Miracle-dz/UniFAR-FTUs huggingface dataset:
A Proposed Opioid Tapering Tool

Introduction: Previous studies suggest a lack of confidence among primary care providers in managing patients on chronic opioid therapy (COT) for chronic non-cancer related pain (CNCP). The US Department of Health and Human Services (HHS) recently introduced guidelines on opioid tapering. In light of these recommendations, our group developed an opioid tapering software to assist healthcare providers in managing patients on COT. Methods: The initial iteration of our software utilizes RedCap for the application programming interface (API). This tool is designed to reduce a patient's prescribed chronic opioids by 5-10% every month, or 5 morphine milligram equivalents per day (MME), whichever is the greatest, in line with HHS guidelines. Users can also adjust the rate of taper. Discussion: Our group plans to use this software in an upcoming pilot study to taper patients on COT for CNCP. We are exploring the possibility of transitioning our software into other available APIs with the goal of integrating this software into major electronic health record systems. Our group envisions that our software will provide an additional tool within a patient-centered, multi-modal framework in managing patients on COT for CNCP.
Physician Perspectives on Mammography Screening for Average-Risk Women: “Like a Double-Edged Sword”

Background: On balance, the benefits and harms of mammography screening put systematic screening for average-risk women into question. Since screening decisions frequently occur in primary care, it is important to understand what family physicians think of the evidence on mammography screening, and how they intend to use this information in practice. Methods: Using a cross-sectional design, we obtained data from a group of physician participants who rated the daily Patient-Oriented Evidence that Matters (POEM), which is a short, research-based synopsis. Physicians responded to closed and open-ended questions, based on the validated Information Assessment Method. Quantitative data were assessed with descriptive statistics. The qualitative data were subjected to inductive and deductive iterative thematic analysis. These data were organized into subthemes, and then grouped into major themes. Results: Four relevant POEMs were identified. Each of these POEMs was rated by 1243 to 1351 physicians, and these ratings provided 310 comments. Three major themes emerged across all 4 POEMs: 1) perspectives on information presented in POEMs, 2) applying this information in practice, and 3) confronting clinical and cultural realities. Our findings highlight important differences in the ways physicians value research-based information on mammography screening and use this information in their practice. Conclusions: Although POEMs about mammography screening raise awareness of harms and benefits, deeply rooted ideas illustrate how any change process is complex. In sum, rethinking breast cancer screening for average-risk women is challenging.
Going in Early: Hypoxia as a Target for Kidney Disease Prevention in Diabetes?

Diabetic kidney disease (DKD) begins early, which is pertinent to those diagnosed with diabetes during childhood and adolescence. The initiators of DKD are not fully defined, but hypoxia and metabolic abnormalities are important. With growing numbers of young people diagnosed with diabetes and concomitant risk for early mortality, this commentary examines the study by Vinovskis et al. (1) in this issue of Diabetes , which highlights renal hypoxia as an early phenomenon in diabetes associated with risk for DKD. Many diabetologists and nephrologists consider DKD an affliction of late-middle age. Certainly, the proportion of affected individuals with diabetes escalates with age (2), and at least one-third of these will develop DKD, a major risk factor for cardiovascular disease and early mortality (3). Global estimates of people living with diabetes have tripled in the past 20 years (2), topping 463 million individuals, suggesting that 167 million of these already have or will develop DKD. Perhaps less well known is the growing incidence of diabetes in children and adolescents, which is escalating by 3% each year, and at a higher rate in some ethnic groups (2). Another underappreciated fact is that many children and adolescents with diabetes develop complications in early adulthood, placing significant burden on the individual, the family, and society. Data from the International Diabetes Federation suggest that almost half (46.2%) of deaths associated with diabetes among the 20–79 years age-group are in people under the age of 60 years (2). Hence, because the average age of enrolment in phase 3 studies of diabetes-related mortality is 60 years of age, younger individuals who may have benefited from these interventions were excluded. Therefore, undertaking studies to understand and potentially intervene in early complications of diabetes in a much younger cohort than standard is crucial to potentially improving the outcomes of diabetes …
Turbulence and combustion

- Volume I Preface. Transition: Group Summary: Experiments. Group Summary: Stability Theory and Applications. Group Summary: Advanced Asymptotics. Group Summary: Receptivity. Group Summary: Simulations I. Group Summary: Simulations II. - Volume II Turbulence: Group Summary: Quasi-Equilibrium Turbulent Flows. Group Summary: Renormalization Group Theory and Turbulence Modeling. Combustion: Group Summary: Counter-Jet Diffusion Flames. Group Summary: Turbulent Combustion. Group Summary: Shock-Induced Combustion/Detonation. Index.
Modélisation de l'adsorption des ions dans les carbones nanoporeux

L'augmentation de capacite observee recemment dans les carbones nanoporeux ouvre la voie vers de nouvelles optimisations des supercondensateurs. La comprehension des phenomenes microscopiques a l'origine de cette augmentation de capacite est l'objet de cette these. Nous utilisons la dynamique moleculaire pour simuler des supercondensateurs modeles. Nos simulations presentent des caracteristiques originales : nous representons l'electrolyte par un modele gros grains, les electrodes par une structure poreuse complexe, et nous maintenons ces electrodes a un potentiel electrique constant. A partir de nos simulations, nous avons montre que l'augmentation de capacite dans les carbones poreux est le resultat d'une modification importante de la structure du liquide a l'interface avec l'electrode. Plus precisement, le confinement empeche la formation de couches successives de liquide qui ont tendance a diminuer l'efficacite du stockage de charge. Nous presentons egalement plusieurs methodes de determination de la capacite par dynamique moleculaire. L'utilisation d'une structure poreuse complexe et l'inclusion de la polarisation des electrodes nous permettent de caracteriser finement la correlation entre le confinement et l'efficacite du stockage de charge. Enfin, nous etudions les phenomenes dynamiques survenant au sein des supercondensateurs, cette derniere partie permettant d'envisager dans le futur une caracterisation de la puissance des supercondensateurs par dynamique moleculaire.
Ex Vivo Entrainment of the Isolated Mammalian Biological Clock Reveals Intrinsic Plasticity in Clock Gene Rhythm Dynamics

The suprachiasmatic nucleus (SCN) in the brain, the central circadian clock, governs timekeeping under different lighting conditions throughout seasons. It remains elusive how circadian alignment with various light cycles is achieved by the SCN at the level of core clock gene rhythms. We instituted ex vivo long-term periodic optogenetic stimulation and bioluminescence recording on a timescale of weeks to study circadian entrainment of core clock gene PER2 rhythms in the isolated SCN. We show that a single early-night optogenetic stimulation elongates the PER2 falling phase, while a late-night stimulation contracts the rising phase, to induce delay and advance phase resetting. Phase resetting also resulted in subsequent persistent changes in clock period – with phase advances leading to period shortening, and phase delays resulting in lengthening. We demonstrate stable entrainment of the isolated clock to 22h and 25h stimulation cycles, which is achieved via repeated rising phase shortening and falling phase lengthening, respectively. When presented with optogenetic skeleton photoperiods (2 pulses/24h cycle) that simulate short-day or long-day photoperiods, isolated SCN entrained preferentially to the short-day photoperiod by phase-jumping, similar to circadian behavioral plasticity classically described in intact mice and files. Skeleton photoperiod entrainment is achieved via increasing the relative duration of the falling phase to the rising phase. Clock gene waveform changes are specific to entrainment as they do not persist following release into constant darkness. Our results reveal how core clock gene rhythms in the SCN encode different lighting conditions, and that key aspects of circadian behavioral plasticity reside within the SCN itself.
Exploring correlations in genetic and cultural variation across language families in northeast Asia

Grammar can reflect genetic history better than other cultural traits, including the lexicon. Culture evolves in ways that are analogous to, but distinct from, genomes. Previous studies examined similarities between cultural variation and genetic variation (population history) at small scales within language families, but few studies have empirically investigated these parallels across language families using diverse cultural data. We report an analysis comparing culture and genomes from in and around northeast Asia spanning 11 language families. We extract and summarize the variation in language (grammar, phonology, lexicon), music (song structure, performance style), and genomes (genome-wide SNPs) and test for correlations. We find that grammatical structure correlates with population history (genetic history). Recent contact and shared descent fail to explain the signal, suggesting relationships that arose before the formation of current families. Our results suggest that grammar might be a cultural indicator of population history while also demonstrating differences among cultural and genetic relationships that highlight the complex nature of human history.
Optimization of the Fine to Coarse Aggregate Ratio for the Workability and Mechanical Properties of High Strength Steel Fiber Reinforced Concretes

High-strength concrete is used to provide quality control for concrete structures, yet it has the drawback of brittleness. The inclusion of fibers improves the ductility of concrete but negatively affects the fresh properties of fiber-reinforced concrete. The effects of different fine to coarse aggregate ratios on the fresh and hardened properties of steel fiber reinforced concrete were investigated in this study. Mixtures were prepared with various fine to coarse aggregate (FA/CA) ratios incorporating 1% steel fiber content (by volume) at constant water to cement ratio. The workability, unit weight, and temperature of the concrete in the fresh state, and the mechanical properties of steel-fiber-reinforced concrete (SFRC) were investigated. The inclusion of fiber in concrete influenced the mobility of concrete in the fresh state by acting as a barrier to the movement of coarse aggregate. It was observed that the concrete with an FA/CA ratio above 0.8 showed better flowability in the fresh state, whilst an above 0.9 FA/CA ratio requires excessive superplasticizer to maintain the flowability of the mixtures. The compressive and flexural strength of SFRC increased with an increase in the FA/CA ratio by around 10% and 28%, respectively. Experimental values of compressive strength and flexural strength showed good agreement, however, modulus of elasticity demonstrated slightly higher values. The experimentally obtained measurements of the mechanical properties of SFRC conformed reasonably well with the available existing prediction equations, and further enabled establishing predictive isoresponse interactive equations within the scope of the investigation domain.
Enhancing Salt Tolerance of Plants: From Metabolic Reprogramming to Exogenous Chemical Treatments and Molecular Approaches

Plants grow on soils that not only provide support for root anchorage but also act as a reservoir of water and nutrients important for plant growth and development. However, environmental factors, such as high salinity, hinder the uptake of nutrients and water from the soil and reduce the quality and productivity of plants. Under high salinity, plants attempt to maintain cellular homeostasis through the production of numerous stress-associated endogenous metabolites that can help mitigate the stress. Both primary and secondary metabolites can significantly contribute to survival and the maintenance of growth and development of plants on saline soils. Existing studies have suggested that seed/plant-priming with exogenous metabolites is a promising approach to increase crop tolerance to salt stress without manipulation of the genome. Recent advancements have also been made in genetic engineering of various metabolic genes involved in regulation of plant responses and protection of the cells during salinity, which have therefore resulted in many more basic and applied studies in both model and crop plants. In this review, we discuss the recent findings of metabolic reprogramming, exogenous treatments with metabolites and genetic engineering of metabolic genes for the improvement of plant salt tolerance.
Prevalence and Correlates of Intimate Partner Violence Experience Among Partners of Naval Personnel in Lagos, Nigeria

Background Military personnel are one of the high risk groups recognized as perpetrators of intimate partner violence (IPV). Little is known about IPV experience of partners of naval personnel. This study determined the prevalence and correlates of IPV experience among partners of naval personnel. Methods A cross-sectional survey of 435 male and female partners of naval personnel selected using the multistage sampling technique from the Navy Barracks in Lagos, Nigeria was conducted. Data were collected using a 40 item interviewer-administered questionnaire between August and September 2017. Univariate, bivariate and multivariate analysis was done to identify the predictors of partners’ experience of IPV. Analysis was done at p-value ≤0.05. Results The mean age of the respondents was 32.7 ± 7.86yrs and 72% were females. The lifetime prevalence of any IPV experience was 40.7% (with 74.4% of this experienced by females, CI: 0.81–1.91). The prevalence of controlling behaviour, psychological, sexual, economic and physical IPV were 31.5%, 16.3% 12.4%, 12.0% and 8.5% respectively. There was a positive association between experience of IPV and respondents’ occupational status (p < 0.0001), lifetime experience of physical (p < 0.0001), sexual abuse (<0.0001), and history of childhood abuse (p < 0.0001). After adjustment for confounders, age (AOR = 2.11, CI = 1.07–4.16), occupational status (AOR = 4.56, CI = 2.30–9.02), history of childhood abuse (AOR = 2.10, CI = 1.26–3.49,) and partners’ alcohol use (AOR = 3.41, CI = 1.38–8.39) remained significant factors influencing experience of IPV. Conclusion The prevalence of IPV experience among partners of naval personnel was high. Being unemployed, experience of abuse in childhood and having a partner who consumed alcohol increased partners’ vulnerability to IPV. Naval personnel would benefit from marital counseling and training on non-violence conflict resolution strategies.
Exploratory Analysis of Racial/Ethnic and Educational Differences in a Randomized Controlled Trial of a Mindfulness-Based Weight Loss Intervention

Supplemental digital content is available in the text. ABSTRACT Objective People of color and lower socioeconomic groups have higher obesity prevalence, lose less weight compared with Whites and higher socioeconomic groups, and are underrepresented in randomized controlled trials of mindfulness-based interventions. We examined whether mindfulness approaches reduce disparities in weight loss interventions. Methods We analyzed data from a randomized controlled trial of 194 participants with obesity (41% participants of color, 36% without college degree) comparing a 5.5-month mindfulness-based weight loss intervention to an active-control with identical diet-exercise guidelines. We assessed attendance, 18-month attrition, and weight change at 6, 12, and 18 months by race/ethnicity and education level using linear mixed models, adjusting for baseline body mass index, age, and education or race/ethnicity, respectively. Results Participants without versus with a college degree attended fewer sessions and had higher attrition across interventions. Participants of color attended fewer intervention sessions in the mindfulness compared with the control intervention. Overall, participants of color lost significantly less weight at 12 and 18 months compared with Whites. However, during the 6- to 18-month maintenance period, we found an interaction of intervention arm, race/ethnicity, and time (p = .035), indicating that participants of color compared with Whites regained more weight in the control (0.33 kg/mo; p = .005) but not mindfulness intervention (0.06 kg/mo; p = .62). Participants without a college degree had greater initial weight loss in the mindfulness compared to control intervention from 0 to 6 months (−0.46 kg/mo; p = .039). Conclusions Although disparities persist, mindfulness approaches may mitigate some racial/ethnic and socioeconomic differences in weight loss compared with conventional diet-exercise programs. Trial Registration: Clinicaltrials.gov registration: NCT00960414
Monoclonal IgM and neuropathy: not always anti-MAG.

In this issue of Blood , Le Cann et al reported a series of 45 patients with the very rare CANOMAD syndrome (chronic ataxic neuropathy, ophthalmoplegia, immunoglobulin M [IgM] paraprotein, cold agglutinins, and disialosyl antibodies) that almost doubled the number of published patients. 1 The only other series with 18 patients was published in 2001 with no data on treatment. 2 This study was an excellent example of collaboration between neurologists and hematologists that took place in 17 French centers. This number of patients allowed them to complete the description of CANOMAD, and particularly, of the associated monoclonal B-cell diseases, and more im-portantly, to provide a precise guideline on treatment. Coexistence of neuropathy and monoclonal immunoglobulin (MIg) represents a common but complex problem that requires neurological and hematological collaboration for a precise diagnosis. Because of the frequency of MIg, it can be a coincidental cooccurrence, in the majority of cases for IgG and IgA isotypes but not for IgM isotype associated with a neuropathy in one-third of patients. 3
Population-based organized screening by faecal immunochemical testing and colorectal cancer mortality: a natural experiment.

BACKGROUND Population-based organized screening programmes for colorectal cancer (CRC) are underway worldwide, with many based on the faecal immunochemical test (FIT). No clinical trials assessing FIT compared with no screening are planned, and few studies have assessed the population impact of such programmes. METHODS Before 2010, 11 out of 50 Spanish provinces initiated population-based organized screening programmes with FIT for an average-risk population aged 50-69 years. We used a quasi-experimental design across Spanish provinces between 1999 and 2016 to evaluate their impact on population age-standardized mortality and incidence rates due to CRC. Difference-in-differences and synthetic control analyses were performed to test for validation of statistical assumptions and to assess the dynamics of screening-associated changes in outcomes over time. RESULTS No differences in outcome trends between exposed (n = 11) and control (n = 36) provinces were observed for up to 7 years preceding the implementation of screening. Relative to controls, exposed provinces experienced a mean increase in age-standardized incidence of 10.08% [95% confidence interval (CI) (5.09, 15.07)] 2 years after implementation, followed by a reduction in age-standardized mortality rates due to CRC of 8.82% [95% CI (3.77, 13.86)] after 7 years. Results were similar for both women and men. No associated changes were observed in adjacent age bands not targeted by screening, nor for 10 other major causes of death in the exposed provinces. CONCLUSIONS FIT-based organized screening in Spain was associated with reductions in population colorectal cancer mortality. Further research is warranted in order to assess the replicability and external validity of our findings, and on gender-specific use of FIT in organized screening.
Mines in the End Zone: Are there Downsides to Team Performance?

Abstract Research on teams in organizations tends to focus on understanding the causes of team performance with a focus on how to enjoy the benefits of team success and avoid the negative consequences of team failure. This paper instead asks the question, ‘what are some of the negative consequences of team success? ’ A review of the literature on teams is augmented with research from cognitive science, sociology, occupational psychology, and psychology to explore the potential negative long-term consequences of teamwork success. The general topics of groupthink, overconfidence bias, regression to the mean, role overload, and strategy calcification are reviewed while discussing the implications for future research streams and practical team management.
Cheminformatics to Characterize Pharmacologically Active Natural Products

Natural products have a significant role in drug discovery. Natural products have distinctive chemical structures that have contributed to identifying and developing drugs for different therapeutic areas. Moreover, natural products are significant sources of inspiration or starting points to develop new therapeutic agents. Natural products such as peptides and macrocycles, and other compounds with unique features represent attractive sources to address complex diseases. Computational approaches that use chemoinformatics and molecular modeling methods contribute to speed up natural product-based drug discovery. Several research groups have recently used computational methodologies to organize data, interpret results, generate and test hypotheses, filter large chemical databases before the experimental screening, and design experiments. This review discusses a broad range of chemoinformatics applications to support natural product-based drug discovery. We emphasize profiling natural product data sets in terms of diversity; complexity; acid/base; absorption, distribution, metabolism, excretion, and toxicity (ADME/Tox) properties; and fragment analysis. Novel techniques for the visual representation of the chemical space are also discussed.