Miracle-dz/UniFAR-FTUs huggingface dataset:
Clearing the waters: Evaluating the need for site‐specific field fluorescence corrections based on turbidity measurements

In situ fluorescent dissolved organic matter (fDOM) measurements have gained increasing popularity as a proxy for dissolved organic carbon (DOC) concentrations in streams. One challenge to accurate fDOM measurements in many streams is light attenuation due to suspended particles. Downing et al. (2012) evaluated the need for corrections to compensate for particle interference on fDOM measurements using a single sediment standard in a laboratory study. The application of those results to a large river improved unfiltered field fDOM accuracy. We tested the same correction equation in a headwater tropical stream and found that it overcompensated fDOM when turbidity exceeded ∼ 300 formazin nephelometric units (FNU). Therefore, we developed a site‐specific, field‐based fDOM correction equation through paired in situ fDOM measurements of filtered and unfiltered streamwater. The site‐specific correction increased fDOM accuracy up to a turbidity as high as 700 FNU, the maximum observed in this study. The difference in performance between the laboratory‐based correction equation of Downing et al. (2012) and our site‐specific, field‐based correction equation likely arises from differences in particle size distribution between the sediment standard used in the lab (silt) and that observed in our study (fine to medium sand), particularly during high flows. Therefore, a particle interference correction equation based on a single sediment type may not be ideal when field sediment size is significantly different. Given that field fDOM corrections for particle interference under turbid conditions are a critical component in generating accurate DOC estimates, we describe a way to develop site‐specific corrections.
Impaired Fibrinolysis in the Antiphospholipid Syndrome

Abstract The pathogenesis of the antiphospholipid syndrome (APS) is complex and involves the persistent presence of antiphospholipid antibodies (aPL) in the bloodstream causing a prothrombotic condition. aPL induce excessive activation of the endothelium, monocytes, and platelets in consort with aberrations in hemostasis/clotting, fibrinolytic system, and complement activation. Impaired fibrinolysis has been found in APS patients with thrombotic as well as obstetric manifestations. Increased levels of plasminogen activator inhibitor-1 and thrombin-activatable fibrinolysis inhibitor, together with the presence of aPL against annexin-2, tissue-type plasminogen activator, and plasminogen contribute to the compromised fibrinolytic activity in these patients. Furthermore, unfavorably altered fibrin morphology, less amenable to fibrinolysis, has been proposed as a novel prothrombotic mechanism in APS. This review aims to summarize the present knowledge of the mechanisms involved in impaired fibrinolysis in APS patients. We also present a case from clinical practice as an illustration of fibrinolysis impairment in APS patients from a real-life setting.
Accident Mechanisms and Injury Patterns in E-Scooter Users.

BACKGROUND E-scooter sharing systems were initiated in Hamburg in June 2019. The number of persons injured in Hamburg in e-scooter accidents rose thereafter. The goal of this study was to determine the typical accident mechanisms and injury patterns after e-scooter accidents in Germany, and to compare these with bicycle accidents. METHODS In a retrospective study, accidents with e-scooters and bicycles that occurred from June 2019 to June 2020 were registered and analyzed with respect to demography, accident mechanisms, diagnostics, patterns of injury, emergency medical care, operations, and inpatient hospitalizations. RESULTS 89 persons sustained e-scooter accidents (mean age 33.9 years, standard deviation [SD] 14 years); 435 persons who sustained bicycle accidents (mean age 42.5 years, SD 17 years) served as a comparison group. E-scooter accidents more commonly occurred at night (37% versus 14%), and 28% of the persons who sustained them were under the influence of alcohol (cyclists: 6%). 54% of the injured e-scooter riders suffered trauma to the head or face; 14% had a severe head injury and 16% had a severe facial injury. Fractures of the upper limbs were more common than fractures of the lower limbs (18% versus 6%). On initial assessment in the emergency room, injured cyclists were more frequently classified as needing immediate treatment than injured e-scooter riders (7% versus 1%). CONCLUSION The head, face, and upper limbs are the most commonly affected parts of the body in e-scooter accidents. Compared to bicycle accidents, e-scooter accidents more commonly occur on weekends and in association with alcohol. From a medical point of view, abstaining from alcohol consumption and wearing a helmet when using an e-scooter is strongly recommended.
Fibrinolysis in Venous Thromboembolism

Abstract Fibrinolysis is of paramount importance in maintaining or regaining the patency of veins and pulmonary arteries obstructed by thrombi. Growing experimental and clinical evidence indicates that impaired fibrinolysis mediated by multiple complex mechanisms is involved in venous thromboembolism (VTE). Global plasma fibrin clot lysis markers, especially clot lysis time, have been reported to predict recurrent deep-vein thrombosis and pulmonary embolism. The current overview summarizes available data linking fibrinolysis to VTE and its long-term sequelae.
RTEX: A novel framework for ranking, tagging, and explanatory diagnostic captioning of radiography exams

Abstract Objective The study sought to assist practitioners in identifying and prioritizing radiography exams that are more likely to contain abnormalities, and provide them with a diagnosis in order to manage heavy workload more efficiently (eg, during a pandemic) or avoid mistakes due to tiredness. Materials and Methods This article introduces RTEx, a novel framework for (1) ranking radiography exams based on their probability to be abnormal, (2) generating abnormality tags for abnormal exams, and (3) providing a diagnostic explanation in natural language for each abnormal exam. Our framework consists of deep learning and retrieval methods and is assessed on 2 publicly available datasets. Results For ranking, RTEx outperforms its competitors in terms of nDCG@k. The tagging component outperforms 2 strong competitor methods in terms of F1. Moreover, the diagnostic captioning component, which exploits the predicted tags to constrain the captioning process, outperforms 4 captioning competitors with respect to clinical precision and recall. Discussion RTEx prioritizes abnormal exams toward the improvement of the healthcare workflow by introducing a ranking method. Also, for each abnormal radiography exam RTEx generates a set of abnormality tags alongside a diagnostic text to explain the tags and guide the medical expert. Human evaluation of the produced text shows that employing the generated tags offers consistency to the clinical correctness and that the sentences of each text have high clinical accuracy. Conclusions This is the first framework that successfully combines 3 tasks: ranking, tagging, and diagnostic captioning with focus on radiography exams that contain abnormalities.
Human hematopoietic microenvironments

Dormancy of hematopoietic stem cells and formation of progenitors are directed by signals that come from the bone marrow microenvironment. Considerable knowledge has been gained on the murine hematopoietic stem cell microenvironment, while less so on the murine progenitor microenvironment and even less so on these microenvironments in humans. Characterization of these microenvironments is decisive for understanding hematopoiesis and finding new treatment modalities against bone marrow malignancies in the clinic. However, it is equally challenging, because hematopoietic stem cells are difficult to detect in the complex bone marrow landscape. In the present study we are characterizing the human hematopoietic stem cell and progenitor microenvironment. We obtained three adjacent bone marrow sections from ten healthy volunteers. One was used to identify a population of CD34+/CD38- “hematopoietic stem cells and multipotent progenitors” and a population of CD34+/CD38+ “progenitors” based on immunofluorescence pattern/intensity and cellular morphology. The other two were immunostained respectively for CD34/CD56 and for CD34/SMA. Using the combined information we performed a non-computer-assisted quantification of nine bone marrow components (adipocytes, megakaryocytes, bone surfaces, four different vessel types (arteries, capillaries, sinusoids and collecting sinuses), other “hematopoietic stem cells and multipotent progenitors” and other “progenitors”) within 30 μm of “hematopoietic stem cells and multipotent progenitors”, “progenitors”, and “random cell profiles”. We show that the microenvironment of the “hematopoietic stem cells and multipotent progenitors” is significantly enriched in sinusoids and megakaryocytes, while the microenvironment of the “progenitors” is significantly enriched in capillaries, other “progenitors”, bone surfaces and arteries.
Determinants of life satisfaction among stroke survivors 1 year post stroke

Abstract Stroke is the major leading cause of death and severe long-term disability worldwide. The consequences of stroke, aside from diminished survival, have a significant impact on an individual's capability in maintaining self-autonomy and life satisfaction (LS). Thus, this study aimed to assess LS and other specific domains of LS in stroke survivors following their first-ever stroke, and to describe the relationship using socio-demographic and stroke-related variables. This study recruited 376 stroke survivors (244 men and 132 women, mean age: 57 years) 1 year following stroke. Data on participants’ LS (measured using the Life Satisfaction Questionnaire [LiSat-11]), socio-demographics, and stroke-related variables were collected. Univariate analysis showed that LS and the 10 specific domains were not associated with the patients’ gender or stroke type; however, age at onset, marital status, and vocational situation were significantly associated with some domains in LiSat-11 (Spearman's rho = 0.42–0.87; all P < 0.05). Logistic regression revealed that verbal and cognitive dysfunction were the most negative predictors of LS (odds ratio 4.1 and 3.7, respectively). LS is negatively affected in stroke survivors 1 year post onset. The results indicate that recovering social engagement is a positive predictor of higher LS in stroke survivors. More importantly, the findings revealed that cognitive and verbal dysfunctions were the most prominent negative predictors of the overall gross level of LS. Multidisciplinary rehabilitation for stroke survivors is therefore critical.
Associations of physician burnout with organizational electronic health record support and after-hours charting

Abstract In 2017, 43.9% of US physicians reported symptoms of burnout. Poor electronic health record (EHR) usability and time-consuming data entry contribute to burnout. However, less is known about how modifiable dimensions of EHR use relate to burnout and how these associations vary by medical specialty. Using the KLAS Arch Collaborative’s large-scale nationwide physician (MD/DO) data, we used ordinal logistic regression to analyze associations between self-reported burnout and after-hours charting and organizational EHR support. We examined how these relationships differ by medical specialty, adjusting for confounders. Physicians reporting ≤ 5 hours weekly of after-hours charting were twice as likely to report lower burnout scores compared to those charting ≥6 hours (aOR: 2.43, 95% CI: 2.30, 2.57). Physicians who agree that their organization has done a great job with EHR implementation, training, and support (aOR: 2.14, 95% CI: 2.01, 2.28) were also twice as likely to report lower scores on the burnout survey question compared to those who disagree. Efforts to reduce after-hours charting and improve organizational EHR support could help address physician burnout.
A pilot comparison of medical records sensitivity perspectives of patients with behavioral health conditions and healthcare providers

This pilot study compares medical record data sensitivity (e.g., depression is sensitive) and categorization perspective (e.g., depression categorized as mental health information) of patients with behavioral health conditions and healthcare providers using a mixed-methods approach employing patient’s own EHR. Perspectives of 25 English- and Spanish-speaking patients were compared with providers. Data categorization comparisons resulted in 66.3% agreements, 14.5% partial agreements, and 19.3% disagreements. Sensitivity comparisons obtained 54.5% agreement, 11.9% partial agreement, and 33.6% disagreements. Patients and providers disagreed in classification of genetic data, mental health, drug abuse, and physical health information. Factors influencing patients’ sensitivity determination were sensitive category comprehension, own experience, stigma towards category labels (e.g., drug abuse), and perception of information applicability (e.g., alcohol dependency). Knowledge of patients’ sensitivity perceptions and reconciliation with providers could expedite the development of granular and personalized consent technology.
The Association Between the Risk of Hypertensive Disorders of Pregnancy and Folic Acid: A Systematic Review and Meta-Analysis.

PURPOSE Although folic acid (FA) supplementation has been shown to reduce general cardiovascular risks, its impact on hypertensive disorders of pregnancy (HDP) is unclear. We performed a systematic review and meta-analysis to clarify the association between FA and the risk of HDP (pre-eclampsia (PE) and gestational hypertension (GH)). METHODS PubMed, EmBase, and Cochrane Library were searched up to June 18, 2020, stratified by type of disease, initiation time of FA, form of FA and pre-conception Body Mass Index (BMI). The quality assessment of included studies was evaluated using Newcastle-Ottawa Scale (NOS) for cohort studies and Cochrane Collaboration's Risk of Bias Assessment Tool for randomized controlled trials (RCTs). Between-study heterogeneity was quantified using Cochran's Q-statistic and I2 statistics. Sensitivity analysis was performed by excluding the studies one by one, and publication bias was analyzed using funnel plots. RESULTS Twenty studies with 359041 patients were identified for inclusion in the meta-analysis which included 3 RCTs and 17 cohort studies. Pooled estimates showed RR of 0.83 (95%CI 0.74-0.93, P=0.0008) for association between low dose FA (LD-FA) and the risk of PE, but LD-FA was not associated with GH (RR 1.05, 95% CI 0.97-1.13, P=0.20). In addition, the results of subgroup analysis showed that post-conception LD-FA had a 31% decreased risk of PE (RR 0.69, 95% CI 0.59-0.80, P<0.00001), and LD-FA in patients with pre-conception BMI<25 kg/m2 had a 32% decreased risk of PE (RR 0.68, 95% CI 0.56-0.81, P<0.0001) Conclusions: LD-FA significantly decreased the risk of PE but not GH, and post-conception LD-FA and pre-conception BMI<25 kg/m2 were considered as protective factors to reduce the risk of PE.
Fabrication of Three-Dimensional Bioactive Composite Scaffolds for Hemostasis and Wound Healing

Fabrication of 3D composite scaffolds was carried out by lyophilization of variable concentrations of collagen and chitosan gel solutions. Fibrinogen and thrombin aerosol were deposited over the surface of scaffolds to enhance hemostasis and wound healing. Composite scaffolds were characterized using differential scanning calorimetry, thermogravimetric analysis, and Fourier-transform infrared spectrophotometer to ascertain the aerosol deposition and stability. Scanning electron microscope showed multilayered porosity with pore size of ~30 μm and mushroom-like fibril growth of aerosol. A detailed investigation by surface plasmon resonance confirmed higher binding affinity of collagen toward the human blood platelets and erythrocytes in comparison to chitosan and was found to increase with the increase in blood cell concentration from 480.8 to 886.4 RU for erythrocytes. Scaffolds showed higher binding response for platelets than erythrocytes, while fibrinogen and thrombin showed no or limited interaction. Highest blood sorption of 83 ± 4% was observed in case of aerosol deposited scaffolds. Aerosol deposited scaffolds showed minimum clotting time of 20 ± 3 s and bleeding time of 38 ± 4 s, which was significantly lower compared to the scaffolds without aerosol treatment. Aerosol deposited composite scaffolds with 2:1 concentration of chitosan/collagen showed complete wound contraction by day 14, while 50% was observed in case of the control group. In vivo studies revealed that chitosan had a crucial role in the inflammatory phase, while collagen played an important role in the proliferation and maturation phase. The present study suggests that the fabricated 3D composite scaffolds with bioactive moieties may be a potential candidate for enhanced hemostasis and wound healing applications.
Anemia May Increase the Overall Risk of Cancer: Findings from a Cohort Study with a 12-Year Follow-up Period in South Korea

Background: No previous study has assessed cancer risk in individuals with anemia diagnosed based on hemoglobin levels. Thus, we aimed to investigate whether anemia increases the risk of cancer. Methods: Adult individuals who underwent a standardized medical examination during 2002 and 2003 in South Korea were included, and their cancer status was evaluated between January 2004 and December 2015 (12 years) as a primary endpoint. Anemia was defined as serum hemoglobin levels of <12 and <13 g/dL for women and men, respectively. Results: A total of 454,304 adults were included in the final analysis. Among them, 41,947 (9.2%) and 412,357 (90.8%) individuals constituted the anemia and control groups, respectively. After propensity score matching, a total of 83,886 individuals (41,943 per group) were included in the analysis. Cox regression revealed that the risk of cancer in the anemia group was 3% higher than that in the control group (HR, 1.03; 95% confidence interval, 1.01–1.05; P = 0.023). Specifically, relative to the control group, the anemia group was at an increased risk of gastric (HR, 1.29), esophageal (HR, 1.37), lung (HR, 1.14), and thyroid cancers (HR, 1.14), neoplasms of breast and genital organs (HR, 1.12), and lymphoma or leukemia (HR, 1.63). Conclusions: Anemia was independently associated with an increased overall risk of cancer. Further research is required to clarify the associated mechanism. Impact: Anemia was independently associated with an increased overall risk of cancer in the South Korean population.
Experiences of social support among Kashmiri women with breast cancer

One of the major global health crises in the contemporary scenario is the rapid increase in the incidence of the disease of cancer in general with breast cancer in particular affecting millions of women worldwide. The diagnosis of breast cancer provokes a series of changes in patient’s lives with social support seen as critical in facilitating women cope with the illness as well as the stress associated with it. Although breast cancer has emerged as the focus of clinical research and intervention in Kashmir, the experiences of support dynamics characterising post-diagnosis situation among such patients have been neglected. This qualitative study, thus, investigated the experiences of Kashmiri women with breast cancer regarding social support. Participants were invited for in-depth face-to-face interviews between November 2018 and March 2019 using snowball sampling technique, and the participants were recruited until data saturation was reached (n= 12). The study revealed that participants received overwhelming support (emotional, financial, practical, moral, and informational) from significant others (parents, siblings, husbands, children, extended family), important others (relatives, friends, neighbours, colleagues, peers), healthcare providers (doctors, nurses, paramedics, physician’s assistants), and religion and spirituality (religious beliefs and practices, spiritual healers, shrines) throughout their journey with breast cancer and reported varying positive outcomes as a result of the support received. Moreover, social support received provided them strength, and encouragement and instilled feeling of optimism that helped them to deal with their illness. The study further highlights a need for interventions that could address the unmet support needs thereby reducing the disturbance and sufferings experienced by women post-diagnosis.
Regional planning: an arena of interests, institutions and relations

ABSTRACT This special issue approaches regional planning as a contested arena of strategic planning. With this view, we transcend the idea that regional planning is purely a matter of scale and approach the complexity of regional planning from three perspectives: interests, institutions and relations. The perspective of ‘interests’ reveals the various underlying motivations connected to regional planning. The perspective of ‘institutions’ addresses the encounter of formal and informal rules, norms and discourses shaping planning and governance practices. The perspective of ‘relations’ uncovers the complex constellations of actors and processes associated with planning, involving various administrative scales, territorial entities and sectoral policies.
OFC: an opportunistic caching system for FaaS platforms

Cloud applications based on the "Functions as a Service" (FaaS) paradigm have become very popular. Yet, due to their stateless nature, they must frequently interact with an external data store, which limits their performance. To mitigate this issue, we introduce OFC, a transparent, vertically and horizontally elastic in-memory caching system for FaaS platforms, distributed over the worker nodes. OFC provides these benefits cost-effectively by exploiting two common sources of resource waste: (i) most cloud tenants overprovision the memory resources reserved for their functions because their footprint is non-trivially input-dependent and (ii) FaaS providers keep function sandboxes alive for several minutes to avoid cold starts. Using machine learning models adjusted for typical function input data categories (e.g., multimedia formats), OFC estimates the actual memory resources required by each function invocation and hoards the remaining capacity to feed the cache. We build our OFC prototype based on enhancements to the OpenWhisk FaaS platform, the Swift persistent object store, and the RAM-Cloud in-memory store. Using a diverse set of workloads, we show that OFC improves by up to 82 % and 60 % respectively the execution time of single-stage and pipelined functions.
Unikraft: fast, specialized unikernels the easy way

Unikernels are famous for providing excellent performance in terms of boot times, throughput and memory consumption, to name a few metrics. However, they are infamous for making it hard and extremely time consuming to extract such performance, and for needing significant engineering effort in order to port applications to them. We introduce Unikraft, a novel micro-library OS that (1) fully modularizes OS primitives so that it is easy to customize the unikernel and include only relevant components and (2) exposes a set of composable, performance-oriented APIs in order to make it easy for developers to obtain high performance. Our evaluation using off-the-shelf applications such as nginx, SQLite, and Redis shows that running them on Unikraft results in a 1.7x-2.7x performance improvement compared to Linux guests. In addition, Unikraft images for these apps are around 1MB, require less than 10MB of RAM to run, and boot in around 1ms on top of the VMM time (total boot time 3ms-40ms). Unikraft is a Linux Foundation open source project and can be found at www.unikraft. org.