Miracle-dz/UniFAR-FTUs huggingface dataset:
Introduction of evidence-based medicine in undergraduate medical curriculum for development of professional competencies in medical students

Purpose of review Current undergraduate medical curricula in most institutions around the globe do not nurture the skills, needed for self-directed lifelong learning in medical graduates, and it needs to be reformed in such a way that the medical graduate who is trained through this reformed curriculum, possesses all the competencies of a self-directed learner. Evidence-based medicine (EBM), a new vision of physician learning which is based on continuous development and assessment of competencies needed for creating self-directed learners is to be strongly advocated for inclusion in the undergraduate medical curriculum. Recent findings Clinical teaching opportunities which are available while treating patients, in outpatient clinic, operating room, and by the bedside need to be utilized to teach EBM. Medical curricula, both undergraduate and postgraduate, should incorporate both EBM and quality improvement training, and these should be taught in a holistic fashion. Evidence-based practice competency was shown to increase, regardless of whether evidence-based practice is delivered to medical students at an undergraduate or postgraduate level. Early introduction of EBM in the undergraduate medical curriculum, in the form of a short course, using various modes of instruction, enhances the competence of critical thinking and also influences change in attitude towards EBM positively in medical students. Summary Introduction of EBM in undergraduate medical curriculum helps in the development of professional competencies of self-directed learners in medical students.
Multi-Entity Polarity Analysis and Detection of Subjectivity in Financial Documents

Polarity analysis aims at classifying an author’s opinion as positive, negative, or neutral. However, given the sheer volume of information available on the web, manually carrying out such task is unfeasible. In particular, this type of analysis is useful for companies when making decisions related to the financial market, which is particularly prone to changes according to shifting moods and opinions. Most studies in the literature deal with this problem by considering that whole documents have a single, global polarity. However it is not unusual that documents have opinions on several entities with possibly different polarities. This suggests that the polarity classification should be performed in an entity level. We also noted that many financial documents may not emit any opinion. Therefore, in this paper we propose a supervised polarity classification method based on multiple models and detection of subjectivity, in order to deal with financial documents that cite multiple entities. Our results showed that the hierarchical, multiple-models approach significantly outperformed the global-model baseline.
IXIARO® updated: overview of clinical trials and developments with the inactivated vaccine against Japanese encephalitis

The mosquito-borne Japanese encephalitis virus causes an estimated 50,000 cases in Asia, accounting for at least 10,000 deaths and 15,000 cases of neuropsychiatric sequelae. IXIARO® (Intercell AG, Vienna, Austria), an inactivated, Vero cell-derived vaccine against Japanese encephalitis was introduced in 2009. The vaccine is highly immunogenic, showing significantly higher geometric mean antibody titers compared with previous, mouse brain-derived vaccines. Postmarketing studies have confirmed the excellent safety profile. Studies on children aged 2 months to 18 years have been published. Based on these data, positive opinion from the EMA for vaccination of children has recently been given. Since a safe and effective vaccine against Japanese encephalitis is now available, outdated guidelines and recommendations have to be revised: travelers to rural areas of Asia should generally be recommended vaccination.
Recent trends in cutaneous melanoma incidence among whites in the United States.

BACKGROUND It is not yet clear whether increasing melanoma incidence is real or whether recent incidence trends mainly reflect improved diagnosis. To address this question, we examined the most recent melanoma incidence patterns among the white population stratified by sex, age, tumor stage, and tumor thickness by use of data from the Surveillance, Epidemiology, and End Results Program. METHODS We examined log-transformed age-specific rates for melanoma by 5-year age groups and time periods by year of diagnosis and birth cohort. Melanoma trends were further examined among broader age groups (<40 years, 40-59 years, and > or =60 years) by tumor stage and tumor thickness. Rates were age-adjusted to the 1970 U.S. standard population, and trends were tested by use of a two-sided Student's t test. RESULTS Melanoma incidence increased in females born since the 1960s. From 1974-1975 through 1988-1989, upward trends for the incidence of localized tumors and downward trends for the incidence of distant-stage tumors occurred in the age group under 40 years. In the more recent time period, 1990-1991 through 1996-1997, age specific rates among females compared with males generally remained stable or declined more for distant-stage tumors and increased less for local-stage tumors. Thin tumors (<1 mm) increased statistically significantly in all age groups (P<.05 for all), except in men under age 40 years. In contrast, rates for thick tumors (> or =4 mm) increased statistically significantly (P =.0003) only in males aged 60 years and older. CONCLUSION Melanoma incidence may well continue to rise in the United States, at least until the majority of the current population in the middle-age groups becomes the oldest population. The recent trends may reflect increased sunlight exposure.
Androgen-regulated transcription of ESRP2 drives alternative splicing patterns in prostate cancer

Prostate is the most frequent cancer in men. Prostate cancer progression is driven by androgen steroid hormones, and delayed by androgen deprivation therapy (ADT). Androgens control transcription by stimulating androgen receptor (AR) activity, yet also control pre-mRNA splicing through less clear mechanisms. Here we find androgens regulate splicing through AR-mediated transcriptional control of the epithelial-specific splicing regulator ESRP2. Both ESRP2 and its close paralog ESRP1 are highly expressed in primary prostate cancer. Androgen stimulation induces splicing switches in many endogenous ESRP2-controlled mRNA isoforms, including a key splicing switch in the metastatic regulator FLNB which is associated with disease relapse. ESRP2 expression in clinical prostate cancer is repressed by ADT, which may thus inadvertently dampen epithelial splice programmes. Supporting this, FLNB splicing was reciprocally switched by the AR antagonist bicalutamide (Casodex®). Our data reveal a new mechanism of splicing control in prostate cancer with important implications for metastatic disease progression. Key points Transcriptional regulation of ESRP2 by the androgen receptor controls splice isoform patterns in prostate cancer cells. Splicing switches regulated by the androgen-ESRP2 axis include a splice isoform in the FLNB gene that is a known metastatic driver. Both ESRP1 and ESRP2 are highly expressed in prostate cancer tissue. Ectopic expression of ESRP1 and 2 inhibits prostate cancer cell growth. By repressing ESRP2 expression androgen deprivation therapy (ADT) may dampen epithelial splicing programmes to inadvertently prime disease progression towards metastasis.
QOOK: a new physical-virtual coupling experience for active reading

We present QOOK, an interactive reading system that incorporates the benefits of both physical and digital books to facilitate active reading. QOOK uses a top-projector to create digital contents on a blank paper book. By detecting markers attached to each page, QOOK allows users to flip pages just like they would with a real book. Electronic functions such as keyword searching, highlighting and bookmarking are included to provide users with additional digital assistance. With a Kinect sensor that recognizes touch gestures, QOOK enables people to use these electronic functions directly with their fingers. The combination of the electronic functions of the virtual interface and free-form interaction with the physical book creates a natural reading experience, providing an opportunity for faster navigation between pages and better understanding of the book contents.
Serum free immunoglobulin light chain fingerprint identifies a subset of newly diagnosed multiple myeloma patients with worse outcome

Multiple myeloma (MM) is a multi–subclonal malignancy with relatively high heterogeneity. Patients who initially presented with both monoclonal‐protein (MP) and free light chain (FLC) secretion but then relapsed with a light chain escape pattern have been shown to reflect disease clonal evolution and to bare a worse prognosis. We hypothesized that a discordant MP/FLC pattern at diagnosis may reflect a similar clonal evolution that had occurred prior to diagnosis of active myeloma, conferring a worse outcome. We analyzed 255 consecutive newly diagnosed MM patients who received first line bortezomib‐based therapy between 2007 and 2014, hypothesizing that their MP/FLC fingerprint at diagnosis reflects clonal heterogeneity and, therefore, affects outcome. An involved FLC level ≥ 700 mg/L and MP ≥ 2.5 g/L were used as cutoffs for low vs high FLC and MP levels, respectively. Patients were divided into 4 subgroups according to their involved FLC and MP blood levels at diagnosis: HiLC and HiMP for patients with either a predominant FLC or a predominant MP, respectively, and HiLC‐MP and LoLC‐MP when both FLC and MP were increased or decreased, respectively. There were 68 (27%) patients with HiLC, which presented more often with International Staging System‐3 stage (P < .0001). Multivariate analysis showed that HiLC was associated with a 5.1‐fold risk for mortality in a multivariate model (95% confidence interval [CI], 1.34‐19.68). Both HiLC and HiLC‐MP phenotypes were associated with shorter progression‐free survival (hazard ratio of 2.66 [95% CI, 1.33‐5.32] and 2.82 [95% CI, 1.37‐5.83], respectively), independently of other prognostic factors, including the use of autograft. Thus, we identified an LC predominant secretory fingerprint (HiLC phenotype) at diagnosis as a potential independent risk factor that may affect disease control and survival in newly diagnosed MM patients treated with bortezomib‐based induction therapy; this may represent increased subclonal heterogeneity.
Pharmacy Management of Vaccines

BACKGROUND: Although standard vaccines have traditionally been granted full coverage in managed care, the recent introduction of several novel vaccine products has necessitated the revision of pharmacy management strategies throughout the nation. OBJECTIVES: To review pharmacy management strategies for a number of emerging vaccines, with unique plan perspectives from SelectHealth, an Intermountain Healthcare company serving approximately 500,000 members in Utah. SUMMARY: Because several recently introduced vaccines target previously unaddressed diseases and carry higher costs than traditional vaccines, several plans have adapted a novel approach to manage vaccine coverage on an individual product basis. At SelectHealth, recently introduced vaccines for rotavirus, respiratory syncytial virus (RSV), herpes zoster, and human papillomavirus (HPV) have required special attention in terms of pharmacy management. After carefully weighing acquisition and administration costs, anticipated uptake and use, direct and indirect health care costs averted, and quality of life issues, plan leadership decided to cover many of the new vaccines (i.e., rotavirus, RSV, and herpes zoster) under a nonstandard vaccination benefit. However, because substantial cost savings and high use of the quadrivalent HPV vaccine was anticipated within SelectHealth, the plan decided to fully cover the product. CONCLUSIONS: Although they complicate traditional pharmacy management, novel vaccines provide clinical benefit that managed care organizations cannot ignore. One universal strategy will not suffice in managing all the different vaccines entering the market, and a tailored approach should be employed based on the individual characteristics and use of each product.
SHould we emergently revascularize Occluded Coronaries for cardiogenic shocK: an international randomized trial of emergency PTCA/CABG-trial design. The SHOCK Trial Study Group.

BACKGROUND Cardiogenic shock (CS) is the leading cause of death in patients hospitalized with acute myocardial infarction (MI). Nonrandomized studies suggest reduced mortality rate with revascularization. TRIAL DESIGN The SHOCK trial is a multicenter, randomized, and unblinded study with a Registry for trial-eligible and ineligible nonrandomized patients. The trial is testing the hypothesis that a direct invasive strategy of emergency revascularization for patients with cardiogenic shock complicating acute MI will reduce 30-day all-cause mortality rate by 20 absolute percentage points compared with initial medical stabilization. Eligibility criteria include development of CS within 36 hours of an acute transmural MI as evidenced by ST elevation or new left bundle branch block MI; clinical criteria for CS with hemodynamic confirmation; absence of a mechanical, iatrogenic, or other cause of shock; and enrollment within 12 hours of CS diagnosis. Patients randomly assigned to emergency revascularization immediately undergo coronary angiography, with percutaneous transluminal coronary angioplasty or coronary artery bypass grafting depending on the coronary anatomy. Patients assigned to initial medical stabilization may undergo revascularization >/=54 hours after randomization. END POINTS The primary end point is all-cause 30-day mortality after randomization. Secondary end points include death at trial termination, changes in left ventricular dimensions and function measured by echocardiography at randomization and 2 weeks later, and changes in quality of life and physical functioning from 2 weeks after discharge to 6 months after MI.
Identifying emotional and behavioral problems in children aged 4-17 years: United States, 2001-2007.

OBJECTIVES This report examines two measures that identify children with emotional and behavioral problems: high scores based on questions in the brief version of the Strengths and Difficulties Questionnaire (SDQ) and a single question about serious (definite or severe) overall emotional and behavioral difficulties. Children were classified into four groups, those with: only high scores on the brief SDQ, only serious overall difficulties, both high scores on the brief SDQ and serious overall difficulties, and neither high scores on brief SDQ nor serious overall difficulties. Children's characteristics, conditions, and service use in these four groups were compared. METHODS Data from the 2001-2007 National Health Interview Survey identified the emotional and behavioral problems, characteristics, conditions, and service use of children aged 4-17 years. RESULTS Approximately 7% of children had either high scores on the brief SDQ or serious overall difficulties, with 2% having only high scores on the brief SDQ, 3% having only serious overall difficulties, and 2% having both high scores on the brief SDQ and serious overall difficulties. Characteristics of the three groups of children identified with emotional and behavioral problems differed from each other and from children without problems. Children in each of the groups with emotional and behavioral problems, compared with children without problems, were more likely to have developmental conditions and to have used services. Additionally, children with serious overall difficulties (either with or without high scores on the brief SDQ) were more likely to have developmental conditions, receive special education, and use mental health services than children with only high scores on the brief SDQ.
Behavior-Aware Design, Optimization and Information Mining in Wearable Sensing Systems

Wearable sensing systems are becoming widely used for a variety of applications including sports, entertainment, and the military. These systems have recently enabled a variety of medical monitoring and diagnostic applications. Such sensing systems have high potential to significantly improve the quality of life for large segments of the population and enable conceptually new types of applications. However, various research challenges including energy sensitivity and semantic complexity must be addressed before these devices can reach their full potential in improving our lives. The need for multiple sensors, high frequency sampling and constant monitoring leads these systems to be power-hungry and expensive with a short operation lifetime. In addition these systems generate a massive amount of data, where designing efficient and effective data mining algorithms to interpret and analyze the data is very costly due to field experts' involvement. This dissertation presents a methodology that takes advantage of contextual and semantic properties in human physiological behavior to enable efficient design and optimization of such systems from the data and information point of view. The methodology uses combinatorial modeling and simultaneous minimization to reduce the wireless communication and local processing power consumption. The effectiveness of this technique is shown on an insole instrumented with 99 pressure sensors placed in each shoe, which is used for human gait analysis. Further, the proposed methodology is used to design unsupervised data mining techniques to extract information such as frequent or rare events and patterns from collected multi-dimensional time series data of wearable sensing devices, where high level of noise and uncertainty is inherent. This approach transforms multi-dimensional time series data to combinatorial space and constructs behavior models, which is used for frequent and rare event detection and pattern classification. The effectiveness of this method is demonstrated by applying this technique to discovery and classification of frequent human activities and abnormalities.
Variation in the Femoral Bow: A Novel High-Throughput Analysis of 3922 Femurs on Cross-Sectional Imaging

Objectives: To evaluate femoral radius of curvature in a large sample of computed tomography scans to definitively determine the relationship between radius of curvature and femoral length, age, gender, ethnicity, body mass index and cortical thickness. Methods: A retrospective review was conducted of the electronic medical records and advanced imaging of 1961 patients who underwent pulmonary embolism protocol computed tomography scans between December 1999 and March 2010. The computed tomography scans were imported from the clinical picture archiving and communication system archive into a research image archive and analysis system. Each scan was processed by an automated system that algorithmically determined bony landmarks, adjusted for body position within the scanner and measured the radius of curvature. Results: The mean medullary radius of curvature of 3922 femurs was 112 cm (SD = 26 cm). The mean anterior radius of curvature of the femurs was 145 cm (SD = 55 cm). There was a moderately strong positive correlation (0.36–0.39) between femoral length and radius of curvature (P < 0.0001) that was not affected by age, body mass index, cortical thickness, gender, or ethnicity. No significant relationship was found between either gender or ethnicity and radius of curvature independent of femoral length. Conclusions: Differences in radius of curvature based on ethnicity and gender exist primarily because of the variation in average height, and therefore femur length, that exists between ethnic groups and genders. These data may prove useful in the design of safer intramedullary implants that accommodate a greater spectrum of anatomic variation.
Quantitative comparisons of gamma‐aminobutyric acid neurons and receptors in the visual cortex of normal and dark‐reared cats

Physiological studies suggest that the function of the visual cortical gamma‐aminobutyric acid (GABA) system is abnormal in cats reared in total darkness. The present study asked whether visual input is necessary for the normal postnatal anatomical development of the GABA system by comparing GABA neurons and receptors in the visual cortex of normal and dark‐reared cats. Immunohistochemical techniques (anti‐GABA) were used to localize GABA neurons. In both rearing conditions, GABA neurons were stained rather uniformly in all cortical layers. Counts of GABA cells indicated a marked increase in density in dark‐reared compared to normal cats. Counts of total cellular density in cresyl‐stained sections, however, indicated a comparable increase in dark‐reared cats. When corrected for total cellular density, there were no differences between dark‐reared and normal cats in the density of GABA cells per layer, or the relative proportion of GABA cells across cortical layers.
Erasure channel modelling–based secure bit allocation schemes for multipath routing in wireless sensor networks

In this article, we study secure multipath routing with energy efficiency for a wireless sensor network in the presence of eavesdroppers. We consider two objectives: (1) the multipath routing scheme for maximising the energy efficiency with security constraints and (2) the multipath routing scheme for maximising the secrecy capacity. The binary erasure channel model is adopted to describe the wireless channel states among neighbouring nodes. Based on the binary erasure channel model, the problem of multipath routing degrades to a problem of bit allocation for each path. We formulate the problems and find that the problems are both quasi-convex. For the first one, it is a linear fractional optimisation problem. The optimal solution is obtained by the Charnes–Cooper transformation. For the second one, we propose an iterative algorithm to obtain the η -optimal solution. The performance analysis shows that the probability of the secure bit allocation increases along with the number of multipaths and decreases along with the number of hops per path and eavesdroppers. Simulation results are presented to illustrate the proposed algorithms.
/spl gamma/-rays and pulsed X-ray radiation responses of germanosilicate single-mode optical fibers: influence of cladding codopants

The radiation-induced attenuation (RIA) in germanosilicate single-mode optical fibers was measured at 1.55 and 1.31 mm after a pulsed X-ray irradiation and at 1.55 mm during and after a steady-state g-ray irradiation. The influence of codoping the fiber cladding with germanium (Ge), phosphorus (P), and fluorine (F) on the sensitivity of Ge-doped core fibers was characterized. P-codoping makes it possible to decrease the RIA for short times (10/sup *6/ s*10/sup *3/ s) post- pulse. However, P-codoped fibers exhibit larger values of permanent RIA than P-free fibers after transient exposure and are inadequate for a steady-state environment. The impact of F-codoping depends on the other codopants incorporated in the fiber cladding, but its addition seems to be deleterious for the radiation hardening of the germanosilicate fiber at the two tested wavelengths. Ge-codoping increases the sensitivity of P-, F-codoped fibers under X-rays and steady-state g-ray irradiation, whereas it decreases the RIA in F-doped ones. Some hypotheses on the creation mechanisms and properties of the color centers related to these three codopants are proposed.