Miracle-dz/UniFAR-FTUs huggingface dataset:
CORRELATIONS between Functional and Structural Tests Measured by Spectral Domain Optical Coherence Tomography in Severe Glaucoma

ABSTRACT Purpose: To evaluate the relationship between visual acuity, visual field and spectral domain optical coherence tomography (OCT) parameters, including retinal nerve fiber layer (RNFL), ganglion cell-internal plexiform layer (GC-IPL) thicknesses, and optic nerve head parameters in patients with severe glaucoma. Material and Methods: Patients with the diagnosis of severe glaucoma were recruited from the data gathered at our glaucoma department. A detailed ophthalmic examination was performed using the Standard Automated Perimetry (the 30–2 SITA standard program was used for VF testing). Cirrus EDI-OCT was used for peripapillary RNFL and GC-IPL thickness measurements. Optic nerve head parameters, including mean cup-to-disc (c/d) ratio, rim area, vertical c/d ratio, cup volume, were also measured by spectral domain OCT. Correlations between these structural parameters and functional parameters (visual acuity, VF parameters) were investigated. Results: Forty-one eyes of 34 patients with severe glaucoma were enrolled in this study. Correlations between BCVA and mean GC-IPL thickness (p = .03), superior GC-IPL thickness (p = .03), inferonasal GC-IPL thickness (p = .01), superonasal GC-IPL thickness (p = .01), superotemporal GC-IPL thickness (p = .04), and rim area (p = .00) were found to be positive statistically significant. There was also a positive statistically significant correlation between MD and inferotemporal GC-IPL thickness (p = .03). Negative statistically significant correlations were found between BCVA and mean c/d ratio (p = .00), vertical c/d ratio (p = .02) and cup volume (p = .00). Discussion: Mean, superior, inferonasal, superonasal, and superotemporal GC-IPL thicknesses and mean c/d ratio, vertical c/d ratio and cup volume were found to be correlated with BCVA in patients with severe glaucoma.
Hepatitis B and C prevalence and incidence in key population groups with multiple risk factors in the EU/EEA: a systematic review

Background People living with HIV (PLHIV) and people in prison are population groups with a potentially high risk and/or prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection. Aim We conducted a systematic review in order to find prevalence and incidence estimates in these populations in the European Union/European Economic Area (EU/EEA). Methods Original research articles published between January 2005 and February 2017 were retrieved from PubMed and Embase in February 2017. Results Fifty-two articles were included, providing 97 estimates of HBV/HCV infection prevalence or incidence. Estimates of HBV infection prevalence ranged between 2.9% and43.4% in PLHIV and 0.0% and 25.2% in people in prison. Estimates of HCV infection prevalence ranged from 2.9% to 43.4% in PLHIV and 0.0% to 25.2% in people in prison. Incidence estimates ranged between 0.0 and 2.5 cases per 100 person-years for HBV infection in PLHIV. No such data was available for people in prison. HCV infection incidence ranged between 0.3 and 0.9 cases per 100 person-years in PLHIV and between 1 and 1.2 cases per 100 person-years in people in prison. Prevalence estimates were generally higher than in the general population, especially for HCV infection and among groups with multiple risk factors. Conclusions PLHIV, people in prison and groups with multiple risk factors, have a high prevalence of HBV and HCV and may be at ongoing risk of infection. These groups should be among the populations prioritised and targeted for active case finding and prevention programmes in the EU/EEA.
Three IMRT advanced planning tools: A multi‐institutional side‐by‐side comparison

Abstract Purpose To assess three advanced radiation therapy treatment planning tools on the intensity‐modulated radiation therapy (IMRT) quality and consistency when compared to the clinically approved plans, referred as manual plans, which were planned without using any of these advanced planning tools. Materials and Methods Three advanced radiation therapy treatment planning tools, including auto‐planning, knowledge‐based planning, and multiple criteria optimization, were assessed on 20 previously treated clinical cases. Three institutions participated in this study, each with expertise in one of these tools. The twenty cases were retrospectively selected from Cleveland Clinic, including five head‐and‐neck (HN) cases, five brain cases, five prostate with pelvic lymph nodes cases, and five spine cases. A set of general planning objectives and organs‐at‐risk (OAR) dose constraints for each disease site from Cleveland Clinic was shared with other two institutions. A total of 60 IMRT research plans (20 from each institution) were designed with the same beam configuration as in the respective manual plans. For each disease site, detailed isodoseline distributions and dose volume histograms for a randomly selected representative case were compared among the three research plans and manual plan. In addition, dosimetric endpoints of five cases for each site were compared. Results Compared to the manual plans, the research plans using advanced tools showed substantial improvement for the HN patient cases, including the maximum dose to the spinal cord and brainstem and mean dose to the parotid glands. For the brain, prostate, and spine cases, the four types of plans were comparable based on dosimetric endpoint comparisons. Conclusion With minimal planner interventions, advanced treatment planning tools are clinically useful, producing a plan quality similarly to or better than manual plans, improving plan consistency. For difficult cases such as HN cancer, advanced planning tools can further reduce radiation doses to numerous OARs while delivering adequate dose to the tumor targets.
Carotid versus femoral access for transcatheter aortic valve implantation: a propensity score inverse probability weighting study.

OBJECTIVES The transcarotid (TC) approach for transcatheter aortic valve implantation (TAVI) is potentially an optimal alternative to the transfemoral (TF) approach. Our goal was to compare the safety and efficacy of TC- and TF-TAVI. METHODS Patients who underwent TF-TAVI or TC-TAVI in the prospectively collected FRANCE TAVI registry between January 2013 and December 2015 were compared. Propensity score inverse probability weighting methods were employed to minimize the impact of bias related to non-random treatment assignment. RESULTS Of the 11 033 patients included in the current study, 10 598 (96%) underwent a TF-TAVI and 435 (4.1%) had a TC-TAVI. Patients in the TC-TAVI access group presented with a higher risk profile but were significantly younger. There were no differences in the perioperative and 2-year mortality rates after adjustment [odds ratio (OR) 1.02, 95% confidence interval (CI) 0.62-1.68; P = 0.99 and hazard ratio 1.03, 95% CI 0.7-1.35; P = 0.83). TC-TAVI was associated with a significant risk of stroke (OR 2.42, 95% CI 2.01-2.92; P < 0.001), ST-elevation myocardial infarction (OR 7.32, 95% CI 3.87-13.87; P < 0.001), infections (OR 2.36, 95% CI 2.04-2.71; P < 0.001), bleeding (OR 2.01, 95% CI 1.76-2.29; P < 0.001), renal failure (OR 2.23, 95% CI 1.90-2.60; P < 0.001) and need for dialysis (OR 2.36, 95% CI 2.01-2.76, P < 0.001). Conversely, TC-TAVI was not confirmed as a risk factor for pacemaker implantation after adjustment (OR 1.05, 95% CI 0.96-1.15; P < 0.28) and was a protective factor for vascular complications (OR 0.37, 95% CI 0.32-0.43; P < 0.001). CONCLUSIONS TC-TAVI is a safe procedure compared to TF-TAVI, although it holds an increased risk of perioperative complications. It should be considered in case of non-femoral peripheral access as the second access choice, to increase the overall safety of TAVI procedures.
Durability of glycaemic control with dapagliflozin, an SGLT2 inhibitor, compared with saxagliptin, a DPP4 inhibitor, in patients with inadequately controlled type 2 diabetes

Dapagliflozin is associated with greater reductions in HbA1c and weight than saxagliptin in management of type 2 diabetes mellitus (T2DM). The present post hoc analyses compared the durability of these effects over short‐ and long‐term follow‐up in patients with T2DM who were inadequately controlled with metformin (≥1500 mg/day) and who were receiving either dapagliflozin (10 mg/day) or saxagliptin (5 mg/day). Failure of glycaemiccontrol was assessed using the slope of the change in HbA1c from baseline‐over‐time regression line (coefficient of failure [CoF]). CoF was compared directly (dapagliflozin vs saxagliptin) over the short term (NCT01606007, 24 weeks) and indirectly (placebo‐adjusted) over the long term (NCT00528879 and NCT00121667, 102 weeks). A low CoF value indicated greater durability. CoF was lower for dapagliflozin versus saxagliptin over 18–24 weeks (−1.38%/year; 95% CI, −2.41 to −0.35; P = .009) and 20–102 weeks (−0.37%/year; 95% CI, −0.73 to −0.02; P = .04). Fewer dapagliflozin‐treated patients versus saxagliptin‐treated patients required rescue medication or discontinued the study because of failure to achieve glycaemic control at 24 weeks (3.4% vs 9.4%; P = .0191). In patients with T2DM who were inadequately controlled with metformin, dapagliflozin was associated with greater durability of glycaemic control than saxagliptin over 18–24 and 20–102 weeks.
Identification of subgroups of chemotherapy patients with distinct sleep disturbance profiles and associated co-occurring symptoms.

STUDY OBJECTIVES Purposes of this study were to identify subgroups of patients with distinct sleep disturbance profiles and to evaluate for differences in demographic, clinical, and various sleep characteristics, as well for differences in the severity of co-occurring symptoms among these subgroups. METHODS Outpatients with breast, gynecological, gastrointestinal, or lung cancer (n = 1331) completed questionnaires six times over two chemotherapy cycles. Self-reported sleep disturbance was evaluated using the General Sleep Disturbance Scale (GSDS). Latent profile analysis was used to identify distinct subgroups. RESULTS Three latent classes with distinct sleep disturbance profiles were identified (Low [25.5%], High [50.8%], Very High [24.0%]) across the six assessments. Approximately 75% of the patients had a mean total GSDS score that was above the clinically meaningful cutoff score of at least 43 across all six assessments. Compared to the Low class, patients in High and Very High classes were significantly younger, had a lower functional status, had higher levels of comorbidity, and were more likely to be female, more likely to have childcare responsibilities, less likely to be employed, and less likely to have gastrointestinal cancer. For all of the GSDS subscale and total scores, significant differences among the latent classes followed the expected pattern (Low < High < Very High). For trait and state anxiety, depressive symptoms, morning and evening fatigue, decrements in attentional function, and decrements in morning and evening energy, significant differences among the latent classes followed the expected pattern (Low < High < Very High). CONCLUSIONS Clinicians need to perform in-depth assessments of sleep disturbance and co-occurring symptoms to identify high-risk patients and recommend appropriate interventions.
Tissue and serum metabolomic phenotyping for diagnosis and prognosis of hepatocellular carcinoma

More than two‐thirds of patients with hepatocellular carcinoma (HCC) cannot receive curative therapy and have poor survival due to late diagnosis and few prognostic directions. In our study, nontargeted and targeted metabolomics analyses were conducted by liquid chromatography–mass spectrometry to characterize metabolic features of HCC and identify diagnostic and prognostic biomarker candidate incorporating liver tissue and serum metabolites. A total of 552 subjects, including 432 with liver tissue and 120 with serum specimens, were recruited in China. In the discovery cohort, a series of 138 metabolites were identified to discriminate HCC tissues from matched nontumor tissues. Retinol presented with the highest area under the curve (AUC) of 0.991 and associated with Edmondson grade. In the validation cohort, all metabolites in retinol metabolism pathway were examined and the levels of retinol and retinal in tumor tissue and serum decreased in the order of normal to cirrhosis to HCC of Edmondson Grades I to IV. Retinol and retinal levels could also differentiate between HCC and cirrhosis, with AUCs of 0.996 and 0.994, respectively, in tissue and 0.812 and 0.744, respectively, in serum. The AUC of the combined retinol and retinal panel in serum was 0.852. Univariate and multivariate Cox regression identified this panel as an independent predictor for HCC and showed that low expression of retinol and retinal correlated with decreased survival time. In conclusion, the retinol metabolic signature had considerable diagnostic and prognostic value for identifying HCC patients who would benefit from prompt therapy and optimal prognostic direction.
Range of Motion and Injury Occurrence in Elite Spanish Soccer Academies. Not Only a Hamstring Shortening-Related Problem.

Sanz, A, Pablos, C, Ballester, R, Sanchez-Alarcos, JV, and Huertas, F. Range of motion and injury occurrence in elite Spanish soccer academies. Not only a hamstring shortening-related problem. J Strength Cond Res XX(X): 000-000, 2019-Age-related development of range of motion (ROM) during an active hip flexion (active straight leg raise) and its relationship with hamstring injury occurrence were examined in 1657 young male soccer players (9-18 years of age). Age-related differences in ROM showed a significant decrease from U9 to U11 (p = 0.001), from U11 to U13 (p < 0.005), and from U9 to U13 (p < 0.001), whereas ROM increased from U13 to U15 and from U13 to U18 (both p's < 0.001). Interestingly, younger and older players reached similar ROM values (U9-U18, p = 0.87). Higher ROM was found in dominant than nondominant leg in all age groups (all ps < 0.001). No differences related to playing position were found on ROM (all ps > 0.478). During the follow-up period (11 months) 97 hamstring injuries were reported showing higher rates in the older age groups (p < 0.001) and outfield players (p < 0.001). Remarkably, no differences in ROM average were found between injured players and noninjured players (p = 0.152). Our results suggest that ROM during hip flexion does not only depend on the hamstrings shortening but also on the variables related to joint stability, motor control, and hip flexor muscle weakness. Sport scientists in youth sport soccer academies should develop age-specific screening and action plans to develop strength, motor control, and flexibility to optimize ROM and reduce injuries from the grassroots stages.
Characterization and Immunomodulatory Effects of High Molecular Weight Fucoidan Fraction from the Sporophyll of Undaria pinnatifida in Cyclophosphamide-Induced Immunosuppressed Mice

Immunomodulation involves two mechanisms, immunostimulation and immunosuppression. It is a complex mechanism that regulates the pathophysiology and pathogenesis of various diseases affecting the immune system. Immunomodulators can be used as immunostimulators to reduce the side effects of drugs that induce immunosuppression. In this study, we characterized the chemical composition of high molecular weight fucoidan (HMWF) and low molecular weight fucoidan and compared their functions as natural killer (NK) cell-derived immunostimulators in vitro. We also tested the effectiveness of HMWF, which has a relatively high function in vitro, as an immunostimulator in immunosuppressed animal models. In these models, HWMF significantly restored NK cell cytotoxicity and granzyme B release to the control group level. In addition, the expression of interleukin (IL)-1β, IL-2, IL-4, IL-5, IL-12, interferon (IFN)-γ, and tumor necrosis factor (TNF)-α also increased in the spleen. This study suggests that HMWF acts as an effective immunostimulant under immunosuppressive conditions.
Warming and Nitrogen Addition Change the Soil and Soil Microbial Biomass C:N:P Stoichiometry of a Meadow Steppe

Soil and soil microbial biomass (SMB) carbon: nitrogen: phosphorus (C:N:P) stoichiometry are important parameters to determine soil balance of nutrients and circulation of materials, but how soil and SMB C:N:P stoichiometry is affected by climate change remains unclear. Field experiments with warming and N addition had been implemented since April 2007. Infrared radiators were used to manipulate temperature, and aqueous ammonium nitrate (10 g m−2 yr−1) was added to simulate nitrogen deposition. We found that molar nutrient ratios in the soil averaged 60:11:1, warming and warming plus N addition reduced soil C:N by 14.1% and 20% (P < 0.01), and reduced soil C:P ratios by 14.5% and 14.8% (P < 0.01). N addition reduced soil C:N significantly by 17.6% (P < 0.001) (Figure 2B,D). N addition and warming plus N addition increased soil N:P significantly by 24.6% and 7.7% (P < 0.01). The SMB C:N, C:P and N:P ratios increased significantly with warming, N addition and warming plus N addition. Warming and N addition increased the correlations between SOC and soil microbial biomass C (SMBC), soil total P and soil microbial biomass P (SMBP), warming increased the correlation between the soil total N and soil microbial biomass N (SMBN). After four years’ treatment, our results demonstrated that the combined effects of warming and N fertilization could change the C, N, P cycling by affecting soil and SMB C:N:P ratios significantly and differently. At the same time, our results suggested SMB might have weak homeostasis in Sonnen Grassland and warming and N addition would ease N-limitation but aggravate P-limitation in northeastern China. Furthermore, these results further the current demonstration of the relationships between the soil and SMB C:N:P stoichiometry in response to global change in temperate grassland ecosystems.
The Role of Lineage Plasticity in Prostate Cancer Therapy Resistance

Lineage plasticity has emerged as an important mechanism of treatment resistance in prostate cancer. Treatment-refractory prostate cancers are increasingly associated with loss of luminal prostate markers, and in many cases induction of developmental programs, stem cell–like phenotypes, and neuroendocrine/neuronal features. Clinically, lineage plasticity may manifest as low PSA progression, resistance to androgen receptor (AR) pathway inhibitors, and sometimes small cell/neuroendocrine pathologic features observed on metastatic biopsy. This mechanism is not restricted to prostate cancer as other malignancies also demonstrate lineage plasticity during resistance to targeted therapies. At present, there is no established therapeutic approach for patients with advanced prostate cancer developing lineage plasticity or small cell neuroendocrine prostate cancer (NEPC) due to knowledge gaps in the underlying biology. Few clinical trials address questions in this space, and the outlook for patients remains poor. To move forward, urgently needed are: (i) a fundamental understanding of how lineage plasticity occurs and how it can best be defined; (ii) the temporal contribution and cooperation of emerging drivers; (iii) preclinical models that recapitulate biology of the disease and the recognized phenotypes; (iv) identification of therapeutic targets; and (v) novel trial designs dedicated to the entity as it is defined. This Perspective represents a consensus arising from the NCI Workshop on Lineage Plasticity and Androgen Receptor-Independent Prostate Cancer. We focus on the critical questions underlying lineage plasticity and AR-independent prostate cancer, outline knowledge and resource gaps, and identify strategies to facilitate future collaborative clinical translational and basic studies in this space.
Implementation of electronic health records systems in surgical units and its impact on performance

Electronic health records (EHR) systems have been utilized in New South Wales for more than a decade; however, there is no agreement as to what clinical benefits they provide. This study aims at determining whether the introduction of EHR systems resulted in changes in documentation quality and other markers of clinical performance such as post‐operative length of stay (PO LOS), use of imaging modality, rates of readmission and morbidity.
Study of the Impact of Standard Image Compression Techniques on Performance of Image Classification with a Convolutional Neural Network

In this study, we have measured the impact of image compression on the classification performance of Convolutional Neural Networks (CNNs). By using a pre-trained CNN to classify compressed images, we have shown that on average, an image can be compressed by a factor 7, 16, 40 for a JPEG, JPEG200 and an HEVC encoder, respectively, while still maintaining a correct classification by the CNN. This study also showed that pretrained AlexNet CNN was making use of JPEG artifacts learned during the training phase to perform classification. To further study the impact of compression on CNN-based classification, a large set of encoding parameters was explored: color-space, resolution, Quantization Parameter (QP). Main conclusions of this study are that color is essential for classification with AlexNet CNN, and that classification is resilient to image downscaling. Finally, we have studied the correlation between classification performance of a CNN and image quality measured with two objective metrics, namely the Peak Signal to Noise Ratio (PSNR) and the Structural SIMilarity (SSIM). We have found that the SSIM metrics was more appropriate to measure the degradation of an image with regards the CNN performance.
Activated PPARβ/δ Protects Pancreatic β Cells in Type 2 Diabetic Goto-Kakizaki Rats from Lipoapoptosis via GPR40.

GW501516-activated peroxisome proliferator-activated receptor (PPAR) β/δ and G-protein-coupled receptor (GPR) 40 were shown to protect pancreatic β cells against lipoapoptosis. Therefore, this study aimed to investigate whether activated PPARβ/δ could protect type 2 diabetic rats from lipoapoptosis through regulation of GPR40 and to compare the protective effects of activated PPARβ/δ and PPARγ. We made an animal model of type 2 diabetic lipoapoptosis by feeding spontaneously type 2 diabetic Goto-Kakizaki (GK) rats with a high-fat diet (HFD) to evaluate the effects of PPARβ/δ on islet β cell apoptosis. And, treated INS-1 cells with 0.5 mM palmitate (PAM) in the absence/presence of GW501516 (a specific agonist of PPAR β/δ) and with/without transfection of GPR40 siRNA to explore the underlying molecular mechanism. HFD aggravated GK rats' poorer INSR30, lower mass, greater apoptosis of β cells, lower mass, and lower expression of GPR40, which were similarly improved by GW501516 at 3 or 6 mg/kg day and pioglitazone. Compared with pioglitazone, GW501516 caused more weight loss and had no effect on insulin resistance. GW501516 protected INS-1 cells from PAM-induced apoptosis by upregulating GPR40 and activating Akt/Bcl-2/caspase-3. Activated extracellular regulated protein kinases (ERK) was relevant to the lipoapoptosis in INS-1 cells, but was not involved in the antilipoapoptotic effect of GW501516. These results showed that the PPARβ/δ agonist GW501516 protected β cells from lipoapoptosis and improved β cell mass by upregulating GPR40 and activating the Akt/Bcl-2/caspase-3 pathway, but not the ERK-signaling pathway.