Miracle-dz/UniFAR-FTUs huggingface dataset:
New Termination-of-Resuscitation Models and Prognostication in Out-of-Hospital Cardiac Arrest Using Electrocardiogram Rhythms Documented in the Field and the Emergency Department

Background Electrocardiogram (ECG) rhythms, particularly shockable rhythms, are crucial for planning cardiac arrest treatment. There are varying opinions regarding treatment guidelines depending on ECG rhythm types and documentation times within pre-hospital settings or after hospital arrivals. We aimed to determine survival and neurologic outcomes based on ECG rhythm types and documentation times. Methods This prospective observational study of 64 emergency medical centers was performed using non-traumatic out-of-hospital cardiac arrest registry data between October 2015 and June 2017. From among 4,608 adult participants, 4,219 patients with pre-hospital and hospital ECG rhythm data were enrolled. Patients were divided into 3 groups: those with initial-shockable, converted-shockable, and never-shockable rhythms. Patient characteristics and survival outcomes were compared between groups. Further, termination of resuscitation (TOR) validation was performed for 6 combinations of TOR criteria confirmed in previous studies, including 2 rules developed in the present study. Results Total survival to discharge after cardiac arrest was 11.7%, and discharge with good neurologic outcomes was 7.9%. Survival to discharge rates and favorable neurologic outcome rates for the initial-shockable group were the highest at 35.3% and 30.2%, respectively. There were no differences in survival to discharge rates and favorable neurologic outcome rates between the converted-shockable (4.2% and 2.0%, respectively) and never-shockable groups (5.7% and 1.9%, respectively). Irrespective of rhythm changes before and after hospital arrival, TOR criteria inclusive of unwitnessed events, no pre-hospital return of spontaneous circulation, and asystole in the emergency department best predicted poor neurologic outcomes (area under the receiver operating characteristic curve of 0.911) with no patients classified as Cerebral Performance Category 1 or 2 (specificity = 1.000). Conclusion Survival outcomes and TOR predictions varied depending on ECG rhythm types and documentation times within pre-hospital filed or emergency department and should, in the future, be considered in treatment algorithms and prognostications of patients with out-of-hospital cardiac arrest. Trial Registration ClinicalTrials.gov Identifier: NCT03222999
Gender differences in sagittal standing alignment before pubertal peak growth: the importance of subclassification and implications for spinopelvic loading

The aim of this study was to analyze gender differences in sagittal standing alignment at pre‐peak height velocity age thereby applying a scientifically sound and practically oriented classification scheme for overall standing balance. The study population consisted of healthy boys (n = 639) and girls (n = 557) before pubertal peak growth. During subjects' habitual standing, sagittal plane measures of the spine, pelvis and lower limbs were collected using a clinical screening protocol. With each subject classified as one of three postural types (neutral, sway‐back, or leaning‐forward), differences in sagittal plane alignment were analyzed between sexes. The results revealed clear differences between genders in each of the postural types. Within the neutral and sway‐back postural subgroups, boys presented more forward inclination of the trunk, more thoracic kyphosis and more pelvis backtilt compared with girls. Within the leaning‐forward category, girls displayed more forward trunk lean, less thoracic kyphosis and more pelvic anteversion. A state of lumbar segmental hyperextension appeared to exist in female leaning‐forward subjects. Our results reveal for the first time that sagittal standing alignment is different between prepubescent boys and girls when subjects are appropriately subclassified, and conversely represent a ‘wash‐out effect’ when pooled. When the classification system is applied, gender‐specificity in gravity line position is suggested, implying gender‐related differences in lever arms and thus load. Present findings may add to our understanding of gender‐specific biomechanical challenges posed by habitual posture, and may shed new light on sagittal standing alignment as a possible contributory factor in developmental spinal‐pelvic disorders.
Quality of life in patients with chronic hepatitis C infection: Severe comorbidities and disease perception matter more than liver-disease stage

Background and aims This study evaluated the clinical and non-clinical determinants of health-related quality of life (HRQoL) associated with untreated chronic hepatitis C (CHC) in France. Methods From 01/2014 to 01/2015, untreated CHC patients were invited to complete a questionnaire including EQ-5D utility instrument and two visual analogue scales (VAS) measuring overall health and fatigue in three French centers (Paris, Lille and Montpellier). Answers were analyzed in mixed models (taking into account the clustering effects of centers and physicians). Results Five hundreds and five patients were enrolled: 52% males; the mean age was 54; 41% had BMI>25; 64% had genotype 1; 36% were at the stage of severe fibrosis (F3-F4); 38% had severe comorbidities other than liver-related. In the univariate analysis, EQ-5D utility was associated with socio-demographic variables as age, place of birth, education, and employment; CHC-related variables as conditions of HCV screening and severity of fibrosis; CHC-unrelated variables as comorbidities other than CHC, being overweight, and psychiatric disorders; feelings about CHC disease as perception of progression, lack of information on CHC and its treatments, and entourage’s feeling. In multivariate analysis, EQ-5D utility was affected by not being in employment (0.72 vs. 0.80), having severe comorbidities other than CHC (0.72 vs. 0.79), being overweight (0.73 vs. 0.78), and feeling worried about CHC progression (0.66 vs. 0.72–0.84). Similar results were found for the VAS. Conclusions The presence of severe comorbidities and worrying about CHC progression, but not stage of fibrosis, seem to alter significantly EQ-5D health utility in CHC French patients.
Multi‐contrast reconstruction with Bayesian compressed sensing

Clinical imaging with structural MRI routinely relies on multiple acquisitions of the same region of interest under several different contrast preparations. This work presents a reconstruction algorithm based on Bayesian compressed sensing to jointly reconstruct a set of images from undersampled k‐space data with higher fidelity than when the images are reconstructed either individually or jointly by a previously proposed algorithm, M‐FOCUSS. The joint inference problem is formulated in a hierarchical Bayesian setting, wherein solving each of the inverse problems corresponds to finding the parameters (here, image gradient coefficients) associated with each of the images. The variance of image gradients across contrasts for a single volumetric spatial position is a single hyperparameter. All of the images from the same anatomical region, but with different contrast properties, contribute to the estimation of the hyperparameters, and once they are found, the k‐space data belonging to each image are used independently to infer the image gradients. Thus, commonality of image spatial structure across contrasts is exploited without the problematic assumption of correlation across contrasts. Examples demonstrate improved reconstruction quality (up to a factor of 4 in root‐mean‐square error) compared with previous compressed sensing algorithms and show the benefit of joint inversion under a hierarchical Bayesian model. Magn Reson Med, 2011. © 2011 Wiley Periodicals, Inc.
Efficacy and safety of clindamycin-tretinoin gel versus clindamycin or tretinoin alone in acne vulgaris: a randomized, double-blind, vehicle-controlled study.

BACKGROUND Topical combination therapy containing a retinoid and an antimicrobial is an effective treatment for acne vulgaris. OBJECTIVE To evaluate the efficacy and safety of a new topical formulation containing clindamycin phosphate 1.2% and tretinoin 0.025% solubilized in an aqueous-based gel (CT gel). METHODS 1,649 participants were randomized 2:2:2:1 to 12 weeks of double-blind treatment with CT gel, clindamycin, tretinoin, or vehicle gel administered once daily. RESULTS Significantly more participants achieved 2-grade or greater improvement on the Investigator's Static Global Assessment score with CT gel versus clindamycin, tretinoin, or vehicle gel. CT gel produced a significantly greater reduction in absolute number of total lesions versus all other treatment groups, in total and noninflammatory lesions versus clindamycin, and in total and inflammatory lesions versus tretinoin. Local tolerability was similar to that of tretinoin alone; signs and symptoms of irritation were most notable at week 2. There were no more adverse events with CT gel than with tretinoin gel. CONCLUSION CT gel is more effective than clindamycin or tretinoin monotherapy, with a safety and tolerability profile similar to that of tretinoin.
Genetically Distinct Behavioral Modules Underlie Natural Variation in Thermal Performance Curves

Thermal reaction norms pervade organismal traits as stereotyped responses to temperature, a fundamental environmental input into sensory and physiological systems. Locomotory behavior represents an especially plastic read-out of animal response, with its dynamic dependence on environmental stimuli presenting a challenge for analysis and for understanding the genomic architecture of heritable variation. Here we characterize behavioral reaction norms as thermal performance curves for the nematode Caenorhabditis briggsae, using a collection of 23 wild isolate genotypes and 153 recombinant inbred lines to quantify the extent of genetic and plastic variation in locomotory behavior to temperature changes. By reducing the dimensionality of the multivariate phenotypic response with a function-valued trait framework, we identified genetically distinct behavioral modules that contribute to the heritable variation in the emergent overall behavioral thermal performance curve. Quantitative trait locus mapping isolated regions on Chromosome II associated with locomotory activity at benign temperatures and Chromosome V loci related to distinct aspects of sensitivity to high temperatures, with each quantitative trait locus explaining up to 28% of trait variation. These findings highlight how behavioral responses to environmental inputs as thermal reaction norms can evolve through independent changes to genetically distinct modular components of such complex phenotypes.
Attenuation of anti-tuberculosis therapy induced hepatotoxicity by Spirulina fusiformis, a candidate food supplement

Abstract Therapy using Isoniazid (INH) and Rifampicin (RIF) leads to induction of hepatotoxicity in some individuals undergoing anti-tuberculosis treatment. In this study, we assessed the effect of Spirulina fusiformis on INH and RIF induced hepatotoxicity in rats compared with hepatoprotective drug Silymarin. Induction of hepatotoxicity was measured by changes in the liver marker enzymes (aspartate transaminase, alanine transaminase, and alkaline phosphatase). The antioxidant status was also analyzed in liver tissue homogenate and plasma by measurement of superoxide dismutase, catalase, glutathione-S-transferase, glutathione reductase, and lipid peroxidation levels. We also aimed to study the binding and interactions of the transcription factors Pregnane X Receptor (PXR) and Farnesoid X Receptor (FXR) with INH, RIF, and representative active compounds of Spirulina fusiformis by in silico methods. The administration of INH and RIF resulted in significant (p < 0.05) decrease in the antioxidant levels and total protein levels. There was also a significant (p < 0.05) increase in the levels of liver marker enzymes. Spirulina fusiformis was seen to protect the parameters from significant changes upon challenge with INH and RIF in a dose-dependent manner. This was corroborated by histological examination of the liver. The results of the in silico analyses further support the wet lab results.
ISCAS in English-Chinese CLIR at NTCIR-5

We participated in the Chinese single language information retrieval(SLIR) C-C task and EnglishChinese cross-language information retrieval(CLIR) E-C tasks in NTCIR5. Our project concentrates on the two aspects of the CLIR research: 1) We test various IR models especially language models for Chinese SLIR using the training corpus provided by the NTCIR organizer, and different smoothing methods have been studied for Chinese SLIR; 2) Our C-E CLIR task is based on the dictionary-based translation approach, and a new context-based translation algorithm using web corpus is proposed to solve the outof-vocabulary(OOV) problem in CLIR.
Autoimmune Diseases and Gastric Cancer Risk: A Systematic Review and Meta-Analysis

Purpose Autoimmunity is an alternative etiology of gastric inflammation, the initiating event in the gastric carcinogenic cascade. This mechanism may be an increasingly important cause of gastric cancer with the waning prevalence of its primary etiologic factor, chronic Helicobacter pylori infection. Materials and Methods PubMed and EMBASE were searched up to September 2018. Autoimmunity and 96 specific manifestations were considered for associations with gastric cancer risk. Random effects analysis was used to calculate pooled relative risk estimates (RR) and 95% confidence intervals (CI). Results We found a total of 52 observational studies representing 30 different autoimmune diseases. Overall, the presence of an autoimmune condition was associated with a gastric cancer pooled RR of 1.37 (95% CI, 1.24 to 1.52). Among the 24 autoimmune conditions with two or more independent reports, nine were significantly associated with increased gastric cancer risk: dermatomyositis (RR, 3.69; 95% CI, 1.74 to 7.79), pernicious anemia (RR, 2.84; 95% CI, 2.30 to 3.50), Addison disease (RR, 2.11; 95% CI, 1.26 to 3.53), dermatitis herpetiformis (RR, 1.74; 95% CI, 1.02 to 2.97; n=3), IgG4-related disease (RR, 1.69; 95% CI, 1.00 to 2.87), primary biliary cirrhosis (RR, 1.64; 95% CI, 1.13 to 2.37), diabetes mellitus type 1 (RR, 1.41; 95% CI, 1.20 to 1.67), systemic lupus erythematosus (RR, 1.37; 95% CI, 1.01 to 1.84), and Graves disease (RR, 1.27; 95% CI, 1.06 to 1.52). Conclusion Our analysis documents the wide range of autoimmune diseases associated with gastric cancer. These associations may reflect unreported links between these conditions and autoimmune gastritis. Further studies are warranted to investigate potential causal mechanisms.
Roles of protein kinase C and G proteins in activation of murine resting B lymphocytes by endotoxin-associated protein

Endotoxin-associated protein (EP) from the outer membrane of gram-negative bacteria is a potent immunomodulator. To examine the mechanism of EP stimulation, the protein kinase C inhibitors H7 and staurosporine were used. Both DNA and RNA synthesis of EP-stimulated murine resting B cells were completely inhibited when inhibitors were added at 0 h, whereas 55 to 76% inhibition of DNA synthesis was observed when H7 was added after 12 h of stimulation. In contrast, HA 1004, which blocks protein kinase A and protein kinase G activity, was relatively ineffective even at high concentrations, suggesting that the activity of protein kinase C is a primary mechanism of EP-induced murine B-cell proliferation. To examine the role of G proteins in EP-induced DNA synthesis in B cells, the effects of pertussis toxin (PT), which inactivates certain G proteins, and the B oligomer of PT (PTB), which does not, were also examined. PT was found to inhibit EP-induced DNA synthesis in a dose-dependent manner. However, PTB also caused equivalent inhibition, suggesting that PTB may be responsible for most of the inhibitory effect seen with the holotoxin. These results serve to question whether G proteins are involved in the signal transduction that occurs during EP-induced DNA synthesis in murine B cells.
Drug, Healthcare and Patient Safety Dovepress Gastrointestinal Injury Associated with Nsaid Use: a Case Study and Review of Risk Factors and Preventative Strategies

Nonsteroidal anti-inflammatory drugs (NSAIDs) are effective anti-inflammatory and analgesic agents and are among the most commonly used classes of medications worldwide. However, their use has been associated with potentially serious dose-dependent gastrointestinal (GI) complications such as upper GI bleeding. GI complications resulting from NSAID use are among the most common drug side effects in the United States, due to the widespread use of NSAIDs. The risk of upper GI complications can occur even with short-term NSAID use, and the rate of events is linear over time with continued use. Although gastroprotective therapies are available, they are underused, and patient and physician awareness and recognition of some of the factors influencing the development of NSAID-related upper GI complications are limited. Herein, we present a case report of a patient experiencing a gastric ulcer following NSAID use and examine some of the risk factors and potential strategies for prevention of upper GI mucosal injuries and associated bleeding following NSAID use. These risk factors include advanced age, previous history of GI injury, and concurrent use of medications such as anticoagulants, aspirin, corticosteroids, and selective serotonin reuptake inhibitors. Strategies for prevention of GI injuries include anti-secretory agents, gastroprotective agents, alternative NSAID formulations, and nonpharmacologic therapies. Greater awareness of the risk factors and potential therapies for GI complications resulting from NSAID use could help improve outcomes for patients requiring NSAID treatment. Case study A 53-year-old otherwise healthy female was admitted to the emergency department following two bouts of hematemesis and a single melenic stool. She denied abdominal pain or discomfort and reported no personal or family history of gastric ulcer. The patient reported being prescribed naproxen 500 mg twice daily for the 2 days prior for an ankle sprain. On examination, the patient was hypotensive in the supine position , with a blood pressure of 90/30 mmHg, and was tachycardic, with a heart rate of 130 beats per minute. Abdominal examination was benign without tenderness. Hemoglobin was 10.2 g/dL and hematocrit was 33.4%; all other evaluated laboratory values were within normal limits. Endoscopy revealed a 1×1 cm hemorrhagic gastric ulcer in the antrum with a visible vessel (Figure 1), which was cauterized at the time of endoscopy. Biopsies of the antrum and body were negative for Helicobacter pylori. Cautery was successful, and the patient was treated with an intravenous proton-pump inhibitor (PPI) and remained hospitalized for observation and to evaluate for rebleed-ing. During hospitalization, the …
Interobserver agreement in assessing early CT signs of middle cerebral artery infarction.

PURPOSE To assess the reliability of detecting signs of hemispheric infarction on CT scans obtained within 6 hours of the onset of symptoms. METHODS A neuroradiologist selected 12 normal and 33 abnormal CT studies showing the hyperdense middle cerebral artery sign (HMCAS) (n = 10), brain swelling (n = 22), and parenchymal hypodensity (n = 33) from two series of 750 patients with recent onset of middle cerebral artery stroke. These selections served as the reference source for a nonblinded analysis of the initial and follow-up CT scans. Six neuroradiologists then reviewed the CT scans twice, first blinded then not blinded to clinical symptoms. They assessed the signs of infarction for each hemisphere separately and estimated the volume of abnormal parenchymal hypodensity in increments of 20% within the territory of the middle cerebral artery. RESULTS Unblinding the reviewers did not change interobserver agreement significantly. The chance adjusted agreement was moderate to substantial: kappa = . 62 (95% confidence interval [CI], .46 to .78) and kappa = . 57 (95% CI, .33 to .81) for the HMCAS of the right and left hemisphere, respectively; kappa = . 59 (95% CI, .47 to .71) and kappa = . 56 (95% CI, .38 to .74) for focal brain swelling of the right and left hemisphere, respectively; and kappa = . 58 (95% CI, .50 to .66) and kappa = . 55 (95% CI, .32 to .67) for parenchymal hypodensity of the right and left hemisphere, respectively. Weighted kappa was . 65 and . 57 for the estimation of the hypodense tissue volume in the right and left hemisphere, respectively. Agreement with the reference source ranged from 73% to 93% for all variables and both hemispheres. CONCLUSION Even with no clinical information, neuroradiologists can assess subtle CT signs of cerebral infarction within the first 6 hours of symptom onset with moderate to substantial interobserver agreement.
Financial Inclusion, Health-Seeking Behavior, and Health Outcomes Among Older Adults in Ghana

Purpose: This study examines the associations between financial inclusion, health-seeking behavior, and health-related outcomes in older persons in Ghana. Method: Employing data from a 2016/2017 Aging, Health, Psychological Well-Being and Health-Seeking Behavior Study (N = 1,200; mean age = 66.2 years [standard deviation = 11.9], we estimated regression models of self-rated health (SRH), psychological distress (PD), and health-care use (HCU) on a variable representing compositional characteristics of financial inclusion. Results: Multivariate logistic and generalized Poisson models showed that financial inclusion is positively associated with SRH (β = .104, standard error [SE] = .033, p < .001) but inversely related to both PD (β = .038, SE = .032, p < .005) and HCU (β = −.006, SE = .009, p < .05) independent of other factors. However, after adjusting for socioeconomic and health-related factors, the associations were tempered and the effect of SRH decreased by 0.094 and PD increased by 0.065 points but HCU became statistically insignificant (β = −.020, SE = .0114, p > .05) Conclusions: Financial services inclusion profoundly appears to buffer against and retard health-related challenges in later life. Social and health policies targeted at improving the health outcomes of older people should include and build on the growing recognition of the importance of inclusive financial services and strategies.
Islands in the stream: from individual to communal fiber degradation in the rumen ecosystem

ABSTRACT The herbivore rumen ecosystem constitutes an extremely efficient degradation machinery for the intricate chemical structure of fiber biomass, thus, enabling the hosting animal to digest its feed. The challenging task of deconstructing and metabolizing fiber is performed by microorganisms inhabiting the rumen. Since most of the ingested feed is comprised of plant fiber, these fiber-degrading microorganisms are of cardinal importance to the ecology of the rumen microbial community and to the hosting animal, and have a great impact on our environment and food sustainability. We summarize herein the enzymological fundamentals of fiber degradation, how the genes encoding these enzymes are spread across fiber-degrading microbes, and these microbes' interactions with other members of the rumen microbial community and potential effect on community structure. An understanding of these concepts has applied value for agriculture and our environment, and will also contribute to a better understanding of microbial ecology and evolution in anaerobic ecosystems.