Miracle-dz/UniFAR-FTUs huggingface dataset:
Managing Patients With Severe and Enduring Anorexia Nervosa: When Is Enough, Enough?

OBJECTIVE Approximately 20% of patients with anorexia nervosa develop severe and enduring anorexia nervosa (SE-AN), manifest by decades-long illnesses. At certain points, demoralized and/or based on judicious appraisals of the seeming futility of further professional treatment to radically alter their course, some SE-AN patients decide that "enough is enough" and opt out of intensive treatment. This article considers courses and treatment options available at these stages for patients, families, and clinicians. METHODS The author uses clinical illustrations, Socratic questioning, and available literature to explore questions of treatment strategies with patients struggling with SE-AN. RESULTS SE-AN patients have frequently received care in varieties of medical, psychiatric, and specialized eating disorders inpatient, residential, partial hospital, and outpatient treatment settings. Patients may reject further high-intensity treatment for judicious or capricious reasons, but may still accept lower intensity treatments. Some may reject any and all offers of treatment. Clinicians' treatment recommendations, not always coinciding with patients' wishes, are influenced by numbers of clinical, social, and professional pressures, including those from families, treatment settings, regulatory bodies, and payors. CONCLUSIONS When managing patients with decades-long disease and multiple comorbidities, clinicians must be realistic about the low odds of effecting cure and adjust treatment expectations accordingly. For patients with SE-AN, a variety of low-intensity treatment approaches, at times extending to palliative and hospice care, may be useful. Clinicians should always strive to provide humane comfort and support, as closely aligned to patients' judicious wishes as realistically possible.
Adaptive Neural Output-Feedback Controller Design of Switched Nonlower Triangular Nonlinear Systems With Time Delays

In this article, we study the issue of adaptive neural output-feedback controller design for a class of uncertain switched time-delay nonlinear systems with nonlower triangular structure. The prominent contribution of this article is that the delay-dependent stability criterion of nonswitched nonlinear systems is successfully extended to that of switched nonlower triangular nonlinear systems. The design algorithm is listed as follows. First, a switched state observer is designed such that the error dynamic system can be generated. Second, neural networks, adaptive backstepping technique, and variable separation method are, respectively, applied to construct a common controller for all subsystems, in which the Lyapunov–Krasovskii functionals are deliberately constructed such that the average dwell-time scheme can be employed to guarantee the stability and performance of the closed-loop system, despite the existence of time delays. Third, the stability analysis process confirms in detail that all the variables of the closed-loop system are semiglobally uniformly ultimately bounded. Finally, simulation study is given to show the validity of the proposed control approach.
Synthetic and Biological Studies on New Urea and Triazole Containing Cystobactamid Derivatives

Abstract Cystobactamids belong to the group of arene‐based oligoamides that effectively inhibit bacterial type IIa topoisomerases. Cystobactamid 861‐2 is the most active member of these antibiotics. Most amide bonds present in the cystobactamids link benzoic acids with anilines and it was found that some of these amide bonds undergo chemical and enzymatic hydrolysis, especially the one linking ring C with ring D. This work reports on the chemical synthesis and biological evaluation of thirteen new cystobactamids that still contain the methoxyaspartate hinge. However, we exchanged selected amide bonds either by the urea or the triazole groups and modified ring A in the latter case. While hydrolytic stability could be improved with these structural substitutes, the high antibacterial potency of cystobactamid 861‐2 could only be preserved in selected cases. This includes derivatives, in which the urea group is positioned between rings A and B and where the triazole is found between rings C and D.
Evidence on nutritional therapy practice guidelines and implementation in adult critically ill patients: A systematic scoping review

Background The rapid increase in disease-related malnutrition makes it almost impossible for healthcare practitioners and policymakers to keep up with its negative consequences. Consequently, healthcare organisations and decision-makers have called for accelerated and double-duty actions to manage the double burden of malnutrition. Guidelines standardise nutritional practices, improve nutritional status and reduce hospitalisation duration and save costs. Objectives A systematic scoping review of the nutritional therapy practice guidelines and implementation in critically ill adults was undertaken to identify the breadth of literature on the topic, summarise findings and identify gaps. Methods A comprehensive search strategy was designed and implemented to identify eligible studies from eight databases, websites of organisations, government departments and academic platforms. Reference lists of included studies were also searched for relevant studies. We assessed the quality of included studies, completed a descriptive numerical summary and analysed them. Results In total, 1555 titles and 101 abstracts were screened, 65 underwent full text review and 19 were retained for data extraction. Studies scored average to high on quality assessment, and a summary of characteristics of included studies is presented. Nutritional therapy practice guidelines are considered a proactive strategy for enhanced, uniform and individualised nutritional practices and factors that influence implementation were identified. Conclusions A gap exists between research recommendations and actual practice despite the growing interest in implementation of nutritional therapy guidelines in critical care. There is a need for more research to evaluate the practicality of available guidelines.
Assessment of the perceived safety culture in the petrochemical industry in Japan: A cross-sectional study

This study assessed the perceived safety culture among five petrochemical production companies in Japan. Current effects of the perceived safety culture on employee safety motivation and performance were also examined. A total of 883 workers from the five petrochemical companies, which were located in the Chugoku region of Japan, provided valid responses to the survey distributed by email. Structural equation modeling was used to evaluate the personnel safety culture in these industries. The endogenous variables considered in this study included petrochemical safety culture, personnel error behavior and personnel attitudes toward violation behaviors. Petrochemical personnel safety motivation was a mediating variable. This study’s findings highlight the importance of the perceived safety culture as a significant component of the organizational culture that influences employee behaviors and safety attitudes. This study further verifies the significant impact of the perceived safety culture in this industry sector on improving petrochemical personnel safety motivation and performance. Future research should explore the differences between the subcultures that have formed under larger safety cultures within similar high-risk industries, such as construction, aviation, manufacturing and mining.
Kirigami‐Based Light‐Induced Shape‐Morphing and Locomotion

The development of stimuli‐responsive soft actuators, a task largely undertaken by material scientists, has become a major driving force in pushing the frontiers of microrobotics. Devices made of soft active materials are oftentimes small in size, remotely and wirelessly powered/controlled, and capable of adapting themselves to unexpected hurdles. However, nowadays most soft microscale robots are rather simple in terms of design and architecture, and it remains a challenge to create complex 3D soft robots with stimuli‐responsive properties. Here, it is suggested that kirigami‐based techniques can be useful for fabricating complex 3D robotic structures that can be activated with light. External stress fields introduce out‐of‐plane deformation of kirigami film actuators made of liquid crystal networks. Such 2D‐to‐3D structural transformations can give rise to mechanical actuation upon light illumination, thus allowing the realization of kirigami‐based light‐fuelled robotics. A kirigami rolling robot is demonstrated, where a light beam controls the multigait motion and steers the moving direction in 2D. The device is able to navigate along different routes and moves up a ramp with a slope of 6°. The results demonstrate a facile technique to realize complex and flexible 3D structures with light‐activated robotic functions.
The use of automated procedures by older adults with high arithmetic skills during addition problem solving.

In contrast to other cognitive abilities, arithmetic skills are known to be preserved in healthy elderly adults. In fact, they would even outperform young adults because they more often retrieve arithmetic facts from long-term memory. Nevertheless, we suggest here that the superiority of older over younger adults could also stem from the use of more efficient automated and unconscious counting procedures. We tested 35 older participants using the sign priming paradigm and selected the 18 most efficient ones, aged from 60 to 77. Sign priming is interpreted as the indicator of the preactivation of an abstract procedure as soon as the arithmetic sign is presented. We showed that expert elderly arithmeticians behaved exactly as 26 young participants presenting the same level of arithmetic proficiency. More precisely, we showed that presenting the "+" sign 150 ms before the operands speeds up the solving process compared to a situation wherein the problem is classically presented in its whole on the screen. Only tie problems and problems involving 0 were not subjected to these priming effects, and we concluded that only these problems were solved by retrieval, either of the answer for tie problems or of a rule for + 0 problems. These results could provide new insights for the conception of training programs aiming at preserving older individuals' arithmetical skills and, in a longer-term perspective, at maintaining their financial autonomy, which is decisive for keeping them in charge of their daily life. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
Weighted multiple model adaptive boundary control for a flexible manipulator

In this article, a weighted multiple model adaptive boundary control scheme is proposed for a flexible manipulator with unknown large parameter uncertainties. First, the uncertainties are approximatively covered by a finite number of constant models. Second, based on Euler–Bernoulli beam theory and Hamilton principle, the distributed parameter model of the flexible manipulator is constructed in terms of partial differential equation for each local constant model. Correspondingly, local boundary controllers are designed to control the manipulator movement and suppress its vibration for each partial differential equation model, which are based on Lyapunov stability theory. Then, a novel weighted multiple model adaptive control strategy is developed based on an improved weighting algorithm. The stability of the overall closed-loop system is ensured by virtual equivalent system theory. Finally, numerical simulations are provided to illustrate the feasibility and effectiveness of the proposed control strategy.
Learning Non-Local Spatial Correlations To Restore Sparse 3D Single-Photon Data

This paper presents a new algorithm for the learning of spatial correlation and non-local restoration of single-photon 3D Lidar images acquired in the photon starved regime (fewer or less than one photon per pixel) or with a reduced number of scanned spatial points (pixels). The algorithm alternates between three steps: (i) extract multi-scale information, (ii) build a robust graph of non-local spatial correlations between pixels, and (iii) the restoration of depth and reflectivity images. A non-uniform sampling approach, which assigns larger patches to homogeneous regions and smaller ones to heterogeneous regions, is adopted to reduce the computational cost associated with the graph. The restoration of the 3D images is achieved by minimizing a cost function accounting for the multi-scale information and the non-local spatial correlation between patches. This minimization problem is efficiently solved using the alternating direction method of multipliers (ADMM) that presents fast convergence properties. Various results based on simulated and real Lidar data show the benefits of the proposed algorithm that improves the quality of the estimated depth and reflectivity images, especially in the photon-starved regime or when containing a reduced number of spatial points.
Deletion of astrocytic BMAL1 results in metabolic imbalance and shorter lifespan in mice

Disruption of the circadian cycle is strongly associated with metabolic imbalance and reduced longevity in humans. Also, rodent models of circadian arrhythmia, such as the constitutive knockout of the clock gene Bmal1, leads to metabolic disturbances and early death. Although astrocyte clock regulates molecular and behavioral circadian rhythms, its involvement in the regulation of energy balance and lifespan is unknown. Here, we show that astrocyte‐specific deletion of Bmal1 is sufficient to alter energy balance, glucose homeostasis, and reduce lifespan. Mutant animals displayed impaired hypothalamic molecular clock, age‐dependent astrogliosis, apoptosis of hypothalamic astrocytes, and increased glutamate and GABA levels. Importantly, modulation of GABAA‐receptor signaling completely restored glutamate levels, delayed the reactive gliosis as well as the metabolic phenotypes and expanded the lifespan of the mutants. Our results demonstrate that the astrocytic clock can influence many aspects of brain function and neurological disease and suggest astrocytes and GABAA receptor as pharmacological targets to prevent the metabolic dysfunctions and shortened lifespan associated with alterations of circadian rhythms.
Targeting human epidermal growth factor receptor 2 (HER2) in gynecologic malignancies.

PURPOSE OF REVIEW The purpose of this review is to describe the role of the human epidermal growth factor receptor 2 (HER2) as a biomarker and potential target in gynecologic malignancies and to describe contemporary updates in the use of anti-HER2 treatments for these cancers. RECENT FINDINGS Approximately 25-30% of all patients with uterine serous carcinoma overexpress tumoral HER2. The anti-HER2 antibody trastuzumab represents an effective, targeted therapy with significant efficacy in the treatment of HER2-positive breast and gastric cancer. Recently, trastuzumab efficacy has also been demonstrated in a randomized controlled trial of women with advanced or recurrent uterine serous carcinoma. Additionally, trastuzumab may be effective in women with HER2-positive uterine carcinosarcoma. The role of anti-HER2 therapy is unclear in women with other gynecologic malignancies but is being evaluated. SUMMARY HER2 amplification/overexpression is an effective therapeutic target in select gynecologic malignancies, and especially in the rare endometrial cancer subtype, uterine serous carcinoma. As anti-HER2-targeted therapies become increasingly available, more treatment options may become available for women with HER2-positive disease.
Food Safety Concerns: Crop Breeding as a Potential Strategy to Address Issues Associated with the Recently Lowered Reference Doses for Perfluorooctanoic Acid and Perfluorooctane sulfonate.

Perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) are perfluorinated alkyl substances widely used in industrial and domestic products. The European Food Safety Authority and U.S. EPA have recently lowered the reference doses (RfDs) for PFOA and PFOS 4~1800-fold. The recently lowered RfDs call for re-evaluation of potential human health risks from PFOA and PFOS via food consumption. Serious concerns arise because some intakes of PFOA and PFOS exceeded the RfDs. Innovative cultivation of low-accumulating crop varieties becomes an option to decrease human exposure. We present an up-to-date review on low-accumulating crop varieties for PFOA and PFOS, in reference to toxic metals and other organic pollutants, including the variety identification, physiological-biochemical mechanisms, and molecular uptake mechanisms and molecular docking. It is to call for attention and research efforts to decrease human intakes of PFOA and PFOS via crop consumption.
A New Case with Corpus Callosum Abnormalities, Microcephaly and Seizures Associated with a 2.3-Mb 1q43-q44 Deletion

1q44 deletion is a rare syndrome associated with facial dysmorphism and developmental delay, in particular related with expressive speech, seizures, and hypotonia (ORPHA:238769). Until today, the distinct genetic causes for the different symptoms remain not entirely clear. We present a patient with a 2.3-Mb 1q44 deletion, including AKT3, ZBTB18, and HNRNPU, who shows microcephaly, developmental delay, abnormal corpus callosum, and seizures. The genetic findings in this case and a review of the literature spotlight a region between 243 Mb and 245 Mb on chromosome 1q related to the genesis of the typical symptoms of 1q44 deletion.
A critical role for c‐Myc in group 2 innate lymphoid cell activation

Asthma is a complicated chronic inflammatory disorder characterized by airway inflammation and bronchial hyperresponsiveness. Group 2 innate lymphoid cells (ILC2) are tissue‐resident innate effector cells that can mediate airway inflammation and hyperresponsiveness through production of IL‐5, IL‐13 and VEGFA. ILC2 in asthma patients exhibit an activated phenotype. However, molecular pathways that control ILC2 activation are not well understood.
Breakfast consumption modulates postprandial glycaemic, insulinaemic and NEFA response in pre-diabetic Asian males

Abstract Breakfast consumption is associated with a variety of nutritional and lifestyle-related health outcomes. The objective of the present study was to investigate how the consumption of breakfast affected blood glucose, insulin and NEFA profiles. A lower postprandial blood glucose, insulin and NEFA response is associated with a lower risk of development of metabolic diseases. In a randomised crossover non-blind design, thirteen pre-diabetic Chinese adult males (BMI 26·7 (sd 4·2) kg/m2) attended two sessions where they either consumed a high-glycaemic index breakfast or no breakfast consumption. Changes in glycaemic response over 27 h periods were measured using the Medtronic MiniMed iProTM2 continuous glucose monitoring system. Blood samples were collected using a peripheral venous catheter at fixed intervals for 3 h after the test meal and 3 h after standardised lunch consumption. Postprandial glucose, insulin and NEFA response was calculated as total AUC and incremental AUC using the trapezoidal rule that ignored the area under the baseline. It was found that breakfast consumption significantly decreased postprandial glucose, insulin and NEFA excursion response at lunch time (P = 0·001). Consumption of breakfast attenuated blood glucose profiles by minimising glycaemic excursions and reduced both insulinaemic and NEFA responses in pre-diabetic Asian males during the second meal. This simple dietary intervention may be a novel approach to help improve subsequent lunch glycaemic responses in Asians at high risk of developing diabetes.
Characterizing and automatically detecting smooth pursuit in a large-scale ground-truth data set of dynamic natural scenes.

Eye movements are fundamental to our visual experience of the real world, and tracking smooth pursuit eye movements play an important role because of the dynamic nature of our environment. Static images, however, do not induce this class of eye movements, and commonly used synthetic moving stimuli lack ecological validity because of their low scene complexity compared to the real world. Traditionally, ground truth data for pursuit analyses with naturalistic stimuli are obtained via laborious hand-labelling. Therefore, previous studies typically remained small in scale. We here present the first large-scale quantitative characterization of human smooth pursuit. In order to achieve this, we first provide a methodological framework for such analyses by collecting a large set of manual annotations for eye movements in dynamic scenes and by examining the bias and variance of human annotators. To enable further research on even larger future data sets, we also describe, improve, and thoroughly analyze a novel algorithm to automatically classify eye movements. Our approach incorporates unsupervised learning techniques and thus demonstrates improved performance with the addition of unlabelled data. The code and data related to our manual and automated eye movement annotation are publicly available via https://web.gin. g-node.org/ioannis.agtzidis/gazecom_annotations/.
Stimulation of MMP-9 of oral epithelial cells by areca nut extract is related to TGF-β/Smad2-dependent and –independent pathways and prevented by betel leaf extract, hydroxychavicol and melatonin

Background: There are 200-600 million betel quid (BQ) chewers in the world. BQ increases oral cancer risk. Matrix metalloproteinase-9 (MMP-9) is responsible for matrix degradation, cancer invasion and metastasis. Whether areca nut extract (ANE), a BQ component, stimulates MMP-9 secretion, and the related signaling pathways awaits investigation. Results: ANE (but not arecoline) stimulated MMP-9 production of gingival keratinocytes and SAS cancer epithelial cells. ANE stimulated TGF-β1, p-Smad2, and p-TAK1 protein expression. ANE-induced MMP-9 production/expression in SAS cells can be attenuated by SB431542 (ALK5/Smad2 inhibitor), 5Z-7-Oxozeaenol (TAK1 inhibitor), catalase, PD153035 (EGFR tyrosine kinase inhibitor), AG490 (JAK inhibitor), U0126 (MEK/ERK inhibitor), LY294002 (PI3K/Akt inhibitor), betel leaf (PBL) extract, and hydroxychavicol (HC, a PBL component), and melatonin, but not by aspirin. Conclusions: AN components contribute to oral carcinogenesis by stimulating MMP-9 secretion, thus enhancing tumor invasion/metastasis. These events are related to reactive oxygen species, TGF-β1, Smad2-dependent and –independent signaling, but not COX. These signaling molecules can be biomarkers of BQ carcinogenesis. PBL, HC and melatonin and other targeting therapy can be used for oral cancer treatment. Methods: ANE-induced MMP-9 expression/secretion of oral epithelial cells and related TGF-β1, Smad-dependent and –independent signaling were studied by MTT assay, RT-PCR, western blotting, immunofluorescent staining, and ELISA.