Miracle-dz/UniFAR-FTUs huggingface dataset:
“The Water in Which We Swim:” A Unique, Post-Clerkship Multidisciplinary Course

OBJECTIVE To improve patient outcomes and promote health equity, medical students must be taught not only biomedicine, but also the social sciences to understand the larger contexts in which patients live and health care operates. Yet, most undergraduate medical education does not explicitly cover these topics in a required, longitudinal curriculum. METHODS In January 2015 at Harvard Medical School, we created a two-part sequence (pre- and post-clerkship) of required, 4-week multidisciplinary courses—“Essentials of the Profession I and II”—to fill this gap. “Essentials of the Profession II (EOP2)” is an advanced social sciences course anchored in patient narratives and the lived experiences of students and includes clinical epidemiology and population health, healthcare delivery and leadership, health policy, medical ethics and professionalism, and social medicine that engages students to conduct structural analyses to be effective healers, advocates, and leaders. RESULTS Per student course evaluations, the overall course rating was 1.7 (SD 0.9, 1 = excellent and 5 = poor); its overall rating has improved over time; and it has scored well even when run virtually. It was rated highly in application of critical thinking, integration of the disciplines, and relevance for clinical work. Qualitative analyses of student responses revealed the following key course strengths: breadth of topics, teaching faculty and guest speakers, and small group discussions. The weaknesses included workload, lack of diversity of opinions, repetition, and time spent in lectures. CONCLUSIONS We argue that EOP2 is “essential” for post-clerkship medical education. It offers an opportunity to re-ignite and enhance humanism and activism; remind students why they chose the medical profession; equip them with frameworks and toolkits to help them to overcome challenges; and devise solutions to improve health care and patient outcomes that are applicable to their future training and ongoing practice of medicine.
On the Implementation and Evaluation of AbTweakQiang Yang

In this paper we describe the implementation and evaluation of the AbTweak planning system, a test bed for studying and teaching concepts in partial-order planning, abstraction, and search control. We start by extending the hierarchical, precondition-elimination abstraction of Abstrips to partial-order-based, least-commitment planners such as Tweak. The resulting system, AbTweak, is used to illustrate the advantages of using abstraction to improve the eeciency of search. We show that by protecting a subset of abstract conditions achieved so far, and by imposing a bias on search toward deeper levels in a hierarchy, planning eeciency can be greatly improved. Finally, we relate AbTweak to other planning systems Snlp, Alpine and Sipe by exploring their similarities and diierences.
Far‐field connectivity of the UK's four largest marine protected areas: Four of a kind?

Marine Protected Areas (MPAs) are established to conserve important ecosystems and protect marine species threatened in the wider ocean. However, even MPAs in remote areas are not wholly isolated from anthropogenic impacts. “Upstream” activities, possibly thousands of kilometers away, can influence MPAs through ocean currents that determine their connectivity. Persistent pollutants, such as plastics, can be transported from neighboring shelf regions to MPAs, or an ecosystem may be affected if larval dispersal is reduced from a seemingly remote upstream area. Thus, improved understanding of exactly where upstream is, and on what timescale it is connected, is important for protecting and monitoring MPAs. Here, we use a high‐resolution (1/12°) ocean general circulation model and Lagrangian particle tracking to diagnose the connectivity of four of the UK's largest MPAs: Pitcairn; South Georgia and Sandwich Islands; Ascension; and the British Indian Ocean Territory (BIOT). We introduce the idea of a circulation “connectivity footprint”, by which MPAs are connected to upstream areas. Annual connectivity footprints were calculated for the four MPAs, taking into account seasonal and inter‐annual variability. These footprints showed that, on annual timescales, Pitcairn was not connected with land, whereas there was increasing connectivity for waters reaching South Georgia, Ascension, and, especially, BIOT. BIOT also had a high degree of both seasonal and inter‐annual variability, which drastically changed its footprint, year‐to‐year. We advocate that such connectivity footprints are an inherent property of all MPAs, and need to be considered when MPAs are first proposed or their viability as refuges evaluated.
Semi‐supervised auto‐segmentation method for pelvic organ‐at‐risk in magnetic resonance images based on deep‐learning

Abstract Background and purpose In radiotherapy, magnetic resonance (MR) imaging has higher contrast for soft tissues compared to computed tomography (CT) scanning and does not emit radiation. However, manual annotation of the deep learning‐based automatic organ‐at‐risk (OAR) delineation algorithms is expensive, making the collection of large‐high‐quality annotated datasets a challenge. Therefore, we proposed the low‐cost semi‐supervised OAR segmentation method using small pelvic MR image annotations. Methods We trained a deep learning‐based segmentation model using 116 sets of MR images from 116 patients. The bladder, femoral heads, rectum, and small intestine were selected as OAR regions. To generate the training set, we utilized a semi‐supervised method and ensemble learning techniques. Additionally, we employed a post‐processing algorithm to correct the self‐annotation data. Both 2D and 3D auto‐segmentation networks were evaluated for their performance. Furthermore, we evaluated the performance of semi‐supervised method for 50 labeled data and only 10 labeled data. Results The Dice similarity coefficient (DSC) of the bladder, femoral heads, rectum and small intestine between segmentation results and reference masks is 0.954, 0.984, 0.908, 0.852 only using self‐annotation and post‐processing methods of 2D segmentation model. The DSC of corresponding OARs is 0.871, 0.975, 0.975, 0.783, 0.724 using 3D segmentation network, 0.896, 0.984, 0.890, 0.828 using 2D segmentation network and common supervised method. Conclusion The outcomes of our study demonstrate that it is possible to train a multi‐OAR segmentation model using small annotation samples and additional unlabeled data. To effectively annotate the dataset, ensemble learning and post‐processing methods were employed. Additionally, when dealing with anisotropy and limited sample sizes, the 2D model outperformed the 3D model in terms of performance.
A numerical study of rapid intensity change in Hurricane Lili (2002)

Rapid intensity change in tropical cyclones is one of the most difficult problems in hurricane prediction today. Hurricane Lili (2002) went through a rapid intensification (from category 2 to a category 4 hurricane in about 24 hours) followed by a rapid weakening (from category 4 to a category 1 hurricane in about 18 hours) before landfall on the Louisiana coast. None of the operational numerical weather prediction (NWP) models were able to forecast the rapid intensity change in Hurricane Lili. Numerous studies have shown that the principal factors involved in intensity changes are air-sea interactions, environmental factors (e.g. vertical wind shear, dry air), internal dynamics or a combined effect of two or more of these factors. The analysis we conducted with a numerical model is mainly focused on the role played by the vertical wind shear as a weakening factor in Hurricane Lili’s case.
Cellular Senescence, Mitochondrial Dysfunction, and Their Link to Cardiovascular Disease

Cardiovascular diseases (CVDs), a group of disorders affecting the heart or blood vessels, are the primary cause of death worldwide, with an immense impact on patient quality of life and disability. According to the World Health Organization, CVD takes an estimated 17.9 million lives each year, where more than four out of five CVD deaths are due to heart attacks and strokes. In the decades to come, an increased prevalence of age-related CVD, such as atherosclerosis, coronary artery stenosis, myocardial infarction (MI), valvular heart disease, and heart failure (HF) will contribute to an even greater health and economic burden as the global average life expectancy increases and consequently the world’s population continues to age. Considering this, it is important to focus our research efforts on understanding the fundamental mechanisms underlying CVD. In this review, we focus on cellular senescence and mitochondrial dysfunction, which have long been established to contribute to CVD. We also assess the recent advances in targeting mitochondrial dysfunction including energy starvation and oxidative stress, mitochondria dynamics imbalance, cell apoptosis, mitophagy, and senescence with a focus on therapies that influence both and therefore perhaps represent strategies with the most clinical potential, range, and utility.
The Motivation of Electronic Voting towards Game Theory

With rapid development of computer science and network technology, the technology of electronic voting is widely applied in various fields. There are lots of security requirements in electronic voting such as privacy, verifiability, fairness and robustness etc. Previous works mainly discuss how to guarantee these requirements by using cryptographic tools, such as encryption, commitment etc. There, most works assume that parties are honest who will follow the protocol or malicious who will arbitrarily break the security of the protocol. In fact parties in real life are neither honest nor malicious, but instead they may consider the benefits when they decide to participate in voting. This paper discusses the motivations of parties to participate into voting towards the view of game theory. More specifically, motivations are quantized as the notion of utilities just as those in game theory. Then we prove how to assign people to have motivations to vote by achieving Nash equilibrium.
Untersuchungen zur Speziation von verschmutzungsrelevanten Spurenmetallen in tropischen Ästuar- und Küstensystem (Südchina und Nord-Ost-Brasilien)

Dissolved and particulate cadmium, copper, iron, lead, cobalt and nickel were analyzed in surface waters of the Wanquan River estuary and the Wenchang/Wenjiao River estuary in East-Hainan Island during the dry season (December 2006) and two wet seasons (August 2007 and July/August 2008). A major difference to other Chinese rivers was the very low concentration of suspended particles in these tropical Hainan estuaries. In the dissolved phase, a positive deviation from the theoretical dilution line was observed for Cd during different expeditions. Dissolved Cu and Ni essentially behaved conservatively, while Fe, Pb and partly also Co correlated in their negative deviation from simple mixing. Strong seasonal variability was observed only for dissolved Fe, Pb and Cd: sorption by the much higher loading with suspended particles during the dry season lead to a strong lowering of dissolved Fe and Pb, while the opposite was observed for dissolved Cd. In both estuaries all six metals in particulate form showed almost constant values with a tendency for slight decreases along the salinity profile. The normalization to particulate Al revealed some specific particle properties during the different expeditions. The dynamics of Fe chemistry dominated the distribution of Pb in all forms. The distribution coefficients KD showed a general decrease in the order Fe > Pb > Co > Ni > Cu ≈ Cd. There was no ‘‘particle concentration effect’’; rather the KD’s of Fe and Pb exhibited slightly positive correlations with the suspended particle loadings. Elevated concentrations levels in the Wenchang/Wenjiao River estuary, especially during the wet season 2008, were ascribed to diffuse inputs from Kapitel 4: Publikation 1 60 aquaculture ponds which girdle the upper estuary. In comparison to major Chinese rivers, the tropical Hainan estuaries (S > 0) showed similar levels for Cd, Cu, Pb, Co and Ni in particles and solution, while Fe was enriched in both matrices. On a global scale, neither in the Wanquan River estuary nor in the Wenchang/Wenjiao River estuary significant trace metal contamination was observed.
In Vitro Glioblastoma Model on a Plate for Localized Drug Release Study from a 3D-Printed Drug-Eluted Hydrogel Mesh

Glioblastoma multiforme (GBM) is an aggressive type of brain tumor that has limited treatment options. Current standard therapies, including surgery followed by radiotherapy and chemotherapy, are not very effective due to the rapid progression and recurrence of the tumor. Therefore, there is an urgent need for more effective treatments, such as combination therapy and localized drug delivery systems that can reduce systemic side effects. Recently, a handheld printer was developed that can deliver drugs directly to the tumor site. In this study, the feasibility of using this technology for localized co-delivery of temozolomide (TMZ) and deferiprone (DFP) to treat glioblastoma is showcased. A flexible drug-loaded mesh (GlioMesh) loaded with poly (lactic-co-glycolic acid) (PLGA) microparticles is printed, which shows the sustained release of both drugs for up to a month. The effectiveness of the printed drug-eluting mesh in terms of tumor toxicity and invasion inhibition is evaluated using a 3D micro-physiological system on a plate and the formation of GBM tumoroids within the microenvironment. The proposed in vitro model can identify the effective combination doses of TMZ and DFP in a sustained drug delivery platform. Additionally, our approach shows promise in GB therapy by enabling localized delivery of multiple drugs, preventing off-target cytotoxic effects.
Association between anthropization and rodent reservoirs of zoonotic pathogens in Northwestern Mexico

The world is facing a major pulse of ecological and social changes that may favor the risk of zoonotic outbreaks. Such risk facilitation may occur through the modification of the host’s community diversity and structure, leading to an increase in pathogen reservoirs and the contact rate between these reservoirs and humans. Here, we examined whether anthropization alters the relative abundance and richness of zoonotic reservoir and non-reservoir rodents in three Socio-Ecological Systems. We hypothesized that anthropization increases the relative abundance and richness of rodent reservoirs while decreasing non-reservoir species. We first developed an Anthropization index based on 15 quantitative socio-ecological variables classified into five groups: 1) Vegetation type, 2) Urbanization degree, 3) Water quality, 4) Potential contaminant sources, and 5) Others. We then monitored rodent communities in three regions of Northwestern Mexico (Baja California, Chihuahua, and Sonora). A total of 683 rodents of 14 genera and 27 species were captured, nine of which have been identified as reservoirs of zoonotic pathogens (359 individuals, 53%). In all regions, we found that as anthropization increased, the relative abundance of reservoir rodents increased; in contrast, the relative abundance of non-reservoir rodents decreased. In Sonora, reservoir richness increased with increasing anthropization, while in Baja California and Chihuahua non-reservoir richness decreased as anthropization increased. We also found a significant positive relationship between the anthropization degree and the abundance of house mice (Mus musculus) and deer mice (Peromyscus maniculatus), the most abundant reservoir species in the study. These findings support the hypothesis that reservoir species of zoonotic pathogens increase their abundance in disturbed environments, which may increase the risk of pathogen exposure to humans, while anthropization creates an environmental filtering that promotes the local extinction of non-reservoir species.
Misophonia is related to stress but not directly with traumatic stress

The relationship between misophonia, stress, and traumatic stress has not been well characterized scientifically. This study aimed to explore the relationships among misophonia, stress, lifetime traumatic events, and traumatic stress. A community sample of adults with self-reported misophonia (N = 143) completed structured diagnostic interviews and psychometrically validated self-report measures. Significant positive correlations were observed among perceived stress, traumatic stress, and misophonia severity. However, multivariate analyses revealed that perceived stress significantly predicted misophonia severity, over and above traumatic stress symptoms. The number of adverse life events was not associated with misophonia severity. Among symptom clusters of post-traumatic stress disorder, only hyperarousal was associated with misophonia severity. These findings suggest that transdiagnostic processes related to stress, such as perceived stress and hyperarousal, may be important phenotypic features and possible treatment targets for adults with misophonia.
Intradialytic hypotension and worse outcomes in patients with acute kidney injury requiring intermittent hemodialysis.

Background Intradialytic hypotension (IDH) is a critical complication related to worse outcomes in patients undergoing maintenance hemodialysis. Herein, we addressed the impact of IDH on mortality and other outcomes in patients with severe acute kidney injury (AKI) requiring intermittent hemodialysis. Methods We retrospectively reviewed 1,009 patients who underwent intermittent hemodialysis due to severe AKI. IDH was defined as either dialysis discontinuation due to hemodynamic instability or a decrease in systolic blood pressure (BP) of ≥30 mmHg, with or without a nadir systolic BP of <90 mmHg during the first session. The primary outcome was all-cause mortality, and transfer to the intensive care unit (ICU) due to unstable status was additionally analyzed. Hazard ratios (HRs) of outcomes were calculated using a Cox regression model after adjusting for multiple variables. Risk factors for IDH were evaluated using a logistic regression model. Results IDH occurred in 449 patients (44.5%) during the first hemodialysis session. Patients with IDH had a higher mortality rate than those without IDH (40% vs. 23%; HR, 1.30; 95% confidence interval [CI], 1.02-1.65). The rate of ICU transfer was higher in patients experiencing IDH than in those without IDH (17% vs. 11%; HR, 1.43; 95% CI, 1.02-2.02). Factors such as old age, high BP and pulse rate, active malignancy, cirrhosis, and hypoalbuminemia were associated with an increased risk of IDH episodes. Conclusion The occurrence of IDH is associated with worse outcomes in patients with AKI requiring intermittent hemodialysis. Therefore, careful monitoring and early intervention of IDH may be necessary in this patient subset.
The K41 theory and turbulence in 1D Burgers equation.

This work is a review of a group of results on the stochastic Burgers equation with small viscosity, obtained during the last two decades. These results jointly show that the equation makes a good model of hydrodynamical turbulence. The model provides natural and rigorously justified analogies of a number of key predictions of the theory of turbulence, including the main assertions of the Kolmogorov approach to turbulence, known as the K41 theory. The presentation is based on the recent book by Boritchev and Kuksin, One-Dimensional Turbulence and the Stochastic Burgers Equation (AMS, 2021) and on two papers that develop the book's results. Part of the assertions that we review here together with their rigorous proofs were earlier heuristically proved in works of physicists.
Identificación bioinformática de Polimorfismos de Nucleótido Simple (PNSs) en genes candidatos para las características de la fibra en alpacas (Vicugna pacos)

El objetivo fue identificar y predecir la ubicación de polimorfismos de nucleótido simple (PNSs) en genes relacionados al crecimiento de la fibra. Se realizó el estudio con un total de 31 genes de queratina (KRT9, KRT12, KRT13, KRT14, KRT16, KRT18, KRT20, KRT25, KRT1, KRT3, KRT5, KRT6a, KRT6b, KRT6c, KRT7, KRT8, KRT71, KRT80, KRT31, KRT32, KIRT40, KRT81, KRT82, KRT10, KRT15, KRT17, KRT19, KRT2, KRT4, KRT79 y KRT83) asociados con las características de lana, fibra y pelo en ovinos, cabras y humanos respectivamente, cuyas secuencias fueron encontradas en la base de datos del National Center for Biotechnology Information (NCBI). Mediante el uso de bases de datos y herramientas bioinformáticas como el Conserved Domains Database, Spling, y MegaBlast se logró ubicar secuencias únicas para cada gen. Estas secuencias fueron comparadas con los genomas de referencia Vicugna_pacos-2.0. 2 y Vi_pacos_V1. 0. Se identificaron 48 PNSs ubicados en las regiones intrónicas y exónicas de 22 genes. No se localizaron PNSs en o alrededor de los genes KRT10, KRT15, KRT17, KRT19, KRT2, KRT4, KRT6b, KRT6c y KRT79. El análisis comparativo entre las cuatro especies estudiadas permitió observar que los genes KRT81, KRT6b y KRT6c no están presentes en los genomas de referencia de alpaca, los genes KRT31, KRT14, KRT81, KRT83, KRT6b y KRT6c no están presentes en el genoma de referencia de ovino y los genes KRT31, KRT13, KRT81, KRT83, KRT6b y KRT6c no están presentes en el genoma de referencia de cabra.
Orthopaedic materials derived from keratin

The present invention provides a biocompatible material derived from keratin useful in various aspects of the medical treatment of bone. Keratin materials be porous to be used as bone replacement and increase the product but also the use of dense keratin materials in bone treatment, for use as an internal locking mechanism in the treatment and bone fractures, and preservation of the form and function of the bone, restore and methods of keratin material for use in the development is provided.
Organismal Function Enhancement through Biomaterial Intervention

Living organisms in nature, such as magnetotactic bacteria and eggs, generate various organic–inorganic hybrid materials, providing unique functionalities. Inspired by such natural hybrid materials, researchers can reasonably integrate biomaterials with living organisms either internally or externally to enhance their inherent capabilities and generate new functionalities. Currently, the approaches to enhancing organismal function through biomaterial intervention have undergone rapid development, progressing from the cellular level to the subcellular or multicellular level. In this review, we will concentrate on three key strategies related to biomaterial-guided bioenhancement, including biointerface engineering, artificial organelles, and 3D multicellular immune niches. For biointerface engineering, excess of amino acid residues on the surfaces of cells or viruses enables the assembly of materials to form versatile artificial shells, facilitating vaccine engineering and biological camouflage. Artificial organelles refer to artificial subcellular reactors made of biomaterials that persist in the cytoplasm, which imparts cells with on-demand regulatory ability. Moreover, macroscale biomaterials with spatiotemporal regulation characters enable the local recruitment and aggregation of cells, denoting multicellular niche to enhance crosstalk between cells and antigens. Collectively, harnessing the programmable chemical and biological attributes of biomaterials for organismal function enhancement shows significant potential in forthcoming biomedical applications.