Miracle-dz/UniFAR-FTUs huggingface dataset:
An integrated operational definition and conceptual model of asthma self-management in teens

ABSTRACT Objectives: A previous definition of adolescent asthma self-management was derived from interviews with clinicians/researchers and published literature; however, it did not incorporate perspectives of teens or parents. Therefore, we conducted in-depth interviews with teens and parents and synthesized present findings with the prior analysis to develop a more encompassing definition and model. Methods: Focal concepts were qualitatively extracted from 14-day self-management voice-diaries (n = 14) and 1-hour interviews (n = 42) with teens and parents (28 individuals) along with concepts found in the previous clinical/research oriented analysis. Conceptual structure and relationships were identified and key findings synthesized to develop a revised definition and model of adolescent asthma self-management. Results: There were two primary self-management constructs: processes of self-management and tasks of self-management. Self-management was defined as the iterative process of assessing, deciding, and responding to specific situations in order to achieve personally important outcomes. Clinically relevant asthma self-management tasks included monitoring asthma, managing active issues through pharmacologic and non-pharmacologic strategies, preventing future issues, and communicating with others as needed. Self-management processes were reciprocally influenced by intrapersonal factors (both cognitive and physical), interpersonal factors (family, social and physical environments), and personally relevant asthma and non-asthma outcomes. Conclusion: This is the first definition of asthma self-management incorporating teen, parent, clinician, and researcher perspectives, which suggests that self-management processes and behaviors are influenced by individually variable personal and interpersonal factors, and are driven by personally important outcomes. Clinicians and researchers should investigate teens' symptom perceptions, medication beliefs, current approaches to symptom management, relevant outcomes, and personal priorities.
Specificity of genome evolution in experimental populations of Escherichia coli evolved at different temperatures

Significance Organisms evolve and adapt via changes in their genomes that improve survival and reproduction in the context of their environment. Few experiments have examined how these genomic signatures of adaptation, which may favor mutations in certain genes or molecular pathways, vary across a set of similar environments that have both shared and distinctive characteristics. We sequenced complete genomes from 30 Escherichia coli lineages that evolved for 2,000 generations in one of five environments that differed only in the temperatures they experienced. Particular “signature” genes acquired mutations in these bacteria in response to selection imposed by specific temperature treatments. Thus, it is sometimes possible to predict aspects of the environment recently experienced by microbial populations from changes in their genome sequences. Isolated populations derived from a common ancestor are expected to diverge genetically and phenotypically as they adapt to different local environments. To examine this process, 30 populations of Escherichia coli were evolved for 2,000 generations, with six in each of five different thermal regimes: constant 20 °C, 32 °C, 37 °C, 42 °C, and daily alternations between 32 °C and 42 °C. Here, we sequenced the genomes of one endpoint clone from each population to test whether the history of adaptation in different thermal regimes was evident at the genomic level. The evolved strains had accumulated ∼5.3 mutations, on average, and exhibited distinct signatures of adaptation to the different environments. On average, two strains that evolved under the same regime exhibited ∼17% overlap in which genes were mutated, whereas pairs that evolved under different conditions shared only ∼4%. For example, all six strains evolved at 32 °C had mutations in nadR, whereas none of the other 24 strains did. However, a population evolved at 37 °C for an additional 18,000 generations eventually accumulated mutations in the signature genes strongly associated with adaptation to the other temperature regimes. Two mutations that arose in one temperature treatment tended to be beneficial when tested in the others, although less so than in the regime in which they evolved. These findings demonstrate that genomic signatures of adaptation can be highly specific, even with respect to subtle environmental differences, but that this imprint may become obscured over longer timescales as populations continue to change and adapt to the shared features of their environments.
“Delayed Pial Vessels” in Multiphase CT Angiography Aid in the Detection of Arterial Occlusion in Anterior Circulation

We read the article by Byrne et al, “Improved Detection of Anterior Circulation Occlusions: The ‘Delayed Vessel Sign’ on Multiphase CT Angiography” with great interest. [1][1] However, we would like to point out other important aspects of multiphase CT angiography (mCTA) to the readers of the
Geographic variations in the PARADIGM-HF heart failure trial

Aims The globalization of clinical trials has highlighted geographic variations in patient characteristics, event rates, and treatment effects. We investigated these further in PARADIGM-HF, the largest and most globally representative trial in heart failure (HF) to date. Methods and results We looked at five regions: North America (NA) 602 (8%), Western Europe (WE) 1680 (20%), Central/Eastern Europe/Russia (CEER) 2762 (33%), Latin America (LA) 1433 (17%), and Asia-Pacific (AP) 1487 (18%). Notable differences included: WE patients (mean age 68 years) and NA (65 years) were older than AP (58 years) and LA (63 years) and had more coronary disease; NA and CEER patients had the worst signs, symptoms, and functional status. North American patients were the most likely to have a defibrillating-device (54 vs. 2% AP) and least likely prescribed a mineralocorticoid receptor antagonist (36 vs. 65% LA). Other evidence-based therapies were used most frequently in NA and WE. Rates of the primary composite outcome of cardiovascular (CV) death or HF hospitalization (per 100 patient-years) varied among regions: NA 13.6 (95% CI 11.7–15.7) WE 9.6 (8.6–10.6), CEER 12.3 (11.4–13.2), LA 11.2 (10.0–12.5), and AP 12.5 (11.3–13.8). After adjustment for prognostic variables, relative to NA, the risk of CV death was higher in LA and AP and the risk of HF hospitalization lower in WE. The benefit of sacubitril/valsartan was consistent across regions. Conclusion There were many regional differences in PARADIGM-HF, including in age, symptoms, comorbidity, background therapy, and event-rates, although these did not modify the benefit of sacubitril/valsartan. Clinical trial registration URL http://www.clinicaltrials. gov. Unique identifier: NCT01035255.
Acid–base regulation and sensing: Accelerators and brakes in metabolic regulation of cerebrovascular tone

Metabolic regulation of cerebrovascular tone directs blood flow to areas of increased neuronal activity and during disease states partially compensates for insufficient perfusion by enhancing blood flow in collateral blood vessels. Acid–base disturbances frequently occur as result of enhanced metabolism or insufficient blood supply, but despite definitive evidence that acid–base disturbances alter arterial tone, effects of individual acid–base equivalents and the underlying signaling mechanisms are still being debated. H+ is an important intra- and extracellular messenger that modifies cerebrovascular tone. In addition, low extracellular [HCO3–] promotes cerebrovascular contraction through an endothelium-dependent mechanism. CO2 alters arterial tone development via changes in intra- and extracellular pH but it is still controversial whether CO2 also has direct vasomotor effects. Vasocontractile responses to low extracellular [HCO3–] and acute CO2-induced decreases in intracellular pH can counteract H+-mediated vasorelaxation during metabolic and respiratory acidosis, respectively, and may thereby reduce the risk of capillary damage and cerebral edema that could be consequences of unopposed vasodilation. In this review, the signaling mechanisms for acid–base equivalents in cerebral arteries and the mechanisms of intracellular pH control in the arterial wall are discussed in the context of metabolic regulation of cerebrovascular tone and local perfusion.
‘Mom—I don’t want to hear it’: Brain response to maternal praise and criticism in adolescents with major depressive disorder

Abstract Recent research has implicated altered neural response to interpersonal feedback as an important factor in adolescent depression, with existing studies focusing on responses to feedback from virtual peers. We investigated whether depressed adolescents differed from healthy youth in neural response to social evaluative feedback from mothers. During neuroimaging, twenty adolescents in a current episode of major depressive disorder (MDD) and 28 healthy controls listened to previously recorded audio clips of their own mothers’ praise, criticism and neutral comments. Whole-brain voxelwise analyses revealed that MDD youth, unlike controls, exhibited increased neural response to critical relative to neutral clips in the parahippocampal gyrus, an area involved in episodic memory encoding and retrieval. Depressed adolescents also showed a blunted response to maternal praise clips relative to neutral clips in the parahippocampal gyrus, as well as areas involved in reward and self-referential processing (i.e. ventromedial prefrontal cortex, precuneus, and thalamus/caudate). Findings suggest that maternal criticism may be more strongly encoded or more strongly activated during memory retrieval related to previous autobiographical instances of negative feedback from mothers in depressed youth compared to healthy youth. Furthermore, depressed adolescents may fail to process the reward value and self-relevance of maternal praise.
Towards Psychometrics-Based Friend Recommendations in Social Networking Services

Two of the defining elements of Social Networking Services are the social profile, containing information about the user, and the social graph, containing information about the connections between users. Social Networking Services are used to connect to known people as well as to discover new contacts. Current friend recommendation mechanisms typically utilize the social graph. In this paper, we argue that psychometrics, the field of measuring personality traits, can help make meaningful friend recommendations based on an extended social profile containing collected smartphone sensor data. This will support the development of highly distributed Social Networking Services without central knowledge of the social graph.
Improving quit rates of web‐delivered interventions for smoking cessation: full‐scale randomized trial of WebQuit.org versus Smokefree.gov

BACKGROUND AND AIMS Millions of people world-wide use websites to help them quit smoking, but effectiveness trials have an average 34% follow-up data retention rate and an average 9% quit rate. We compared the quit rates of a website using a new behavioral approach called Acceptance and Commitment Therapy (ACT; WebQuit.org) with the current standard of the National Cancer Institute's (NCI) Smokefree.gov website. DESIGN A two-arm stratified double-blind individually randomized trial (n = 1319 for WebQuit; n = 1318 for Smokefree.gov) with 12-month follow-up. SETTING United States. PARTICIPANTS Adults (n = 2637) who currently smoked at least five cigarettes per day were recruited from March 2014 to August 2015. At baseline, participants were mean [standard deviation (SD)] age 46.2 years (13.4), 79% women and 73% white. INTERVENTIONS WebQuit.org website (experimental) provided ACT for smoking cessation; Smokefree.gov website (comparison) followed US Clinical Practice Guidelines for smoking cessation. MEASUREMENTS The primary outcome was self-reported 30-day point prevalence abstinence at 12 months. FINDINGS The 12-month follow-up data retention rate was 88% (2309 of 2637). The 30-day point prevalence abstinence rates at the 12-month follow-up were 24% (278 of 1141) for WebQuit.org and 26% (305 of 1168) for Smokefree.gov [odds ratio (OR) = 0.91; 95% confidence interval (CI) = 0.76, 1.10; P = 0.334] in the a priori complete case analysis. Abstinence rates were 21% (278 of 1319) for WebQuit.org and 23% (305 of 1318) for Smokefree.gov (OR = 0.89 (0.74, 1.07; P = 0.200) when missing cases were imputed as smokers. The Bayes factor comparing the primary abstinence outcome was 0.17, indicating 'substantial' evidence of no difference between groups. CONCLUSIONS WebQuit.org and Smokefree.gov had similar 30-day point prevalence abstinence rates at 12 months that were descriptively higher than those of prior published website-delivered interventions and telephone counselor-delivered interventions.
Migration from Mexico to the United States: A high‐speed cancer transition

Differences and similarities in cancer patterns between the country of Mexico and the United States' Mexican population, 11% of the entire US population, have not been studied. Mortality data from 2008 to 2012 in Mexico and California were analyzed and compared for causes of cancer death among adult and pediatric populations, using standard techniques and negative binomial regression. A total of 380,227 cancer deaths from Mexico and California were included. Mexican Americans had 49% and 13% higher mortality than their counterparts in Mexico among males and females, respectively. For Mexican Immigrants in the US, overall cancer mortality was similar to Mexico, their country of birth, but all‐cancers‐combined rates mask wide variation by specific cancer site. The most extreme results were recorded when comparing Mexican Americans to Mexicans in Mexico: with mortality rate ratios ranging from 2.72 (95% CI: 2.44–3.03) for colorectal cancer in males to 0.28 (95% CI: 0.24–0.33) for cervical cancer in females. These findings further reinforce the preeminent role that the environment, in its multiple aspects, has on cancer. Overall, mortality from obesity and tobacco‐related cancers was higher among Mexican origin populations in the US compared to Mexico, suggesting a higher risk for these cancers, while mortality from prostate, stomach, and especially cervical and pediatric cancers was markedly higher in Mexico. Among children, brain cancer and neuroblastoma patterns suggest an environmental role in the etiology of these malignancies as well. Partnered research between the US and Mexico for cancer studies is warranted.
Cluster Analysis on Utilization Patterns of Patients with Chronic Diseases Based on Flattened Electronic Medical Records

Designing efficient strategies of reducing health care costs and optimizing facility utilization has long be a pursue of health systems, and stratifying patients into different expenditure/utilization patterns and further profiling these patient groups can provide useful clues for the strategy design. In this study, a data set including patients with chronic diseases (hypertension, diabetes, heart failure, chronic obstructive pulmonary disease (COPD) and/or stroke) was constructed, based on flattening massive electronic medical records and aggregating such records into the patient level. After outlier removal, the total cost and length-of-stay (LOS) of patients were used to cluster the patients into high-cost utilizers and low-cost ones, depending on k-medoids clustering with subsampling validation. To further profile or compare the two patient clusters, median-cost and median-LOS difference between the patients with a specific type or number of disease in the high-cost cluster and those in the low-cost one were investigated. Ultimately, COPD corresponds to the highest cost/LOS difference among the five diseases, implying that it is a potentially important disease that drives high costs/LOS. Moreover, patients with all five diseases correspond to the highest cost/LOS difference compared to those with one to four diseases. Overall, this study can usefully promote the development of healthcare-strategy design and implementation.
The growing disconnect between food prices and wages in Europe: cross-national analysis of food deprivation and welfare regimes in twenty-one EU countries, 2004–2012

Abstract Objective Food insecurity has been rising across Europe following the Great Recession, but to varying degrees across countries and over time. The reasons for this increase are not well understood, nor are what factors might protect people’s access to food. Here we test the hypothesis that an emerging gap between food prices and wages can explain increases in reported inability to afford protein-rich foods and whether welfare regimes can mitigate its impact. Design We collected data in twenty-one countries from 2004 to 2012 using two databases: (i) on food prices and deprivation related to food (denoted by reported inability to afford to eat meat, chicken, fish or a vegetarian equivalent every second day) from EuroStat 2015 edition; and (ii) on wages from the Organisation for Economic Co-operation and Development 2015 edition. Results After adjusting for macroeconomic factors, we found that each 1 % rise in the price of food over and above wages was associated with greater self-reported food deprivation (β=0·060, 95 % CI 0·030, 0·090), particularly among impoverished groups. However, this association also varied across welfare regimes. In Eastern European welfare regimes, a 1 % rise in the price of food over wages was associated with a 0·076 percentage point rise in food deprivation (95 % CI 0·047, 0·105) while in Social Democratic welfare regimes we found no clear association (P=0·864). Conclusions Rising prices of food coupled with stagnating wages are a major factor driving food deprivation, especially in deprived groups; however, our evidence indicates that more generous welfare systems can mitigate this impact.
Semantic Text Encoding for Text Classification Using Convolutional Neural Networks

In this paper, we encode semantics of a text document in an image to take advantage of the same Convolutional Neural Networks (CNNs) that have been successfully employed to image classification. We use Word2Vec, which is an estimation of word representation in a vector space that can maintain the semantic and syntactic relationships among words. Word2Vec vectors are transformed into graphical words representing sequence of words in the text document. The encoded images are classified by using the AlexNet architecture. We introduced a new dataset named Text-Ferramenta gathered from an Italian price comparison website and we evaluated the encoding scheme through this dataset along with two publicly available datasets i.e. 20news-bydate and StackOverflow. Our scheme outperforms the text classification approach based on Doc2Vec and Support Vector Machine (SVM) when all the words of a text document can be completely encoded in an image. We believe that the results on these datasets are an interesting starting point for many Natural Language Processing works based on CNNs, such as a multimodal approach that could use a single CNN to classify both image and text information.
A Clinical Quantitative Evaluation of Hepatobiliary Transport of [11C]Dehydropravastatin in Humans Using Positron Emission Tomography

Various positron emission tomography (PET) probes have been developed to assess in vivo activities in humans of drug transporters, which aid in the prediction of pharmacokinetic properties of drugs and the impact of drug-drug interactions. We developed a new PET probe, sodium (3R, 5R)-3, 5-dihydroxy-7-((1S, 2S, 6S, 8S)-6-hydroxy-2-methyl-8- ((1-[11C]-(E)-2-methyl-but-2-enoyl) oxy) -1, 2, 6, 7, 8, 8a-hexahydronaphthalen-1-yl) heptanoate ([11C]DPV), and demonstrated its usefulness for the quantitative investigation of Oatps (gene symbol SLCO) and Mrp2 (gene symbol ABCC2) in rats. To further analyze the species differences and verify the pharmacokinetic parameters in humans, serial PET scanning of the abdominal region with [11C]DPV was performed in six healthy volunteers with and without an OATP1Bs and MRP2 inhibitor, rifampicin (600 mg, oral), in a crossover fashion. After intravenous injection, [11C]DPV rapidly distributed to the liver and kidney followed by secretion into the bile and urine. Rifampicin significantly reduced the liver distribution of [11C]DPV 3-fold, resulting in a 7.5-fold reduced amount of excretion into the bile and the delayed elimination of [11C]DPV from the blood circulation. The hepatic uptake clearance (CLuptake, liver) and canalicular efflux clearance (CLint, bile) of [11C]DPV (544 ± 204 and 10.2 ± 3.5 µl/min per gram liver, respectively) in humans were lower than the previously reported corresponding parameters in rats (1800 and 298 µl/min per gram liver, respectively) (Shingaki et al., 2013). Furthermore, rifampicin treatment significantly reduced CLuptake, liver and CLint, bile by 58% and 44%, respectively. These results suggest that PET imaging with [11C]DPV is an effective tool for quantitatively characterizing the OATP1Bs and MRP2 functions in the human hepatobiliary transport system.
Immune checkpoint blockade can synergize with radiation therapy, even in tumors resistant to checkpoint monotherapy

Immunotherapy has evolved as a new pillar of cancer treatment during the last decade. The main breakthrough was the development of immune checkpoint blocking (ICB) antibodies, which antagonize inhibitory receptors on T cells and their ligands and thus unleash the cellular immune system against the tumor. ICB showed tremendous effects in several types of cancer. However, only a proportion of the patients suffering from tumors, which are in principle sensitive, benefit from this treatment and other kinds of neoplasia are completely resistant. Great effort is currently being undertaken to distinguish responders from non‐responders, and concepts to turn the latter into the former are urgently required. One approach is to combine ICB with already well‐established treatment strategies, that is, the other mainstays of cancer therapy such as surgery, radiation therapy (RT), and chemotherapy. Depending on the circumstances, both chemotherapy and RT may act either immune suppressively or immune stimulatingly. In this issue of EMBO Molecular Medicine, Azad et al ( ) show that indeed, pancreatic ductal adenocarcinoma, which is resistant to ICB monotherapy, becomes responsive to this treatment by simultaneous RT or chemotherapy.