Miracle-dz/UniFAR-FTUs huggingface dataset:
Validation of a novel molecular host response assay to diagnose infection in hospitalized patients admitted to the ICU with acute respiratory failure

Purpose The discrimination between infectious and non-infectious causes of acute respiratory failure (ARF) in hospitalized patients admitted to the intensive care unit (ICU) is difficult. Using a novel diagnostic test measuring the expression of four RNA biomarkers in blood (SeptiCyte LAB) we aimed to distinguish between infection and inflammation in this setting. Methods We enrolled hospitalized patients with ARF requiring prompt intubation in the ICU from 2011 to 2013. We excluded patients having an established infection diagnosis or an evidently non-infectious reason for intubation. Blood samples were collected upon ICU admission. Test results were categorized into four probability bands (with higher bands indicating a higher probability of infection) and compared with the plausibility of infection as rated by post-hoc assessment using predefined definitions. Results Of 467 included patients, 373 (80%) were treated for a suspected infection at admission. Plausibility of infection was classified as ruled-out, undetermined, or confirmed in 41 (11%), 135 (36%), and 197 (53%) of these, respectively. Overall, the pre-test probability of infection was 42%. Test results correlated with the plausibility of infection (Spearman’s rho 0.332; p<0.001). After exclusion of undetermined cases, positive predictive values were 29%, 54%, and 76% for probability bands 2, 3, and 4, respectively, whereas the negative predictive value for band 1 was 76%. However, SeptiCyte LAB did not outperform CRP when comparing diagnostic discrimination (AUC 0.731; 95%CI 0.677-0.786 vs. 0.727; 95%CI 0.666-0.788). Conclusion In a setting of hospitalized patients admitted to the ICU with ARF, the diagnostic value of SeptiCyte LAB seems limited.
Sjögren's syndrome manifesting as clinicopathological features of TAFRO syndrome

Rationale: TAFRO syndrome is a newly proposed disorder that manifests as thrombocytopenia, anasarca, fever, reticulin myelofibrosis, renal dysfunction, and organomegaly. In this report, we describe the development of severe TAFRO syndrome-like systemic symptoms during the clinical course of juvenile-onset Sjögren's syndrome in a 32-year-old woman. Patient concerns: The patient was admitted due to dyspnea, fever, polyarthralgia, and generalized edema. She had been diagnosed with Sjögren's syndrome at the age of 14 years, based on histopathological examination of a biopsy of the minor salivary glands and the development of Raynaud's phenomenon, with no follow-up treatment required. On admission, she presented with anemia, elevated C-reactive protein levels, anasarca, and hepato-splenomegaly. A bone marrow examination revealed increased megakaryocytes with reticulin fibrosis, and the histopathology of an axillary lymph node was consistent with mixed-type Castleman disease. Eventually, she developed thrombocytopenia. Interventions: Her symptoms fulfilled all of the major and minor categories of the diagnostic criteria for TAFRO syndrome. However, considering her prior diagnosis, we assumed that the clinical presentation was consistent with an acute exacerbation of Sjögren's syndrome. Unlike typical cases of TAFRO syndrome, the administration of relatively low-dose prednisolone relieved her symptoms. Lessons: Differentiation between TAFRO syndrome and exacerbation of an autoimmune disease is clinically important, although this can be challenging. Identification of specific biomarkers for TAFRO syndrome would be clinically beneficial.
Spatio-Temporal Graph Convolution for Skeleton Based Action Recognition

Variations of human body skeletons may be considered as dynamic graphs, which are generic data representation for numerous real-world applications. In this paper, we propose a spatio-temporal graph convolution (STGC) approach for assembling the successes of local convolutional filtering and sequence learning ability of autoregressive moving average. To encode dynamic graphs, the constructed multi-scale local graph convolution filters, consisting of matrices of local receptive fields and signal mappings, are recursively performed on structured graph data of temporal and spatial domain. The proposed model is generic and principled as it can be generalized into other dynamic models. We theoretically prove the stability of STGC and provide an upper-bound of the signal transformation to be learnt. Further, the proposed recursive model can be stacked into a multi-layer architecture. To evaluate our model, we conduct extensive experiments on four benchmark skeleton-based action datasets, including the large-scale challenging NTU RGB+D. The experimental results demonstrate the effectiveness of our proposed model and the improvement over the state-of-the-art.
Description of the deformation process under thermo-mechanical fatigue

Purpose: The main problem addressed in the paper is the description of a deformation process under the conditions of mechanical and thermal interactions. Design/methodology/approach: The mathematical modelling has been used to describe the stress-strain behaviour of materials. The method of fatigue testing has been adopted to determine experimentally stress-strain characteristics. The method based on the long term own experience in thermo-mechanical investigations and new European Code-of-Practice for Thermo-Mechanical Fatigue Testing. Findings: An appropriate model description has been developed. Fatigue examinations of the P91 steel that is used in power industry, were carried out. The validation of the model has been performed. So far, experimental verification of the usefulness of the model description to determine the stress-strain characteristics’ course for a selected value of the phase shift angle between the temperature and total strain cycles has been made. It has been found that the proposed model reflects the deformation process nature very well in variable temperature, strain and stress conditions. Hence, a conclusion seems to be justified that the approach presented in the paper could constitute the right basis for appropriate constitutive equations, which depict the material behaviour under thermo-mechanical conditions. Research limitations/implications: The developed description should be useful in problems of fatigue behaviour predictions of materials under different mechanical and thermal loadings in industry practical applications and in research problems connected for instance with fatigue life criteria description and validation. Originality/value: The new material characteristics have been shown in the work and the own new method of the material fatigue behaviour prediction. The work is addressed to researchers interested in problems of material testing and material behaviour prediction under different loadings that we can meet in the operation practice.
Rapid flow cytometry-based assay for the evaluation of γδ T cell-mediated cytotoxicity

The effector function of natural killer, lymphokine-activated killer cells and T lymphocytes is commonly evaluated by radioactive chromium-release cytotoxicity assays. In addition to this indirect method, fluorescence assays have been described for the assessment of in vitro cell-mediated cytotoxicity. In the present study, target cells were stained with 5-(and-6)-carboxyfluorescein diacetate succinimidyl ester (CFSE), which is a stable integrated fluorescent probe that allows target and effector cells to be distinguished from one another. Staining of target THP-1 cells with 8 µM CFSE revealed high and stable loading of fluorescence and no effect of the viability of cells. After 4 h of in vitro co-culture between γδ T cells and CFSE-labeled infected or uninfected THP-1 cells, staining with propidium iodide (PI) was performed to distinguish between vital and dead cells. During sample acquisition, target cells were gated on the CFSE positivity and examined for cell death based on the uptake of PI. CFSE and PI double positive cells were recognized as the dead target cells. The percentage of cytotoxicity in the CFSE-gated cell population was calculated by subtracting the value obtained for non-specific PI-positive target cells, which was measured in a control group that did not contain effector cells. The present study describes a simple and convenient assay that is based on the direct quantitative and qualitative analysis of cell damage at a single cell level utilizing a two-color flow cytometric assay. In conclusion, the flow cytometric-based assay described in the current study is a simple, sensitive and reliable tool to determine the cytolytic activity of γδ T lymphocytes against mycobacteria. Therefore, the present study may provide valuable information concerning the methods employed to investigate the function of γδ T cells and potentially other lymphocyte subsets.
Application of cohesive zone model in crack propagation analysis in multiphase composite materials

ABSTRACT A nonlinear cohesive stress distribution function is employed by relating the cohesive stress to the cohesive zone size (CZS) and the distance from the crack tip to investigate the elastic-plastic fracture behaviors. A crack-inclusion interaction problem is taken as an example to explore the fracture process in the cohesive zone area. The CZS and crack surface opening displacement are evaluated numerically. It is found that for different cohesive parameter combinations, the normalized CZS and crack surface opening displacements change drastically. By reducing the current model to the famous Dugdale model, the results obtained match well with the existing ones.
Experimental verification of GEPLL architecture performance for grid connected inverter

In order to guarantee the proper operation of grid-connected power converters, a correct synchronization with utility networks is required to extract quickly and precisely the fundamental signal. This paper presents an experimental verification of the performance of an architecture called Generalized filtering Enhanced Phase-Locked Loop, proposed in [1] to detect the amplitude, the frequency and the phase of a sinusoidal signal from a noisy measurement. The considered application regards the synchronization of the power converters with the utility network. The GEPLL scheme is characterized by an error filter and a phase-feed forward term that are embedded in the estimation algorithm for improved noise rejection and transient performances. By properly selecting the transfer function of the error filter the transient dynamic performance is improved. The presence of measurement bias and the effect of high frequency noise and harmonics are taken into account by suitably selecting the parameters of the Phase Locked Loop. Both the single and three phase grid connected power inverter systems are considered. The comparison with the original Enhanced Phase- Locked Loop shows the superior performances of the proposed Generalized filtering Enhanced Phase-Locked Loop.
WORLD: A Vocoder-Based High-Quality Speech Synthesis System for Real-Time Applications

SUMMARY A vocoder-based speech synthesis system, named WORLD, was developed in an e ﬀ ort to improve the sound quality of real-time applications using speech. Speech analysis, manipulation, and synthesis on the basis of vocoders are used in various kinds of speech research. Although several high-quality speech synthesis systems have been developed, real-time processing has been di ﬃ cult with them because of their high computational costs. This new speech synthesis system has not only sound quality but also quick processing. It consists of three analysis algorithms and one synthesis algorithm proposed in our previous research. The e ﬀ ectiveness of the system was evaluated by comparing its output with against natural speech including consonants. Its processing speed was also compared with those of conventional systems. The results showed that WORLD was superior to the other systems in terms of both sound quality and processing speed. In particular, it was over ten times faster than the conventional systems, and the real time factor (RTF) indicated that it was fast enough for real-time processing.
Anxiety and Depression in Drug-Dependent Patients with Cluster C Personality Disorders

Objective Comorbidity between personality disorders (PD) and substance-use disorders (SUD) is one of the most common findings in the psychiatric field. The patients with Cluster C disorders present maladjustment traits often characterized by high levels of anxiety. The main aim of this study was to find evidences about higher anxiety and depression prevalence on Cluster C than others Clusters, analyzing similarities and differences within, with other Cluster A and B PD patients and patients without PD. Method A total of 822 substance dependent patients (ages18–78; Mean = 38.35, SD = 10.14) completed the structured clinical interview for DSM-IV Axis I and Axis II disorders, Beck Depression Inventory, and State-Trait Anxiety Inventory. Results Results supported poly-consumption in Cluster C patients, being greater alcohol consumption as well as abuse of both stimulants and depressants. Anxiety and depression did not show just one pattern for all patients with SUD-Cluster C PD. There was a relation between anxiety and depression for all the groups except for the Dependent-PD. Conclusion Interventions should focus on aspects like depression and anxiety more than on the substance consumed.
Dabigatran following acute transient ischemic attack and minor stroke II (DATAS II)

Rationale Patients with transient ischemic attack or minor stroke are at high risk of early recurrent cerebrovascular events. Anticoagulation with heparin or warfarin acutely after ischemic stroke is at least as efficacious as aspirin for preventing recurrent events but is associated with an increased risk of clinical worsening due to hemorrhagic transformation. Aim and hypothesis We aim to demonstrate the safety of early anticoagulation with dabigatran, an oral direct thrombin inhibitor, in acute cerebrovascular syndrome patients. The primary hypothesis is that symptomatic hemorrhagic transformation rates in dabigatran and aspirin-treated patients will be similar. Sample size estimates At least 136 participants in two groups required to demonstrate an absolute between-group difference in the rate of hemorrhagic transformation of 5.6% with 80% power, assuming alpha = 5%. Methods and design A randomized, multicenter open-label clinical trial (NCT02295826). Three-hundred participants with a transient ischemic attack/ischemic stroke (National Institutes of Health Stroke Scale ≤ 9) will undergo magnetic resonance imaging within 72 h of symptom onset and will be randomized to aspirin 81 mg daily or dabigatran 150 mg twice daily for 30 days. Participants undergo repeat magnetic resonance imaging at 30 days and clinical assessment to 90 days. Study outcomes The primary outcome is the symptomatic hemorrhagic transformation rate. Secondary outcomes include recurrent stroke and new ischemic lesions on repeat magnetic resonance imaging. Discussion This study will determine the safety of early anticoagulation with dabigatran in patients with acute transient ischemic attack/ischemic stroke and will inform the design of a phase III randomized trial aimed at demonstrating reduced recurrent early ischemic events after acute transient ischemic attack/stroke.
Diet in Saudi Arabia: findings from a nationally representative survey

Abstract Objective No recent original studies on the pattern of diet are available for Saudi Arabia at the national level. The present study was performed to describe the consumption of foods and beverages by Saudi adults. Design The Saudi Health Interview Survey (SHIS) was conducted in 2013. Data were collected through interviews and anthropometric measurements were done. A diet history questionnaire was used to determine the amount of consumption for eighteen food or beverage items in a typical week. Setting The study was a household survey in all thirteen administrative regions of Saudi Arabia. Subjects Participants were 10 735 individuals aged 15 years or older. Results Mean daily consumption was 70·9 (se 1·3) g for fruits, 111·1 (se 2·0) g for vegetables, 11·6 (se 0·3) g for dark fish, 13·8 (se 0·3) g for other fish, 44·2 (se 0·7) g for red meat, 4·8 (se 0·2) g for processed meat, 10·9 (se 0·3) g for nuts, 219·4 (se 5·1) ml for milk and 115·5 (se 2·6) ml for sugar-sweetened beverages. Dietary guideline recommendations were met by only 5·2 % of individuals for fruits, 7·5 % for vegetables, 31·4 % for nuts and 44·7 % for fish. The consumption of processed foods and sugar-sweetened beverages was high in young adults. Conclusions Only a small percentage of the Saudi population met the dietary recommendations. Programmes to improve dietary behaviours are urgently needed to reduce the current and future burden of disease. The promotion of healthy diets should target both the general population and specific high-risk groups. Regular assessments of dietary status are needed to monitor trends and inform interventions.
Long-term outcome and safety of prolonged bedaquiline treatment for multidrug-resistant tuberculosis

Bedaquiline, a recently approved drug for the treatment of multidrug-resistant tuberculosis (MDR-TB), is recommended for a duration of 24 weeks. There are scarce data on patients treated with this drug outside clinical trials. All MDR-TB patients who started treatment from January 1, 2011 to December 31, 2013 and received ≥30 days of bedaquiline were included in a multicentre observational cohort. Among 45 MDR-TB patients, 53% harboured isolates resistant to both fluoroquinolones and second-line injectables, and 38% harboured isolates resistant to one of these drug classes. Median bedaquiline treatment duration was 361 days and 33 patients (73%) received prolonged (>190 days) bedaquiline treatment. Overall, 36 patients (80%) had favourable outcome, five were lost to follow-up, three died, and one failed and acquired bedaquiline resistance. No cases of recurrence were reported. Severe and serious adverse events were recorded in 60% and 18% of patients, respectively. Values of Fridericia-corrected QT interval (QTcF) >500 ms were recorded in 11% of patients, but neither arrhythmias nor symptomatic cardiac side-effects occurred. Bedaquiline was discontinued in three patients following QTcF prolongation. No significant differences in outcomes or adverse events rates were observed between patients receiving standard and prolonged bedaquiline treatment. Bedaquiline-containing regimens achieved favourable outcomes in a large proportion of patients. Prolonged bedaquiline treatment was overall well tolerated in this cohort. Treatment regimens including prolonged bedaquiline use are effective and overall well tolerated in MDR-TB patients http://ow.ly/vhtl305CYJj
Reproductive hormones and metabolic syndrome in 24 testicular cancer survivors and their biological brothers

Testicular cancer survivors have impaired gonadal function and increased risk of metabolic syndrome when compared to healthy controls. However, because of the fetal etiology of testicular cancer, familial unrelated healthy men might not be an optimal control group. The objective of this study was to clarify if testicular cancer survivors have impaired gonadal function and increased risk of metabolic syndrome when compared to their biological brothers. A cross‐sectional study of testicular cancer survivors (ClinicalTrials.gov number, NCT02240966) was conducted between 2014 and 2016. Of 158 testicular cancer survivors included, 24 had a biological brother who accepted to participate in the study. Serum levels of reproductive hormones and prevalence of metabolic syndrome according to International Diabetes Federation Criteria and National Cholesterol Education Program (Adult Treatment Panel III) criteria comprised the main outcome measures of the study. Median age was similar in testicular cancer survivors and their biological brothers [44 years (IQR 39–50) vs. 46 (40–53) years respectively (p = 0.1)]. In testicular cancer survivors, follow‐up since treatment was 12 years (7–19). Serum levels of luteinizing hormone and follicle‐stimulating hormone were elevated (p ≤ 0.001), while total testosterone, free testosterone, inhibin B and anti‐Müllerian hormone were lower (p ≤ 0.001) in testicular cancer survivors than in their biological brothers. The prevalence of metabolic syndrome was similar and apart from HDL‐cholesterol, which was lower in testicular cancer survivors (p = 0.01); there were no differences in the individual components of the metabolic syndrome between testicular cancer survivors and their brothers. In conclusion, gonadal function was impaired in testicular cancer survivors, while we did not detect any difference in the prevalence of metabolic syndrome between testicular cancer survivors and their biological brothers.
Transplant‐related survival benefit should influence prioritization for liver transplantation especially in patients with hepatocellular carcinoma

Transplant‐related survival benefit is calculated as the difference between life expectancy with transplantation and life expectancy without transplantation. Determining eligibility and prioritization for liver transplantation based on the highest survival benefit is a superior strategy to prioritization based on the highest urgency (ie, the highest wait‐list mortality) or the highest utility (ie, the highest posttransplant survival) because prioritization based on the highest survival benefit maximizes the overall life expectancy of all patients in need of liver transplantation. Although the Model for End‐Stage Liver Disease (MELD)–based prioritization system was designed as an urgency‐based system, in practice it functions to a large extent as a survival benefit–based system, when the natural MELD score is used without exceptions. Survival benefit considerations should be used to determine the consequences of deviating from prioritization based on the natural MELD score, such as when exception points are awarded to patients with hepatocellular carcinoma (HCC) that are independent of MELD score or tumor burden, or the appropriateness of expanding eligibility for transplantation. The most promising application of survival benefit–based prioritization would be to replace the current system of prioritization of patients with HCC by one that uses their natural MELD score and tumor characteristics such as HCC tumor burden, serum alpha fetoprotein level, and response to locoregional therapies to predict the impact on survival benefit caused by the presence of HCC and adjust the natural MELD score for prioritization accordingly. Liver Transplantation 23 652–662, 2017 AASLD.