Miracle-dz/UniFAR-FTUs huggingface dataset:
Clinical factors affecting semen improvement after microsurgical subinguinal varicocelectomy: which subfertile patients benefit from surgery?

Background: The exact mechanism of varicocele-related infertility is still elusive, therefore, the current challenges for its management lie in determining which patients stand to benefit most from surgical correction. The authors aimed to assess the clinical factors affecting semen improvement after left microsurgical subinguinal varicocelectomy (MSV) in relation to patient age, ultrasound varicocele grading (USVG), and presence of a right subclinical varicocele (RSV). Methods: From 2010 to 2017 a total of 228 infertile patients underwent left MSV for clinical varicocele. Descriptive statistics were used to describe the cohort and verify the surgical benefit in terms of semen improvement, in addition, subsets of patients were selected according to clinical covariates. Logistic regression modeling was applied to evaluate the presence of RSV, operative time, age, and USVG as explanatory variables. Results: Sperm concentration (SC), progressive sperm motility (PSM), and normal sperm morphology (NSM) increased significantly after surgery (p = 0.002; p = 0.011; p = 0.024; respectively). Mean SC improved after MSV in ⩾35 year-old patients and the grade 3 USVG group (p = 0.01; p = 0.02; respectively). Logistic regression modeling showed a that the probability of SC improvement was 76% lower in subjects presenting RSV (p = 0.011). In addition, patients with a grade 3 USVG presented a three-times greater probability of SC improvement compared with patients with a lower USVG (p = 0.035). In addition, older patients showed a greater probability of SC improvement after MSV (p = 0.041). Conclusions: MSV is an effective varicocele-related infertility treatment that should also be offered to older patients. In addition, patients with a higher USVG benefit from surgery. In infertile men with an RSV in association with a left clinical disease, a bilateral varicocele repair should be considered.
Effect of hyperthermic intraperitoneal chemotherapy for gastric cancer patients: a meta-analysis of the randomized controlled trials

Objective To determine the effectiveness and safety of hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with advanced gastric cancer and peritoneal metastases. Methods PubMed®, CNKI, Web of Science, VIP and WANFANG databases were searched to identify randomized controlled trials (RCTs) that examined the effect of HIPEC on survival, clinical response and adverse events. Patients with advanced gastric cancer and peritoneal metastases were divided into an experimental group and a control group. The statistical results are presented as relative ratio (RR), mean difference (MD) and 95% confidence interval (CI). Results Twenty-one RCTs met the inclusion criteria (n = 1674 patients). Meta-analysis showed that the 3-year survival rate was significantly higher in the HIPEC group than in the control group (RR 1.61; 95% CI 1.43, 1.82) and the complete response rate was significantly higher in the HIPEC group than in the control group (RR 2.35; 95% CI 1.67, 3.31). HIPEC was also beneficial in terms of decreased CEA (MD −1.79; 95% CI −2.22, −1.35). There was no significant difference in the rate of adverse reactions (RR 1.00; 95% CI 0.87, 1.14). Conclusions HIPEC had a beneficial effect on 3-year survival rate and complete response in patients with advanced gastric cancer and peritoneal metastases.
Pharmacokinetics and other risk factors for kanamycin-induced hearing loss in patients with multi-drug resistant tuberculosis

Abstract Objective: The toxicity associated with the use of kanamycin includes irreversible hearing loss. There are limited data describing the relationship between hearing loss and kanamycin pharmacokinetics (PK). We explored the association of kanamycin PK with hearing loss in patients on MDR-TB treatment. Design: We prospectively recruited patients on kanamycin-based MDR-TB treatment in Cape Town. Hearing thresholds from 0.25 to 16 kHz were tested at baseline and at 4, 8 and 12 weeks. We determined kanamycin concentrations at steady-state in serial plasma samples over 10 h, and explored factors associated with hearing loss. Study sample: One hundred and two participants including 58 (56.9%) men had analysable audiometric data; median age was 34.9 years, 65 (63.7%) were HIV-positive, and 24 (23.5%) had been treated for MDR-TB previously. Results: Eighty-four participants (82.4%) developed hearing loss. We found a 3% (95% CI: 1–6%, p = 0.028) increased risk of cochleotoxicity for each 10 µg h/L increase in 0–10 h AUC. Conclusion: We describe a high incidence of hearing loss in MDR-TB patients treated with kanamycin, with higher AUC0–10 significantly associated with hearing loss.
Outcome of children and adolescents with Burkitt lymphoma and diffuse large B cell lymphoma treated with a modified NHL-BFM-90 protocol

Objective To evaluate the efficacy of a modified NHL-BFM-90 protocol in childhood and adolescence with Burkitt lymphoma(BL)and diffuse large B-cell lymphoma(DLBCL). Methods A total of 138 de novo patients with BL and DLBCL were enrolled.All patients were stratified into low(R1),intermediate(R2)and high risk(R3)groups based on the stage,chemotherapy
The Emerging Role of Toxic Adulterants in Street Drugs in the US Illicit Opioid Crisis

Drug overdose deaths in the United States are a substantial public health issue. The number of annual reported drug overdose deaths increased roughly 3-fold, from 23 500 in 2002 to 70 200 in 2017. Of even greater concern, during this same period, the number of opioid-related overdose deaths increased 4-fold, from 11 900 in 2002 to 47 600 in 2017. From 2016 to 2017, rates of opioid-related overdose deaths rose from 42 400 to 47 600, an increase of 12%. Also during this period, death rates associated with cocaine and psychostimulants increased by 34.4% (from 3.2 to 4.3 per 100 000 population) and 33.3% (from 2.4 to 3.2 per 100 000 population), respectively, likely contributing to the rise in overall drug overdose deaths. On the other hand, the number of overdose deaths related to either prescription opioids (which include buprenorphine, codeine, hydrocodone, hydromorphone, meperidine, methadone, morphine, oxycodone, oxymorphone, and tramadol) or heroin did not increase. Estimates based on provisional data for 2018 from the Centers for Disease Control and Prevention (CDC) explain these findings. Of an estimated 48 000 overall opioid-related overdose deaths in 2018, 28 400 deaths involved nonmethadone synthetic opioids, the most common of which was illicitly manufactured fentanyl. This trend is concerning because illicitly manufactured drugs commonly contain additional pharmacologically active components. These components are added during the illicit manufacturing process to either increase the bulk of the product or enhance the potency of the primary active component, are known as adulterants or cutting agents, and can themselves be toxic. In this Executive Perspective, we review data on the opioid crisis and describe recent US and global trends in the role of toxic adulterants and other pharmacologically active components in illicitly manufactured street drugs. We also highlight the role of toxic adulterants in opioid-related overdose deaths, chronic illicit drug abuse, and other public health issues. Finally, based on the information provided, we propose that clinicians increase attention to the potential role of toxic adulterants when evaluating and treating patients involved in drug abuse, overdose death, and addiction and that future public and personal health responses to the opioid epidemic emphasize building awareness and knowledge about the presence and dangers of toxic adulterants. In this way, we can further highlight the need to aggressively decrease the supply of illicitly manufactured drugs.
EFFECTS OF ORTHOGRAPHIC INPUT ON L2 PRODUCTION: THE CASE OF KOREAN-SPEAKING LEARNERS OF MANDARIN CHINESE

This work presents a longitudinal study of the role of orthographic input in the development of Mandarin stops and lexical tones by Korean speakers. One group of learners was tested using Pinyin, a Romanized representation of Mandarin, while the other group was tested with auditory stimuli. It was shown that Pinyin-mediated Mandarin voiceless unaspirated stops (e.g., ) may be incorrectly produced with long aspiration followed by a low-f0 tone due to its mapping onto Korean lenis stops [Long VOT⎼Low f0]. Further, more L2 experience may lead to poorer production of the T2 () T3 () contrast, which is indicative of the pervasive role of the knowledge of the L2 orthography and sound system during early L2 acquisition. The results of the study contribute empirical evidence for the interference of L2 orthography at the subphonemic level to the growing body of research on orthographic input and L2 phonological acquisition.
Multi-Dimensional Factors Associated with Illegal Substance Use Among Gay and Bisexual Men in Taiwan

Illegal substance use in sexual minorities is an important health issue worldwide. The present cross-sectional study aimed to investigate the multi-dimensional factors associated with illegal substance use among gay and bisexual men in Taiwan. This questionnaire-survey study recruited 500 gay or bisexual men aged between 20 and 25 years. Their experiences of using eight kinds of illegal substances in the preceding month were collected. Their previous experiences of homophobic bullying, satisfaction with academic performance, truancy, perceived family and peer support in childhood and adolescence, and social-demographic characteristics, were also collected. Potential factors associated with illegal substance use were identified using univariate logistic regression, and further selected into a forward stepwise logistic regression model to identify the factors most significantly related to illegal substance use. A total of 22 (4.4%) participants reported illegal substance use in the preceding month, and mean age was 22.9 ± 1.6. Forward stepwise logistic regression revealed that being victims of homophobic cyberbullying in childhood and adolescence (odds ratio (OR) = 1.26; p = 0.011), disclosure of sexual orientation at junior high school (OR = 4.67; p = 0.001), and missing classes or truancy in senior high school (OR = 2.52; p = 0.041) were significantly associated with illegal substance use in early adulthood. Multi-dimensional factors in childhood and adolescence that were significantly associated with illegal substance use in early adulthood among gay and bisexual men were identified. Besides traditional bullying, the effect of cyberbullying and school performance on illegal substance use should not be ignored. This study is limited to the cross-sectional design and possible recall bias. Mental health professionals must routinely assess these significant factors to prevent and intervene in illegal substance use among gay and bisexual men.
Combined Effect of Cold Atmospheric Plasma and Hydrogen Peroxide Treatment on Mature Listeria monocytogenes and Salmonella Typhimurium Biofilms

Cold Atmospheric Plasma (CAP) is a promising novel method for biofilm inactivation as log-reduction values up to 4.0 log10 (CFU/cm2) have been reported. Nevertheless, as the efficacy of CAP itself is not sufficient for complete inactivation of mature biofilms, the hurdle technology could be applied in order to obtain higher combined efficacies. In this study, CAP treatment was combined with a mild hydrogen peroxide (H2O2) treatment for disinfection of 1 and 7 day(s) old Listeria monocytogenes and Salmonella Typhimurium biofilms. Three different treatment sequences were investigated in order to determine the most effective treatment sequence, i.e., (i) first CAP, then H2O2, (ii) first H2O2, then CAP, and (iii) a simultaneous treatment of CAP and H2O2. Removal of the biofilm, induction of sub-lethal injury, and H2O2 breakdown due to the presence of catalase within the biofilms were investigated in order to comment on their possible contribution to the combined inactivation efficacy. Results indicated that the preferred treatment sequence was dependent on the biofilm forming species, biofilm age, and applied H2O2 concentration [0.05 or 0.20% (v/v)]. At the lowest H2O2 concentration, the highest log-reductions were generally observed if the CAP treatment was preceded by the H2O2 treatment, while at the highest H2O2 concentration, the opposite sequence (first CAP, then H2O2) proved to be more effective. Induction of sub-lethal injury contributed to the combined bactericidal effect, while the presence of catalase within the biofilms resulted in an increased resistance. In addition, high log-reductions were partially the result of biofilm removal. The highest overall log-reductions [i.e., up to 5.42 ± 0.33 log10 (CFU/cm2)] were obtained at the highest H2O2 concentration if CAP treatment was followed by H2O2 treatment. As this resulted in almost complete inactivation of the L. monocytogenes and S. Typhimurium biofilms, the combined treatment of CAP and H2O2 proved to be a promising method for disinfection of abiotic surfaces.
Deep Sedation or Paracervical Block for Daycare Gynecological Procedures: A Prospective, Comparative Study

Context: Many minor gynecological procedures are done for diagnostic and therapeutic reasons. A balance has to be struck between ability to discharge a patient at the earliest with minimum procedure-related discomfort to ensure patient safety as well as satisfaction. Aim: This prospective randomized study was designed to compare deep sedation versus paracervical block for minor gynecological surgeries comparing the time to discharge readiness, pain after the procedure, and overall patient satisfaction. Setting and Design: This prospective randomized comparative study was conducted at a tertiary level hospital after institutional ethics committee approval and registry of trial at CTRI (India). Methods: Seventy young women underwent minor gynecological procedures under these two modes of anesthesia. Time to discharge readiness from hospital to home was assessed using modified postanesthesia discharge score system (PADSS). Pain after procedure as well as patient satisfaction was evaluated. Patients were also asked whether they would recommend the same anesthetic technique for the procedure in the future. Answers were noted on a Likert scale. Results: Patients were ready to be discharged faster in deep sedation group compared to paracervical block group based upon modified PADSS score (1 h 9.6 min vs. 1 h 18 min) (P = 0.005). Pain in the perioperative period was analyzed using repeated-measures ANOVA and found to be significantly lesser in deep sedation group when considered till 80 min after surgery. The mean satisfaction score in patients who underwent deep sedation was 91.24 (standard deviation [SD] 2.8) compared to patients given paracervical block which was low at 64.67 (SD 15.8). All patients given deep sedation were ready to recommend the anesthesia technique as compared to only 53.3% of patients who were given paracervical block. Conclusions: Deep sedation may be preferred over paracervical block for daycare minor gynecological procedures.
A systematic review of the clinical use of Withania somnifera (Ashwagandha) to ameliorate cognitive dysfunction

Many developed countries are experiencing a rapidly “greying” population, and cognitive decline is common in the elderly. There is no cure for dementia, and pharmacotherapy options to treat cognitive dysfunction provide limited symptomatic improvements. Withania somnifera (Ashwagandha), a popular herb highly valued in Ayurvedic medicine, has often been used to aid memory and cognition. This systematic review thus aimed to evaluate the clinical evidence base and investigate the potential role of W. somnifera in managing cognitive dysfunction. Using the following keywords [withania somnifera OR indian ginseng OR Ashwagandha OR winter cherry] AND [brain OR cognit* OR mental OR dementia OR memory], a comprehensive search of PubMed, EMBASE, Medline, PsycINFO and Clinicaltrials.gov databases found five clinical studies that met the study's eligibility criteria. Overall, there is some early clinical evidence, in the form of randomized, placebo‐controlled, double‐blind trials, to support the cognitive benefits of W. somnifera supplementation. However, a rather heterogeneous study population was sampled, including older adults with mild cognitive impairment and adults with schizophrenia, schizoaffective disorder, or bipolar disorder. In most instances, W. somnifera extract improved performance on cognitive tasks, executive function, attention, and reaction time. It also appears to be well tolerated, with good adherence and minimal side effects.
Predictive factors for treatment success of transforaminal epidural steroid injection in lumbar disc herniation-induced sciatica

Background/aim The aim of this study was to identify predictive factors for treatment success in transforaminal epidural steroid injection in patients with lumbar disc herniation-induced sciatica. Materials and methods A total of 219 patients who were diagnosed with unilateral sciatica and underwent transforaminal epidural steroid injections at the level of L4-5, L5-S1, or S1 neural foramina between March 2016 and May 2018 were retrospectively analyzed. The presence of transitional vertebrae and the grade of nerve root compression were evaluated by a radiologist. Data including age, sex, body mass index, duration of symptoms, injection levels, and pain scores were recorded. Pain scores were evaluated using the numerical rating scale. Treatment success was defined as a ≥50% decrease in pain scores at 3 months. Results The study included 118 female and 101 male patients with a mean age of 43.65 ± 12.18 years. The mean duration of symptoms was 25.64 ± 2.17 weeks. Although the duration of symptoms was longer in patients for whom treatment failed, it did not reach statistical significance. Decreased pain scores at 1 h had a significant effect on treatment success (p = 0.012, odds ratio (OR): 1.015, 95% confidence interval (CI), 1.003–1.026). Conclusions Our study results suggest that a decreased pain score at 1 h is a predictor for a favorable three-month response to transforaminal epidural steroid injection in patients with lumbar disc herniation-induced sciatica.
A curative combination cancer therapy achieves high fractional cell killing through low cross-resistance and drug additivity

Curative cancer therapies are uncommon and nearly always involve multi-drug combinations developed by experimentation in humans; unfortunately, the mechanistic basis for the success of such combinations has rarely been investigated in detail, obscuring lessons learned. Here, we use isobologram analysis to score pharmacological interaction, and clone tracing and CRISPR screening to measure cross-resistance among the five drugs comprising R-CHOP, a combination therapy that frequently cures Diffuse Large B-Cell Lymphomas. We find that drugs in R-CHOP exhibit very low cross-resistance but not synergistic interaction: together they achieve a greater fractional kill according to the null hypothesis for both the Loewe dose-additivity model and the Bliss effect-independence model. These data provide direct evidence for the 50 year old hypothesis that a curative cancer therapy can be constructed on the basis of independently effective drugs having non-overlapping mechanisms of resistance, without synergistic interaction, which has immediate significance for the design of new drug combinations.
Physician Emotional Labour and Job Performance

This study explores the relationship between emotional labour and job performance and examines the mediation effects of emotional exhaustion on the relationship between the emotional labour and job performance of physicians. Data were collected from a sample of 530 physicians in Taiwanese hospitals. To achieve these objectives a mediated model was tested using structural equation modelling (SEM) to examine if the hypothesized model fit the data. The hypothesized model fits the data best (χ2 = 173.048, df = 69, p < 0.0001, goodness of fit index GFI = 0.956, comparative fit index (CFI) = 0.968, root-mean-square error of approximation (RMSEA) = 0.053). Path analysis showed that emotional exhaustion plays a fully mediated role on the relationship between deep acting and job performance as well as plays a partially mediated role on the relationship between surface acting and job performance. We confirmed that surface acting for physicians has a direct impact on job performance and affected job performance through the mediating effect of emotional exhaustion. The influences of surface acting on physicians providing medical services are evident. The results deserve the attention of hospital management to better assist physicians to maintain the correct mindset, take appropriate emotional control and patient communication strategies, rather than simply setting rules that require physicians to suppress displays of emotion.
Effect of some nutritional treatments on productive performance of she-camels

Aim of this study was to determine the effect of supplementation of calcium salts of fatty acids (CSFA) from palm oil (PO) at two levels (3 and 6%) to the concentrate feed mixture (CFM) on productive performance of dromedary she-camels and weights of their calves. Nine she-camels were allocated to 3 groups fed the same basal diet consisted of CFM, berseem hay (BH) and rice straw (RS), but differed in PO level (0, 3, and 6%) representing G1, G2 and G3, respectively. The feeding period lasted from 3 months pre-natal and 3 months post-natal. Live body weight (LBW), yield and composition of milk of she-camels as well as birth weight of calves were recorded during pre, at and post-natal periods. Blood was collected pre, at and post-natal periods to determine protein and lipid metabolites and concentration of transaminases (AST and ALT) and hormones (Progesterone, P4 and estradiol, E2). Results show insignificant effect of dietary treatment on LBW of she-calves during pre-, at and post-natal period, but only weight gain during pre-natal period was higher (P<0.05) in G3 than in G1 and G2. Average daily milk yield (ADMY) was higher in G2 and G3 than in G1, but the differences were not significant. Milk composition levels were not affected by dietary treatment. However, dietary treatment increased (P<0.05) level of blood triglycerides, cholesterol, HDL and LDL, being the highest in G3. Final LBW of calves at 28 wk of age and average daily gain of calves (0–28 wk) were higher in G3 than in G1 and G2.
Whole Genome Assembly of the Snout Otter Clam, Lutraria rhynchaena, Using Nanopore and Illumina Data, Benchmarked Against Bivalve Genome Assemblies

Citation: Thai BT, Lee YP, Gan HM, Austin CM, Croft LJ, Trieu TA and Tan MH (2019) Whole Genome Assembly of the Snout Otter Clam, Lutraria rhynchaena, Using Nanopore and Illumina Data, Benchmarked Against Bivalve Genome Assemblies. Front. Genet. 10:1158. doi: 10.3389/fgene.2019. 01158 Whole Genome Assembly of the Snout Otter Clam, Lutraria rhynchaena, Using Nanopore and Illumina Data, Benchmarked Against Bivalve Genome Assemblies