Miracle-dz/UniFAR-FTUs huggingface dataset:
On assessing the effect of breast cancer screening schemes

When to start breast screening, how often to screen, and how long to screen has been the subject of an often emotional debate for three decades. In this issue of Cancer, Kagan Arleo et al use CISNET modeling to estimate the possible effects of three breast cancer screening schemes on the population. They assess 1) annual screening from age 40 to 84 years; 2) annual screening from age 45 to 54 years, followed by biennial screening from age 55 to 79 years; and 3) biennial screening beginning at age 50 to 74 years. They estimate the mortality reduction and the number of breast cancer deaths prevented over the lifetime of a cohort of approximately 2.5 million American women born in a single year. They also estimate the number of recalls and benign biopsies for the cohort as they follow each of the three screening schemes. The purpose of an editorial is to give a scientific paper some perspective. I do so as a coauthor of the 2012 American Cancer Society (ACS) breast cancer screening guidelines and as the Society’s Chief Medical Officer. It is my belief that the article by Kagan Arleo et al provides reasonable approximations for the screening scheme as outlined. These estimates do have some limitations. The CISNET model assumes 100 percent compliance and assumes that all women have access to quality screening, diagnostics, and treatment. However, numerous studies have shown that a substantial proportion of American women with breast cancer receive less than adequate care. Indeed, one of the greatest frustrations of my career is there is not enough discussion about the need to provide better cancer care to a substantial proportion of Americans. Although Kagan Arleo et al state they are comparing American Cancer Society and US Preventive Services Task Force (USPSTF) guidelines, it is important to note that the screening schemes used to make these projections are not the guidelines of the ACS or the USPSTF. A common misconception is that the ACS recommends that all screening start at age 45 years and the USPSTF recommends all screening begin at age 50 years. The exact wording of the 2016 ACS guideline is as follows:
Determinants of Student Debt in New England

This paper examines the determinants of average student debt in New England based on financial, institutional and demographic variables. The dataset is derived from CollegeInsight and measures 15 variables across 71 institutions during the 2011-2014 academic school years. Between 2011 and 2014, average student debt increased 7%, tuition and room and board increased 10%, the percentage of Hispanic students increased 20% and the percentage of international students increased 26%. The estimated model, ln(AVDEBT) = 7.401 – 0.090ln(TUITION) – 0.042ln(BOOKS) + 0.433ln(ROOMBOARD) + 0.07ln(ENROLLMENT) – 0.200PUBLIC – 4.106ASIAN – 1.992AFAMERICAN + 0.254HISPANIC + 0.007WHITE + 0.641INTERNATIONAL – 0.676PERCENTFEDDEBT + 1.018PERCENTPELL, indicates that the primary determinants of average student debt in the region are: room and board costs, enrollment, public vs. private classification, the percentage of Asian, African American and international students, the percentage of student debt that comes from federal loans and the percentage of Pell Grant recipients. Other regions in the country could leverage a similar study to understand where the student debt burden is most likely coming from. The resulting information can stir policy discussions amongst institutions and governmental organizations to decrease the burden and ease the so-called student debt crisis.
Consumption of fresh fruit rich in vitamin C and wheezing symptoms in children

BACKGROUND A beneficial effect of fresh fruit consumption on lung function has been observed in several studies. The epidemiological evidence of the effect on respiratory symptoms and asthma is limited. The consumption of fruit rich in vitamin C was examined in relation to wheezing and other respiratory symptoms in cross sectional and follow up studies of Italian children. METHODS Standardised respiratory questionnaires were filled in by parents of 18 737 children aged 6–7 years living in eight areas of Northern and Central Italy. The winter intake of citrus fruit and kiwi fruit by the children was categorised as less than once per week, 1–2 per week, 3–4 per week, and 5–7 per week. A subset of 4104 children from two areas was reinvestigated after one year using a second parental questionnaire to record the occurrence of wheezing symptoms over the intervening period. RESULTS In the cross sectional analysis, after controlling for several confounders (sex, study area, paternal education, household density, maternal smoking, paternal smoking, dampness or mould in the child's bedroom, parental asthma), intake of citrus fruit or kiwi fruit was a highly significant protective factor for wheeze in the last 12 months (odds ratio (OR) = 0.66, 95% confidence intervals (CI) 0.55 to 0.78, for those eating fruit 5–7 times per week compared with less than once per week), shortness of breath with wheeze (OR = 0.68, 95% CI 0.56 to 0.84), severe wheeze (OR = 0.59, 95% CI 0.40 to 0.85), nocturnal cough (OR = 0.73, 95% CI 0.65 to 0.83), chronic cough (OR = 0.75, 95% CI 0.65 to 0.88), and non-coryzal rhinitis (OR = 0.72, 95% CI 0.63 to 0.83). In the follow up study fruit intake recorded at baseline was a strong and independent predictor of all symptoms investigated except non-coryzal rhinitis. In most cases the protective effect was evident even among children whose intake of fruit was only 1–2 times per week and no clear dose-response relationship was found. The effect was stronger (although not significantly so (p = 0.13)) in subjects with a history of asthma; those eating fresh fruit at least once a week experienced a lower one year occurrence of wheeze (29.3%) than those eating fruit less than once per week (47.1%) (OR = 0.46, 95% CI 0.27 to 0.81). CONCLUSIONS Although the effect of other dietary components cannot be excluded, it is concluded that the consumption of fruit rich in vitamin C, even at a low level of intake, may reduce wheezing symptoms in childhood, especially among already susceptible individuals.
An easy-to-use wearable step counting device for slow walking using ankle force myography

Step counting is a practical way for evaluating the activity level of people in daily life. However, the widely used accelerometer-based step-counters are not able to accurately detect low-speed steps (<0.6 m/s). Our earlier study used supervised machine learning to achieved a very high performance (error rate <1.5%) in low speed step detection based on the force myography (FMG) signals recorded at the ankle. However, the supervised machine learning approach requires a training process using carefully labelled data. The present study explores the feasibility of using unsupervised learning technique to improve the usability of the ankle force sensing resisters (FSR) band in step detection. An unsupervised K-Means algorithm was employed to train and test with the FMG data recorded from an array of 8 FSRs worn on the ankle position. Eight young healthy volunteers participated in the study by walking on a treadmill at 3 different speeds (0.28 m/s, 0.42 m/s, and 0.56 m/s) while FMG signals were recorded. Results showed a low error rate in the step detection (2.2%) at all 3 walking speeds using the unlabelled data for training.
Regulatory connection between the expression level of classical protein kinase C and pruning of climbing fibers from cerebellar Purkinje cells

Cerebellar Purkinje cells (PCs) express two members of the classical protein kinase C (cPKC) subfamily, namely, PKCα and PKCγ. Previous studies on PKCγ knockout (KO) mice have revealed a critical role of PKCγ in the pruning of climbing fibers (CFs) from PCs during development. The question remains as to why only PKCγ and not PKCα is involved in CF synapse elimination from PCs. To address this question, we assessed the expression levels of PKCγ and PKCα in wild‐type (WT) and PKCγ KO PCs using PC‐specific quantitative real‐time reverse transcription‐polymerase chain reaction, western blotting, and immunohistochemical analysis. The results revealed that the vast majority of cPKCs in PCs were PKCγ, whereas PKCα accounted for the remaining minimal fraction. The amount of PKCα was not up‐regulated in PKCγ KO PCs. Lentiviral expression of PKCα in PKCγ KO PCs resulted in a 10‐times increase in the amount of PKCα mRNA in the PKCγ KO PCs, compared to that in WT PCs. Our quantification showed that the expression levels of cPKC mRNA in PKCγ KO PCs increased roughly from 1% to 22% of that in WT PCs solely through PKCα expression. The up‐regulation of PKCα in PKCγ KO PCs significantly rescued the impaired CF synapse elimination. Although both PKCα and PKCγ are capable of pruning supernumerary CF synapses from developing PCs, these results suggest that the expression levels of cPKCs in PKCγ KO PCs are too low for CF pruning.
Risk Factors for Antenatal Depression and Associations with Infant Birth Outcomes: Results From a South African Birth Cohort Study.

BACKGROUND Maternal antenatal depression may be particularly prevalent in low- and middle-income countries, but there is a paucity of data on its effect on birth outcomes in such settings. We investigated risk factors for antenatal depression and the associations between depression and infant birth outcomes in the Drakenstein Child Health Study (DCHS), a birth cohort study in the Western Cape, South Africa. METHODS The prevalence of depression in pregnant women enrolled in the DCHS from primary care antenatal clinics was measured using the Beck Depression Inventory (BDI-II). Predictors of antenatal depression were investigated using logistic regression, and the associations between depression and infant birth outcomes were examined in linear regression models. RESULTS Among 726 pregnant women (median age: 26 years), 156 (21%) had BDI-II scores suggesting depression. Independent predictors of depression included single marital status, low socioeconomic status (SES), recent stressful life events, unplanned pregnancy, childhood trauma, and past-year intimate partner violence. No association was observed between antenatal depression and preterm birth. Strong associations were observed between antenatal depression and decreased infant weight-for-age (WAZ) and head circumference-for-age (HCAZ) z-scores at birth. In multivariable analysis, the association between depression and decreased HCAZ remained significant, when adjusted for clinic, SES, and recent stressful life events. CONCLUSIONS Antenatal depression and associated risk factors are highly prevalent in this setting and are associated with adverse fetal growth. Maternal mental health may be an important predictor of infant growth in utero.
Tampões de extração e utilização de RNAse na qualidade de análises de citometria de fluxo de bananeira.

A banana e um dos produtos alimentares mais produzidos no mundo atualmente, com mais de 130 paises produtores, sendo muito importante, pois se torna grande geradora de fonte e renda empregando milhoes de pessoas em todo o territorio nacional. O melhoramento desta especie visa a obtencao de hibridos resistentes a doencas e com maior produtividade, neste sentido a duplicacao cromossomica permite a geracao de plantas autotetraploides que, depois de avaliadas e selecionadas, sao utilizadas em cruzamento com diploides melhorados. Para avaliar o nivel de ploidia pode-se utilizar a tecnica de citometria de fluxo. Neste tipo de tecnica o tampao para conservacao dos nucleos mostra-se de grande importância (Stover e Buddenhagen, 1986; Bakry et al., 2007).
Question 1 Is cerebral function monitoring as accurate as conventional EEG in the detection of neonatal seizures?

A term baby girl is admitted to the neonatal unit following concerns regarding abnormal movements noted on the postnatal ward. She is reported to have had tonic posturing of the limbs and back-arching at 10 h of age. As the neonatal registrar on the night shift, you are asked to review the baby and you wonder whether cerebral function monitoring (CFM) of the baby would be an effective and accurate method of detecting seizure activity. Is CFM or amplitude EEG (aEEG) [index test] as accurate as conventional EEG (cEEG) [comparison] in detecting seizures [outcome] in term neonates [population]? ### Primary sources A search of the EMBASE and MEDLINE healthcare databases (limits: publication year 1974–current and English language) identified 42 articles (search performed March 2010). The following search keywords were used: [(neonat* OR newborn* OR infant*) AND (cerebral function monitor* OR electroencephalogra* OR amplitude EEG OR conventional EEG OR aEEG OR cEEG) AND (seizure* OR convulsion*)]. ti ### Secondary sources No systematic reviews were identified from a search of the Cochrane Library. ### Outcome Five relevant studies were identified (see table 1). 1,–,5These studies included sample groups, investigations and outcome measures which were relevant to our original question. All five studies were diagnostic test comparison studies which statistically compared the sensitivity of seizure detection and interobserver agreement of aEEG with cEEG in term or near-term (at least 34 weeks' gestation) neonates with hypoxic ischaemic encephalopathy, suspected clinical seizures or at risk of seizures due to hypoxic events, meningitis …
Evaluating customer lifetime value for customer recommendation

It is crucial for a company to identify which are its most valuable and least profitable customers so that appropriate customer-specific marketing strategies can be developed and put in place. This paper develops a comprehensive customer lifetime value (CLV) measure model. The model not only combines the up-selling, cross-selling, and network influence opportunity, but also considers the churn risk. By regarding the market as a social network, the social influence role of a customer is explicitly modeled into the CLV evaluation. The result from the CLV model is used as a metric for customer selection. The model is empirically validated by the application to a company in the health care industry.
Resolvin E1 promotes phagocytosis-induced neutrophil apoptosis and accelerates resolution of pulmonary inflammation

Inappropriate neutrophil activation contributes to the pathogenesis of acute lung injury (ALI). Apoptosis is essential for removal of neutrophils from inflamed tissues and timely resolution of inflammation. Resolvin E1 (RvE1) is an endogenous lipid mediator derived from the ω-3 polyunsaturated fatty acid eicosapentaenoic acid that displays proresolving actions. Because the balance of prosurvival and proapoptosis signals determines the fate of neutrophils, we investigated the impact of RvE1 on neutrophil apoptosis and the outcome of neutrophil-mediated pulmonary inflammation in mice. Culture of human neutrophils with RvE1 accelerated apoptosis evoked by phagocytosis of opsonized Escherichia coli or yeast. RvE1 through the leukotriene B4 receptor BLT1 enhanced NADPH oxidase-derived reactive oxygen species generation and subsequent activation of caspase-8 and caspase-3. RvE1 also attenuated ERK and Akt-mediated apoptosis-suppressing signals from myeloperoxidase, serum amyloid A, and bacterial DNA, shifting the balance of pro- and anti-survival signals toward apoptosis via induction of mitochondrial dysfunction. In mice, RvE1 treatment enhanced the resolution of established neutrophil-mediated pulmonary injury evoked by intratracheal instillation or i.p. administration of live E. coli or intratracheal instillation of carrageenan plus myeloperoxidase via facilitating neutrophil apoptosis and their removal by macrophages. The actions of RvE1 were prevented by the pan-caspase inhibitor zVAD-fmk. These results identify a mechanism, promotion of phagocytosis-induced neutrophil apoptosis and mitigation of potent anti-apoptosis signals, by which RvE1 could enhance resolution of acute lung inflammation.
Air pollution and hospitalizations in the largest Brazilian metropolis

ABSTRACT OBJECTIVE To evaluate the impact of air pollution on hospitalizations for respiratory and cardiovascular diseases in the largest Brazilian metropolis. METHODS This study was carried out at the Metropolitan Region of São Paulo, Brazil. Environmental data were obtained from the network of monitoring stations of nine municipalities. Air pollution exposure was measured by daily means of PM10 (particles with a nominal mean aerodynamic diameter ≤ 10 μm) per municipality, while daily counts of hospitalizations for respiratory and cardiovascular diseases within the Brazilian Unified Health System were the outcome. For each municipality a time series analysis was carried out in which a semiparametric Poisson regression model was the framework to explain the daily fluctuations on counts of hospitalizations over time. The results were combined in a meta-analysis to estimate the overall risk of PM10 in hospitalizations for respiratory and cardiovascular diseases at the Metropolitan Region of São Paulo. RESULTS Regarding hospitalizations for respiratory diseases, the effect estimates were statistically significant (p < 0.05) for all municipalities, except Santo André and Taboão da Serra. The RR (Relative Risk) of this outcome for an increase of 10 µg/m3 in the levels of PM10 ranged from 1.011 (95%CI 1.009–1.013) for São Paulo to 1.032 (95%CI 1.024–1.040) in São Bernardo do Campo. The RR of hospitalization for respiratory diseases in children for an increase of 10 µg/m3 of PM10 ranged from 1.009 (95%CI 1.001–1.017) in Santo André to 1.077 (95%CI 1.056–1.098) in Mauá. Only São Paulo and São Bernardo do Campo presented positive and statistically significant results for hospitalizations for cardiovascular diseases. CONCLUSIONS This is the first study to estimate the risk of illness from air pollution in the set of municipalities of the Metropolitan Region of São Paulo, Brazil. Global estimates of the effect of exposure to pollution in the region indicated associations only with respiratory diseases. Only São Paulo and São Bernardo do Campo showed an association between the levels of PM10 and hospitalizations for cardiovascular diseases.
Depression Is Associated with Readmission for Acute Exacerbation of Chronic Obstructive Pulmonary Disease.

RATIONALE Hospitalization for acute exacerbation of chronic obstructive pulmonary disease (COPD) is associated with significant morbidity and health care costs, and hospitals in the United States are now penalized by the Centers for Medicare and Medicaid Services for excessive readmissions. Identifying patients at risk of readmission is important, but modifiable risk factors have not been clearly established, and the potential contributing role of psychological disease has not been examined adequately. We hypothesized that depression and anxiety would increase the risk of both short- and long-term readmissions for acute exacerbation of COPD. OBJECTIVES To characterize the associations between depression and anxiety and COPD readmission risk. METHODS We examined the medical records for all patients with a primary diagnosis of acute exacerbation of COPD by International Classification of Diseases, Ninth Revision codes admitted to the University of Alabama at Birmingham Hospital between November 2010 and October 2012. Those who did not meet the standardized study criteria for acute exacerbation of COPD and those with other respiratory illnesses as the primary diagnosis were excluded. Comorbidities were recorded on the basis of physician documentation of the diagnosis and/or the use of medications in the electronic medical record. Multivariable regression analyses identified factors associated with readmission for acute exacerbation of COPD at 1 year and within 30 and 90 days. MEASUREMENTS AND MAIN RESULTS Four hundred twenty-two patients were included, with 132 readmitted in 1 year. Mean age was 64.8 ± 11.7 years, and mean percent predicted FEV1 was 48.1 ± 18.7%. On univariate analysis, readmitted patients had lower percent predicted FEV1 (44.9 ± 17.3% vs. 50.2 ± 19.4%; P = 0.05) and a higher frequency of depression (47.7% vs. 23.4%; P < 0.001). On multivariable analysis, 1-year readmission was independently associated with depression (adjusted odds ratio [OR], 2.67; 95% confidence interval [CI], 1.59-4.47) and in-hospital tobacco cessation counseling (adjusted OR, 0.34; 95% CI, 0.18-0.66). Depression also predicted readmission at 30 days (adjusted OR, 3.83; 95% CI, 1.84-7.96) and 90 days (adjusted OR, 2.47; 95% CI, 1.34-4.55). CONCLUSIONS Depression is an independent risk factor for both short- and long-term readmissions for acute exacerbation of COPD and may represent a modifiable risk factor. In-hospital tobacco cessation counseling was also associated with reduced 1-year readmission.
Functional and long-term outcomes in severe traumatic brain injury following regionalization of a trauma system

BACKGROUND We previously demonstrated that regionalization of trauma (RT) significantly reduced in-hospital mortality from 19% to 14% in patients with severe traumatic brain injury (sTBI). However, functional and long-term outcomes had not been assessed. We hypothesized that RT would be associated with improved functional and long-term outcomes in sTBI patients. METHODS All TBI patients older than 14 years with a head Abbreviated Injury Scale (AIS) score of 3 or greater were identified from the RT database and matched to the state death index and the regional TBI rehabilitation (TBIr) database. Data from 2008 through 2012 were analyzed before and after RT in 2010. For patients discharged to the TBIr unit, overall Functional Independence Measure (FIM) scores and FIM score gains were compared before and after RT. RESULTS A total of 3,496 patients with sTBI were identified in the RT database, 1,359 in the pre-RT and 2,137 in the post-RT period. The mortality rate after discharge decreased significantly after RT from 21% to 16% (p < 0.0001) at 30 days and from 24% to 20% (p = 0.004) at 6 months. Multivariable logistic regression demonstrated RT to be an independent predictor against mortality at 30 days (odds ratio, 0.74; 95% confidence interval, 0.60–0.91; C statistic, 0.84) and 6 months (odds ratio, 0.82; 95% confidence interval, 0.67–0.99; C statistic, 0.82). Discharges to the TBIr unit increased from 117 (9%) in the pre-RT to 297 (14%) in the post-RT period (p < 0.0001), while discharges to home and non-TBIr units remained similar. Injury Severity Score (ISS) and Glasgow Coma Scale (GCS) score for all discharged patients remained similar. FIM admission scores were similar in the pre-RT (median, 54; interquartile range [IQR], 30–65) and post-RT period (median, 48; IQR, 31–61) (p = 0.2) and remained similar at discharge in the pre-RT (median, 92; IQR, 75–102) and post-RT period (median, 89; IQR, 73–100) (p = 0.1). TBIr patients showed similar FIM score gains in the pre-RT (median, 37; IQR, 26–46) and post-RT period (median, 36; IQR, 24–49) (p = 0.6). CONCLUSION RT was associated with reduced long-term mortality, increased TBIr admissions, and similar FIM score improvements for patients with sTBI. LEVEL OF EVIDENCE Therapeutic/care management study, level IV.