Miracle-dz/UniFAR-FTUs huggingface dataset:
The baricity of plain bupivacaine

gery under brachial plexus block). Taken together with surgical satisfaction scores (extremely satisfied or satisfied in all 15 cases), we are confident that this technique provides suitable and adequate operating conditions. The authors raise the issue of why only 16 patients were recruited over a 13-month period. Patients were offered this technique by the lead author on one day per week, excluding time spent on leave. The surgical work-load included minor and major cancer, as well as noncancer breast surgery. All suitable patients were informed of the anaesthetic options available, but low patient numbers simply reflect the reality of conducting a study on a single operating list in a single institution. Ramesh and Carey kindly requested further information about local anaesthetic dosing. We used a fixed volume combination of lidocaine (with adrenaline) and levobupivacaine for both paravertebral and pectoral nerve blocks. Dosage was altered by modifying the concentration of local anaesthesia used, while maintaining the fixed volume. Dosing of local anaesthetic mixtures lacks clear guidelines or consensus [3], but a frequently used rule of thumb is to dose up to 100% of the combined maximum dose [4]. Ten patients received a cumulative dose of local anaesthetic that exceeded this threshold. We have since modified our technique to prioritise mass of local anaesthetic administered via the paravertebral route, using the remainder of local anaesthetic calculated by patient weight for pectoral nerve block. However, we eagerly await dosing studies that would address the common clinical scenario of performing multiple blocks with mixed local anaesthetics. The rationale for prioritising the paravertebral block is that successful proximal intercostal blockade is key to dense blockade of the chest wall, and this primary technique can then be reinforced by subsequent pectoral nerve block. We agree that a majority of patients are likely to express a preference for GA for breast surgery. However, in the correct cohort of patients and with the appropriate experience, an alternative to general anaesthesia exists. Furthermore, we have found that a number of patients express a preference to avoid GA, whether due to previous bad experiences or anxiety. In publishing details of this technique, we hope to highlight the feasibility of performing major breast surgery under combined paravertebral and pectoral nerve blocks rather than suggesting it as the default option. By offering options and choice about anaesthetic technique, we hope to tailor our service to the needs of individuals.
Physical Activity and Incident Cardiovascular Disease in Women: Is the Relation Modified by Level of Global Cardiovascular Risk?

Background The inverse association between physical activity and cardiovascular disease (CVD) is well‐ established and has previously been shown in people with and without single CVD risk factors. We examined whether level of global cardiovascular risk, on the basis of the pooled cohort equation or Reynolds risk score, which include multiple risk factors, modified the physical activity–CVD association. Methods and Results Participants in the prospective WHS (Women's Health Study; n=27 536) reported their leisure‐time physical activity at study entry (1992–1995) and during follow‐up through 2013. Participants were divided into 10‐year cardiovascular risk groups on the basis of the pooled cohort equation and Reynolds risk score. The primary outcome was incident total CVD. The CVD hazard ratio for active (≥500 kcal/wk of physical activity) compared with inactive (<500 kcal/wk) individuals was 0.73 (95% confidence interval, 0.66–0.80) in multivariable models. This association was not modified by level of cardiovascular risk; physical activity was inversely associated with CVD within all pooled cohort equation and Reynolds risk score groups (P=0.17 and P=0.66 for interaction, respectively). When the joint association of physical activity and level of cardiovascular risk was examined, women with higher risk on the basis of either the pooled cohort equation or Reynolds risk score had higher CVD rates compared with those at low risk, regardless of physical activity. However, among women at both high and low risk, being physically active was associated with lower risk of CVD events. Conclusions In this large prospective cohort of women, level of global cardiovascular risk did not modify the inverse association between leisure‐time physical activity and incident CVD. Thus, promoting physical activity is important in women at both low and high cardiovascular risk.
Swarming for Faster Convergence in Stochastic Optimization

We study a distributed framework for stochastic optimization which is inspired by models of collective motion found in nature (e.g., swarming) with mild communication requirements. Specifically, we analyze a scheme in which each one of $N > 1$ independent threads, implements in a distributed and unsynchronized fashion, a stochastic gradient-descent algorithm which is perturbed by a swarming potential. Assuming the overhead caused by synchronization is not negligible, we show the swarming-based approach exhibits better performance than a centralized algorithm (based upon the average of $N$ observations) in terms of (real-time) convergence speed. We also derive an error bound that is monotone decreasing in network size and connectivity. We characterize the scheme's finite-time performances for both convex and non-convex objective functions.
Effect of local anesthesia containing vasoconstrictor on sealing ability of dentin with two adhesive systems: Dye leakage and scanning electron microscopy study

Objectives: To evaluate the effect of 2% lignocaine containing 1:80,000 adrenaline on the microleakage and ultrastructure of resin tooth interface using an acetone based total etch adhesive (Prime and Bond NT) and an ethanol water based self etch adhesive system (Xeno III). Materials and method: Class V cavities were prepared on buccal surfaces of 72 maxillary first premolars scheduled for orthodontic extraction. In 36 premolars procedure was performed under local anaesthesia (LA) and in other 36 teeth without LA. Restorations were done with hybrid composite Spectrum TPH using either Prime and Bond NT or Xeno III bonding agents. Results: Administration of 2% lignocaine with 1:80,000 adrenaline significantly reduced microleakage and improved quality of hybrid layer and tubular penetration in Prime and Bond NT specimens; but no significant effect was observed in Xeno III specimens. Conclusion: Under clinical conditions, administration of LA reduced microleakage and improved quality of hybrid layer and tubular penetration in total etch adhesive systems.
An Extension to Deng’s Entropy in the Open World Assumption with an Application in Sensor Data Fusion

Quantification of uncertain degree in the Dempster-Shafer evidence theory (DST) framework with belief entropy is still an open issue, even a blank field for the open world assumption. Currently, the existed uncertainty measures in the DST framework are limited to the closed world where the frame of discernment (FOD) is assumed to be complete. To address this issue, this paper focuses on extending a belief entropy to the open world by considering the uncertain information represented as the FOD and the nonzero mass function of the empty set simultaneously. An extension to Deng’s entropy in the open world assumption (EDEOW) is proposed as a generalization of the Deng’s entropy and it can be degenerated to the Deng entropy in the closed world wherever necessary. In order to test the reasonability and effectiveness of the extended belief entropy, an EDEOW-based information fusion approach is proposed and applied to sensor data fusion under uncertainty circumstance. The experimental results verify the usefulness and applicability of the extended measure as well as the modified sensor data fusion method. In addition, a few open issues still exist in the current work: the necessary properties for a belief entropy in the open world assumption, whether there exists a belief entropy that satisfies all the existed properties, and what is the most proper fusion frame for sensor data fusion under uncertainty.
[Blocking programmed death-ligand 1 attenuates maturation inhibition of dendritic cells by co-cultured breast cancer cells].

OBJECTIVE To study if programmed death-ligand 1 (PL-L1) expression in breast cancer cell activates PD-L1/PD-1 pathway in dendritic cells to inhibit dendritic cell maturation. METHODS Human monocytes were induced to differentiate into immature dendritic cells using GM-CSF and IL-4, and further to mature dendritic cells using TNF-α. PD-L1-expressing breast cancer cell line MDA-MB-231 was co-cultured in contact with the dendritic cells to observe the effects of the breast cancer cells on the maturation of the dendritic cells. A PD-L1 blocking antibody was applied to the co-culture, and the changes in the inhibitory effect of the MDA-MB-231 cells on dendritic cell maturation was observed. TNF-α-induced dendritic cells were treated with a recombinant human PD-L1 protein to study the effect of PD-L1/PD-1 pathway activation on the maturation of dendritic cells. The expression of PD-L1 in MDA-MB-231 cells and the dendritic cell maturation marker HLA-DR and CD83 were analyzed using flow cytometry. RESULTS MDA-MB-231 cell line showed PD-L1 positivity on the cell membrane cells at a rate as high as (99.7∓0.15)%. In mature dendritic cells, the positivity rates for HLA-DR and CD83 were (88.8∓6.96)% and (18.36∓3.07)%, respectively, but in the co-culture system, the positivity rates of the dendritic cells were significantly decreased to (42.76∓10.52)% (P<0.01) and (9.93∓2.74)% (P<0.05), respectively, indicating that MDA-MB-231 cells inhibited the maturation of dendritic cells. Following treatment with a PD-L1 antibody isotype control, the percentages of HLA-DR- and CD83-positive cells in the co-culture were (45.17∓10.19)% and (10.15∓2.54)%, which were significantly increased to (63.46∓1.72)% and (16.46∓2.58)% after treatment with PD-L1 antibody, respectively (both P<0.05). Compared with the mature dendritic cell controls, the cells treated with the recombinant human PD-L1 protein exhibited significantly lowered percentages of HLA-DR-positive [from (84.23∓4.18)% to (2.56∓2.39)%, P<0.05] and CD83-positive cells [(87.26∓1.54)% to (60.67∓1.63)%, P<0.05]. CONCLUSION The effect of PD-L1 antibody therapy on triple negative breast cancer can be partially mediated by blocking PD-L1 expression on breast cancer cell membrane, which attenuates the inhibition of dendritic cell maturation in the cancer microenvironment.
Single-crystal diamond low-dissipation cavity optomechanics

Single-crystal diamond cavity optomechanical devices are a promising example of a hybrid quantum system: by coupling mechanical resonances to both light and electron spins, they can enable new ways for photons to control solid state qubits. However, realizing cavity optomechanical devices from high quality diamond chips has been an outstanding challenge. Here we demonstrate single-crystal diamond cavity optomechanical devices that can enable photon-phonon-spin coupling. Cavity optomechanical coupling to $2\,\text{GHz}$ frequency ($f_\text{m}$) mechanical resonances is observed. In room temperature ambient conditions, these resonances have a record combination of low dissipation (mechanical quality factor, $Q_\text{m} > 9000$) and high frequency, with $Q_\text{m}\cdot f_\text{m} \sim 1.9\times10^{13}$ sufficient for room temperature single phonon coherence. The system exhibits high optical quality factor ($Q_\text{o} > 10^4$) resonances at infrared and visible wavelengths, is nearly sideband resolved, and exhibits optomechanical cooperativity $C\sim 3$. The devices' potential for optomechanical control of diamond electron spins is demonstrated through radiation pressure excitation of mechanical self-oscillations whose 31 pm amplitude is predicted to provide 0.6 MHz coupling rates to diamond nitrogen vacancy center ground state transitions (6 Hz / phonon), and $\sim10^5$ stronger coupling rates to excited state transitions.
The Veterans Metrics Initiative study of US veterans’ experiences during their transition from military service

Purpose Efforts to promote the health and well-being of military veterans have been criticised for being inadequately informed of veterans’ most pressing needs as they separate from military service, as well as the programmes that are most likely to meet these needs. The current article summarises limitations of the current literature and introduces The Veterans Metrics Initiative (TVMI) study, a longitudinal assessment of US veterans’ well-being and programme use in the first three years after they separate from military service. Veterans were assessed within 3 months of military separation and will complete five additional assessments at 6-month intervals during the subsequent period. Participants The TVMI study cohort consists of a national sample of 9566 newly separated US veterans that were recruited in the fall of 2016. Findings to date The TVMI sample includes representation from all branches of service, men and women, and officers and enlisted personnel. Although representative of the larger population on many characteristics, differential response rates were observed for some subgroups, necessitating the development of non-response bias weights. Comparisons between unweighed and weighted results suggest that the weighting procedure adequately adjusts for observed differences. Future plans Analyses are under way to examine veterans’ well-being and programme use in the period following separation after military service, as well as factors associated with poor outcomes. We have also begun to decompose programmes into their core components to facilitate examination of how these components relate to well-being. Once our third data collection is complete, we will examine factors related to different patterns of readjustment over time.
Detecting Recovery Problems Just in Time: Application of Automated Linguistic Analysis and Supervised Machine Learning to an Online Substance Abuse Forum

Background Online discussion forums allow those in addiction recovery to seek help through text-based messages, including when facing triggers to drink or use drugs. Trained staff (or “moderators”) may participate within these forums to offer guidance and support when participants are struggling but must expend considerable effort to continually review new content. Demands on moderators limit the scalability of evidence-based digital health interventions. Objective Automated identification of recovery problems could allow moderators to engage in more timely and efficient ways with participants who are struggling. This paper aimed to investigate whether computational linguistics and supervised machine learning can be applied to successfully flag, in real time, those discussion forum messages that moderators find most concerning. Methods Training data came from a trial of a mobile phone-based health intervention for individuals in recovery from alcohol use disorder, with human coders labeling discussion forum messages according to whether or not authors mentioned problems in their recovery process. Linguistic features of these messages were extracted via several computational techniques: (1) a Bag-of-Words approach, (2) the dictionary-based Linguistic Inquiry and Word Count program, and (3) a hybrid approach combining the most important features from both Bag-of-Words and Linguistic Inquiry and Word Count. These features were applied within binary classifiers leveraging several methods of supervised machine learning: support vector machines, decision trees, and boosted decision trees. Classifiers were evaluated in data from a later deployment of the recovery support intervention. Results To distinguish recovery problem disclosures, the Bag-of-Words approach relied on domain-specific language, including words explicitly linked to substance use and mental health (“drink,” “relapse,” “depression,” and so on), whereas the Linguistic Inquiry and Word Count approach relied on language characteristics such as tone, affect, insight, and presence of quantifiers and time references, as well as pronouns. A boosted decision tree classifier, utilizing features from both Bag-of-Words and Linguistic Inquiry and Word Count performed best in identifying problems disclosed within the discussion forum, achieving 88% sensitivity and 82% specificity in a separate cohort of patients in recovery. Conclusions Differences in language use can distinguish messages disclosing recovery problems from other message types. Incorporating machine learning models based on language use allows real-time flagging of concerning content such that trained staff may engage more efficiently and focus their attention on time-sensitive issues.
Association of Physical Activity With Income, Race/Ethnicity, and Sex Among Adolescents and Young Adults in the United States: Findings From the National Health and Nutrition Examination Survey, 2007-2016

Importance Physical activity in youth is associated with adult health. Understanding the prevalence and factors of moderate to vigorous physical activity among adolescents and young adults will guide public health and policy efforts. Objectives To describe the current patterns of physical activity and duration among adolescents and young adults and to identify the direction and magnitude of associations between physical activity and income, race/ethnicity, and sex. Design, Setting, and Participants This cross-sectional secondary data analysis used the self-reported physical activity data of adolescents and young adults from the National Health and Nutrition Examination Survey from 2007 through 2016. This data set is a multistage probability sample of the noninstitutionalized US population and allows estimates that represent the US population. The years 2007 through 2016 were selected because of the consistent physical activity questions during this period. Adolescents and young adults aged 12 to 29 years who responded to the survey were included. Individuals who were underweight were excluded. Data analysis was performed from October 17, 2017, to April 27, 2018. Main Outcomes and Measures Self-reported physical activity duration and intensity. Results Of the 9472 participants, 4771 (50.4%) were males, and the weighted mean age (range) was 20.6 (12-19) years. Across all demographic categories, females reported less physical activity than did their male counterparts. White adolescent males were most likely (89.3%; 95% CI, 86.5%-92.1%) and black females aged 18 to 24 years were least likely (45%; 95% CI, 39.0%-51.0%) to report any physical activity. Among those who were active, black males aged 18 to 24 years reported the longest duration of activity (77.9 minutes per day; 95% CI, 66.4-89.3 minutes per day), and black females aged 25 to 29 years reported the shortest duration of activity (33.2 minutes per day; 95% CI, 28.1-38.2 minutes per day). In adjusted models, younger age, white race, and higher income were associated with greater physical activity. Conclusions and Relevance Female adolescents and young adults were not meeting the recommended guidelines for physical activity, and substantial disparities by race and income levels were noted. These data highlight opportunities for targeted physical activity programming and policy efforts.
Impact of Standardized Prenatal Clinical Training for Traditional Birth Attendants in Rural Guatemala

In low-and-middle-income countries (LMICs), traditional birth attendant (TBA) training programs are increasing, yet reports are limited on how those programs affect the prenatal clinical abilities of trained TBAs. This study aims to assess the impact of clinical training on TBAs before and after a maternal health-training program. A prospective observational study was conducted in rural Guatemala from March to December 2017. Thirteen participants conducted 116 prenatal home visits. Data acquisition occurred before any prenatal clinical training had occurred, at the completion of the 14-week training program, and at six months post program completion. The paired t-test and McNemar’s test was used and statistical analyses were performed with R Version 3.3. 1. There was a statistically significant improvement in prenatal clinical skills before and after the completion of the training program. The mean percentage of prenatal skills done correctly before any training occurred was 25.8%, 62.3% at the completion of the training program (p-value = 0.0001), and 71.0% after six months of continued training (p-value = 0.034). This study highlights the feasibility of prenatal skill improvement through a standardized and continuous clinical training program for TBAs. The improvement of TBA prenatal clinical skills could benefit indigenous women in rural Guatemala and other LMICs.
Acute Changes in Community Violence and Increases in Hospital Visits and Deaths From Stress-responsive Diseases

Background: Community violence may affect a broad range of health outcomes through physiologic stress responses and changes in health behaviors among residents. However, existing research on the health impacts of community violence suffers from problems with bias. Methods: We examined the relations of acute changes in community violence with hospital visits and deaths due to stress-responsive diseases (mental, respiratory, and cardiac conditions) in statewide data from California 2005–2013. The community violence exposure was measured as both binary spikes and continuous acute changes. We applied a combined fixed-effects and time-series design that separates the effects of violence from those of community- and individual-level confounders more effectively than past research. Temporal patterning was removed from community violence rates and disease rates in each place using a Kalman smoother, resulting in residual rates. We used linear regression with place fixed-effects to examine within-place associations of acute changes in community violence with residual rates of each outcome, controlling for local time-varying covariates. Results: We found acute increases in hospital visits and deaths due to anxiety disorders (0.31 per 100,000; 95% confidence interval [CI] = 0.02, 0.59), substance use (0.47 per 100,000; 95% CI = 0.14, 0.80), asthma (0.56 per 100,000; 95% CI = 0.16, 0.95), and fatal acute myocardial infarction (0.09 per 100,000; 95% CI = 0.00, 0.18) co-occurring with violence spikes. The pattern of findings was similar for the exposure of continuous acute violence changes. Conclusions: Although the associations were small, the identified increases in stress-responsive conditions suggest the possibility of health impacts of acute changes in community violence.