Miracle-dz/UniFAR-FTUs huggingface dataset:
Is Malignant Potential of Barrett’s Esophagus Predictable by Endoscopy Findings?

Given that endoscopic findings can be used to predict the potential of neoplastic progression in Barrett’s esophagus (BE) cases, the detection rate of dysplastic Barrett’s lesions may become higher even in laborious endoscopic surveillance because a special attention is consequently paid. However, endoscopic findings for effective detection of the risk of neoplastic progression to esophageal adenocarcinoma (EAC) have not been confirmed, though some typical appearances are suggestive. In the present review, endoscopic findings that can be used predict malignant potential to EAC in BE cases are discussed. Conventional results obtained with white light endoscopy, such as length of BE, presence of esophagitis, ulceration, hiatal hernia, and nodularity, are used as indicators of a higher risk of neoplastic progression. However, there are controversies in some of those findings. Absence of palisade vessels may be also a new candidate predictor, as that reveals degree of intense inflammation and of cyclooxygenase-2 protein expression with accelerated cellular proliferation. Furthermore, an open type of mucosal pattern and enriched stromal blood vessels, which can be observed by image-enhanced endoscopy, including narrow band imaging, have been confirmed as factors useful for prediction of neoplastic progression of BE because they indicate more frequent cyclooxygenase-2 protein expression along with accelerated cellular proliferation. Should the malignant potential of BE be shown predictable by these endoscopic findings, that would simplify methods used for an effective surveillance, because patients requiring careful monitoring would be more easily identified. Development in the near future of a comprehensive scoring system for BE based on clinical factors, biomarkers and endoscopic predictors is required.
Electro-Hydrodynamics of Emulsion Droplets: Physical Insights to Applications

The field of droplet electrohydrodynamics (EHD) emerged with a seminal work of G.I. Taylor in 1966, who presented the so-called leaky dielectric model (LDM) to predict the droplet shapes undergoing distortions under an electric field. Since then, the droplet EHD has evolved in many ways over the next 55 years with numerous intriguing phenomena reported, such as tip and equatorial streaming, Quincke rotation, double droplet breakup modes, particle assemblies at the emulsion interface, and many more. These phenomena have a potential of vast applications in different areas of science and technology. This paper presents a review of prominent droplet EHD studies pertaining to the essential physical insight of various EHD phenomena. Here, we discuss the dynamics of a single-phase emulsion droplet under weak and strong electric fields. Moreover, the effect of the presence of particles and surfactants at the emulsion interface is covered in detail. Furthermore, the EHD of multi-phase double emulsion droplet is included. We focus on features such as deformation, instabilities, and breakups under varying electrical and physical properties. At the end of the review, we also discuss the potential applications of droplet EHD and various challenges with their future perspectives.
The Cardiotonic Steroid Marinobufagenin Is a Predictor of Increased Left Ventricular Mass in Obesity: The African-PREDICT Study

The endogenous Na+/K+-ATPase inhibitor, marinobufagenin (MBG), strongly associates with salt intake and a greater left ventricular mass index (LVMi) in humans and was shown to promote cardiac fibrosis and hypertrophy in animals. The adverse effects of MBG on cardiac remodeling may be exacerbated with obesity, due to an increased sensitivity of Na+/K+-ATPase to MBG. This study determined whether MBG is related to the change in LVMi over time in adults with a body mass index (BMI) ≥30 kg/m2 (obese) and <30 kg/m2 (non-obese). The study followed 275 healthy participants (aged 20–30 years) from the African-Prospective study on the Early Detection and Identification of Cardiovascular disease and Hypertension (African-PREDICT) study over 4.5 years. At baseline, we measured 24 h urine MBG excretion. MBG levels were positively associated with salt intake. LVMi was determined by two-dimensional echocardiography at baseline and after >4.5 years. With multivariate adjusted analyses in obese adults (N = 56), we found a positive association of follow-up LVMi (Adjusted (Adj.) R2 = 0.35; Std. β = 0.311; p = 0.007) and percentage change in LVMi (Adj. R2 = 0.40; Std. β = 0.336; p = 0.003) with baseline MBG excretion. No association of LVMi (Adj. R2 = 0.37; p = 0.85) or percentage change in LVMi (Adj. R2 = 0.19; p = 0.68) with MBG excretion was evident in normal weight adults (N = 123). These findings suggest that obese adults may be more sensitive to the adverse cardiac effects of MBG and provide new insight into the potential role of dietary salt, by way of MBG, in the pathogenesis of cardiac remodeling in obese individuals.
The night out task and scoring application: an ill-structured, open-ended clinic-based test representing cognitive capacities used in everyday situations.

OBJECTIVE The night out task (NOT) was developed as a naturalistic, open-ended, multitasking measure that requires individuals to complete eight subtasks comparable to those encountered during real-world functioning (e.g., pack travel bag, prepare tea). We examined psychometric properties and administration feasibility of this direct observation measure within a clinic-like setting using a tablet-based coding application. METHOD A sample of 148 community-dwelling older adults (82% cognitively healthy; 18% mild cognitive impairment) and 57 younger adults completed the NOT along with other neurocognitive tests and questionnaires. RESULTS Inter-rater reliability across NOT primary (i.e., time, accuracy, efficiency) and process-related (e.g., error-types, self-corrections) variables was mostly excellent. NOT primary measures showed expected patterns of convergent and discriminant validity with measures of cognition, demographics, and well-being. External validity was established by the NOT ability to distinguish between age and diagnostic (cognitively healthy vs. mild cognitive impairment) groups. Demonstrating incremental validity, the NOT primary variables (execution time in particular) were predictive of self-reported functional abilities and completion quality of in-home everyday tasks over and earlier variables such as demographics, cognition, and mobility. CONCLUSIONS These findings suggest that the NOT and its app interface, which allows for continuous logging of observations, are a feasible in-clinic measure to assess cognitive capacities important for real-world functioning. With further validation, the NOT may allow for earlier detection of functional difficulties. Understanding errors and strategies used during NOT performance could also have implications for individualized interventions.
User-Centered Clinical Display Design Issues for Inpatient Providers

Abstract Background Suboptimal information display in electronic health records (EHRs) is a notorious pain point for users. Designing an effective display is difficult, due in part to the complex and varied nature of clinical practice. Objective This article aims to understand the goals, constraints, frustrations, and mental models of inpatient medical providers when accessing EHR data, to better inform the display of clinical information. Methods A multidisciplinary ethnographic study of inpatient medical providers. Results Our participants' primary goal was usually to assemble a clinical picture around a given question, under the constraints of time pressure and incomplete information. To do so, they tend to use a mental model of multiple layers of abstraction when thinking of patients and disease; they prefer immediate pattern recognition strategies for answering clinical questions, with breadth-first or depth-first search strategies used subsequently if needed; and they are sensitive to data relevance, completeness, and reliability when reading a record. Conclusion These results conflict with the ubiquitous display design practice of separating data by type (test results, medications, notes, etc.), a mismatch that is known to encumber efficient mental processing by increasing both navigation burden and memory demands on users. A popular and obvious solution is to select or filter the data to display exactly what is presumed to be relevant to the clinical question, but this solution is both brittle and mistrusted by users. A less brittle approach that is more aligned with our users' mental model could use abstraction to summarize details instead of filtering to hide data. An abstraction-based approach could allow clinicians to more easily assemble a clinical picture, to use immediate pattern recognition strategies, and to adjust the level of displayed detail to their particular needs. It could also help the user notice unanticipated patterns and to fluidly shift attention as understanding evolves.
A nomogram for prediction of early allograft dysfunction in living donor liver transplantation

Abstract Liver transplantation is the treatment of choice for end-stage liver diseases. However, early allograft dysfunction (EAD) is frequently encountered and associated with graft loss or mortality after transplantation. This study aimed to establish a predictive model of EAD after living donor liver transplantation. A total of 77 liver transplants were recruited to the study. Multivariate analysis was utilized to identify significant risk factors for EAD. A nomogram was constructed according to the contributions of the risk factors. The predictive values were determined by discrimination and calibration methods. A cohort of 30 patients was recruited to validate this predictive model. Four independent risk factors, including donor age, intraoperative blood loss, preoperative alanine aminotransferase (ALT), and reperfusion total bilirubin, were identified and used to build the nomogram. The c-statistics of the primary cohort and the validation group were 0.846 and 0.767, respectively. The calibration curves for the probability of EAD presented an acceptable agreement between the prediction by the nomogram and the actual incidence. In conclusion, the study developed a new nomogram for predicting the risk of EAD following living donor liver transplantation. This model may help clinicians to determine individual risk of EAD following living donor liver transplantation.
On the importance of tunica intima in the aging aorta: a three-layered in silico model for computing wall stresses in abdominal aortic aneurysms

Abstract Layer-specific experimental data for human aortic tissue suggest that, in aged arteries and arteries with non-atherosclerotic intimal thickening, the innermost layer of the aorta increases significantly its stiffness and thickness, becoming load-bearing. However, there are very few computational studies of abdominal aortic aneurysms (AAAs) that take into account the mechanical contribution of the three layers that comprise the aneurysmal tissue. In this paper, a three-layered finite element model is proposed from the simplest uniaxial stress state to geometrically parametrized models of AAAs with different asymmetry values. Comparisons are made between a three-layered artery wall and a mono-layered intact artery, which represents the complex behavior of the aggregate adventitia-media-intima in a single layer with averaged mechanical properties. Likewise, the response of our idealized geometries is compared with similar experimental and numerical models. Finally, the mechanical contributions of adventitia, media and intima are analyzed for the three-layered aneurysms through the evaluation of the mean stress absorption percentage. Results show the relevance and necessity of considering the inclusion of tunica intima in multi-layered models of AAAs for getting accurate results in terms of peak wall stresses and displacements.
Digital Phenotyping in Bipolar Disorder: Which Integration with Clinical Endophenotypes and Biomarkers?

Bipolar disorder (BD) is a complex neurobiological disorder characterized by a pathologic mood swing. Digital phenotyping, defined as the ‘moment-by-moment quantification of the individual-level human phenotype in its own environment’, represents a new approach aimed at measuring the human behavior and may theoretically enhance clinicians’ capability in early identification, diagnosis, and management of any mental health conditions, including BD. Moreover, a digital phenotyping approach may easily introduce and allow clinicians to perform a more personalized and patient-tailored diagnostic and therapeutic approach, in line with the framework of precision psychiatry. The aim of the present paper is to investigate the role of digital phenotyping in BD. Despite scarce literature published so far, extremely heterogeneous methodological strategies, and limitations, digital phenotyping may represent a grounding research and clinical field in BD, by owning the potentialities to quickly identify, diagnose, longitudinally monitor, and evaluating clinical response and remission to psychotropic drugs. Finally, digital phenotyping might potentially constitute a possible predictive marker for mood disorders.
The Size‐Accelerated Kinetic Resolution of Secondary Alcohols

Abstract The factors responsible for the kinetic resolution of alcohols by chiral pyridine derivatives have been elucidated by measurements of relative rates for a set of substrates with systematically growing aromatic side chains using accurate competitive linear regression analysis. Increasing the side chain size from phenyl to pyrenyl results in a rate acceleration of more than 40 for the major enantiomer. Based on this observation a new catalyst with increased steric bulk has been designed that gives enantioselectivity values of up to s=250. Extensive conformational analysis of the relevant transition states indicates that alcohol attack to the more crowded side of the acyl‐catalyst intermediate is favoured due to stabilizing CH‐π‐stacking interactions. Experimental and theoretical results imply that enantioselectivity enhancements result from accelerating the transformation of the major enantiomer through attractive non‐covalent interactions (NCIs) rather than retarding the transformation of the minor isomer through repulsive steric forces.
Comparison of Various Phase I Combination Therapy Designs in Oncology for Evaluation of Early Tumor Shrinkage Using Simulations

There is still a lack of efficient designs for identifying the dose response in oncology combination therapies in early clinical trials. The concentration response relationship can be identified using the early tumor shrinkage time course, which has been shown to be a good early response marker of clinical efficacy. The performance of various designs using an exposure–tumor growth inhibition model was explored using simulations. Different combination effects of new drug M and cetuximab (reference therapy) were explored first assuming no effect of M on cetuximab (to investigate the type I error (α)), and subsequently assuming additivity or synergy between cetuximab and M. One‐arm, two‐arm, and four‐arm designs were evaluated. In the one‐arm design, 60 patients received cetuximab + M. In the two‐arm design, 30 patients received cetuximab and 30 received cetuximab + M. In the four‐arm design, in addition to cetuximab and cetuximab + M as standard doses, combination arms with lower doses of cetuximab were evaluated (15 patients/arm). Model‐based predictions or “simulated observations” of early tumor shrinkage at week 8 (ETS8) were compared between the different arms. With the same number of individuals, the one‐arm design showed better statistical power than other designs but led to strong inflation of α in case of misestimated reference for ETS8 value. The two‐arm design protected against this misestimation and, with the same total number of subjects, would provide higher statistical power than a four‐arm design. However, a four‐arm design would be helpful for exploring more doses of cetuximab in combination with M to better understand the interaction.
Tumor site discordance in mismatch repair deficiency in synchronous endometrial and ovarian cancers

Objectives For synchronous endometrial and ovarian cancers, most centers rely on mismatch repair testing of the endometrial cancer to identify Lynch syndrome, and neglect the ovarian tumor site completely. We examined the mismatch repair immunohistochemistry and microsatellite instability results from the endometrium and ovary to assess discordance between the tumor sites and between tests. Methods 30 women with newly diagnosed synchronous endometrial and ovarian cancer were prospectively recruited from three cancer centers in Ontario, Canada. Both tumor sites were assessed for mismatch repair deficiency by immunohistochemistry and microsatellite instability test; discordance in results between tumor sites and discordance between test results at each site was examined. Cases with discordant results had tumors sequenced with a targeted panel in order to reconcile the findings. All women underwent mismatch repair gene germline testing. Results Of 30 patients, 11 (37%) were mismatch repair deficient or microsatellite instable at either tumor site, with 5 (17%) testing positive for Lynch syndrome. Mismatch repair immunohistochemistry expression was discordant between endometrial and ovarian tumor sites in 2 of 27 patients (7%) while microsatellite instability results were discordant in 2 of 25 patients (8%). Relying on immunohistochemistry or microsatellite instability alone on the endometrial tumor would have missed one and three cases of Lynch syndrome, respectively. One patient with Lynch syndrome with a PMS2 pathogenic variant was not detected by either immunohistochemistry or microsatellite instability testing. The rate of discordance between immunohistochemistry and microsatellite instability test was 3.8% in the ovary and 12% in the endometrium. Conclusions There was discordance in immunohistochemistry and microsatellite instability results between tumor sites and between tests within each site. Endometrial tumor testing with mismatch repair immunohistochemistry performed well, but missed one case of Lynch syndrome. Given the high incidence of Lynch syndrome (17%), consideration may be given to germline testing in all patients with synchronous endometrial and ovarian cancers.
Interaction of Host‐Microbial Metabolism in Sepsis

The majority of species of the human gut microbiota is not cultivated on artificial nutri ‐ ent media, but they are included in the functioning of microbial metabolic conveyor. Between the numerous gut bacteria (transmitter) and billions of intracellular mitochon ‐ dria (receiver), the function of signaling molecules performs aromatic metabolites. Sepsis destroys the coordinated work of the indigenous anaerobic microflora. This leads to the imbalance of aromatic microbial metabolites (AMM). We hypothesized and proved diag ‐ nostic and pathogenic significance of this. First, deficiency of the end products of micro ‐ bial metabolism—lipophilic AMM (PhPA and derivatives‐cinnamic and benzoic acids) in sepsis, and second, excessive accumulation in blood of intermediate products named, “sepsis‐associated” AMM—both lead to the development of mitochondrial dysfunction. Particularly, the total suppressed production of mROS can manifest by “hibernate‐like state” of cells and lead to MOF. The participation of aromatic metabolites in the devel ‐ opment of septic shock can be explained by the inhibition of tyrosine hydroxylase and impaired synthesis of catecholamines. In clinical research, the high levels of “sepsis‐asso‐ ciated” AMM (p‐HPhAA, p‐HPhLA, and PhLA) correlate with the severity according to APACHE II, Sepsis‐related Organ Failure Assessments ( SOFA) score and mortality. To improve the survival of ICU patients, requires more attention to the role of imbalance of microbial metabolites in sepsis. were compared by Mann‐Whitney U‐test; p ‐values less than 0.05 were considered significant.
Forest Landscape Restoration: Progress in the Last Decade and Remaining Challenges

Forest landscape restoration (FLR) aims to restore forests in a landscape to meet both human needs and ecological priorities. Although the term was first defined in 2000, it has recently become popular and is being promoted as a solution to many of the environmental and social problems associated with land degradation. We take a step back and reflect on developments in FLR in the last twelve years, using as a framework 13 key issues raised in 2005. A decade ago, when the term “forest landscape restoration” had only recently been defined, we identified and documented several pre-requisites, tools, and approaches necessary for its development, as well as outstanding issues. Today FLR is the subject of significant government commitments, and has entered into the language of large multilateral environmental agreements, notably the three so-called Rio Conventions. While FLR can provide an important means of achieving multiple objectives in forested landscapes, outstanding challenges to its effective and widespread application remain. Our analysis of progress to date suggests that particular challenges for the effective implementation of FLR concern implementation of truly large-scale restoration initiatives that have both ecological and socio-economic objectives, tackling governance challenges, focusing on both quality and quantity of restored landscapes, promoting the links between FLR and climate change, and ensuring adequate and long-term monitoring. Given the significant advances in both development and uptake of FLR, we hope this reappraisal of 2005 challenges will help restoration practitioners and decision-makers to prioritize future interventions.