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Investigation regarding mammograms making use of man-made brains to predict response to neoadjuvant chemotherapy in cancer of the breast people: proof idea.
We report on single-longitudinal-mode (SLM) operation of a low-threshold optical parametric oscillator, with a 17 nm tunability near 2 µm. The oscillator uses a MgOPPLN crystal in Type 0 quasi-phase-matching configuration, pumped by a 1.064 µm SLM laser. Despite the huge acceptance bandwidth near-degeneracy of MgOPPLN, spectral selection down to a SLM is achieved by combining a volume Bragg reflector and Vernier filtering in nested signal and idler cavities. Tunability over 17 nm is demonstrated owing to a transverse chirp of the grating period of the Bragg reflector.We demonstrate supercontinuum generation over an octave spaning from 1055 to 2155 nm on the highly nonlinear aluminum gallium arsenide (AlGaAs)-on-insulator platform. This is enabled by the generation of two dispersive waves in a 3-mm-long dispersion-engineered nano-waveguide. The waveguide is pumped at telecom wavelengths (1555 nm) with 3.6 pJ femtosecond pulses. We experimentally validate the coherence of the generated supercontinuum around the pump wavelength (1450-1750 nm), and our numerical simulation shows a high degree of coherence over the full spectrum.An all-solid transverse Anderson localizing optical fiber (TALOF) was fabricated using a novel combination of the stack-and-draw and molten core methods. Strong Anderson localization is observed in multiple regions of the fiber cross section associated with the higher index strontium aluminosilicate phases randomly arranged within a pure silica matrix. Further, to the best of our knowledge, nonlinear four-wave mixing is reported for the first time in a TALOF.In gradient-based optimization of photonic devices, within the overall design parameter space, one iteratively performs a line search in a one-dimensional subspace as spanned by the search direction. Blasticidin S concentration While the search direction can be efficiently determined with the adjoint variable method, there has not been an efficient algorithm that determines the optimal learning rate that controls the distance one moves along the search direction. Here we introduce an efficient algorithm of determining the optimal learning rate, using the Shanks transformation in the Lippmann-Schwinger formalism. Our approach can determine very accurately the optimal learning rates at each epoch, with only a modest increase of computational cost. We show that this approach can significantly improve the figure of merits of the final structure, as compared to conventional methods for estimating the learning rate.BACKGROUND The coatomer protein complex subunit beta 2 (COPB2) gene is upregulated and promotes cell proliferation in some cancer cells. This study aimed to investigate the role of microRNA (miRNA) targeting by COPB2 gene expression in human lung adenocarcinoma cell lines, including NCI-H1975 cells. MATERIAL AND METHODS COPB2 expression in normal human bronchial epithelial cells and lung adenocarcinoma cells was measured by quantitative reverse transcription-polymerase chain reaction (qRT-PCR) and Western blot. NCI-H1975 human lung adenocarcinoma cells were transfected with short-interfering COPB2 (siCOPB2). Cell apoptosis and cell proliferation were evaluated by flow cytometry and Cell Counting Kit-8 (CCK-8) assays, respectively. The transwell assay evaluated cell migration. Targeting of miR-335-3p by COPB2 was predicted using TargetScan 7.2 and verified using a dual-luciferase reporter assay in NCI-H1975 cells. MiR-335-3p mimics were transfected into NCI-H1975 cells. The further functional analysis included detection of protein expression for cyclin D1, tissue inhibitor matrix metalloproteinase-1 (TIMP-1), matrix metallopeptidase 9 (MMP9), Bcl-2, and Bax, to verify the role of miR-335-3p targeting by COPB2 in lung adenocarcinoma cells. RESULTS COPB2 was upregulated in lung adenocarcinoma cells and was a direct target of miR-335-3p mimics. COPB2 knockdown promoted cell apoptosis, inhibited cell migration and proliferation in NCI-H1975 cells. The effects of COPB2 knockdown on NCI-H1975 cells were increased by miR-335-3p mimics, which also further reduced the expression levels of cyclin D1, MMP9, and Bcl-2 and further increased TIMP-1 and Bax by siCOPB2. CONCLUSIONS This study showed that COPB2 was the functional target of miR-335-3p in NCI-H1975 human adenocarcinoma cells.BACKGROUND In a recent Sexually Transmitted Disease (STD) surveillance report from the Centers for Disease Control and Prevention (CDC), Miami-Dade County had the nation's fourth-highest rate of infectious syphilis, with rates of congenital syphilis on the rise. As a public health response, Homestead Hospital (HH), in collaboration with the Florida Department of Health, enhanced their emergency department's (ED's) routine HIV/HCV "opt-out" screening infrastructure to include a syphilis smart screening algorithm. The purpose of this article is to describe the development, implementation, and evaluation of the algorithm. METHODS A retrospective evaluation of patient records prompted the development of the algorithm. HH's electronic health record (EHR) system automatically triggers a syphilis test based on the reason for medical visit (e.g., rash, penile discharge, a positive pregnancy test, historical or present STD result). If a patient tests positive, they are counseled and linked to care. RESULTS Since implementation (April 2018 to August 2019), the smart screening algorithm triggered 4,806 syphilis tests 122 patients tested positive (2.5% seropositivity). After confirmatory testing, 59 patients were positive for syphilis, of which 27 were pregnant. CONCLUSIONS The HH and DOH-Miami-Dade's response to Miami-Dade County's syphilis problem is innovative and replicable. The program embraces technology, enhances the routine "opt-out" screening model, and does not affect pre-existing workflows. Ultimately, implementation of this algorithm allows patients to get treatment, receive comprehensive prevention services, and, in some cases, avert congenital syphilis.BACKGROUND Studies on Chlamydia trachomatis associated pregnancy outcomes are largely conflicting, ignoring the heterogeneous natures of pregnancy complications and potential effect modification by maternal age. This study determined if prenatal Chlamydia trachomatis infection is associated with preterm birth (PTB) and preeclampsia subtypes. METHODS A retrospective cohort study was conducted using 22,772 singleton pregnancies with a prenatal C. trachomatis diagnostic test. Spontaneous and medically indicated preterm births, term and preterm preeclampsia were outcomes. Modified Poisson regression calculated relative risk (RR) and 95% confidence intervals (CI) with propensity score adjustments stratified by maternal age less then 25 and ≥25. RESULTS Overall, C. trachomatis was significantly associated with term preeclampsia (RRadj=1.88 95% CI 1.38-2.57). Among young women (age less then 25), C. trachomatis was significantly associated with medically indicated preterm birth (RRadj=2.29 CI 95% 1.38-3.78) and term preeclampsia (RRadj=1.57 CI 95% 1.05-2.36) in propensity adjusted models. No significant associations in older women were detected. CONCLUSION C. trachomatis was associated with medically indicated preterm birth and term preeclampsia in young women. Associations between chlamydia and perinatal outcomes may depend on the subtype of preterm birth and preeclampsia, which should be investigated through mechanistic studies.Urogenital and rectal specimens collected from the 'IWantTheKit' internet-based STI screening program were evaluated for Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis. Of 881 paired specimens submitted from August 2013-December 2016, 15.0% (n=132) tested positive for one or more STIs, of which 50.8% (n=67) were identified exclusively through rectal testing.PURPOSE This study describes and examines the short- and longer-term impact of a required longitudinal medical Spanish curriculum on physician assistant student preparedness and ability to communicate with patients in Spanish during clinical rotations. METHODS Fifty-eight preclinical students participated in an 80-hour curriculum delivered weekly over 3 semesters. Teaching followed a framework of second-language acquisition and included structured grammar and medical vocabulary practice with didactic, interactive, and group assignments. Vocabulary and grammar were assessed with quizzes. Oral proficiency was assessed by faculty with Spanish Objective Structured Clinical Examination (OSCE) stations at midpoint and end using the Interagency Language Roundtable (ILR), a 6-level scale (immediate outcome). Students self-rated proficiency and confidence and evaluated curriculum effectiveness for preparing them to care for Spanish-speaking patients (longer-term outcomes). RESULTS All students passed the written and oral quizzes. Faculty-scored ILR verbal proficiency at the OSCEs increased by a mean level of 0.5 over 6 months. Student self-assessed proficiency improved on average by one level from baseline to 24 months later. Students rated highly curriculum effectiveness, preparedness to communicate in Spanish during clinical rotations, ability to judge when an interpreter was needed, and the importance of medical Spanish to future practice. CONCLUSIONS A required integrated longitudinal medical Spanish curriculum was well received. Physician assistant students demonstrated short-term interval progression in Spanish proficiency, with improvements in both faculty and self-rating scores, and readiness to apply the skill to practice. They valued active learning associated with repeated practice with feedback, role playing, and interval assessments throughout the curriculum.PURPOSE The purpose of this study was to describe participant characteristics and effective teaching methods at a national continuing medical education (CME) conference on hospital medicine for physician assistants (PAs) and nurse practitioners (NPs). METHODS In this cross-sectional study, participants provided demographic information and teaching effectiveness scores for each presentation. Associations between teaching effectiveness score and presentation characteristics were determined. RESULTS In total, 163 of 253 participants (64.4%) completed evaluations of 28 presentations. Many of the participants were younger than 50 years (69.0%), had practiced for fewer than 5 years (41.5%), and worked in nonacademic settings (76.7%). Teaching effectiveness scores were significantly associated with the use of clinical cases (perfect scores for 68.8% of presentations with clinical cases vs. 59.8% without; P = .04). CONCLUSION Many PAs and NPs at an HM CME conference were early-career clinicians working in nonacademic settings. Presenters at CME conferences in hospital medicine should consider using clinical cases to improve their teaching effectiveness among PA and NP learners.PURPOSE The purpose of this study was to provide a descriptive analysis of the goals of the accredited physician assistant (PA) programs across the country in order to obtain a baseline understanding of their themes. METHODS Initial review of the goals resulted in the identification of recurring themes. The goals were evaluated relative to meeting the requirements specified in Standard A3.14 of the Accreditation Review Commission on Education for the Physician Assistant, including listing the goal with the defined benchmark expected and the program's progress in reaching the goal. Accreditation status was compared. RESULTS Of the 238 accredited PA programs at the time of the study, 157 (66%) had Accreditation-Continued status, 56 (24%) were Accreditation-Provisional, and 25 (11%) had Accreditation-Probation status. The median number of 5 goals per program did not vary dependent on accreditation status. Only 43 of 238 PA programs (18%) provided goals with required benchmarks and supporting outcomes on their webpages.
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