Miracle-dz/UniFAR-FTUs huggingface dataset:
A soft voting ensemble classifier for early prediction and diagnosis of occurrences of major adverse cardiovascular events for STEMI and NSTEMI during 2-year follow-up in patients with acute coronary syndrome

Objective Some researchers have studied about early prediction and diagnosis of major adverse cardiovascular events (MACE), but their accuracies were not high. Therefore, this paper proposes a soft voting ensemble classifier (SVE) using machine learning (ML) algorithms. Methods We used the Korea Acute Myocardial Infarction Registry dataset and selected 11,189 subjects among 13,104 with the 2-year follow-up. It was subdivided into two groups (ST-segment elevation myocardial infarction (STEMI), non ST-segment elevation myocardial infarction NSTEMI), and then subdivided into training (70%) and test dataset (30%). Third, we selected the ranges of hyper-parameters to find the best prediction model from random forest (RF), extra tree (ET), gradient boosting machine (GBM), and SVE. We generated each ML-based model with the best hyper-parameters, evaluated by 5-fold stratified cross-validation, and then verified by test dataset. Lastly, we compared the performance in the area under the ROC curve (AUC), accuracy, precision, recall, and F-score. Results The accuracies for RF, ET, GBM, and SVE were (88.85%, 88.94%, 87.84%, 90.93%) for complete dataset, (84.81%, 85.00%, 83.70%, 89.07%) STEMI, (88.81%, 88.05%, 91.23%, 91.38%) NSTEMI. The AUC values in RF were (98.96%, 98.15%, 98.81%), ET (99.54%, 99.02%, 99.00%), GBM (98.92%, 99.33%, 99.41%), and SVE (99.61%, 99.49%, 99.42%) for complete dataset, STEMI, and NSTEMI, respectively. Consequently, the accuracy and AUC in SVE outperformed other ML models. Conclusions The performance of our SVE was significantly higher than other machine learning models (RF, ET, GBM) and its major prognostic factors were different. This paper will lead to the development of early risk prediction and diagnosis tool of MACE in ACS patients.
“You Probably Won’t Notice Any Symptoms”: Blood Pressure in Pregnancy—Discourses of Contested Expertise in an Era of Self-Care and Responsibilization

Pregnancy is not a disease or illness, but requires clinical surveillance as life-threatening complications can develop. Preeclampsia, one such potentially serious complication, puts both mother and baby at risk. Self-monitoring blood pressure in the general population is well established, and its potential in pregnancy is currently being explored. In the context of self-monitoring, the information and guidance given to women regarding hypertension, and the literature they themselves seek out during pregnancy, are vital to perceptions of disease risk and subsequent responses to, and management of, any symptoms. Drawing on online, offline, official, and unofficial sources of information, discourses are examined to provide analysis of how self-responsibilization is reflected in contemporary information, advice, and guidance drawn from multiple sources. A paradox emerges between the paternalistic and lay discourses that seek to challenge and regain control. Findings are discussed in the context of Foucault’s governmentality and medical power.
Neurogenesis in the adult Drosophila brain

We describe the Drosophila central brain as a new model in which to investigate adult neurogenesis. Following injury, we observe a significant increase in the number of proliferating cells. We subsequently detect both new glia and new neurons and the formation of new axon tracts that target appropriate brain regions. We anticipate that this paradigm will facilitate the dissection of the mechanisms of neural regeneration and that these processes will be relevant to human brain repair.
Stochastic optimal feedforward-feedback control determines timing and variability of arm movements with or without vision

Human movements with or without vision exhibit timing (i.e. speed and duration) and variability characteristics which are not well captured by existing computational models. Here, we introduce a stochastic optimal feedforward-feedback control (SFFC) model that can predict the nominal timing and trial-by-trial variability of self-paced arm reaching movements carried out with or without online visual feedback of the hand. In SFFC, movement timing results from the minimization of the intrinsic factors of effort and variance due to constant and signal-dependent motor noise, and movement variability depends on the integration of visual feedback. Reaching arm movements data are used to examine the effect of online vision on movement timing and variability, and test the model. This modelling suggests that the central nervous system predicts the effects of sensorimotor noise to generate an optimal feedforward motor command, and triggers optimal feedback corrections to task-related errors based on the available limb state estimate.
IBD goes home: from telemedicine to self-administered advanced therapies

ABSTRACT Introduction Major challenges have been posed by the coronavirus disease 2019 pandemic in the routine management of patients with inflammatory bowel disease (IBD). The need for constant monitoring of diseases activity and prompt adjustment of therapy have been balanced with the risk of contagion related to face-to-face consultations. Therefore, digital health initiatives have been pursued for safety reasons as vicarious instruments to avoid overcrowding of the IBD clinics. However, concerns and skepticism about the feasibility of digital health and telemedicine modalities limited their uptake in clinical practice in the pre-pandemic period. Areas covered We conducted a literature overview on the current state of the art and the potential future benefits deriving from the integration of telemedicine systems, home-based laboratory tests, and self-administered drugs into IBD daily practice. Expert opinion Digital health and telemedicine approaches at distance have been experimented as effective tools to avoid overcrowding of clinics and reduce risk from SARS-CoV2 exposure. Home-based point of care testing, such as fecal calprotectin and dried blood samples, might represent an effective method of remote monitoring of patients particularly when in-person visits are precluded. High expectations are placed on the use of self-administered advanced therapies, such as new subcutaneous formulation of biologics.
Predicting species and community responses to global change using structured expert judgement: An Australian mountain ecosystems case study

Conservation managers are under increasing pressure to make decisions about the allocation of finite resources to protect biodiversity under a changing climate. However, the impacts of climate and global change drivers on species are outpacing our capacity to collect the empirical data necessary to inform these decisions. This is particularly the case in the Australian Alps which have already undergone recent changes in climate and experienced more frequent large‐scale bushfires. In lieu of empirical data, we use a structured expert elicitation method (the IDEA protocol) to estimate the change in abundance and distribution of nine vegetation groups and 89 Australian alpine and subalpine species by the year 2050. Experts predicted that most alpine vegetation communities would decline in extent by 2050; only woodlands and heathlands are predicted to increase in extent. Predicted species‐level responses for alpine plants and animals were highly variable and uncertain. In general, alpine plants spanned the range of possible responses, with some expected to increase, decrease or not change in cover. By contrast, almost all animal species are predicted to decline or not change in abundance or elevation range; more species with water‐centric life‐cycles are expected to decline in abundance than other species. While long‐term ecological data will always be the gold standard for informing the future of biodiversity, the method and outcomes outlined here provide a pragmatic and coherent basis upon which to start informing conservation policy and management in the face of rapid change and a paucity of data.
Structural connectivity differs between males and females in the brain object manipulation network

Object control skills are one of the most important abilities in daily life. Knowledge of object manipulation is an essential factor in improving object control skills. Although males and females equally try to use object manipulation knowledge, their object control abilities often differ. To explain this difference, we investigated how structural brain networks in males and females are differentially organized in the tool-preferring areas of the object manipulation network. The structural connectivity between the primary motor and premotor regions and between the inferior parietal regions in males was significantly higher than that in females. However, females showed greater structural connectivity in various regions of the object manipulation network, including the paracentral lobule, inferior parietal regions, superior parietal cortices, MT+ complex and neighboring visual areas, and dorsal stream visual cortex. The global node strength found in the female parietal network was significantly higher than that in males but not for the entire object manipulation, ventral temporal, and motor networks. These findings indicated that the parietal network in females has greater inter-regional structural connectivity to retrieve manipulation knowledge than that in males. This study suggests that differential structural networks in males and females might influence object manipulation knowledge retrieval.
Clean and Affordable Hydrogen Fuel from Alkaline Water Splitting: Past, Recent Progress, and Future Prospects

Hydrogen economy has emerged as a very promising alternative to the current hydrocarbon economy, which involves the process of harvesting renewable energy to split water into hydrogen and oxygen and then further utilization of clean hydrogen fuel. The production of hydrogen by water electrolysis is an essential prerequisite of the hydrogen economy with zero carbon emission. Among various water electrolysis technologies, alkaline water splitting has been commercialized for more than 100 years, representing the most mature and economic technology. Here, the historic development of water electrolysis is overviewed, and several critical electrochemical parameters are discussed. After that, advanced nonprecious metal electrocatalysts that emerged recently for negotiating the alkaline oxygen evolution reaction (OER) and hydrogen evolution reaction (HER) are discussed, including transition metal oxides, (oxy)hydroxides, chalcogenides, phosphides, and nitrides for the OER, as well as transition metal alloys, chalcogenides, phosphides, and carbides for the HER. In this section, particular attention is paid to the catalyst synthesis, activity and stability challenges, performance improvement, and industry‐relevant developments. Some recent works about scaled‐up catalyst synthesis, novel electrode designs, and alkaline seawater electrolysis are also spotlighted. Finally, an outlook on future challenges and opportunities for alkaline water splitting is offered, and potential future directions are speculated.
Attitudes Scale on Alcohol, Alcoholism, and Persons With Alcohol Use Disorders

Abstract Background The Attitudes Scale on Alcohol, Alcoholism, and Persons with alcohol use disorders (“Escala de Atitudes Frente ao Álcool, ao Alcoolismo e ao Persons with alcohol use disorders” [EAFAA]) is an instrument designed to measure attitudes toward alcohol, alcoholism, and persons with alcohol use disorders. It has been validated in Portuguese and Spanish. Objective The purpose of this study was to examine the psychometric properties and factor structure of the American English version of the EAFAA (EAFAA-AEV). Methods One hundred eighty-seven participants (nurses = 101 and nursing students = 86) completed the EAFAA-AEV. Results Confirmatory factor analysis resulted in a four-factor solution, supporting the original factor structure of the EAFAA. The scale has shown good internal consistency and reliability for the four factors. The total scale had a Cronbach's alpha of . 85 and a McDonald's omega of . 87. Conclusion The EAFAA-AEV has similarly strong psychometric properties as the original version, suggesting that it is a reliable tool to identify attitudes toward alcohol and related issues among American-English-speaking nurses and nursing students.
Implementation of Patient Safety Structures and Processes in the Patient-Centered Medical Home

ABSTRACT Although most patient–clinician interactions occur in ambulatory care, little research has addressed measuring ambulatory patient safety or how primary care redesign such as the patient-centered medical home (PCMH) addresses patient safety. Our objectives were to identify PCMH standards relevant to patient safety, construct a measure of patient safety activity implementation, and examine differences in adoptions of these activities by practice and community characteristics. Using a consensus process, we selected elements among a widely adopted, nationally representative PCMH program representing activities that, according to a physician panel, represented patient safety overall and in four domains (diagnosis, treatment delays, medications, and communication and coordination) and generated a score for each. We then evaluated this score among 5,007 practices with the highest PCMH recognition level. Implementation of patient safety activities varied; the few military practices (2.4%) had the highest, and community clinics the lowest, patient safety score, both overall (82.0 and 72.0, respectively, p < .001) and across specific domains. Other practice and community characteristics were not associated with the patient safety score. Understanding better what factors are associated with implementation of patient safety activities may be a key step in improving ambulatory patient safety.
The association of polymorphisms in related circadian rhythm genes and clopidogrel resistance susceptibility

Previous studies have confirmed that a dynamic change in circadian rhythm will affect platelet activity, resulting in clopidogrel resistance (CR). We attempted to evaluate whether polymorphisms of related circadian rhythm genes are involved in CR in stable coronary artery disease (SCAD) patients. A sum of 204 SCAD patients met our requirements and were recruited, and 96 patients were considered to have CR. After clinical data collection and platelet function evaluation, genomic DNA was isolated from human peripheral blood, and 23 tagSNPs from related circadian rhythm genes were genotyped by GenomeLab SNPstream Genotyping System. After RNA isolation, relative expression of related gene mRNAs (CLOCK, CRY1, CACNA1C and PRKCG) was measured by real‐time PCR. The results showed that polymorphisms in CRY1, CACNA1C and PRKCG changed the response to clopidogrel. And then, the rs1801260 polymorphism might lead to higher mRNA expression in CLOCK and potentially induce the occurrence of CR. Additionally, the TC genotype of rs3745406 might lower mRNA expression of PRKCG, resulting in CR. These findings support the hypothesized role of circadian rhythm genes in CR and indicate probable biomarkers for CR susceptibility, providing new insight into individualized medicine for coronary heart disease.
Herbacetin Broadly Blocks the Activities of CYP450s by Different Inhibitory Mechanisms

Abstract Herbacetin is a bioactive flavanol compound that has various pharmacological effects. However, the pharmacokinetic characteristics have not been thoroughly investigated. Previously, we screened a natural compound library and identified herbacetin as a potent CYP blocker. Herein, we aimed to mechanistically determine the inhibitory effects of herbacetin on CYP450 and its potential application. A human liver microsome incubation system was developed based on a UPLC-MS/MS method. Moreover, an in silico docking assay and a human CYP recombinase reaction system were developed and used to investigate binding affinity and inhibitory efficacy. Subsequently, the effects of the combination of herbacetin and sorafenib on HepG2 cells were assessed by MTT and immunoblotting assays. The concentration of sorafenib and its main metabolite were measured by UPLC-MS/MS after incubation with or without herbacetin. As a result, we found herbacetin almost completely inhibited the functions of major CYPs at 100 µM. Moreover, through analysis of the structure-activity relationship, we found 4-, 6-, and 8-hydroxyl were essential groups for the inhibitory effects. Herbacetin inhibited CYP3A4, CYP2B6, CYP2C9, and CYP2E1 in a mixed manner, but non-competitively blocked CYP2D6. These results are in good agreement with the recombinase reaction in vitro results, with an IC50 < 10 µM for each tested isoenzyme. Interestingly, the stimulatory effects of sorafenib on HepG2 cell apoptosis were significantly enhanced by combining with herbacetin, which was associated with increased sorafenib exposure. In summary, herbacetin is a potent inhibitor of a wide spectrum of CYP450s, which may enhance the exposure of drugs in vivo.
Genetic diversity and inter-trait relationship of tropical extra-early maturing quality protein maize inbred lines under low soil nitrogen stress

Information on the genetic diversity, population structure, and trait associations of germplasm resources is crucial for predicting hybrid performance. The objective of this study was to dissect the genetic diversity and population structure of extra-early yellow and orange quality protein maize (QPM) inbred lines and identify secondary traits for indirect selection for enhanced grain yield under low-soil nitrogen (LN). One hundred and ten inbred lines were assessed under LN (30 kg ha -1) and assayed for tryptophan content. The lines were genotyped using 2500 single nucleotide polymorphism (SNP) markers. Majority (85.4%) of the inbred lines exhibited wide pairwise genetic distances between 0.4801 and 0.600. Genetic distances were wider between yellow and orange endosperm lines and predicted high heterosis in crosses between parents of different endosperm colors. The unweighted pair group method with arithmetic mean (UPGMA) and the admixture model-based population structure method both grouped the lines into five clusters. The clustering was based on endosperm color, pedigree, and selection history but not on LN tolerance or tryptophan content. Genotype by trait biplot analysis revealed association of grain yield with plant height and ear height. TZEEQI 394 and TZEEIORQ 73A had high expressivity for these traits. Indirect selection for high grain yield among the inbred lines could be achieved using plant and ear heights as selection criteria. The wide genetic variability observed in this study suggested that the inbred lines could be important sources of beneficial alleles for LN breeding programs in SSA.
Macroscopic identification of visceral titanium pigment in an intravenous drug user

Autopsy findings in intravenous drug addicts are quite variable and may involve a number of organ systems. Reports of the macroscopic identification at autopsy of components of tablets that have been crushed and injected are, however, exceedingly rare. The case of 34‐year‐old man who died of zolpidem toxicity on a background of pulmonary hypertension attributed to intravenous injections of crushed tablets is described. A very unusual finding was very fine white stippling on the cut surfaces of both the liver and spleen which was shown on energy‐dispersive x‐ray spectroscopy (EDS) to be titanium dioxide most likely from the coating of the zolpidem tablets. This case is significant in demonstrating titanium dioxide accumulation within organs at both macroscopic and microscopic levels, with confirmation of exposure by EDS analysis. The clinical significance of exposure to such high levels of titanium dioxide is unclear.
Phase II clinical trial using anti-CD3 × anti-HER2 bispecific antibody armed activated T cells (HER2 BATs) consolidation therapy for HER2 negative (0–2+) metastatic breast cancer

Background Metastatic human epidermal growth receptor II (HER2) negative breast cancer remains incurable. Our phase I study showed that anti-CD3 × anti-HER2 bispecific antibody armed activated T cells (HER2 BATs) may be effective against HER2-tumors. This phase II trial evaluates the efficacy and immune responses of HER2 BATs given to patients with metastatic HER2-estrogen and/or progesterone receptor positive (HR+) and triple negative breast cancer (TNBC) as immune consolidation after chemotherapy. The primary objective of this study was to increase the traditional median time to progression after failure of first-line therapy of 2–4 months with the secondary endpoints of increasing overall survival (OS) and immune responses. Methods HER2- metastatic breast cancer (MBC) patients received 3 weekly infusions of HER2 BATs and a boost after 12 weeks. Results This phase II study included 24 HER2-HR+ and 8 TNBC patients who received a mean of 3.75 and 2.4 lines of prior chemotherapy, respectively. Eight of 32 evaluable patients were stable at 4 months after the first infusion. There were no dose limiting toxicities. Tumor markers decreased in 13 of 23 (56.5%) patients who had tumor markers. The median OS was 13.1 (95% CI 8.6 to 17.4), 15.2 (95% CI 8.6 to 19.8), and 12.3 (95% CI 2.1 to 17.8) months for the entire group, HER2-HR+, and TNBC patients, respectively. Median OS for patients with chemotherapy-sensitive and chemotherapy-resistant disease after chemotherapy was 14.6 (9.6–21.8) and 8.6 (3.3–17.3) months, respectively. There were statistically significant increases in interferon-γ immunospots, Th1 cytokines, Th2 cytokines, and chemokines after HER2 BATs infusions. Conclusions In heavily pretreated HER2-patients, immune consolidation with HER2 BATs after chemotherapy appears to increase the proportion of patients who were stable at 4 months and the median OS for both groups as well as increased adaptive and innate antitumor responses. Future studies combining HER2 BATs with checkpoint inhibitors or other immunomodulators may improve clinical outcomes.
Highly Stable Transparent Conductive Silver Grid/PEDOT:PSS Electrodes for Integrated Bifunctional Flexible Electrochromic Supercapacitors

Silver grids are attractive for replacing indium tin oxide as flexible transparent conductors. This work aims to improve the electrochemical stability of silver‐based transparent conductors. A silver grid/PEDOT:PSS hybrid film with high conductivity and excellent stability is successfully fabricated. Its functionality for flexible electrochromic applications is demonstrated by coating one layer of WO3 nanoparticles on the silver grid/PEDOT:PSS hybrid film. This hybrid structure presents a large optical modulation of 81.9% at 633 nm, fast switching, and high coloration efficiency (124.5 cm2 C−1). More importantly, an excellent electrochemical cycling stability (sustaining 79.1% of their initial transmittance modulation after 1000 cycles) and remarkable mechanical flexibility (optical modulation decay of only 7.5% after 1200 compressive bending cycles) is achieved. A novel smart supercapacitor is presented that functions as a regular energy‐storage device and simultaneously monitors the level of stored energy by a rapid and reversible color variation even at high current charge/discharge conditions. The film sustains an optical modulation of 87.7% and a specific capacitance of 67.2% at 10 A g−1 compared to their initial value at a current density of 1 A g−1. The high‐performance silver grid/PEDOT:PSS hybrid transparent films exhibit promising features for various emerging flexible electronics and optoelectronic devices.