Miracle-dz/UniFAR-FTUs huggingface dataset:
Risk of cognitive impairment with non-vitamin K antagonist oral anticoagulants in atrial fibrillation

Background: The association between use of non-vitamin K antagonist oral anticoagulants (NOACs) with cognitive impairment in atrial fibrillation (AF) remains unknown. Methods: An electronic search of Medline, Embase, Cochrane Library databases and ClinicalTrials.gov Website will be performed for randomized controlled trials (RCTs) that reported cognitive impairment events and observational nationwide database studies that reported adjusted hazard ratio (HR) in AF patients with NOACs. The primacy outcome will be a composite of any forms of cognitive impairment. HRs and their 95% confidence intervals (95% CI) will be calculated by using fixed- and random-effects models. Subgroup analyses will be undertaken based on individual NOACs, study types and follow-up duration. Results: This study will provide evidence of the association between use of NOACs and risk of cognitive impairment in patients with AF by pooling the results of RCTs and real-world studies. Conclusions: The results will bring about vigorous evidence in this topic and provide optimal anticoagulation strategy in AF patients at high risk of cognitive disorder. Ethics and dissemination: Ethical approval is not applicable for this study. PROSPERO registration number: CRD42018103849.
Remote Sensing of Droplet Number Concentration in Warm Clouds: A Review of the Current State of Knowledge and Perspectives

The cloud droplet number concentration (Nd) is of central interest to improve the understanding of cloud physics and for quantifying the effective radiative forcing by aerosol‐cloud interactions. Current standard satellite retrievals do not operationally provide Nd, but it can be inferred from retrievals of cloud optical depth (τc) cloud droplet effective radius (re) and cloud top temperature. This review summarizes issues with this approach and quantifies uncertainties. A total relative uncertainty of 78% is inferred for pixel‐level retrievals for relatively homogeneous, optically thick and unobscured stratiform clouds with favorable viewing geometry. The uncertainty is even greater if these conditions are not met. For averages over 1° ×1° regions the uncertainty is reduced to 54% assuming random errors for instrument uncertainties. In contrast, the few evaluation studies against reference in situ observations suggest much better accuracy with little variability in the bias. More such studies are required for a better error characterization. Nd uncertainty is dominated by errors in re, and therefore, improvements in re retrievals would greatly improve the quality of the Nd retrievals. Recommendations are made for how this might be achieved. Some existing Nd data sets are compared and discussed, and best practices for the use of Nd data from current passive instruments (e.g., filtering criteria) are recommended. Emerging alternative Nd estimates are also considered. First, new ideas to use additional information from existing and upcoming spaceborne instruments are discussed, and second, approaches using high‐quality ground‐based observations are examined.
G-CSF associates with neurogenesis and predicts prognosis and sensitivity to chemotherapy in pancreatic ductal adenocarcinoma

Background Recent studies demonstrated that granulocyte colony-stimulating factor (G-CSF), regularly used for the prevention of neutropenia, is engaged in cancer progression. However, the role of G-CSF in pancreatic ductal adenocarcinoma (PDAC) is not clear. The aim of the present study was to investigate the expression and prognostic value of G-CSF in patients with PDAC. Materials and methods The localization and expression of G-CSF in PDAC were examined by immunohistochemistry (IHC). The analysis of the levels of G-CSF in plasma was evaluated using ELISA kit. The correlation between G-CSF expression and patients’ survival was assessed by Kaplan–Meier analysis. Results In IHC specimens, G-CSF was discovered predominantly in the cell cytoplasm and expressed in most of PDAC, while in plasma, the systemic level of G-CSF is no different between normal patients and pancreatic cancer patients. In 100 PDAC cases with IHC, patients with grades 2 and 3 were defined as the high expression group (41 patients, 41%), and those with grades 0 and 1 as the low expression group (59 patients, 59%). Significant correlation was noted between high G-CSF expression and neural invasion (P = 0.042) or early recurrence (P < 0.001). G-CSF appeared to be an independent adverse prognostic factor (hazard ratio = 1.774, 95% confidence interval 1.150–2.737, P = 0.010) in addition to N stage (P = 0.002). Specifically, adjuvant chemotherapy consisting of gemcitabine prolongs survival of patients with high G-CSF expression (median survival time 14 months vs 7.5 months). Morphologically, high G-CSF expression cells demonstrate the association with neurogenesis. Conclusion High expression of G-CSF is a prognostic marker and an indicator to chemotherapy response in PDAC.
Ablation of low‐molecular‐weight FGF2 isoform accelerates murine osteoarthritis while loss of high‐molecular‐weight FGF2 isoforms offers protection

FGF2 is an essential growth factor implicated in osteoarthritis (OA), and deletion of full‐length FGF2 (Fgf2ALLKO) leads to murine OA. However, the FGF2 gene encodes both high‐molecular‐weight (HMW) and low‐molecular‐weight (LMW) isoforms, and the effects of selectively ablating individual isoforms, as opposed to total FGF2, has not been investigated in the context of OA. We undertook this study to examine whether mice lacking HMW FGF2 (Fgf2HMWKO) or LMW FGF2 (Fgf2LMWKO) develop OA and to further characterize the observed OA phenotype in Fgf2ALLKO mice. Fgf2HMWKO mice never developed OA, but 6‐ and 9‐month‐old Fgf2LMWKO and Fgf2ALLKO mice displayed signs of OA, including eroded articular cartilage, altered subchondral bone and trabecular architecture, and increased OA marker enzyme levels. Even with mechanical induction of OA, Fgf2HMWKO mice were protected against OA, whereas Fgf2LMWKO and Fgf2ALLKO displayed OA‐like changes of the subchondral bone. Before exhibiting OA symptoms, Fgf2LMWKO or Fgf2ALLKO joints displayed differential expression of genes encoding key regulatory proteins, including interleukin‐1β, insulin‐like growth factor 1, bone morphogenetic protein 4, hypoxia‐inducible factor 1, B‐cell lymphoma 2, Bcl2‐associated X protein, a disintegrin and metalloproteinase with thrombospondin motifs 5, ETS domain‐containing protein, and sex‐determining region Y box 9. Moreover, Fgf2LMWKO OA cartilage exhibited increased FGF2, FGF23, and FGFR1 expression, whereas Fgf2HMWKO cartilage had increased levels of FGFR3, which promotes anabolism in cartilage. These results demonstrate that loss of LMW FGF2 results in catabolic activity in joint cartilage, whereas absence of HMW FGF2 with only the presence of LMW FGF2 offers protection from OA.
Molecular detection of Coxiella burnetii in heart valve tissue from patients with culture-negative infective endocarditis

Abstract Coxiella burnetii is a common cause of blood culture–negative infective endocarditis (IE). Molecular detection of C burnetii DNA in clinical specimens is a promising method of diagnosing Q fever endocarditis. Here, we examined the diagnostic utility of Q fever polymerase chain reaction (PCR) of formalin-fixed heart valve tissue from patients with blood culture–negative IE who underwent heart valve surgery. Clinical and laboratory data of patients with blood culture–negative IE who underwent heart valve surgery during a 6-year period and for whom biopsy tissues were available were reviewed retrospectively. Blood culture–positive IE patients who underwent heart valve surgery within the last 3 years were used as controls. Heart valve samples were cultured and also subjected to histological examination and PCR for Q fever, brucellosis, and bartonellosis. Data from 20 patients with blood culture–negative IE and 20 with blood culture–positive IE were analyzed. Eight cases of blood culture–negative IE were PCR-positive for C burnetii (40%; 95% confidence interval, 19–64). No specimen was PCR-positive for brucellosis or bartonellosis. Histologically, 4 of 8 specimens with a positive Q fever PCR result were characterized by clusters of multinucleated giant cells without a fibrin ring. None of 20 patients with blood culture–negative IE received anti-Coxiella antibiotic therapy due to lack of clinical suspicion. Six-month mortality was higher in the Q fever PCR-positive group than in the Q fever PCR-negative group [38% (3/8) vs 0% (0/12), P = . 049). Of the 20 patients with blood culture–positive IE, none yielded a positive Q fever PCR result for valve tissue. Approximately 40% of patients with culture-negative IE who received heart valve surgery were PCR-positive for Q fever; patients without clinical suspicion suffered high mortality. These data suggest that Q fever IE in patients with culture-negative IE is often missed in routine clinical practice.
Risk factors for gastroesophageal reflux disease and analysis of genetic contributors

Gastroesophageal reflux disease (GERD) is a common gastrointestinal disorder with an increasing prevalence. GERD develops when the reflux of stomach contents causes troublesome typical and atypical symptoms and/or complications. Several risk factors of GERD have been identified and evaluated over the years, including a considerable amount of genetic factors. Multiple mechanisms are involved in the pathogenesis of GERD including: (1) motor abnormalities, such as impaired lower esophageal sphincter (LES) resting tone, transient LES relaxations, impaired esophageal acid clearance and delayed gastric emptying; and (2) anatomical factors, such as hiatal hernia and obesity. Genetic contribution seems to play a major role in GERD and GERD- related disorders development such Barrett’s esophagus and esophageal adenocarcinoma. Twin and family studies have revealed an about 31% heritability of the disease. Numerous single-nucleotide polymorphisms in various genes like FOXF1, MHC, CCND1, anti-inflammatory cytokine and DNA repair genes have been strongly associated with increased GERD risk. GERD, Barrett’s esophagus and esophageal adenocarcinoma share several genetic loci. Despite GERD polygenic basis, specific genetic loci such as rs10419226 on chromosome 19, rs2687201 on chromosome 3, rs10852151 on chromosome 15 and rs520525 on the paired related homeobox 1 gene have been mentioned as potential risk factors. Further investigation on the risk genes may elucidate their exact function and role and demonstrate new therapeutic approaches to this increasingly common disease.
What Are the Options for the Treatment of Stuttering in Preschool Children?

Abstract Treatment of stuttering during the preschool years is considered to be the best prevention of persistent chronic stuttering; however, many clinicians do not feel comfortable treating stuttering and may be confused about choosing an intervention. This article summarizes the history of direct and indirect methodology for treatment of stuttering in preschool children. It provides an update of contemporary treatments and discusses issues related to the timing of treatment. Guidelines for choosing a level of treatment based on the risk of a preschool child continuing to stutter are discussed, with examples of which children would be most appropriate for which level of intervention.
Emergent Life Events: An In-Depth Investigation of Characteristics and Provider Responses during Youth Evidence-Based Treatment

Emergent life events (ELEs), or acute client stressors disclosed within psychotherapy sessions, are not addressed by many evidence-based psychosocial treatments (EBTs). Preliminary provider-report studies suggest that ELEs may interfere with effective EBT implementation. The present study offers a detailed, observational examination of ELEs and their impact on EBT within therapy sessions. Data were observationally coded from 274 sessions with 55 primarily low-income, Latino youth clients (58% male, ages 5–15) in the modular EBT condition (Modular Approach to Therapy for Children [MATCH]) of the Child STEPs California trial. The ELE Coding System–Revised was used to measure ELEs, their characteristics, and provider responses to ELEs, including provider adherence to MATCH. Interrater reliability was generally high. At least one ELE was identified in 13% of randomly selected sessions. ELEs ranged widely in content, and their characteristics did not cluster together. Providers responded more frequently to ELEs with non-EBT content (e.g., information gathering, empathy) than EBT content; use of the ELE as a “teaching moment” for EBT content was the least common response (40% of ELEs). Multilevel regression analyses revealed that compared to sessions without an ELE, ELE sessions were significantly associated with reduced provider adherence to MATCH. Within ELE sessions, higher client distress when discussing the ELE was associated with reduced provider adherence to MATCH, but only when ELE severity was high. Beyond provider report, observational measures indicate that ELEs are prevalent and unpredictable in community settings and disrupt EBT delivery. Findings can inform the development of structured ELE management procedures to enhance existing EBTs.
Transforaminal epidural steroid injection combined with pulsed radio frequency on spinal nerve root for the treatment of lumbar disc herniation

Background Lumbar disc herniation (LDH) is a common disease in clinical practice. The symptoms recur and are aggravated by time; severe pain and long-term movement disorder cause physiological and psychological problems that affect the quality of life of patients. Therefore, relieving the pain symptoms and promoting functional recovery are the primary goals that have gained increased attention. Objective To assess the efficacy of CT-guided transforaminal epidural steroid injection (TFESI) combined with pulsed radio frequency (PRF) on spinal nerve root for the treatment of LDH. Study design Retrospective comparative study. Setting Shengjing Hospital of China Medical University. Methods A total of 135 patients with LDH were selected from the Department of Pain Management in the Shengjing Hospital of China Medical University between January 2014 and December 2016. All patients were divided into three groups according to the order of entry (n=45): TFESI (group A); PRF on spinal nerve root (group B); and TFESI combined with PRF on spinal nerve root (group C). The visual analog scale (VAS), Oswestry disability index (ODI), and global perceived effect (GPE) before treatment and at different time points after treatment were observed, and patients’ satisfaction was assessed. Results At every point of observation, the VAS and ODI decreased significantly as compared to that before treatment in all groups (P<0.05). The VAS and ODI in group A at 3 and 6 months after treatment were significantly higher than that in the other two groups (P<0.05). At day 1, day 14, and 1 month after treatment, the VAS and ODI in group C were significantly lower than that in group B (P<0.05). The GPE in group C was high in the early days, while that at day 14 and 1 month after treatment was significantly higher than that in the other two groups (P<0.05); no significant difference was observed in GPE at 3 and 6 months after treatment between groups B and C (P>0.05). Conclusion TFESI combined with PRF for the treatment of LDH could effectively and rapidly relieve lumbago and radicular pain and achieve long-term remission. Although the method is widely applicable, the precise selection of patients is imperative.
Reliability of bedside ultrasound of limb and diaphragm muscle thickness in critically ill children

Introduction: We evaluated the reliability of measuring muscle thickness with ultrasound in limbs and diaphragms of critically ill children and determined the sensitivity of these measures to quantitate muscle atrophy over time. Methods: An expert and trained novice sonographers prospectively measured limb and diaphragm muscle thickness in 33 critically ill children. Results: Expert and novice intrarater and interrater reliability were similar. Intraclass correlations (ICC) and coefficients of variation (CoV) were better in limbs (ICC > 0.9; CoV 3.57%–5.40%) than in diaphragm (ICC > 0.8; CoV novice 11.88%, expert, 12.28%). Mean relative difference in all muscles was small (1%‐8%). Limits of agreement of the relative difference were smaller in limb (<13%–18%) than in diaphragm (<38%) muscles. Discussion: Muscle thickness is reliably measured with ultrasound by trained examiners in critically ill children. Our approach detects atrophy >13% in limb and >38% in diaphragm muscles. The smaller detectable change in limb muscles is likely due to their greater thickness. Muscle Nerve 59:88–94, 2019
Predictors of Physical Activity among Adults with Type 2 Diabetes Mellitus, Isfahan, 2015: Structural Equation Modeling Approach

Background: The prevalence of Type 2 diabetes mellitus (T2DM) has been increasing globally in the recent decades. Physical activity (PA) helps preventing diabetes complications by keeping the blood sugar of T2DM patients within the normal range. The objective of this study was to explore underlying beliefs corresponding to PA in T2DM patients using health action process approach (HAPA). Methods: This cross-sectional study was conducted in Isfahan, 2015. A convenience sample of 203 participants with T2DM was collected. Participants completed HAPA inventory containing the following constructs: Risk perception, outcome expectation, task self-efficacy, intention, action and coping planning, coping self-efficacy, recovery self-efficacy, and PA questionnaire. Structural equation modeling was used for statistical analysis. Results: The common fit indices revealed that the HAPA had an acceptable fit to the observations (CMIN/df = 2.36 [P < 0.001], root mean square error of approximation = 0.089, comparative fit index = 0.891, normal fit index = 0.902). Intention was associated with task self-efficacy (β = 0.92, P < 0.001), whereas risk perception (β = 0.16, P = 0.073) and outcome expectation (β = 0.32, P < 0.081) did not predict intention to participate in PA behavior. PA was well predicted by planning (β =0.84, P < 0.01) while it was not significantly associated to coping self-efficacy (β = 0.66, P = 0.73) and recovery self-efficacy (β = 0.6, P = 0.69). Conclusions: HAPA could be used as a proper framework to identify the beliefs of the patients with T2DM and guide for effective theory-based interventions regarding PA.
Combined effect of pegylated interferon α with adefovir on renal function in Chinese patients with chronic hepatitis B

Background: Long-term safety of treatment with hepatitis B virus (HBV) polymerase inhibitors is a concern. Adefovir dipivoxil (ADV) and/or interferon alfa (IFN-&agr;) therapies have previously been associated with impairment of renal function. Limited data are available on the safety of combination therapy with nucleos (t)ide analogues (NAs) and IFN-&agr;. The aim of this analysis was to assess the renal function during combined therapy with pegylated interferon &agr;-2b (PEG-IFN-&agr;-2b) and ADV versus PEG-IFN-&agr;-2b alone in patients with chronic hepatitis B (CHB). Methods: We performed a multicenter, prospective, open-label, randomized-controlled trial of renal function data to investigate the efficacy of 48 weeks of therapy with PEG-IFN-&agr;-2b and ADV versus PEG-IFN-&agr;-2b alone in 102 patients with CHB in Anhui, China. Glomerular filtration rates (GFRs) were calculated by Cockcroft–Gault (CG), abbreviated Modification of Diet in Renal Disease (MDRD) study, and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation, and were tested by repeated-measures 1-way analysis of variance within groups. A linear mixed effects model for repeated measures was also used to evaluate the association between baseline information and estimated glomerular filtration rate (eGFR) changes overtime in all enrolled patients. The model considered the baseline age, sex, HBV DNA, aminotransferase, treatment group, time, and group-by-time interaction as fixed effects and incorporated random effects for individual subjects. Results: After 48 weeks of therapy and further 24 weeks of follow-up, the eGFR decreased both in patients given PEG-IFN-&agr;-2b single therapy and combined therapy. Age, HBV DNA, and combined therapy were significant negative predictive factors for eGFR changes. Conclusion: The incidence of renal adverse events in both groups was low, and the combination therapy may have delayed, but reversible renal impairment.
Effects of cobalt and chromium ions on oxidative stress and energy metabolism in macrophages in vitro

Cobalt and chromium ions released from cobalt‐chromium‐molybdenum (CoCrMo)‐based implants are a potential health concern, especially since both ions have been shown to induce oxidative stress in macrophages, the predominant immune cells in periprosthetic tissues. Ions of other transition metals (Cd, Ni) have been reported to inhibit the activity of mitochondrial enzymes in the electron transport chain. However, the effects of Co and Cr ions on the energy metabolism of macrophages remain largely unknown. The objective of the present study was to analyze the effects of Co2+ and Cr3+ on oxidative stress and energy metabolism in macrophages in vitro. RAW 264.7 murine macrophages were exposed to 6–18 ppm Co2+ or 50–150 ppm Cr3+. Results showed a significant increase in two markers of oxidative stress, reactive oxygen species level and protein carbonyl content, with increasing concentrations of Co2+, but not with Cr3+. In addition, oxygen consumption rates (OCR; measured using an extracellular flux analyzer) showed significant decreases in both mitochondrial respiration and non‐mitochondrial oxygen consumption with increasing concentrations of Co2+, but not with Cr3+. OCR results further showed that Co2+, but not Cr3+, induced mitochondrial dysfunction, including a decrease in oxidative phosphorylation capacity. Overall, this study suggests that mitochondrial dysfunction may contribute to Co2+‐induced oxidative stress in macrophages, and thereby to the inflammatory response observed in periprosthetic tissues. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:3178–3187, 2018.
Factors Associated With Progression of Lung Function Abnormalities in HIV-Infected Individuals

Background: HIV is an independent risk factor for chronic obstructive pulmonary disease; however, baseline risk factors for lung function decline remain largely unknown in this population. Methods: HIV-infected participants in the Pittsburgh Lung HIV Cohort with at least 3 pulmonary function measurements between 2007 and 2016 were included. Pulmonary function testing including postbronchodilator (BD) spirometry and diffusion capacity for carbon monoxide (DLco) was performed every 18 months. We used a mixed-effect linear model to evaluate factors associated with pulmonary function testing and DLco decline and logistic regression models to evaluate factors associated with rapid FEV1 decline (defined as >80 mL per year) and any DLco decline. Results: Two hundred eighty-five HIV-infected participants were included. Median baseline CD4 cell count was 521 cells per micro liter, 61.9% had an undetectable HIV viral load at baseline, and 78.5% were receiving ART. Approximately 20% of participants met Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria for a diagnosis of chronic obstructive pulmonary disease at baseline. Older age and baseline GOLD stage 1 compared with stage 0 were associated with faster decline in post-BD FEV1%, whereas female sex was associated with slower decline. Similarly, female sex was associated with slower decline in DLco%. HIV-related factors including CD4 cell count, viral load, and ART use were not significantly associated with pulmonary function decline. Conclusions: Older age, male sex, and higher baseline GOLD stage were associated with more rapid post-BD FEV1% decline in HIV-infected individuals.