Miracle-dz/UniFAR-FTUs huggingface dataset:
A Clinical Training Program for Hybrid Closed Loop Therapy in a Pediatric Diabetes Clinic

Background: Hybrid closed loop (HCL) therapy is now available in clinical practice for treatment of type 1 diabetes; however, there is limited research on how to educate patients on this new therapy. The purpose of this quality improvement project was to optimize a HCL education program for pediatric patients with type 1 diabetes (T1D). Methods: Our multidisciplinary team developed a novel HCL clinical training program for current insulin pump users, using a quality improvement process called the Plan-Do-Study-Act model. Seventy-two patients participated in the HCL training program, which included (1) an in-person group class to reinforce conventional insulin pump and CGM use on the new system, (2) a live video conference class to teach HCL use, and (3) three follow-up phone calls in the first 4 weeks after HCL training to assess system use, make insulin adjustments, and provide targeted reeducation. Diabetes educators collected data during follow-up calls, and patients completed a training satisfaction survey. Results: The quality improvement process resulted in a training program that emphasized education on HCL exits, CGM use, and optimizing insulin to carbohydrate ratio settings. Patients successfully sustained time in HCL in the initial weeks of use and rated the trainings and follow-up calls highly. Conclusions: Ongoing educational support is vital in the early weeks of HCL use. This quality improvement project is the first to examine strategies for implementation of HCL therapy into a large pediatric diabetes center, and may inform best practices for implementation of new diabetes technologies into other diabetes clinics.
KLOTHO heterozygosity attenuates APOE4-related amyloid burden in preclinical AD

Objective To examine whether the KLOTHO gene variant KL-VS attenuates APOE4-associated β-amyloid (Aβ) accumulation in a late-middle-aged cohort enriched with Alzheimer disease (AD) risk factors. Methods Three hundred nine late-middle-aged adults from the Wisconsin Registry for Alzheimer's Prevention and the Wisconsin Alzheimer's Disease Research Center were genotyped to determine KL-VS and APOE4 status and underwent CSF sampling (n = 238) and/or 11C-Pittsburgh compound B (PiB)-PET imaging (n = 183). Covariate-adjusted regression analyses were used to investigate whether APOE4 exerted expected effects on Aβ burden. Follow-up regression analyses stratified by KL-VS genotype (i.e., noncarrier vs heterozygous; there were no homozygous individuals) evaluated whether the influence of APOE4 on Aβ was different among KL-VS heterozygotes compared to noncarriers. Results APOE4 carriers exhibited greater Aβ burden than APOE4-negative participants. This effect was stronger in CSF (t = −5.12, p < 0.001) compared with PiB-PET (t = 3.93, p < 0.001). In the stratified analyses, this APOE4 effect on Aβ load was recapitulated among KL-VS noncarriers (CSF: t = −5.09, p < 0.001; PiB-PET: t = 3.77, p < 0 .001). In contrast, among KL-VS heterozygotes, APOE4-positive individuals did not exhibit higher Aβ burden than APOE4-negative individuals (CSF: t = −1.03, p = 0.308; PiB-PET: t = 0.92, p = 0.363). These differential APOE4 effects remained after KL-VS heterozygotes and noncarriers were matched on age and sex. Conclusion In a cohort of at-risk late-middle-aged adults, KL-VS heterozygosity was associated with an abatement of APOE4-associated Aβ aggregation, suggesting KL-VS heterozygosity confers protections against APOE4-linked pathways to disease onset in AD.
Draft Genome Sequence of Clostridium perfringens Strain TAMU, Which Causes Necrotic Enteritis in Broiler Chickens

Clostridium perfringens causes severe gastrointestinal diseases, which include necrotic enteritis (NE) in chickens, a deadly disease worldwide. We report here the draft genome sequence of Clostridium perfringens strain TAMU, which was used in developing an NE chicken challenge model. This C. perfringens TAMU genome sequence will aid in advancing potential intervention strategies to reduce NE pathogenesis. ABSTRACT Clostridium perfringens causes severe gastrointestinal diseases, which include necrotic enteritis (NE) in chickens, a deadly disease worldwide. We report here the draft genome sequence of Clostridium perfringens strain TAMU, which was used in developing an NE chicken challenge model. This C. perfringens TAMU genome sequence will aid in advancing potential intervention strategies to reduce NE pathogenesis.
RerankEverything: a reranking interface for exploring search results

This paper proposes a system called "RerankEverything", which enables users to rerank search results in any search service, such as a Web search engine, an e-commerce site, a hotel reservation site, and so on. This system helps users explore diverse search results. In conventional search services, interactions between users and systems are quite limited and complicated. By using RerankEverything, users can interactively explore search results in accordance with their interests by reranking search results from various viewpoints. Experimental results show that our system potentially help users search more proactively. When using our system, users were more likely to click search results that were initially low ranked. Users also browsed through more diverse search results by reranking search results after giving various types of feedback with our system.
Medicare expenditures attributable to dementia.

OBJECTIVE To estimate dementia's incremental cost to the traditional Medicare program. DATA SOURCES Health and Retirement Study (HRS) survey-linked Medicare part A and B claims from 1991 to 2012. STUDY DESIGN We compared Medicare expenditures for 60 months following a claims-based dementia diagnosis to those for a randomly selected, matched comparison group. DATA COLLECTION/EXTRACTION METHODS We used a cost estimator that accounts for differential survival between individuals with and without dementia and decomposes incremental costs into survival and cost intensity components. PRINCIPAL FINDINGS Dementia's five-year incremental cost to the traditional Medicare program is approximately $15 700 per patient, nearly half of which is incurred in the first year after diagnosis. Shorter survival with dementia mitigates the incremental cost by about $2650. Increased costs for individuals with dementia were driven by more intensive use of Medicare part A covered services. The incremental cost of dementia was about $7850 higher for females than for males because of sex-specific differential mortality associated with dementia. CONCLUSIONS Dementia's cost to the traditional Medicare program is significant. Interventions that target early identification of dementia and preventable inpatient and post-acute care services could produce substantial savings.
Patchouli Oil Attenuates High Fat Diet-induced Non-alcoholic Hepatic Steatosis

Abstract Non-alcoholic fatty liver disease (NAFLD) is one of the most common chronic liver diseases worldwide. Nevertheless, no first-line therapy exists. Hepatic steatosis is the earliest stage of NAFLD, which is characterized by an accumulation of hepatic lipids. Patchouli oil (PO), which is isolated from the well-known Chinese herb named Pogostemon cablin (Blanco) Benth. (Lamiaceae), inhibits hepatic lipid accumulation effectively. However, its potential ability for the treatment of NAFLD had not been reported before. Thus, the objective of this study was to investigate the effectiveness of PO against hepatic steatosis and its underlying mechanisms. We used a high fat diet (HFD)-induced hepatic steatosis model of rats to estimate the effect of PO against NAFLD. Hematoxylin-eosin and oil red O staining were used to analyze the hepatic histopathological changes. ELISA, RT-qPCR, and Western blotting analysis were applied to evaluate the parameters for hepatic steatosis. Our results showed that PO significantly attenuated the lipid profiles and the serum enzymes, evidenced by quantitative and histopathological analyses. It also markedly down-regulated the expression of sterol regulatory element-binding protein 1 (SREPB-1c) with its downstream factors in de novo lipogenesis. And, likewise, in lipid export by very low-density lipoproteins (VLDL), related molecules were dramatically improved. Furthermore, PO observably normalized the aberrant peroxisome proliferator-activated receptor α (PPAR-α) signal in fatty acids oxidation. In conclusion, PO exerted a preventing effect against HFD-induced steatosis and might be due to decrease de novo lipogenesis, promote export of lipids, as well as owing to improve fatty acids oxidation.
Hankel-Norm-Based Model Reduction for Stochastic Discrete-Time Nonlinear Systems in Interval Type-2 T–S Fuzzy Framework

This article is concerned with the problem of the Hankel-norm model reduction for stochastic discrete-time nonlinear systems in interval type-2 (IT2) Takagi–Sugeno (T–S) fuzzy framework. The IT2 T–S fuzzy model is an efficient model for describing uncertain nonlinear systems, and the model reduction is to simplify the high-order complex systems by reducing the order of the original system. The aim of this article is to reduce the order of the original stochastic discrete-time IT2 fuzzy system into lower order system without ignoring the influence of IT2 membership functions. First, the Hankel-norm performance of the stochastic discrete-time IT2 fuzzy model is analyzed. Then, based on the projection theorem and cone complementary linearization approach, a convex Hankel-norm-based model reduction approach subject to conditions in the form of linear matrix inequalities (LMIs) is obtained. A membership-functions-dependent (MFD) technique is applied to capture the information of IT2 membership functions and further reduce the conservativeness. A numerical example is presented to illustrate the effectiveness of the proposed results.
A Listeria monocytogenes ST2 clone lacking chitinase ChiB from an outbreak of non-invasive gastroenteritis

ABSTRACT An outbreak with a remarkable Listeria monocytogenes clone causing 163 cases of non-invasive listeriosis occurred in Germany in 2015. Core genome multi locus sequence typing grouped non-invasive outbreak isolates and isolates obtained from related food samples into a single cluster, but clearly separated genetically close isolates obtained from invasive listeriosis cases. A comparative genomic approach identified a premature stop codon in the chiB gene, encoding one of the two L. monocytogenes chitinases, which clustered with disease outcome. Correction of this premature stop codon in one representative gastroenteritis outbreak isolate restored chitinase production, but effects in infection experiments were not found. While the exact role of chitinases in virulence of L. monocytogenes is still not fully understood, our results now clearly show that ChiB-derived activity is not required to establish L. monocytogenes gastroenteritis in humans. This limits a possible role of ChiB in human listeriosis to later steps of the infection.
An Unusual Case of Essential Tremor Deep Brain Stimulation: Where is the Lead?

Clinical Vignette A 73‐year‐old female with essential tremor (ET) underwent bilateral thalamic ventralis intermedius (Vim) deep brain stimulation (DBS) surgery. The leads provided tremor benefit, but the location was suboptimal and contributed to stimulation‐induced hemichorea. Clinical Dilemma Can patients with ET derive benefit when stimulating outside the Vim? What do we know about stimulation‐induced hemichorea in the setting of ET? Clinical Solution Lead localization combined with advanced programming strategies can be employed to troubleshoot DBS in settings when benefits are observed along with adverse effects. Gap in Knowledge Sparse information exists about DBS when applied to neuroanatomic regions outside the Vim for the management of ET. Subthalamic nucleus DBS‐induced chorea has been reported in multiple movement disorders, but not in ET.
Cinnamic Derivatives as Antitubercular Agents: Characterization by Quantitative Structure–Activity Relationship Studies

Tuberculosis, caused by Mycobacterium tuberculosis (Mtb), remains one of the top ten causes of death worldwide and the main cause of mortality from a single infectious agent. The upsurge of multi- and extensively-drug resistant tuberculosis cases calls for an urgent need to develop new and more effective antitubercular drugs. As the cinnamoyl scaffold is a privileged and important pharmacophore in medicinal chemistry, some studies were conducted to find novel cinnamic acid derivatives (CAD) potentially active against tuberculosis. In this context, we have engaged in the setting up of a quantitative structure–activity relationships (QSAR) strategy to: (i) derive through multiple linear regression analysis a statistically significant model to describe the antitubercular activity of CAD towards wild-type Mtb; and (ii) identify the most relevant properties with an impact on the antitubercular behavior of those derivatives. The best-found model involved only geometrical and electronic CAD related properties and was successfully challenged through strict internal and external validation procedures. The physicochemical information encoded by the identified descriptors can be used to propose specific structural modifications to design better CAD antitubercular compounds.
Possible causes of divergent population trends in sympatric African herbivores

Sympatric herbivores experience similar environmental conditions but can vary in their population trends. Identifying factors causing these differences could assist conservation efforts aimed at maintaining fully functional ecosystems. From 1996–2013, tsessebe and wildebeest populations in the Okavango Delta, Botswana, declined by 73% and 90%, respectively, whereas zebra populations remained stable. These sympatric, medium sized herbivores are exposed to similar natural and anthropogenic pressures, but apparently differ in their responses to those pressures. To identify factors that could cause these differences, we fitted GPS-enabled collars to six zebra, eight tsessebe and seven wildebeest in the Moremi Game Reserve, Botswana. We calculated utilisation distributions (UDs) from GPS data, and used 95% isopleths to compare seasonal home range size between species. We calculated utilisation intensity (UI) from the UDs and generated spatial layers representing resources and disturbances, and then used model averaging to identify factors affecting UI for each species. We calculated second and third order habitat selection ratios to determine whether species were habitat specialists or generalists. Zebra occupied larger home ranges than tsessebe and wildebeest, showed weaker responses to spatial variables and displayed no third order habitat selection; zebra social systems are also more fluid, allowing for information exchange between stable harems. Herbivore species that are sedentary, occupy small home ranges, are habitat specialists and exist in relatively isolated groups are likely to be less resistant and resilient to the rapid pace of environmental change forecast by climate change scenarios. Resources contained within existing protected areas are unlikely to maintain populations of such species at sufficiently high levels, potentially leading to functional extinction. Special precautions may be needed to ensure that such species can persist in the wild, such as buffer zones around existing protected areas, which would allow greater potential for adaptive movement should current environmental conditions change.
Finding the Way Forward: The Lived Experience of People With Stroke After Participation in a Complex Psychosocial Intervention

Stroke patients’ well-being is threatened after stroke. A psychosocial intervention was developed for Norwegian stroke patients living in the community. Eight individual sessions between people with stroke and a trained health care professional were conducted 1 to 6 months post-stroke with one group of participants and 6 to 12 months post-stroke with another group. Subsequently, 19 of these stroke patients were interviewed to gain an in-depth understanding of their lived experience of the influence of the intervention on their adjustment process. Interview texts were analyzed using Ricoeur’s interpretation theory. Two participants did not personally find the intervention useful. The remaining participants greatly appreciated dialogues with the empathetic intervention personnel, feeling free to discuss their fears and worries. The intervention raised these participants’ awareness of their needs and resources. They were guided to resume their everyday life and adopt a future-oriented attitude. The intervention facilitated their meaning-making endeavors and post-stroke adjustment.
The role of micro-RNAs in management of germ cell tumors: future directions.

PURPOSE OF REVIEW miRNAs 371 and 302/367 clusters are abundantly secreted in the blood of patients with active germ cell malignancy (aGCM), both seminoma and nonseminoma. The serum concentration of those micro-RNAs correlates with tumor burden and to the activity of specific treatments; therefore, representing attractive biomarkers for the diagnosis and follow-up of patients with germ cell tumors. This review summarizes the most relevant evidence supporting their clinical validity in germ cell tumors. RECENT FINDINGS Several retrospective studies have reported high sensitivity and specificity of those micro-RNAs in identifying aGCM prior to the orchiectomy or in patients with metastatic germ cell tumor prior to or during chemotherapy. Most recently, few prospective studies have confirmed their clinical validity during the follow-up of patients after surgery and/or chemotherapy. Large studies are panned across the spectrum of germ cell tumors to assess their clinical utility and several efforts to identify biomarkers of teratoma are underway. SUMMARY The integration of those micro-RNAs in the management of germ cell tumors has the potential to refine the therapeutic decision, especially in some clinical situations characterized by high uncertainty, such as clinical stage I, clinical stage IIA with normal tumor markers and residual disease postchemotherapy.
Blind method for discovering number of clusters in multidimensional datasets by regression on linkage hierarchies generated from random data

Determining intrinsic number of clusters in a multidimensional dataset is a commonly encountered problem in exploratory data analysis. Unsupervised clustering algorithms often rely on specification of cluster number as an input parameter. However, this is typically not known a priori. Many methods have been proposed to estimate cluster number, including statistical and information-theoretic approaches such as the gap statistic, but these methods are not always reliable when applied to non-normally distributed datasets containing outliers or noise. In this study, I propose a novel method called hierarchical linkage regression, which uses regression to estimate the intrinsic number of clusters in a multidimensional dataset. The method operates on the hypothesis that the organization of data into clusters can be inferred from the hierarchy generated by partitioning the dataset, and therefore does not directly depend on the specific values of the data or their distribution, but on their relative ranking within the partitioned set. Moreover, the technique does not require empirical data to train on, but can use synthetic data generated from random distributions to fit regression coefficients. The trained hierarchical linkage regression model is able to infer cluster number in test datasets of varying complexity and differing distributions, for image, text and numeric data, using the same regression model without retraining. The method performs favourably against other cluster number estimation techniques, and is also robust to parameter changes, as demonstrated by sensitivity analysis. The apparent robustness and generalizability of hierarchical linkage regression make it a promising tool for unsupervised exploratory data analysis and discovery.
Assessing whether dairy cow welfare is “better” in pasture-based than in confinement-based management systems

ABSTRACT Consumers perceive pasture-based systems of milk production as natural and therefore better for cow welfare than confinement systems. However both systems are heterogeneous and continually evolving, varying from total confinement to total pasture with many hybrid intermediaries. To compare the welfare of dairy cows in these various systems, we use the three spheres framework, comprising biological functioning, natural behaviour and affective states. Considering biological functioning, pasture-based cows are less at risk of subclinical and clinical mastitis, claw lesions, lameness, metritis, early embryonic mortality, culling and mortality, but at more risk of internal parasitism, malnutrition and delayed onset of oestrous activity postpartum than confined cows. Regarding natural behaviours, pasture-based cows exhibit less agonistic behaviour, better lying behaviour, more normal oestrous behaviours and better synchronicity of behaviours than confined cows. They also have the opportunity to graze, which is one of the main features of the behavioural repertoire of dairy cows, but, they may also experience long periods away from pasture in larger herds, and severe climatic stresses which will become increasingly important as the climate changes. Our current ability to assess the affective state of dairy cows is poor. For example, hunger is an important subjective state that cannot be measured directly. The growing focus on ensuring that animals have lives worth living, means that dairy cows should garner some positive emotions from their lives, and it seems clear that pasture access is essential for this. Clearly measurement of affective state is an important challenge for future dairy cow welfare research. At the extremes of management systems, there can be major differences in animal welfare but in hybrid systems, dairy cows experience elements of both confinement and pasture which may ameliorate the negative effects of each on cow welfare. Ultimately, the optimal system gives cows an element of choice between both environments. Moreover management of the system, whether it is confinement or pastured-based, may be as important as the system of management in ensuring good dairy cow welfare and addressing societal concerns. Abbreviations: BCS: Body condition score; TMR: Total mixed ration
Cardiac Output: The Neglected Stepchild of the Cerebral Blood Flow Physiology Family.

T notion that cardiac output (CO) might influence cerebral blood flow (CBF) is not new.1,2 Yet, despite substantial evidence that some relationship exists, the concept is not widely acknowledged. During the most recent meeting of the Society for Neuroscience in Anesthesiology and Critical Care, CBF autoregulation was the subject of numerous presentations and not once was CO mentioned. A suggestion once made by coauthors and me,3 that epinephrine used to support the circulation during hypotension might have enhanced CBF via an effect on CO was met with reviewer derision and passed through the review process only in a much diluted form. Why has such a frequently described phenomenon not achieved credibility among anesthesiologists? I suspect that there are several elements to the explanation for the nonacceptance of this concept: (1) there is no tidy, unifying mechanism to explain the phenomenon in all of the situations in which it has been observed; and (2) the relationship between CO and CBF is not always evident, and may exist only in specific situations of physiological stress. The problem of acceptance has been compounded by some attempts to explain the phenomenon that have yielded physiological gobbledygook that has done more to discredit the idea than to support it.