonality ("downshifting") or a more decisive increase ("upshifting"). Tree-dwellers adopt the second option to eliminate unilateral bipods of support from the gait cycle. The upshifted horse line represents an early phase in the evolution of primate-like diagonal-sequence gaits.
The proper timing to introduce simulation-based education in internal medicine clerkship

Clinical training of medical students is an important part of medical curricula, and it is highly relevant to professional practice [1]. Clinical education has been modified in the last few decades in response to the development of educational theories and research, and to changes in medical knowledge and health care requirements [2]. It has been shown that, students enrolled in traditional medical curricula perform basic clinical skills poorly and that medical schools cannot rely on clerkship experiences alone to offer students adequate basic clinical skills training [3,4]. In order to overcome these deficiencies, a mix of teaching strategies including problem-based learning, community-based education and skills laboratories have been introduced for undergraduate training. These shifts in medical curricula were based on contemporary educational theories such as social constructivism, experiential learning and communities of practice [2].
Attrition of HIV-positive children from HIV services in low- and middle-income countries: a systematic review and meta-analysis.

INTRODUCTION Identification and retention of HIV-positive children in HIV services is essential to ensure optimal health outcomes. This systematic review and meta-analysis examines the magnitude of attrition (loss to follow-up [LTFU] and death) of HIV-positive children from HIV services in low- and middle-income countries (LMICs). METHODS We performed a comprehensive multi-database search of original studies reporting retention/attrition data for HIV-positive children in LMICs through April 2016. Outcomes included LTFU, death, and overall attrition (LTFU + death) at intervals up to 60 months of follow-up. At least two authors determined study eligibility, performed data extraction, and made quality assessments. We used random effects meta-analytic methods to aggregate effect sizes and perform meta-regression analyses. RESULTS We identified 3,040 unique studies; 91 met eligibility criteria and were included in the analysis. This represents 147,129 HIV-positive children; most were from Africa (83%). LTFU definitions varied widely, with significant variability in outcomes across studies. Most attrition occurred in the first six months of follow-up, increasing to 23% by 36 months. HIV-positive children receiving antiretroviral therapy (ART) had significantly better retention in care than those not on ART. Studies that performed case-finding/tracing for those LTFU had better retention in care up to 24 months of follow-up. CONCLUSIONS These findings underscore the high attrition of children from HIV services in LMICs. Early ART initiation and decentralized patient support services (e.g., tracing for those LTFU) have potential to improve retention in care. Implementation research and resources are urgently needed to improve retention among this vulnerable population.
A systematic review protocol of randomized controlled trials

Background: This study aims to systematically explore the efficacy of sacubitril valsartan sodium tablet (SVST) for the treatment of chronic heart failure (CHF). Methods: Nine electronic databases, including PUBMED, Cochrane Library, EMBASE, PsycINFO, Web of Science, Allied and Complementary Medicine Database, WANGFANG, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure will be searched. Randomized controlled trials on SVST in the treatment of CHF will be collected. The search time limit will be from the establishment of each electronic database until June 1, 2019. Two authors will independently select the literature, carry out the data, and assess the methodological quality. Results: This study will systematically investigate the efficacy and safety of SVST for CHF. The outcomes consist of all-cause mortality, change in body weight, urine output, change in serum sodium; and incidence of any expected and unexpected adverse events. Conclusion: The findings of this study will summarize from evidence-based medicine and a scientific basis for the efficacy and safety of SVST in the clinical treatment of CHF. PROSPERO registration number: PROSPERO CRD42019138882. Abbreviations: CHF = chronic heart failure, PRISRMA = Preferred Reporting Items for Systematic Reviews and Meta-Analysis, RCTs = randomized controlled trials, SVST = sacubitril valsartan sodium tablet.
Intraperitoneal Recombinant α-Interferon for “Salvage” Immunotherapy in Stage III Epithelial Ovarian Cancer: A Gynecologic Oncology Group Study

Fourteen patients with persistent epithelial ovarian cancer documented at second look laparotomy after combination chemotherapy were treated with 146 cycles of α-recombinant interferon (rlFN-α2) administered i.p. The initial dose was 5 × 106 units which was escalated weekly to 50 × 106 units over 4 weeks and then continued weekly for a total of 16 weeks. Eleven patients underwent surgical reevaluation after therapy which confirmed four pathological complete responses (36%), one partial response (9%), and disease progression in six patients (55%). Five of seven patients (71%) with residual tumor <5 mm had a surgically documented response, whereas there was no response in the four patients whose tumors were ≥5 mm. Three patients were evaluable for clinical response only: one patient who refused surgery had a complete clinical response with total resolution of ascites; one had stable disease; and one had disease progression. Fever ≥38°C was seen in 58%, fever ≥39.0°C was seen in 18%, vomiting in 37%, abdominal pain was reported in 22%, and one patient had infectious peritonitis. Peripheral white blood cell counts and i.p. washings were obtained pretreatment and on days 1, 3, and 7 after treatment. While there was no consistent alteration in peripheral white blood cell counts, the numbers of i.p. monocytes and lymphocytes showed a significant boost on day 1 after each dose of rlFN-α2. Natural killer lymphocyte cytotoxicity was elevated in the i.p. cavity fluid obtained from most patients on day 1 after treatment, while blood natural killer lymphocyte cytotoxicity values showed considerable variability. Pharmacokinetic studies show that i.p. levels of rlFN-α2 were 30–1000 times blood levels. rlFN-α2 i.p. may act by increasing concentrations of drug and augmenting regional host cells in patients with minimal residual ovarian cancer.
Family Weight Teasing, LGBTQ Attitudes, and Well-being Among LGBTQ Adolescents

This study explored weight-based victimization by family members, accepting lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) attitudes, and family connectedness, and how these experiences are associated with health, self-esteem, and depressive symptoms among LGBTQ adolescents. Data came from the LGBTQ National Teen Survey (N = 9261, mean age = 15.6 years). The 3 key variables were significantly associated with poorer self-rated health, self-esteem, and depressive symptoms. For example, weight-based victimization was associated with approximately 2 more points on the depressive symptoms scale (β = 1.81, P < .001), adjusting for covariates. Findings highlight the negative impact of weight-based victimization among LGBTQ youth, even in the context of other types of family support.
Magnetik Rezonans Görüntüleme Mrg Nin Klinik Uygulamaları Ve Endikasyonları

Magnetic resonance imaging MRI is an imaging technique to produce high resolution tissue contrast images of the human body. It was first demonstrated by Paul Lauterbur in 1973. MRI is a safe diagnostic procedure that uses a powerful magnet and radio waves to produce detailed images of the body's organs and structures, without the use of Xrays or other radiation. Hydrogen atom nuclei which make the human body approximately 63% have a source MR signal. MRI is widely used to imagine and diagnose pathologic conditions in all over the human body, especially central nervous system, musculoskeletal system, head and neck, abdomen and pelvis. MRI is often preferred as a fast and noninvasive diagnostic modality for examination of the vascular MR-Angiography , pancreatico-biliary MRCholangiopancreaticography , and urinary systems MR-Urography . MRI can be also helping physicians evaluate the function as well as the structure of many organs with spectroscopy, diffusion, perfusion images. In this review; clinical application and indications of MRI and the radiologic algorithms have been presented with our sample cases
Clinicopathologic and Molecular Analysis of the TFEB Fusion Variant Reveals New Members of TFEB Translocation Renal Cell Carcinomas (RCCs)

Supplemental Digital Content is available in the text. Xp11 renal cell carcinoma (RCC) with different gene fusions may have different clinicopathologic features. We sought to identify variant fusions in TFEB translocation RCC. A total of 31 cases of TFEB RCCs were selected for the current study; MALAT1-TFEB fusion was identified in 25 cases (81%, 25/31) using fusion probes. The remaining 6 cases (19%, 6/31) were further analyzed by RNA sequencing and 5 of them were detected with TFEB-associated gene fusions, including 2 ACTB-TFEB, 1 EWSR1-TFEB, 1 CLTC-TFEB, and 1 potential PPP1R10-TFEB (a paracentric inversion of the TFEB gene, consistent with “negative” TFEB split FISH result, and advising a potential diagnostic pitfall in detecting TFEB gene rearrangement). Four of the 5 fusion transcripts were successfully validated by reverse transcription-polymerase chain reaction and Sanger sequencing. Morphologically, approximately one third (29%, 9/31) of TFEB RCCs showed typical biphasic morphology. The remaining two thirds of the cases (71%, 22/31) exhibited nonspecific morphology, with nested, sheet-like, or papillary architecture, resembling other types of renal neoplasms, such as clear cell RCC, Xp11 RCC, perivascular epithelioid cell tumor (PEComa), or papillary RCC. Although cases bearing a MALAT1-TFEB fusion demonstrated variable morphologies, all 9 cases featuring typical biphasic morphology were associated with MALAT1-TFEB genotype. Accordingly, typical biphasic morphology suggests MALAT1-TFEB fusion, whereas atypical morphology did not suggest the specific type of fusion. Isolated or clustered eosinophilic cells were a common feature in TFEB RCCs, which may be a useful morphology diagnostic clue for TFEB RCCs. Clinicopathologic variables assessment showed that necrosis was the only morphologic feature that correlated with the aggressive behavior of TFEB RCC (P=0.004). In summary, our study expands the genomic spectrum and the clinicopathologic features of TFEB RCCs, and highlights the challenges of diagnosis and the importance of subtyping of this tumor by combining morphology and multiple molecular techniques.
A SIMPLE ANALYSIS OF THE INFLUENCE OF STRAIN AND CURVATURE ON LAMINAR

The aim of this work is to describe the influence of nonuniform flow on laminar flames. A simple steady flow analysis is presented in which gas density and molecular transport coefficients are assumed constant and a global reaction rate expression is employed in the high activation energy asymptotic limit. Considerable further simplification is achieved by a priori specification of a function related to the mass flow rate normal to the flame. The analysis allows the influence of flame curvature and strain on the mass burning rate to be clearly identified. It is shown that, except in the weak stretch limit, the relationship between mass burning rate and flame stretch is dependent on flame geometry. Conversely the mass burning rate is uniquely related to the temperature gradient at the reaction surface irrespective of flame geometry.
Brain signatures of threat-safety discrimination in adolescent chronic pain.

Approximately 1.7 million youth suffer from debilitating chronic pain in the US alone, conferring risk for continued pain in adulthood. Abberations in threat-safety (T-S) discrimination are proposed to contribute to pain chronicity in adults and youth by interacting with pain-related distress. Yet, few studies have examined the neural circuitry underlying T-S discrimination in patients with chronic pain or how T-S discrimination relates to pain-related distress. In this study, 91 adolescents (10-24 years; 78 females) including 30 chronic pain patients with high pain-related distress, 29 chronic pain patients with low pain-related distress, and 32 healthy peers without chronic pain completed a developmentally-appropriate T-S learning paradigm. We measured self-reported fear, psychophysiology (skin conductance response), and functional MRI responses (N = 72 after fMRI exclusions). After controlling for age and anxiety symptoms, patients with high pain-related distress showed altered self-reported fear and fronto-limbic activity in response to learned threat and safety cues compared to both patients with low pain-related distress and healthy controls. Specifically, adolescent patients with high pain-related distress reported elevated fear and showed elevated limbic (hippocampus, amygdala) activation in response to a learned threat cue (CS+). In addition, they showed decreased frontal (vmPFC) activation and aberrant fronto-limbic connectivity in response to a learned safety cue (CS-). Patients with low pain-related distress and healthy controls appeared strikingly similar across brain and behavior. These findings indicate that altered T-S discrimination, mediated by fronto-limbic activation and connectivity, may be one mechanism maintaining pain chronicity in adolescents with high levels of pain-related distress.
Case report of rehabilitation of a subject with post polio syndrome

Post-polio syndrome (PPS) affects polio survivor’s years after the initial polio attack. They report new musculoskeletal symptoms.The purpose of this case report was to determine the effect of a physical therapy intervention on these symptoms in a 53 year old male subject with residual poliomyelitis of left lower limb more than right. Strengthening and aerobic exercises along with lifestyle modification advices were found to be beneficial with respect to all outcome measures taken after 4 and 12 weeks of program, with deterioration in none.This is a first case report documenting benefits of physical therapy following PPS in India. Its findings support the use of exercise in subjects with late effects of poliomyelitis and provide clinically valuable knowledge regarding the treatment efficacy of PPS exercise regimens.
Electronic Memory Aids for Community-Dwelling Elderly Persons: Attitudes, Preferences, and Potential Utilization

This article focuses on the attitudes of community-dwelling elderly persons toward the use of electronic memory aids. Questionnaire data from 100 elderly volunteers indicate that more than one half were interested in an electronic memory device for at least one purpose. Those who said that they would use the device had higher levels of education, used more household electronic devices, were more likely to have someone available to help them use a device, and had more health problems than those who preferred to not use it. Most would use a memory aid to monitor medications and remember appointments, followed by remembering addresses and phone numbers. The expected use, design, preferred methods of instruction, and concerns about the device varied. Study results suggest the need to develop devices with different degrees of flexibility and complexity. Future studies should evaluate training methods to use such technology.
The position of the spinal cord relative to the vertebrae in adolescent idiopathic scoliosis

Abstract We aimed to clarify the position of the spinal cord relative to the vertebra in patients with Lenke type 1 adolescent idiopathic scoliosis (AIS). In all, 35 patients with Lenke type 1 AIS who underwent posterior spinal fusion using a pedicle screw construct and preoperative computed tomography (CT) after myelography were recruited. The following radiological parameters were measured on preoperative CT myelography: spinal cord–vertebral (SV) angle, entry–spinal cord distance (ESD), ESD-X, ESD-Y, spinal cord–pedicle (SP) angle, and rotation angle (RAsag). The SV and SP angles were the smallest at T9 level, followed by T8 and T7 levels, and tended to increase cranially and caudally. The ESD was the shortest at T9 level, followed by T8 and T10 levels. The ESD-X was the smallest at T9 level, followed by T8 level, while the ESD-Y was the smallest at T10 level, followed by T9 and T8 levels. Mean RAsag increased from T4 to T9 levels and decreased from T9 to T12 levels. The ESD was significantly negatively correlated to RAsag. Among all apical vertebrae, the SV and SP angles were negatively correlated to Cobb angle. The RAsag was positively correlated while the ESD was negatively correlated to the Cobb angle. The spinal cord is close to the vertebrae in the apical vertebral region and far from the vertebrae at the upper and lower thoracic vertebral levels in AIS. Therefore, the potential risk of spinal cord injury by pedicle screw is the highest in the apical vertebral region.
The Effect of Curcumin in Patients with Chronic Fatigue Syndrome (or) Myalgic Encephalomyelitis Disparate Responses in Different Disease Severities

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), is a chronic and often disabling disease. Although the exact pathophysiological mechanism of ME/CFS is unknown, immunological abnormalities may play an important role. Curcumin is an herb with powerful anti-oxidative and anti-inflammatory properties. Therefore, we hypothesized that curcumin would have favorable effects on symptomatology in ME/CFS patients. In an open trial among 65 ME/CFS participants, 6 stopped the use of curcumin because of side effects and 8 did not complete the end of study questionnaire. Before and 8 weeks after the use of curcumin complexed with phosphatidyl choline-, 500 mg bid, participants completed the CDC inventory for assessment of Chronic Fatigue Syndrome. The CDC questions (n=19) were scored and divided into 2 parts: the first being specific for CFS complaints (n=9), the second being scores of less specific symptoms (n=10); denoted as CDC other score. Results showed that 8 weeks of curcumin significantly decreased the CDC CFS-related symptom scores and CDC other scores, especially in patients with mild disease. Conclusion: in this open-labeled study 8 week curcumin use in a phosphatidyl choline complex reduced ME/CFS symptomatology, especially in patients with mild disease severity.
D2NN: a fine-grained dual modular redundancy framework for deep neural networks

Deep Neural Networks (DNNs) have attracted mainstream adoption in various application domains. Their reliability and security are therefore serious concerns in those safety-critical applications such as surveillance and medical systems. In this paper, we propose a novel dual modular redundancy framework for DNNs, namely D2NN, which is able to tradeoff the system robustness with overhead in a fine-grained manner. We evaluate D2NN framework with DNN models trained on MNIST and CIFAR10 datasets under fault injection attacks, and experimental results demonstrate the efficacy of our proposed solution.