Miracle-dz/UniFAR-FTUs huggingface dataset:
Induced pluripotent stem (iPS) cells from human fetal stem cells (hFSCs)

Introduction (1) Human embryonic stem (ES) cells are pluripotent but are difficult to be used for therapy because of immunological, oncological and ethical barriers. (2) Pluripotent cells exist in vivo, i.e., germ cells and epiblast cells but cannot be isolated without sacrificing the developing embryo. (3) Reprogramming to pluripotency is possible from adult cells using ectopic expression of OKSM and other integrative and non-integrative techniques. (4) Hurdles to overcome include i.e stability of the phenotype in relation to epigenetic memory. Sources of data We reviewed the literature related to reprogramming, pluripotency and fetal stem cells. Areas of agreement (1) Fetal stem cells present some advantageous characteristics compared with their neonatal and postnatal counterparts, with regards to cell size, growth kinetics, and differentiation potential, as well as in vivo tissue repair capacity. (2) Amniotic fluid stem cells are more easily reprogrammed to pluripotency than adult fibroblast. (3) The parental population is heterogeneous and present an intermediate phenotype between ES and adult somatic stem cells, expressing markers of both. Areas of controversy (1) It is unclear whether induced pluripotent stem (iPS) derived from amniotic fluid stem cells are fully or partially reprogrammed. (2) Optimal protocols to ensure highest efficiency and phenotype stability remains to be determined. (3) The “level” of reprogramming, fully vs partial, of iPS derived from amniotic fluid stem cells remain to be determined. Growing points Banking of fully reprogrammed cells may be important both for (1) autologous and allogenic applications in medicine, and (2) disease modeling.
Cognitive impairments and mood disruptions negatively impact instrumental activities of daily living performance in the first three months after a first stroke

Abstract Background: Cognition and mood play crucial roles in post-stroke recovery; however, the stroke literature is unclear as to how impairments in both domains influence performance of instrumental activities of daily living (IADL). Objective: (1) Evaluate the extent to which mood and cognition at two weeks post-stroke predict performance three months post-stroke. (2) Assess performance differences in patients with impairments in both cognition and mood to patients with impairments in either cognition or mood. Methods: Inpatients with a first-ever ischemic or hemorrhagic stroke were assessed at 2 weeks (n = 52) and at 3 months (n = 41) post-stroke. Patients completed a battery of neuropsychological tests, self-report measures and performance-based tests. Cognitive impairments and mood disruptions were assessed at 2 weeks and three months and IADL performance, as assessed by the Executive Function Performance Test, was evaluated at three months. Results: Complete data from the 41 patients assessed at both time points were analyzed. Regression analysis showed that composite cognition and composite mood variables at two weeks post-stroke predicted 48% of the variance in IADL performance at three months (F3,37 = 12.04; adjusted R2 = 0.48, P < 0.001). Statistically significant differences were found in performance scores for patients with a single impairment (M = 7.86, SD = 7.81) and for those with impairments in both mood and cognition (M = 19.2, SD = 13.2) (t(39) = − 3.41, P = 0.008). Conclusion: The results of this study suggest that cognitive and mood impairments at two weeks post-stroke are important predictors of performance in complex activities required for full independence at home and should be routinely assessed in stroke rehabilitation.
The effect of headgear on upper third molars: a retrospective longitudinal study

Objectives To investigate the effects of orthodontic non-extraction treatment with or without headgear on the position of and the space available for upper third molars in growing children with class II malocclusions. Materials and methods The sample consisted of pre- and post-treatment panoramic radiographs and lateral cephalograms of 294 class II orthodontic patients; 160 were treated with headgear and 134 were treated without headgear. The space available for the upper third molar was measured on the lateral cephalogram as the distance from pterygoid vertical (PTV) to the distal surface of the upper first molar crown (PTV-M1). Angulation, vertical position and tooth development stage of the upper third molars were evaluated on panoramic radiographs. All measurements were evaluated statistically. Results In both groups PTV-M1 increased, but the increase in PTV-M1 was significantly higher for patients treated without headgear. A linear model for repeated measures revealed that this difference was still significant after correction for age, gender and molar occlusion. Further, there is no evidence that the change in angulation, vertical position and development stage of the upper third molars during orthodontic treatment is influenced by headgear therapy. Conclusion This study indicates that the use of headgear in growing patients significantly affects the space available for upper third molars. However, orthodontic treatment with headgear does not influence the angulation, vertical position and development stage of upper third molars. It is therefore important to always take into account third molars during treatment planning.
Psychometric properties and feasibility of instruments for the detection of delirium in older hospitalized patients: a systematic review

Delirium is a serious and common complication among older hospitalized patients and is a predictor of many adverse outcomes. However, up to 72% of delirium incidents are unrecognized or misdiagnosed. The aim of this systematic review is to determine the validity, reliability, and feasibility of instruments for the detection of delirium in older hospitalized patients.
Overview of procalcitonin assays and procalcitonin-guided protocols for the management of patients with infections and sepsis

ABSTRACT Introduction: Procalcitonin is a surrogate infection blood marker whose levels help estimate the likelihood of bacterial infections and correlate with their resolution. Recent trials have revealed the benefits of inclusion of procalcitonin in antibiotic stewardship protocols for initiation and discontinuation of antimicrobial therapy. Areas covered: Procalcitonin-guided antibiotic stewardship protocols have shown appreciable reductions in antibiotic use and duration of therapy in respiratory infections, sepsis, and other infections, with positive effects on clinical outcomes. Multiple fully automated and sensitive procalcitonin assays are routinely used in clinical practice. Utilization of these assays requires consideration of the clinical setting and knowledge of assay characteristics, particularly assay sensitivities, reproducibility, and performance across routinely used cut-off ranges. The authors provide an overview of the strengths and limitations of currently available procalcitonin assays and antibiotic therapy algorithms incorporating procalcitonin currently used in different clinical settings and in patients with different underlying infections. Expert commentary: Use of sensitive procalcitonin measurements in clinical algorithms can reduce antimicrobial overuse, decreasing the risk of side effects and controlling emerging bacterial multi-resistance. Before use in clinical practice, it is important to carefully assess the quality of novel PCT assays and rigorously evaluate them in target patient populations across clinically relevant cut-off ranges.
Vitamin D receptor Taq I polymorphism and the risk of prostate cancer: a meta-analysis

Numerous previous studies reported the association of Vitamin D receptor gene Taq Ipolymorphism with prostate cancer risk, however these results were controversial. In order to provide a relatively comprehensive description of this relationship, we conducted this meta-analysis by searching PubMed, Embase, and China National Knowledge Infrastructure. Finally, 36 studies with 8,423 cases and 8,887 controls were included. Taq I polymorphism was found to marginally increase the prostate cancer risk in recessive genetic model (tt/Tt vs. TT: Odds Ratio (OR) = 0.89, 95% Confidence Interval (CI) = 0.80–1.00, p = 0.05) and allele genetic model (t vs. T allele: OR = 0.91, 95% CI = 0.84–0.99, p = 0.003) in the overall analysis. Subgroup analyses showed that significant increased risk was found in Asians in homozygote model (tt vs. TT: OR = 0.63, 95% CI = 0.41–0.95, p = 0.029) and allele genetic model (t vs. T: OR = 0.78, 95% CI = 0.67–0.90, p = 0.002), and in the subgroup of population-based controls in all the genetic models. These results suggest that Taq Ipolymorphism might be a risk factor of prostate cancer risk, especially in Asians. It could be considered as a promising target to predict the prostate cancer risk for clinical practice.
Creating virtual electrodes with 2D current steering

Objective. Current steering techniques have shown promise in retinal prostheses as a way to increase the number of distinct percepts elicitable without increasing the number of implanted electrodes. Previously, it has been shown that ‘virtual’ electrodes can be created between simultaneously stimulated electrode pairs, producing unique cortical response patterns. This study investigated whether virtual electrodes could be created using 2D current steering, and whether these virtual electrodes can produce cortical responses with predictable spatial characteristics. Approach. Normally-sighted eyes of seven adult anaesthetised cats were implanted with a 42-channel electrode array in the suprachoroidal space and multi-unit neural activity was recorded from the visual cortex. Stimuli were delivered to individual physical electrodes, or electrodes grouped into triangular, rectangular, and hexagonal arrangements. Varying proportions of charge were applied to each electrode in a group to ‘steer’ current and create virtual electrodes. The centroids of cortical responses to stimulation of virtual electrodes were compared to those evoked by stimulation of single physical electrodes. Main results. Responses to stimulation of groups of up to six electrodes with equal ratios of charge on each electrode resulted in cortical activation patterns that were similar to those elicited by the central physical electrode (centroids: RM ANOVA on ranks, p > 0.05; neural spread: one-way ANOVA on Ranks, p > 0.05). We were also able to steer the centroid of activation towards the direction of any of the electrodes of the group by applying a greater charge to that electrode, but the movement in the centroid was not found to be significant. Significance. The results suggest that current steering is possible in two dimensions between up to at least six electrodes, indicating it may be possible to increase the number of percepts in patients without increasing the number of physical electrodes. Being able to reproduce spatial characteristics of responses to individual physical electrodes suggests that this technique could also be used to compensate for faulty electrodes.
Frailty scoring in transcatheter aortic valve replacement patients

Background: Transcatheter aortic valve replacement (TAVR) is a less invasive treatment option for patients that are deemed too high a risk for surgical aortic valve replacement (SAVR). The aim of this review is to evaluate the frailty tools currently being used in patients referred for TAVR. Methods: Using a literature search involving database search engines from CINAHL, PubMed, SAGE publications and European Society of Cardiology conducted from 2010 to the present, a critical evaluation of studies dealing with frailty assessment in patients referred for TAVR/SAVR is discussed. Results: Eight studies met the criteria using frailty assessment in TAVR/SAVR patients. In all reviewed studies the impact of frailty on clinical outcome has been proved. Different instruments for measurements of frailty were used that have not been robustly evaluated. Frailty was defined differently and results may not be comparable. All reviewed studies used different cutoffs and scales and some a composite scoring system, although validity was limited. Conclusion: For frailty assessment implementation of validated standardized test protocols based on well-established assessment tools, covering all domains of frailty among TAVR centers is crucial for patient selection. Secondly, validated cutoffs and scoring systems are essential.
Unsupervised convolutional neural networks for large-scale image clustering

The paper proposes an unsupervised convolutional neural network (UCNN) to solve clustering and representation learning jointly in an iterative manner. The key idea behind the proposed method is that learning better feature representations of images leads to more accurate image clustering results, whereas better image clustering can benefit the feature learning with the proposed UCNN. In the proposed method, given an input image set, we first randomly pick k samples and extract their features as the initial centroids of image clusters using the proposed UCNN with an initial representation model pre-trained from the ImageNet dataset. Mini-batch k-means is then performed to assign cluster labels to individual input samples for a mini-batch of images randomly sampled from the input image set until all images are processed. Subsequently, UCNN simultaneously updates the parameters of UCNN and the centroids of image clusters iteratively based on stochastic gradient descent. Experimental results demonstrate the proposed method outperforms start-of-the-art clustering schemes in terms of accuracy and memory complexity on large-scale image sets containing millions of images.
Impact of Facility- and Community-Based Peer Support Models on Maternal Uptake and Retention in Malawi's Option B+ HIV Prevention of Mother-to-Child Transmission Program: A 3-Arm Cluster Randomized Controlled Trial (PURE Malawi)

Background: Many sub-Saharan African countries have adopted Option B+, a prevention of mother-to-child transmission approach providing HIV-infected pregnant and lactating women with immediate lifelong antiretroviral therapy. High maternal attrition has been observed in Option B+. Peer-based support may improve retention. Methods: A 3-arm stratified cluster randomized controlled trial was conducted in Malawi to assess whether facility- and community-based peer support would improve Option B+ uptake and retention compared with standard of care (SOC). In SOC, no enhancements were made (control). In facility-based and community-based models, peers provided patient education, support groups, and patient tracing. Uptake was defined as attending a second scheduled follow-up visit. Retention was defined as being alive and in-care at 2 years without defaulting. Attrition was defined as death, default, or stopping antiretroviral therapy. Generalized estimating equations were used to estimate risk differences (RDs) in uptake. Cox proportional hazards regression with shared frailties was used to estimate hazard of attrition. Results: Twenty-one facilities were randomized and enrolled 1269 women: 447, 428, and 394 in facilities that implemented SOC, facility-based, and community-based peer support models, respectively. Mean age was 27 years. Uptake was higher in facility-based (86%; RD: 6%, confidence interval [CI]: −3% to 15%) and community-based (90%; RD: 9%, CI: 1% to 18%) models compared with SOC (81%). At 24 months, retention was higher in facility-based (80%; RD: 13%, CI: 1% to 26%) and community-based (83%; RD: 16%, CI: 3% to 30%) models compared with SOC (66%). Conclusions: Facility- and community-based peer support interventions can benefit maternal uptake and retention in Option B+.
Vitamin D Level in Alopecia Areata

Background: Alopecia areata (AA) is an immune-mediated disease in which autoantigens play an important part in activating T-lymphocytes. Vitamin D has been associated with various autoimmune diseases, and Vitamin D receptors are strongly expressed in hair follicles and their expression in keratinocytes is necessary for the maintenance of the normal hair cycle. Aim: The aim of this study was to find the association between Vitamin D level and AA. Materials and Methods: This was a hospital-based cross-sectional study in which 50 patients with clinically and trichoscopically diagnosed AA cases, and 35 healthy age- and sex-matched controls were studied in summer months. Blood samples were taken from both cases as well as controls and samples were immediately processed by centrifugation (4000 rpm) at room temperature. Plasma 25-hydroxyvitamin D (25(OH)D) was analyzed by chemiluminescence method. A deficiency in Vitamin D was defined as serum 25(OH)D concentrations <30 ng/ml. Results: The mean body mass index in cases was 20.96 ± 1.91, whereas in controls, it was 21.37 ± 1.70 (P = 0.31). The mean serum 25(OH)D levels of AA patients was 16.6 ± 5.9 ng/ml, whereas in control group, the mean level was 40.5 ± 5.7, the difference being statistically significant (P < 0.001). A significant negative correlation was found between severity of alopecia tool score and Vitamin D level (P < 0.001; r = −0.730) and also between the number of patches and Vitamin D level (P < 0.001, r = −0.670). Conclusion: In our study, we found that the levels of 25(OH)D were low in AA patients when compared to healthy controls. Furthermore, there was a significant negative correlation between the levels of serum Vitamin D and severity of AA. Thus, the study suggests the role of Vitamin D in pathogenesis of AA and hence a possible role of Vitamin D supplementation in treatment of same. Limitations: Our study was limited by the lesser number of patients and lack of therapeutic trial of Vitamin D for these patients.
Nitric oxide synthase inhibition restores orthostatic tolerance in young vasovagal syncope patients

Objective Syncope is sudden transient loss of consciousness and postural tone with spontaneous recovery; the most common form is vasovagal syncope (VVS). We previously demonstrated impaired post-synaptic adrenergic responsiveness in young VVS patients was reversed by blocking nitric oxide synthase (NOS). We hypothesised that nitric oxide may account for reduced orthostatic tolerance in young recurrent VVS patients. Methods We recorded haemodynamics in supine VVS and healthy volunteers (aged 15–27 years), challenged with graded lower body negative pressure (LBNP) (−15, –30, −45 mm Hg each for 5 min, then −60 mm Hg for a maximum of 50 min) with and without NOS inhibitor NG-monomethyl-L-arginine acetate (L-NMMA). Saline plus phenylephrine (Saline+PE) was used as volume and pressor control for L-NMMA. Results Controls endured 25.9±4.0 min of LBNP during Saline+PE compared with 11.6±1.4 min for fainters (p<0.001). After L-NMMA, control subjects endured 24.8±3.2 min compared with 22.6±1.6 min for fainters. Mean arterial pressure decreased more in VVS patients during LBNP with Saline+PE (p<0.001) which was reversed by L-NMMA; cardiac output decreased similarly in controls and VVS patients and was unaffected by L-NMMA. Total peripheral resistance increased for controls but decreased for VVS during Saline+PE (p<0.001) but was similar following L-NMMA. Splanchnic vascular resistance increased during LBNP in controls, but decreased in VVS patients following Saline+PE which L-NMMA restored. Conclusions We conclude that arterial vasoconstriction is impaired in young VVS patients, which is corrected by NOS inhibition. The data suggest that both pre- and post-synaptic arterial vasoconstriction may be affected by nitric oxide.
The Correlates of Similarity Estimates Are Often Misleadingly Positive

Research on similarity constructs (e.g., dyadic similarity, personality stability, judgment agreement and accuracy) frequently find them to be associated with positive outcomes. However, a methodological pitfall associated with common “overall similarity” indices, which we term the normative-desirability confound (NDC), will regularly result in similarity constructs apparently having more positive effects than they do in reality. In essence, when an individual is estimated to be similar to another person by common indices, this will strongly indicate that the individual has desirable characteristics. Consequently, the correlates of overall similarity indices can often be interpreted as indicating the beneficial effects of having desirable characteristics, without needing to attribute any additional salutary effect to similarity. We show that this confound is present in overall similarity estimates for a wide range of constructs (e.g., personality traits, attitudes, emotions, behaviors, values), how it can be accounted for, and discuss larger implications for our understanding of similarity constructs.
Headache in military service members with a history of mild traumatic brain injury: A cohort study of diagnosis and classification

Introduction Headaches after concussion are highly prevalent, relatively persistent and are being treated like primary headaches, especially migraine. Methods We studied all new patients seen between August 2008 and December 2009 assessed by a civilian headache specialist at the TBI Center at Womack Army Medical Center, Fort Bragg, NC. We report sample demographics, injuries and headache characteristics, including time from injury to headache onset, detailed descriptions and International Classification of Headache Disorders second edition primary headache diagnosis type. Results A total of 95 soldiers reported 166 headaches. The most common injury cited was a blast (53.7%). Most subjects (76.8%) recalled the onset of any headache within 7 days of injury. The most commonly diagnosed headache was a continuous type with migraine features (n = 31 (18.7%)), followed by chronic migraine (type 1.5.1, n = 14 (8.4%)), migraine with aura (type 1.2.1, n = 10 (6.0%)), hemicrania continua (type 4.7, n = 12 (7.2%)), chronic cluster (type 3.1.2, n = 6 (3.6%)) and headaches not otherwise classifiable (type 14.1, n = 5 (3.0%)) also present. The most clinically important was a continuous headache with migraine features. Conclusion We present a series of patients seen in a military treatment facility for headache diagnosis after concussion in whom we found migraine, as well as uncommon primary headache types, at frequencies that were much higher than expected.
Quality of life after upper third molar removal: A prospective longitudinal study

Background Third molar extraction is a very common procedure in Dentistry. The aim of this study was to evaluate the quality of life (QoL) and satisfaction of patients undergoing extraction of an upper third molar under local anesthesia. A second objective was to describe the evolution of self-reported pain measured in a visual analogue scale (VAS) in the 7 days after surgery and its relationship with pre- and intraoperative factors. Material and Methods A prospective longitudinal cohort study was made. Fifty-five patients received a questionnaire assessing social and working isolation, eating and speaking ability, diet modifications, sleep impairment, physical appearance, discomfort at suture removal and overall satisfaction. Pain was registered daily on a VAS scale. A descriptive and bivariate analysis of the data was performed. Results Forty-seven patients were included. Pain decreased lineally across the 7 days, and relief was significant between days 2 and 3. Intraoperative complications were significantly associated with pain. The complication that showed the highest pain score was the tuberosity fracture. Conclusions Upper third molar removal significantly affects the patient’s quality of life, particularly during the first 2 days after extraction. Key words:Quality of life, upper third molar, extraction, complications.