Miracle-dz/UniFAR-FTUs huggingface dataset:
Physiological and Behavioral Responses to Calibrated Noxious Stimuli Among Individuals with Cerebral Palsy and Intellectual Disability

Objective As individuals with intellectual disability (ID) due to cerebral palsy (CP) are at high risk of experiencing pain, measuring their pain is crucial for adequate treatment. While verbal reports are the gold standard in pain measurements, they may not be sufficient in ID. The aim was to detect behavioral/autonomic responses that may indicate the presence and intensity of pain in individuals with CP and ID, using calibrated stimuli, here for the first time. Subjects Thirteen adults with CP and ID (CPID), 15 healthy controls (HC), and 5 adults with CP with no ID (CPNID). Methods Subjects received pressure stimuli of various intensities. Self-reports (using a pyramid scale), facial expressions (retrospectively analyzed with Facial Action Coding System = FACS), and autonomic function (heart rate, heart rate variability, pulse, galvanic skin response) were analyzed. Results Self-reports and facial expressions but not the autonomic function exhibited stimulus-response relationship to pressure stimulation among all groups. The CPID group had increased pain ratings and facial expressions compared with controls. In addition, the increase in facial expressions along the increase in noxious stimulation was larger than in controls. Freezing in response to pain was frequent in CPID. Conclusions 1) Individuals with CP and ID have increased responses to pain; 2) facial expressions and self-reports, but not autonomic variables can reliably indicate their pain intensity; 3) the pyramid scale is suitable for self-report in this population. Although facial expressions may replace verbal reports, increased facial expressions at rest among these individuals may mask pain, especially at lower intensities.
Surgery for metachronous second primary lung cancer versus surgery for primary lung cancer: a propensity score-matched comparison of postoperative complications and survival outcomes.

OBJECTIVES Surgical treatments for metachronous second primary lung cancer (MSPLC) may be increasing. It was thought that surgery for MSPLC is associated with high mortality and morbidity. However, recent diffusion of minimally invasive surgical procedures may improve the safety of surgery for MSPLC. The aim of this study was to clarify the safety and prognosis of surgery for MSPLC compared with that for primary lung cancer (PLC). METHODS We reviewed medical records of 1340 patients who underwent pulmonary resection for non-small-cell lung cancer between 2006 and 2013. We identified patients with PLC and those with MSPLC, and surgical parameters and survival outcome were compared. To eliminate selection bias between the MSPLC group and the PLC group, propensity score-matched analysis on the basis of clinicopathological factors was performed. RESULTS Fifty-three patients underwent resection for MSPLC. Propensity score matching identified 50 patients from each treatment group. Of the 50 MSPLC patients, 41 (82.0%) underwent segmentectomy or wedge resection, 44 (82.0%) had clinical Stage I tumour and 36 (72.0%) received resection via video-assisted thoracoscopic surgery approach. Postoperative complications with a severity of Grade II or more occurred in 11 (22.0%) patients. The incidence of postoperative complications in the MSPLC group was not different from that of the PLC group (P = 0.4894). The 5-year overall survival rates were 68.7% and 83.0% in the PLC and the MSPLC groups, respectively. There was no significant difference between the PLC and the MSPLC groups in terms of overall survival (P = 0.2018, log-rank test). CONCLUSIONS Pulmonary resection for MSPLC was safely performed with low short-term morbidity similar to that of PLC, and its long-term overall survival was acceptable.
Use of ecoacoustics to determine biodiversity patterns across ecological gradients

The variety of local animal sounds characterizes a landscape. We used ecoacoustics to noninvasively assess the species richness of various biotopes typical of an ecofriendly forest plantation with diverse ecological gradients and both nonnative and indigenous vegetation. The reference area was an adjacent large World Heritage Site protected area (PA). All sites were in a global biodiversity hotspot. Our results showed how taxa segregated into various biotopes. We identified 65 singing species, including birds, frogs, crickets, and katydids. Large, natural, protected grassland sites in the PA had the highest mean acoustic diversity (14.1 species/site). Areas covered in nonnative timber or grass species were devoid of acoustic species. Sites grazed by native and domestic megaherbivores were fairly rich (5.1) in acoustic species but none were unique to this habitat type, where acoustic diversity was greater than in intensively managed grassland sites (0.04). Natural vegetation patches inside the plantation mosaic supported high mean acoustic diversity (indigenous forests 7.6, grasslands 8.0, wetlands 9.1), which increased as plant heterogeneity and patch size increased. Indigenous forest patches within the plantation mosaic contained a highly characteristic acoustic species assemblage, emphasizing their complementary contribution to local biodiversity. Overall, acoustic signals determined spatial biodiversity patterns and can be a useful tool for guiding conservation.
The impact of multidisciplinary care on early morbidity and mortality after heart transplantation.

OBJECTIVES The impact of multidisciplinary care on outcome after heart transplantation (HTx) remains unclear. METHODS This retrospective study investigates the impact of multidisciplinary care on the primary end point 1-year all-cause mortality (ACM) and the secondary end point mean acute cellular rejection (ACR) grade within the first postoperative year. RESULTS This study includes a total 140 HTx recipients (median age: 53.5 years; males: 80%; donor/recipient gender mismatch: 38.3%; mean length of in-hospital stay: 34 days; mean donor age: 41 years). Multidisciplinary care was implemented in 2008, 66 HTx recipients had operation in 2000-07 and 74 patients had HTx thereafter (2008-14). Non-ischaemic dilated cardiomyopathy was more prevalent in HTx recipients of 2000-07 (63.6 vs 43.2%; P = 0.024). Pre-transplant mechanical circulatory support was more frequent in 2008-14 (9.1 vs 24.3%; P = 0.030). Groups were not different for pre-transplant cardiovascular risk factors or other comorbidity, invasive haemodynamics or echocardiographic parameters. In-hospital and 1-year ACM were numerically lower in 2008-14 (16.2 vs 22.2%; 18.9% vs 25.8%; P = 0.47/0.47, respectively). In 2000-07, pre-transplant weight and diabetes mellitus predicted in-hospital ACM (odds ratio -0.14, P = 0.02; OR 5.24, P = 0.01, respectively) while post-transplant length of in-hospital stay was related with in-hospital ACM (odds ratio -0.10; P = 0.016) and 1-year ACM (odds ratio -0.07; P = 0.007). In 2000-07, the mean grade of ACR within the first postoperative year was higher (0.65 vs 0.20; P < 0.0001) and ≥moderate ACR was associated with in-hospital mortality (χ2 = 3.92; P = 0.048). CONCLUSIONS Multidisciplinary care in HTx compensates post-transplant risk associated with pre-transplant disease and has beneficial impact on the incidence of ACR and ACR-associated early mortality.
Evaluation of a community‐based intervention to improve routine childhood vaccination uptake among migrants in urban slums of Ludhiana, India

Background Evidence on the effectiveness of community‐based interventions in improving vaccination uptake in migrant populations is limited. This study aims to evaluate the effectiveness of a community‐based intervention to improve access to and uptake of childhood vaccinations among urban slum‐dwelling migrant communities in Ludhiana, India. Methods A mixed‐methods evaluation was conducted involving a post‐intervention comparison of vaccination uptake in six randomly selected intervention and control slum communities. Multilevel logistic regression to account for clustering of effects was used to investigate the impact of the intervention on vaccination uptake. Thematic analysis was used to analyse qualitative data. Results Overall, vaccination uptake was significantly higher in the intervention clusters and the likelihood of full immunization by the age of 1 year was more than twice that in the control clusters [OR: 2.27 (95%CI: 1.12‐4.60); P = 0.023]. Qualitative findings showed that stakeholders felt ownership of the intervention and that it was effective in increasing accessibility to and uptake of vaccinations. However, they emphasized the importance of continued government support for the intervention. Conclusions Community‐based interventions can significantly increase vaccination coverage in deprived populations with previously low uptake of childhood immunization but such initiatives need to be delivered in partnership with the government.
The association between the patient and the physician genders and the likelihood of intensive care unit admission in hospital with restricted ICU bed capacity

Background Despite the evidence that the patient gender is an important component in the intensive care unit (ICU) admission decision, the role of physician gender and the interaction between the two remain unclear. Objective To investigate the association of both the patient and the physician gender with ICU admission rate of critically ill emergency department (ED) medical patients in a hospital with restricted ICU bed capacity operates with 'closed door' policy. Methods A retrospective population-based cohort analysis. We included patients above 18 admitted to an ED resuscitation room (RR) of a tertiary hospital during 2011-12. Data on medical, laboratory and clinical characteristics were obtained. We used an adjusted multivariable logistic regression to analyze the association between both the patient and the physician gender to the ICU admission decision. Results We included 831 RR admissions, 388 (46.7%) were female patients and 188 (22.6%) were treated by a female physicians. In adjusted multivariable analysis (adjusted for age, diabetes, mode of hospital transportation, first pH and patients who were treated with definitive airway and vasso-pressors in the RR), female-female combination (patient-physician, respectively) showed the lowest likelihood to be admitted to ICU (adjusted OR: 0.21; 95% CI: 0.09-0.51) compared to male-male combination, in addition to a smaller decrease among female-male (adjusted OR: 0.53; 95% CI: 0.32-0.86) and male-female (adjusted OR: 0.43; 95% CI: 0.21-0.89) combinations. Conclusion We demonstrated the existence of the possible gender bias where female gender of the patient and treating physician diminish the likelihood of the restricted health resource use.
Physical Activity and Improvement of Glycemia in Prediabetes by Different Diagnostic Criteria

Context: The effects of physical activity (PA) on improvement of glycemia may differ between prediabetic individuals defined by oral glucose tolerance test vs glycated hemoglobin (HbA1c). Objective: We studied the association between PA and improvement of glycemia in individuals with prediabetes defined by glucose vs HbA1c criteria. Design, Setting, and Participants: From the Whitehall II study, 957 participants with prediabetes defined by isolated impaired fasting glucose (i-IFG), isolated impaired glucose tolerance (i-IGT), or both and 457 with prediabetes defined by HbA1c were included. Main Outcome Measures: The associations of PA with concomitant changes in glucose-related outcomes during 5 years of follow-up were analyzed. A recursive partitioning analysis was performed to study heterogeneity in the association between baseline PA and the probability of reversion to normoglycemia. Results: After 5 years of follow-up, 405 (42%) individuals with glucose-defined prediabetes reverted to normal glucose tolerance (NGT). A 5-year increase in moderate-to-vigorous-intensity PA was associated with improvements in insulin sensitivity and β-cell function, but PA was not generally associated with reversion to NGT. Only among women ≥50 years with i-IFG or i-IGT, higher amounts of PA were associated with higher probability of reversion to NGT. In HbA1c-defined prediabetes, only 20 individuals (4.4%) reverted to normoglycemia, and PA was not associated with improvement in glycemic markers. Conclusions: PA may be particularly important for reversion to normoglycemia among older women with i-IFG or i-IGT. Individuals with prediabetes identified by HbA1c have a low probability of reversion to normoglycemia, and their changes in glycemia are not related to PA.
Intestinal absorption of vitamin D: a systematic review

Context Vitamin D is frequently prescribed as a supplement, yet its absorption remains poorly understood. Objective This systematic review was performed to evaluate data on mechanisms involved in the intestinal absorption of vitamin D. Data Sources PubMed, Embase, and Cochrane Library databases were searched. Study Selection The following studies were included: experimental laboratory studies of vitamin D absorption through the enterocyte brush-border membrane; absorption tests that used radiolabeled vitamin D; and clinical trials in adults that investigated a single dose of cholecalciferol or ergocalciferol and reported at least 2 measurements of serum cholecalciferol, ergocalciferol, or 25-hydroxyvitamin D. Data Extraction From 2069 articles identified, 46 met the inclusion criteria. Results Different methods were employed to evaluate vitamin D absorption. Recent research suggests that vitamin D absorption is not an exclusive simple diffusion process. Vitamin D was better absorbed when it was consumed with fat-containing meals, but absorption also occurred without fat or oily vehicles. Factors that modified cholesterol absorption also altered vitamin D absorption. Conclusion Vitamin D is probably absorbed through passive diffusion and a mechanism involving membrane carriers, especially cholesterol transporters, although data remain scarce. Some data suggest that fat, when consumed concomitantly with vitamin D, improves vitamin D absorption.
Educational inequalities in risky health behaviours in 21 European countries: findings from the European social survey (2014) special module on the social determinants of health

Background: It has been suggested that cross‐national variation in educational inequalities in health outcomes (e.g. NCDs) is due to cross‐national variation in risky health behaviour. In this paper we aim to use highly recent data (2014) to examine educational inequalities in risky health behaviour in 21 European countries from all regions of the continent to map cross‐national variation in the extent to which educational level is associated with risky health behaviour. We focus on four dimensions of risky health behaviour: smoking, alcohol use, lack of physical activity and lack of fruit and vegetable consumption. Methods: We make use of recent data from the 7th wave of the European Social Survey (2014), which contains a special rotating module on the social determinants of health. We performed logistic regression analyses to examine the associations between educational level and the risky health behaviour indicators. Educational level was measured through a three‐category version of the harmonized International Standard Classification of Education (ISCED). Results: Our findings show substantial and mostly significant inequalities in risky health behaviour between educational groups in most of the 21 European countries examined in this paper. The risk of being a daily smoker is higher as respondents' level of education is lower (Low education (L): OR = 4.24 (95% CI: 3.83–4.68); Middle education (M): OR = 2.91 (95% CI: 2.65–3.19)). Respondents have a lower risk of consuming alcohol frequently if they have a low level of education (L: OR = 0.59 (95% CI: 0.54–0.64); M: OR = 0.70 (95% CI: 0.65–0.76)), but a higher risk of binge drinking frequently (L: OR = 1.29 (95% CI: 1.16–1.44); M: OR = 1.15 (95% CI: 1.04–1.27)). People are more likely to be physically active at least 3 days in the past week when they have a higher level of education (M: OR = 1.42 (95% CI: 1.34–1.50); H: OR = 1.67 (95% CI: 1.55–1.80)). Finally, people are more likely to consume fruit and vegetables at least daily if they have a higher level of education (fruit: M: OR = 1.09 (95% CI: 1.03–1.16); H: OR = 1.77 (95% CI: 1.63–1.92); vegetables: M: OR = 1.34 (95% CI: 1.26–1.42); H: OR = 2.35 (95% CI: 2.16–2.55)). However, we also found considerable cross‐national variation in the associations between education and risky health behaviour. Conclusions: Our results yield a complex picture: the lowest educational groups are more likely to smoke and less likely to engage in physical activity and to eat fruit and vegetables, but the highest educational groups are at greater risk of frequent alcohol consumption. Additionally, inequalities in risky health behaviour do not appear to be systematically weakest in the South or strongest in the North and West of Europe.
Mid-regional pro-atrial natriuretic peptide to predict clinical course in heart failure patients undergoing cardiac resynchronization therapy

Aims Cardiac resynchronization therapy (CRT) induces reverse cardiac remodelling in heart failure (HF), but many patients receiving CRT remain non-responders. This study assessed the role of amino-terminal-pro-B-type natriuretic peptide (NT-proBNP), mid-regional-pro-atrial natriuretic peptide (MR-proANP), and mid-regional-pro-adrenomedullin (MR-proADM) at the time of device implantation to predict favourable clinical course (CRT response and/or risk of MACE) in HF patients receiving CRT. Methods and results A total of 137 HF patients were prospectively included. Blood was drawn from the coronary sinus (CS) at CRT implantation, and from a peripheral vein (PV) simultaneously and after 6 months. Clinical CRT response at 6 months and major adverse cardiovascular events (MACE) at 2 years were assessed. Baseline PV-levels of MR-proANP (202 vs. 318 pmol/L, P = 0.009) and MR-proADM (843 vs. 1112 pmol/L, P = 0.02) were lower in CRT responders compared with non-responders. At 6 months, CRT responders showed a decrease in MR-proANP levels, compared with an increase in non-responders (-32 vs. +7 pmol/L, P = 0.02). During the same period, NT-proBNP decreased by a similar way in responders and non-responders, while MR-proADM was unchanged in both groups. High baseline MR-proANP, either in PV (OR 0.41, 95% CI 0.24-0.71, P = 0.002) or CS (OR 0.32, 95% CI 0.15-0.70, P = 0.005) was associated with reduced likelihood of CRT response. Furthermore, PV and CS levels of NT-proBNP, MR-proANP, and MR-proADM were all associated with increased risk of 2-year MACE (all P < 0.01). Conclusion Mid-regional-pro-atrial natriuretic peptide may assist prediction of clinical course in HF patients undergoing CRT implantation. Low circulating MR-proANP at the time of device implantation is associated with CRT response and more favourable outcome.
Creep ductility of 1CrMoV rotor steel

Abstract The creep ductility of 1CrMoV steels at a given temperature is high at high stresses responsible for high strain rates and ductile rupture, and low at lower stresses responsible for low strain rates and constrained cavity growth at grain boundaries. The magnitudes of ductility in the high and low stress regimes and the time to, and strain rate at, the transition between the two is determined by the chemical composition and the adopted quality heat treatment procedure of the steel. The basis for a material pedigree function forming part of a creep ductility model for 1CrMoV rotor steel is presented. Low ductility 1CrMoV steels are expected to be extremely notch sensitive. While this appears to be true for medium to high strength heats of the alloy, it is not necessarily the case for lower strength heats. There is not a simple inverse relationship between creep ductility and creep strength. Increasingly, creep-fatigue lifetime predictions for high temperature 1CrMoV power plant components subjected to thermo-mechanical transients employ a creep ductility exhaustion methodology to determine the creep damage accumulated per cycle. A creep ductility model of the type developed in the paper is suitable for forming the basis of such an approach.
p-Stability and p-Stabilizability of Stochastic Nonlinear and Bilinear Hybrid Systems under Stabilizing Switching Rules

The problem of th mean exponential stability and stabilizability of a class of stochastic nonlinear and bilinear hybrid systems with unstable and stable subsystems is considered. Sufficient conditions for the th mean exponential stability and stabilizability under a feedback control and stabilizing switching rules are derived. A method for the construction of stabilizing switching rules based on the Lyapunov technique and the knowledge of regions of decreasing the Lyapunov functions for subsystems is given. Two cases, including single Lyapunov function and a a single Lyapunov-like function, are discussed. Obtained results are illustrated by examples.
Induction of Type I Interferon through a Noncanonical Toll-Like Receptor 7 Pathway during Yersinia pestis Infection

ABSTRACT Yersinia pestis causes bubonic, pneumonic, and septicemic plague, diseases that are rapidly lethal to most mammals, including humans. Plague develops as a consequence of bacterial neutralization of the host's innate immune response, which permits uncontrolled growth and causes the systemic hyperactivation of the inflammatory response. We previously found that host type I interferon (IFN) signaling is induced during Y. pestis infection and contributes to neutrophil depletion and disease. In this work, we show that type I IFN expression is derived from the recognition of intracellular Y. pestis by host Toll-like receptor 7 (TLR7). Type I IFN expression proceeded independent of myeloid differentiation factor 88 (MyD88), which is the only known signaling adaptor for TLR7, suggesting that a noncanonical mechanism occurs in Y. pestis-infected macrophages. In the murine plague model, TLR7 was a significant contributor to the expression of serum IFN-β, whereas MyD88 was not. Furthermore, like the type I IFN response, TLR7 contributed to the lethality of septicemic plague and was associated with the suppression of neutrophilic inflammation. In contrast, TLR7 was important for defense against disease in the lungs. Together, these data demonstrate that an atypical TLR7 signaling pathway contributes to type I IFN expression during Y. pestis infection and suggest that the TLR7-driven type I IFN response plays an important role in determining the outcome of plague.
Transplantation of miRNA‐34a overexpressing adipose‐derived stem cell enhances rat nerve regeneration

Peripheral nerve injury is an ongoing challenge in reconstructive surgery. Adipose‐derived stem cell (ADSC) application is reported to improve nerve regeneration. In the present study, we evaluated the potential benefit of 34a‐ADSCs for never regeneration. Lentiviral vectors containing miRNA‐34a were constructed and ADSCs were transduced. The obtained 34a‐ADSCs were used to regenerate the sciatic nerve in surgically induced sciatic nerve injury rat model. Sprague–Dawley (SD) rats were randomly divided into two groups, a 34a‐ADSC group and an Lv‐ADSC group. Functional nerve recovery was assessed by walking track analysis at 12 weeks after surgery. In addition, histology, including light microscopy and transmission electron microscopy, and immunohistochemistry, was utilized to investigate the nerve repair effects of 34a‐ADSC. Results showed that reconstruction of the injured sciatic nerve had been significantly enhanced by restoration of nerve continuity and functional recovery in the 34a‐ADSC group compared with the Lv‐ADSC group. Furthermore, sciatic nerve conduction velocity and compound nerve action potential in the 34a‐ADSC group was much higher than that in the Lv‐ADSC group (30.72 ± 2.95 m/s vs. 22.73 ± 1.91 m/s, p< 0.0001; 11.93 ± 0.76 mV vs. 9.52 ± 0.53 mV, p = 0.0418). This study raises the possibility of using miRNA‐34a overexpressed ADSCs as a promising alternative for nerve regeneration.