Miracle-dz/UniFAR-FTUs huggingface dataset:
NOTES AND CORRESPONDENCE Comments on ''Northern Hemisphere Teleconnection Patterns during Extreme Phases of the Zonal-Mean Circulation''

In a recent article published in this journal, Ting et al. (1996) documented the three-dimensional structure of the stationary wave response to a distinctive mode of variability of the zonally averaged basic state: a meridional ‘‘see-saw’’ in zonal momentum represented by the algebraic difference between the zonal-mean, zonal (geostrophic) wind at 558 and 358N. This particular choice of index was motivated by statistics derived from a suite of experiments with a linear baroclinic stationary wave model and prior analyses of observational data by Branstator (1984) and Kidson (1985). Here we relate the mode of variability that they examined to the ‘‘Arctic Oscillation’’ (AO; Thompson and Wallace 1998, hereafter denoted TW98) and reflect upon the broader implications of their findings. In making this comparison we make use of monthly rather than seasonal mean fields because they capture more faithfully the structure of the AO and they afford a larger sample size. As in TW98, the AO is defined as the leading principal component of the (unstandardized) monthly sea level pressure anomaly field poleward of 208N based on the sea level pressure analyses of Trenberth and Paolino (1981). The 58 3 58 lat–long gridded data were weighted by the square root of cosine of latitude. Our analysis of monthly mean 500-hPa height and zonal wind fields is based on the National Centers for Environmental Prediction–National Center for Atmospheric Research reanalyses (Kalnay et al. 1996) for the 119 winter months (DJF) beginning with January 1958 and ending with February 1997, obtained from the National Oceanic and Atmospheric Administration Cli-
Biallelic Cys141Tyr variant of SEL1L is associated with neurodevelopmental disorders, agammaglobulinemia, and premature death

Suppressor of lin-12-like–HMG-CoA reductase degradation 1 (SEL1L-HRD1) ER-associated degradation (ERAD) plays a critical role in many physiological processes in mice, including immunity, water homeostasis, and energy metabolism; however, its relevance and importance in humans remain unclear, as no disease variant has been identified. Here, we report a biallelic SEL1L variant (p. Cys141Tyr) in 5 patients from a consanguineous Slovakian family. These patients presented with not only ERAD-associated neurodevelopmental disorders with onset in infancy (ENDI) syndromes, but infantile-onset agammaglobulinemia with no mature B cells, resulting in frequent infections and early death. This variant disrupted the formation of a disulfide bond in the luminal fibronectin II domain of SEL1L, largely abolishing the function of the SEL1L-HRD1 ERAD complex in part via proteasomal-mediated self destruction by HRD1. This study reports a disease entity termed ENDI-agammaglobulinemia (ENDI-A) syndrome and establishes an inverse correlation between SEL1L-HRD1 ERAD functionality and disease severity in humans.
Geometric and topological characterization of the cytoarchitecture of islets of Langerhans

The islets of Langerhans are critical endocrine micro-organs that secrete hormones regulating energy metabolism in animals. Insulin and glucagon, secreted by beta and alpha cells, respectively, are responsible for metabolic switching between fat and glucose utilization. Dysfunction in their secretion and/or counter-regulatory influence leads to diabetes. Debate in the field centers on the cytoarchitecture of islets, as the signaling that governs hormonal secretion depends on structural and functional factors, including electrical connectivity, innervation, vascularization, and physical proximity. Much effort has therefore been devoted to elucidating which architectural features are significant for function and how derangements in these features are correlated or causative for dysfunction, especially using quantitative network science or graph theory characterizations. Here, we ask if there are non-local features in islet cytoarchitecture, going beyond standard network statistics, that are relevant to islet function. An example is ring structures, or cycles, of α and δ cells surrounding β cell clusters or the opposite, β cells surrounding α and δ cells. These could appear in two-dimensional islet section images if a sphere consisting of one cell type surrounds a cluster of another cell type. To address these issues, we developed two independent computational approaches, geometric and topological, for such characterizations. For the latter, we introduce an application of topological data analysis to determine locations of topological features that are biologically significant. We show that both approaches, applied to a large collection of islet sections, are in complete agreement in the context both of developmental and diabetes-related changes in islet characteristics. The topological approach can be applied to three-dimensional imaging data for islets as well.
Exploring the potential utility of AI large language models for medical ethics: an expert panel evaluation of GPT-4

Integrating large language models (LLMs) like GPT-4 into medical ethics is a novel concept, and understanding the effectiveness of these models in aiding ethicists with decision-making can have significant implications for the healthcare sector. Thus, the objective of this study was to evaluate the performance of GPT-4 in responding to complex medical ethical vignettes and to gauge its utility and limitations for aiding medical ethicists. Using a mixed-methods, cross-sectional survey approach, a panel of six ethicists assessed LLM-generated responses to eight ethical vignettes. The main outcomes measured were relevance, reasoning, depth, technical and non-technical clarity, as well as acceptability of GPT-4’s responses. The readability of the responses was also assessed. Of the six metrics evaluating the effectiveness of GPT-4’s responses, the overall mean score was 4.1/5. GPT-4 was rated highest in providing technical (4.7/5) and non-technical clarity (4.4/5), whereas the lowest rated metrics were depth (3.8/5) and acceptability (3.8/5). There was poor-to-moderate inter-rater reliability characterised by an intraclass coefficient of 0.54 (95% CI: 0.30 to 0.71). Based on panellist feedback, GPT-4 was able to identify and articulate key ethical issues but struggled to appreciate the nuanced aspects of ethical dilemmas and misapplied certain moral principles. This study reveals limitations in the ability of GPT-4 to appreciate the depth and nuanced acceptability of real-world ethical dilemmas, particularly those that require a thorough understanding of relational complexities and context-specific values. Ongoing evaluation of LLM capabilities within medical ethics remains paramount, and further refinement is needed before it can be used effectively in clinical settings.
Transient Heat Transfer Measurements of Surface Roughness due to Ice Accretion

A high-resolution, non-intrusive heat transfer measurement method based on Infra-Red thermography and transient heat transfer analysis is presented. This technique was successfully applied to NACA 0012 airfoils with castings of natural accreted ice surface roughness. A total of 11 representative icing conditions were reproduced at the Adverse Environment Rotor Test Stand (AERTS) facility at the Pennsylvania State University. The ice roughness was retained using ice molding and casting techniques. Roughness on casting models was categorized into a smooth zone and a rough zone. Smooth to rough zone transition location and ice limit of each case was recorded. Arithmetic averages of roughness height (Ra) were calculated for 8 locations on the chordwise direction for each of the casting models. Heat transfer measurement was conducted in a low-speed wind tunnel using thermal transient infra-red measurement techniques as well as multiple embedded heat flux and thermocouple sensors. The measured heat transfer coefficient was non-dimensionalized using Frossling numbers to account for the Reynolds variations between the compared tests. The Frossling number and roughness data were compared to LEWICE predictions in a parametric study. The effects of temperature, velocity, droplet size, liquid water content, and icing time on the heat transfer coefficient and Frossling number were examined. An overprediction of LEWICE roughness height and corresponding heat transfer rate was quantified. A 200% to 391% over-prediction of the peak heat transfer value was identified from the comparison between LEWICE prediction and experimental measurements.
Evaluation of Sampling Strategies for Pesticides in a Macroporous Sandy Loam Soil

It is not straightforward to sample and demonstrate the presence and transport of pesticides in heterogeneous soil. Following leaching experiments with four differently structured 50-cm-long soil columns (tilled and untilled soil), the objective of this study was to investigate the extent that visual tracing of the dye Brilliant Blue could support in soil sampling for two strongly sorbing pesticides (14C-labeled glyphosate and pendimethalin). About 830 samples were collected. No pesticide was found below 10– 25 cm depth by random sampling, even though 0.21–0.31% of the applied amounts were leached, and 0.18% of the soil volume was sampled. With similar sampling efforts, the pesticides could generally be traced throughout the columns by sampling from stained soil volumes, only. None of the two particular sampling strategies for pesticides produced accurate mass balances or balances that were obviously better than the other. No pesticide was detected outside stained soil volumes, except for glyphosate in one sample. Below 30 cm, stained soil comprized on average 5% of the total soil volume, leaving 95% as expectedly pesticide-free. The results suggest that much more efficient sampling for sorbing pesticides can be obtained by using the dye and focusing on stained soil volumes.
Associations between maternal stressful life events experiences and risk of neural tube defects in offspring: a systematic review and meta-analysis

Abstract Objectives Multiple factors associated with neural tube defects (NTDs) risk have been identified, yet there is little evidence on the possible effects of maternal stressful life events. In this study, we aimed to investigate the association between stressful life events during the periconceptional period and risk of NTDs in offspring. Methods Relevant literature was searched in PubMed, Springer Link, ScienceDirect, and Cochrane Library up to July 2023. The pooled odds ratio (OR) and 95% confidence interval (CI) of NTDs risk with maternal stressful life events were estimated using a random effects model. Publication bias was assessed using Egger’s regression asymmetry test and Begg’s rank correlation test with Begg’s funnel plot. Results Analysis results showed that mothers who experienced stressful life events during the periconceptional period were at greater risk of having NTDs offspring (OR: 1.37, 95% CI: 1.08–1.73) than those who did not. In subgroup analysis, the pooled OR was 1.37 (1.13–1.67) and 1.73 (0.36–8.32) for with and without adjusting for folic acid supplementation in each included study, while was 1.37 (1.13–1.67) and 1.64 (0.39–6.88) for exposure time of three months preconception until three months post conception and one year preconception until three months post conception, respectively. Conclusions This study suggests that maternal stressful life events during the periconceptional period are significantly associated with higher NTDs risk in offspring. Tailored approaches for evaluating the risk and policy of NTDs among women of childbearing age should emphasize individual stressful experiences before and during early pregnancy.
Injury-related emergency department use among people with intellectual and developmental disabilities insured by Medicaid from 2010 to 2016

Objectives Data on non-fatal injuries and visits to the emergency department (ED) for injuries are not readily available. The objective of this paper is to describe injury-related ED visits for people with intellectual and developmental disabilities who are covered by the Medicaid insurance programme. Methods We aggregated 2010–2016 Medicaid claims data from eight states. Using these data, we identified individuals with intellectual and developmental disabilities and then determined an all-cause ED visit rate, ED visit due to injury rate and admission from ED due to injury rate. Data were stratified by sex and age group. Results were compared with national rates. Results Medicaid members with intellectual and developmental disabilities visited EDs at approximately 1.8 times the rate of the general population. The ED visit rate due to injury was approximately 1.5 times that observed in the population overall. When ED visits due to injury data were stratified by age and sex, the largest discrepancy was observed in women ages 45–64, who visited EDs due to injury at a rate 2.1 times that of women of the same age in the general population. The admission rate from ED due to injury increased over the study period most notably in the older age groups. Conclusions While rates and patterns of ED utilisation among Medicaid members with intellectual and developmental disabilities vary by age and gender, our findings suggest this group visits the ED due to injury at rates well above the general population.
Use of Virtual Reality in Interdisciplinary Multimodal Pain Treatment With Insights From Health Care Professionals and Patients: Action Research Study

Background Chronic pain is a widespread global health problem. Interdisciplinary multimodal pain treatment (IMPT) is a treatment option for people with chronic pain. Virtual reality (VR) could be used to broaden IMPT programs. However, despite the advantages of VR, it is rarely used in daily clinical practice. Objective This research aimed to explore how, when, and with whom VR can be used meaningfully during IMPT, either as an addition or substitution as a component of IMPT. Methods This research used an action research design to help health care professionals and patients learn how, when, and with whom they can use VR. Data were collected through reflection sessions with health care professionals and semistructured interviews with patients in 2 specialized centers that provide IMPT for chronic pain. Two researchers performed direct content analyses. Results In total, 4 physiotherapists, 1 occupational therapist, 3 psychologists, and 22 patients participated in this research. Three iteration cycles, including 9 reflection sessions and 8 semistructured interviews, were performed. Both health care professionals and patients considered VR to be useful in therapy as an addition but not a substitution. VR was used as a diagnostic and intervention tool with all patients at the rehabilitation center or home. VR was used to gain insight into patients’ pain beliefs, cognitions, and irrational cognitions about additional damage and physical abilities. Considering VR as an intervention tool, the health care professionals had 3 goals: balancing relaxation and competition, grading activities, and exposure in vivo. Conclusions VR could be a valuable addition to IMPT for both patients with chronic pain and health care professionals. More research should be performed to assess the additional effects of VR on patients’ participation in daily life.
Correlation of Plasma Membrane Microviscosity and Cell Stiffness Revealed via Fluorescence-Lifetime Imaging and Atomic Force Microscopy

The biophysical properties of cells described at the level of whole cells or their membranes have many consequences for their biological behavior. However, our understanding of the relationships between mechanical parameters at the level of cell (stiffness, viscoelasticity) and at the level of the plasma membrane (fluidity) remains quite limited, especially in the context of pathologies, such as cancer. Here, we investigated the correlations between cells’ stiffness and viscoelastic parameters, mainly determined via the actin cortex, and plasma membrane microviscosity, mainly determined via its lipid profile, in cancer cells, as these are the keys to their migratory capacity. The mechanical properties of cells were assessed using atomic force microscopy (AFM). The microviscosity of membranes was visualized using fluorescence-lifetime imaging microscopy (FLIM) with the viscosity-sensitive probe BODIPY 2. Measurements were performed for five human colorectal cancer cell lines that have different migratory activity (HT29, Caco-2, HCT116, SW 837, and SW 480) and their chemoresistant counterparts. The actin cytoskeleton and the membrane lipid composition were also analyzed to verify the results. The cell stiffness (Young’s modulus), measured via AFM, correlated well (Pearson r = 0.93) with membrane microviscosity, measured via FLIM, and both metrics were elevated in more motile cells. The associations between stiffness and microviscosity were preserved upon acquisition of chemoresistance to one of two chemotherapeutic drugs. These data clearly indicate that mechanical parameters, determined by two different cellular structures, are interconnected in cells and play a role in their intrinsic migratory potential.
What works for and what hinders deimplementation of low-value care in emergency medicine practice? A scoping review

Objectives Low-value care can harm patients and healthcare systems. Despite a decade of global endeavours, low value care has persisted. Identification of barriers and enablers is essential for effective deimplementation of low-value care. This scoping review is an evidence summary of barriers, enablers and features of effective interventions for deimplementation of low-value care in emergency medicine practice worldwide. Design A mixed-methods scoping review was conducted using the Arksey and O’Malley framework. Data sources Medline, CINAHL, Embase, EMCare, Scopus and grey literature were searched from inception to 5 December 2022. Eligibility criteria Primary studies which employed qualitative, quantitative or mixed-methods approaches to explore deimplementation of low-value care in an EM setting and reported barriers, enablers or interventions were included. Reviews, protocols, perspectives, comments, opinions, editorials, letters to editors, news articles, books, chapters, policies, guidelines and animal studies were excluded. No language limits were applied. Data extraction and synthesis Study selection, data collection and quality assessment were performed by two independent reviewers. Barriers, enablers and interventions were mapped to the domains of the Theoretical Domains Framework. The Mixed Methods Appraisal Tool was used for quality assessment. Results The search yielded 167 studies. A majority were quantitative studies (90%, 150/167) that evaluated interventions (86%, 143/167). Limited provider abilities, diagnostic uncertainty, lack of provider insight, time constraints, fear of litigation, and patient expectations were the key barriers. Enablers included leadership commitment, provider engagement, provider training, performance feedback to providers and shared decision-making with patients. Interventions included one or more of the following facets: education, stakeholder engagement, audit and feedback, clinical decision support, nudge, clinical champions and training. Multifaceted interventions were more likely to be effective than single-faceted interventions. Effectiveness of multifaceted interventions was influenced by fidelity of the intervention facets. Use of behavioural change theories such as the Theoretical Domains Framework in the published studies appeared to enhance the effectiveness of interventions to deimplement low-value care. Conclusion High-fidelity, multifaceted interventions that incorporated education, stakeholder engagement, audit/feedback and clinical decision support, were administered daily and lasted longer than 1 year were most effective in achieving deimplementation of low-value care in emergency departments. This review contributes the best available evidence to date, but further rigorous, theory-informed, qualitative and mixed-methods studies are needed to supplement the growing body of evidence to effectively deimplement low-value care in emergency medicine practice.
Association of an inter‐arm systolic blood pressure difference with all‐cause and cardiovascular mortality: A meta‐analysis of cohort studies

This meta‐analysis evaluated the potential association of a simultaneously measured inter‐arm systolic blood pressure difference (IASBPD) and all‐cause mortality and cardiovascular mortality. The Medline, Cochrane Library, Embase, and PubMed databases were searched through to April 14, 2023 for relevant literature. The outcomes were the associations of IASBPD with all‐cause and cardiovascular mortality. Finally, 10 cohort studies that included 15 320 individuals were included. An IASBPD of ≥15 mm Hg was associated with increased all‐cause mortality (pooled hazard ratio [HR] 1.28, 95% confidence interval [CI] 1.02–1.61) but an IASBPD of ≥10 mm Hg was not (pooled HR 1.28, 95% CI 0.89–1.85). The pooled HR for cardiovascular mortality was 1.88 (95% CI 1.31–2.71) for an IASBPD of ≥10 mm Hg and 1.93 (95% CI 1.24–2.99) for an IASBPD of ≥15 mm Hg. Subgroup analysis showed that younger patients (HR 9.03, 95% CI 2.00–40.82, p = .004) with an IASBPD ≥15 mm Hg were at higher risk of cardiovascular mortality than older patients (HR 1.67, 95% CI 1.06–2.64, p = .03); the difference between groups was statistically significant (p = .04). In conclusions, our findings show that a simultaneously measured IASBPD ≥15 mm Hg predicts increased all‐cause mortality and an IASBPD of ≥15 mm Hg or ≥10 mm Hg predicts increased cardiovascular mortality. An IASBPD ≥15 mm Hg appears to be more correlated with cardiovascular mortality in younger patients than in older patients.
Unified Framework for Faster Clustering via Joint Schatten p-Norm Factorization With Optimal Mean

To enhance the effectiveness and efficiency of subspace clustering in visual tasks, this work introduces a novel approach that automatically eliminates the optimal mean, which is embedded in the subspace clustering framework of low-rank representation (LRR) methods, along with the computationally factored formulation of Schatten <inline-formula> <tex-math notation="LaTeX">$p$ </tex-math></inline-formula>-norm. By addressing the issues related to meaningful computations involved in some LRR methods and overcoming biased estimation of the low-rank solver, we propose faster nonconvex subspace clustering methods through joint Schatten <inline-formula> <tex-math notation="LaTeX">$p$ </tex-math></inline-formula>-norm factorization with optimal mean (JS<inline-formula> <tex-math notation="LaTeX">$p$ </tex-math></inline-formula>NFOM), forming a unified framework for enhancing performance while reducing time consumption. The proposed approach employs tractable and scalable factor techniques, which effectively address the disadvantages of higher computational complexity, particularly when dealing with large-scale coefficient matrices. The resulting nonconvex minimization problems are reformulated and further iteratively optimized by multivariate weighting algorithms, eliminating the need for singular value decomposition (SVD) computations in the developed iteration procedures. Moreover, each subproblem can be guaranteed to obtain the closed-form solver, respectively. The theoretical analyses of convergence properties and computational complexity further support the applicability of the proposed methods in real-world scenarios. Finally, comprehensive experimental results demonstrate the effectiveness and efficiency of the proposed nonconvex clustering approaches compared to existing state-of-the-art methods on several publicly available databases. The demonstrated improvements highlight the practical significance of our work in subspace clustering tasks for visual data analysis. The source code for the proposed algorithms is publicly accessible at <uri>https://github.com/ZhangHengMin/TRANSUFFC</uri>.