Miracle-dz/UniFAR-FTUs huggingface dataset:
Association of Dose and Frequency on the Survival of Patients on Maintenance of Hemodialysis in China: A Kaplan-Meier and Cox-Proportional Hazard Model Analysis

Background Dialysis frequency and dose are controversial prognostic factors of hemodialysis morbidity and mortality. The aim of this study was to find out the effect of frequency and dosage of dialysis on mortality and survival in a group of Chinese hemodialysis patients. Material/Methods In total, 183 patients seen from February 2008 to January 2018, who were on maintenance hemodialysis for at least 3 months, were included in the study cohort. An anonymized database of age, gender, diabetic status, comorbidities, date of initiation of dialysis, hematological characters, biochemical variables, and status of survived or died was established from DICOM (Digital Imaging and Communications in Medicine) files of patients. Kaplan-Meier and Cox-proportional hazard model was used for calculation of survival over time at 95% confidence level. Results Overall, the 10-year survival rate was 27%. Kaplan-Meier analysis showed patient survival as 94% at one-year, 59% at 5-years, and 27% at 10-years. Hemoglobin, serum albumin, calcium, potassium, phosphorous, calcium-phosphorous-products, and hemodialysis frequency and the dose had a significant effect on survival. Cox regression proportional hazard model showed that patients with serum albumin level of >4 g/dL were better associated with survival. Patients who underwent twice-weekly hemodialysis had 4.26 times less chance of survival as compared to patients with thrice-weekly hemodialysis. A higher dialysis dose of >1.2 spKt/V offered better survival as compared to a lower dose of <1.2 spKt/V. Conclusions Hypoalbuminemia, hemodialysis time, and hemodialysis frequency were significantly associated with mortality.
Hepatoprotective effects of vitamin E against hexachlorobenzene-induced hepatotoxicity and oxidative stress in rats: histological, biochimical and antioxidant status changes

Abstract The protective effects of α-Tocopherol (vitamin E) on liver injury induced by hexachlorobenzene (HCB) were investigated in adult male rats of Wistar strain. Animals were randomly divided into six groups of eight rats each. Group 1 and 2 have received HCB, dissolved in olive oil, at a dose of 4 mg or 16 mg/kg b.w. , respectively. Group 3 and 4 were treated by the same doses of HCB (4 mg and 16 mg/kg b.w.) after 1 h of pretreatment with α-tocopherol at a dose of 100 mg kg−1 b.w. The other two groups served as controls; which received either olive oil only, a solvent of HCB, or α-tocopherol. A significant increase in hepatic lipid peroxidation (LPO) and GSH activity were observed following HCB administration. The activities of antioxidant enzymes like superoxide dismutase and catalase were significantly decreased while glutathione peroxidase was significantly increased following HCB administration. Similarly, a significant increase in plasma levels of various marker enzymes [aminotransferase (aspartate aminotransférase (AST) and alanine aminotransferase (ALT)), alkaline phosphatase (ALP) and lactate dehydrogenase (LDH)] and a decrease of total protein level were observed. Pretreatment with vitamin E of HCB treated rats ameliorated all biochemical parameters to near normal values. Liver histological study confirmed biochemical parameters and the beneficial role of vitamin E.
Comparison of RPR and ELISA with TPHA for the Diagnosis of Syphilis: Implication for Updating Syphilis Point-of-Care Tests in Ethiopia

Background Syphilis is a sexually transmitted disease (STD) caused by the spirochete Treponema pallidum, and it persists to be a major public health problem in Africa, including Ethiopia. Syphilis diagnosis is made by either nontreponemal or treponemal approaches, though in developing countries the diagnosis relies mostly on nonspecific tests due to several reasons. Thus, the objective of this study was to assess the sensitivity, specificity, predictive values, and agreement of rapid plasma reagin (RPR) and enzyme-linked immunosorbent assay (ELISA) with Treponema pallidum hemagglutination assay (TPHA) as a gold standard for the diagnosis of syphilis. Results The sensitivity, specificity, and positive and negative predictive values of ECOTEST-RPR were 100%, 80.8%, 76.2%, and 100%, respectively. However, the sensitivity, specificity, and positive and negative predictive values of DIALAB-ELISA were 98.4%, 94.9%, 92.3%, and 98.9%, respectively. The agreement between DIALAB-ELISA and Randox-TPHA was excellent (kappa value: 0.96) as compared to ECOTEST-RPR and Randox-TPHA assay (kappa value: 0.88). Conclusion We found a characteristically variable performance of DIALAB-ELISA test and the currently available traditional ECOTEST-RPR test in the study area. The use of ECOTEST-RPR as a diagnostic test is confronted by its false positivity. Thus, neither the ECOTEST-RPR nor the DIALAB-ELISA test stands on its own to be used either as screening or confirmatory test for syphilis diagnosis. Consequently, thorough studies should be conducted aiming on a change of the current diagnostic scheme in the community.
Differential requirements for conserved peptidoglycan remodeling enzymes during Clostridioides difficile spore formation

Spore formation is essential for the bacterial pathogen and obligate anaerobe, Clostridioides (Clostridium) difficile, to transmit disease. Completion of this process depends on the mother cell engulfing the developing forespore, but little is known about how engulfment occurs in C. difficile. In Bacillus subtilis, engulfment is mediated by a peptidoglycan degradation complex consisting of SpoIID, SpoIIP and SpoIIM, which are all individually required for spore formation. Using genetic analyses, we determined the functions of these engulfment‐related proteins along with the putative endopeptidase, SpoIIQ, during C. difficile sporulation. While SpoIID, SpoIIP and SpoIIQ were critical for engulfment, loss of SpoIIM minimally impacted C. difficile spore formation. Interestingly, a small percentage of ∆spoIID and ∆spoIIQ cells generated heat‐resistant spores through the actions of SpoIIQ and SpoIID, respectively. Loss of SpoIID and SpoIIQ also led to unique morphological phenotypes: asymmetric engulfment and forespore distortions, respectively. Catalytic mutant complementation analyses revealed that these phenotypes depend on the enzymatic activities of SpoIIP and SpoIID, respectively. Lastly, engulfment mutants mislocalized polymerized coat even though the basement layer coat proteins, SpoIVA and SipL, remained associated with the forespore. Collectively, these findings advance our understanding of several stages during infectious C. difficile spore assembly.
Usefulness of Serum Cardiac Biomarkers for Predicting In-Hospital Cardiac Complications in Acute Hip Fracture: A Prospective Cohort in 20 High Surgical Risk patients with Age over 55 Years

Background. Serum cardiac biomarkers have recently been demonstrated to be useful for predicting perioperative complication after hip fracture (HF). However, no previous study has revealed the comparative efficacy of different cardiac biomarkers in high surgical risk HF patients. Methods. A prospective study was conducted, from June to December 2016, in 20 acute HF patients with American Society of Anesthesiologists (ASA) grade 3 or 4. All patients received blood test for high sensitivity Troponin-I (hsTnI) and N-terminal fragment of pro-B-type natriuretic peptide (NT-proBNP) at the time of admission and 24 hours postoperatively. Perioperative data and in-hospital, 3-month, and 6-month postoperative complications were collected. The complications were classified as cardiac and noncardiac HF-related complications. Results. The average patients' age was 79±8 years. Six patients (30%) were male. The incidence of PCI was 30% (n=6). None of the patients (0%) died during the 6-month postoperative followup period. In-hospital overall cardiac and noncardiac complications were found in 12(60%), 5(30%), and 7(45%), respectively. The mean serum hsTnI levels in the patients with cardiac complication were significantly greater than those in the patients without cardiac complication at both time of admission (99.5 ng/mL vs 5.5 ng/mL, p=0.006) and 24 hours postoperatively (28.6 ng/mL vs 9.4 ng/mL, p=0.013). The mean serum NT-proBNP levels in patients with cardiac complication were also greater but nonsignificantly compared to those in the patients without cardiac complication at both time of admission (2299 pg/mL vs 281 pg/mL, p=0.239) and 24 hours postoperatively (2266 pg/mL vs 586 pg/mL, p=0.061). The other significant preoperative predictors for cardiac complication were low hemoglobin level (p=0.014), low glomerular filtration rate level (p=0.039), and ASA grade 4 (p=0.005). Conclusion. In-hospital cardiac complication in high-risk HF patients was significantly associated with the abnormal rise of serum hsTnI level. Therefore, we recommended using the hsTnI test in the perioperative evaluation in high-risk HF patients. Trial registration number is TCTR20160711002.
Insulinemia, heterogeneity of obesity and the risk of different types of endometrial cancer: existing evidence

ABSTRACT Due to a number of reasons, endometrial cancer is a point of interest not only for oncologists, but also for a variety of specialists – especially endocrinologists. The endocrinology of endometrial cancer can be firmly divided into two categories – steroid and non-steroid. The steroid approach dominated during several decades due to hyperestrogenization signs observed in some patients. The balance was only regained in the last 15 years, when the role of diabetes and insulin resistance began to draw attention. This review aims to provide an update on connections between insulinemia (insulin resistance) and different obesity phenotypes as well to discuss their relation to development of endometrial cancer, its clinical-morphological features and the increasing number of its molecular-biological subtypes.
Aiding information security decisions with human factors using quantitative and qualitative techniques

The Information Security Decision Making Process is comprised of an extremely complex and dynamic set of sub-tasks, sub-goals and inter-disciplinary practices. In order to be effective and appropriate, this process must balance both the requirements of the stakeholder as well as the users within the system. Without careful consideration of users’ behaviours and preferences, interventions are often seen as obstacles towards productivity and subsequently circumvented or simply not adhered to. The approach detailed herein requires an intimate knowledge of both Information Security and Human Behaviour. An effective security policy must adequately protect a given set of assets (human and non-human) or systems as well as preserve maximal productivity. Companies rely on their Intellectual Property Rights which are often stored in a digital format. This presents a plethora of issues regarding security, access management and locality (whether on or off the premises). Furthermore, there is the added complexity of employees and how they operate within this environment (a subset of compliance, competence and policy). With the continued increase in consumerisation, more specifically the rise of Bring Your Own Device, there is a significant threat towards data security that persists outside of the typical working environment. This trend enables employees to access and transfer corporate assets remotely but in doing so creates a conflict over identity, ownership and data management. The governance of these activities creates an extremely complex problem space which requires the need to balance these requirements relying on an accurate assessment of risk, identification of security vulnerabilities and knowledge pertaining to the behaviour of employees. The risks to company assets can be estimated by the analysis of the following issues: • Threats to your assets. These are unwanted events that could cause the deliberate or accidental loss, damage or misuse of the assets. • Vulnerabilities. How susceptible your assets are to attack. • Impact. The magnitude of the potential loss or the seriousness of the event. The ability to quantify and accurately represent these variables is critical in developing, implementing and supporting a successful security policy. A methodological based approach
County-level air quality and the prevalence of diagnosed chronic kidney disease in the US Medicare population

Background Considerable geographic variation exists in the prevalence of chronic kidney disease across the United States. While some of this variability can be explained by differences in patient-level risk factors, substantial variability still exists. We hypothesize this may be due to understudied environmental exposures such as air pollution. Methods Using data on 1.1 million persons from the 2010 5% Medicare sample and Environmental Protection Agency air-quality measures, we examined the association between county-level particulate matter ≤2.5 μm (PM2.5) and the prevalence of diagnosed CKD, based on claims. Modified Poisson regression was used to estimate associations (prevalence ratios [PR]) between county PM2.5 concentration and individual-level diagnosis of CKD, adjusting for age, sex, race/ethnicity, hypertension, diabetes, and urban/rural status. Results Prevalence of diagnosed CKD ranged from 0% to 60% by county (median = 16%). As a continuous variable, PM2.5 concentration shows adjusted PR of diagnosed CKD = 1.03 (95% CI: 1.02–1.05; p<0.001) for an increase of 4 μg/m3 in PM2.5. Investigation by quartiles shows an elevated prevalence of diagnosed CKD for mean PM2.5 levels ≥14 μg/m3 (highest quartile: PR = 1.05, 95% CI: 1.03–1.07), which is consistent with current ambient air quality standard of 12 μg/m3, but much lower than the level typically considered healthy for sensitive groups (~40 μg/m3). Conclusion A positive association was observed between county-level PM2.5 concentration and diagnosed CKD. The reliance on CKD diagnostic codes likely identified associations with the most severe CKD cases. These results can be strengthened by exploring laboratory-based diagnosis of CKD, individual measures of exposure to multiple pollutants, and more control of confounding.
Delayed diagnosis of tuberculosis: risk factors and effect on mortality among older adults in Hong Kong.

OBJECTIVE To assess the risk factors and effects of delayed diagnosis on tuberculosis (TB) mortality in Hong Kong. METHODS All consecutive patients with TB notified in 2010 were tracked through their clinical records for treatment outcome until 2012. All TB cases notified or confirmed after death were identified for a mortality survey on the timing and causes of death. RESULTS Of 5092 TB cases notified, 1061 (20.9%) died within 2 years of notification; 211 (4.1%) patients died before notification, 683 (13.4%) died within the first year, and 167 (3.3%) died within the second year after notification. Among the 211 cases with TB notified after death, only 30 were certified to have died from TB. However, 52 (24.6%) died from unspecified pneumonia/sepsis possibly related to pulmonary TB. If these cases are counted, the total TB-related deaths increases from 191 to 243. In 82 (33.7%) of these, TB was notified after death. Over 60% of cases in which TB diagnosed after death involved patients aged ≥80 years and a similar proportion had an advance care directive against resuscitation or investigation. Independent factors for TB notified after death included female sex, living in an old age home, drug abuse, malignancy other than lung cancer, sputum TB smear negative, sputum TB culture positive, and chest X-ray not done. CONCLUSIONS High mortality was observed among patients with TB aged ≥80 years. Increased vigilance is warranted to avoid delayed diagnosis and reduce the transmission risk, especially among elderly patients with co-morbidities living in old age homes.
Expression of Signaling Molecules Involved in Embryonic Development of the Insertion Site Is Inadequate for Reformation of the Native Enthesis: Evaluation in a Novel Murine ACL Reconstruction Model

Background: Since healing of anterior cruciate ligament (ACL) grafts occurs by formation of a fibrovascular scar-tissue interface rather than by reformation of the native fibrocartilage transition zone, the purpose of our study was to examine expression of various signaling molecules and transcription factors that are known to be involved in embryologic insertion-site development following ACL reconstruction. We also aimed to characterize a murine model of ACL reconstruction to allow future study of the molecular mechanisms of healing. Methods: Seventy-nine mice underwent reconstruction of the ACL with autograft. Healing was assessed using histology in 12 mice and quantitative real-time polymerase chain reaction (qRT-PCR) gene-expression analysis in 3 mice at 1 week postoperatively (Group-1 mice) and by biomechanical analysis in 7, histological analysis in 7, immunohistochemical analysis in 5, microcomputed tomography analysis in 5, and qRT-PCR analyses in 8 at 2 weeks (Group-2 mice) and 4 weeks (Group-3 mice) postoperatively. Fifteen additional mice did not undergo surgery and were used for biomechanical (7 mice), qRT-PCR (3 mice), and immunohistochemical (5 mice) analyses to obtain baseline data for the native ACL. Results: Histological analysis demonstrated healing by formation of fibrovascular tissue at the tendon-bone interface. Immunohistochemical analysis showed a positive expression of proteins in the Indian hedgehog, Wnt, and parathyroid hormone-related protein (PTHrP) pathways. There was minimal Sox-9 expression. Gene-expression analysis showed an initial increase in markers of tissue repair and turnover, followed by a subsequent decline. Mean failure force and stiffness of the native ACL were 5.60 N and 3.44 N/mm, respectively. Mean failure force and stiffness were 1.29 N and 2.28 N/mm, respectively, in Group 2 and were 1.79 N and 2.59 N/mm, respectively, in Group 3, with 12 of 14 failures in these study groups occurring by tunnel pull-out. Conclusions: The spatial and temporal pattern of expression of signaling molecules that direct embryologic insertion-site formation was not adequate to restore the structure and composition of the native insertion site. Clinical Relevance: Development of a murine model to study ACL reconstruction will allow the use of transgenic animals to investigate the cellular, molecular, and biomechanical aspects of tendon-to-bone healing following ACL reconstruction, ultimately suggesting methods to improve healing in patients.
Nanoscale anomalous noise source switching with a trap-free current transition in a PEDOT:PSS film

We imaged localized charge traps in a PEDOT:PSS film by using a scanning noise microscopy (SNM) system and observed anomalous noise source switching behaviors affecting the electrical characteristics of the film. The SNM system enabled us to measure the localized electrical current and noise maps of a PEDOT:PSS film with nanoscale resolution. The measured maps of the currents and noises were utilized to calculate effective charge trap densities in the film. As a result, we found non-homogeneous distributions of currents and effective charge trap densities on the localized area of the film due to the non-uniform distribution of PEDOT-rich and PSS-rich grains. At a low bias voltage, we observed high current levels and high charge trap densities in PEDOT-rich grains, while PSS-rich grains showed low-current levels and charge trap densities. Interestingly, the charge trap densities in both grains showed a noise source switching behavior with respect to the applied bias voltages, and the behavior strongly affected their electrical characteristic such as the trap-free transition of currents. These results indicate that the charge traps in a PEDOT:PSS film play an important role in the electrical characteristics of the films. Our observations provide a valuable insight on the understanding of the electrical characteristics of PEDOT:PSS films and an important guideline for its practical applications.
No Difference in Colorectal Cancer Incidence or Stage at Detection by Colonoscopy Among 3 Countries With Different Lynch Syndrome Surveillance Policies.

BACKGROUND & AIMS Patients with Lynch syndrome are at high risk for developing colorectal cancer (CRC). Regular colonoscopic surveillance is recommended, but there is no international consensus on the appropriate interval. We investigated whether shorter intervals are associated with lower CRC incidence and detection at earlier stages by comparing the surveillance policies in Germany, which evaluates patients by colonoscopy annually, in the Netherlands (patients evaluated at 1-2-year intervals), and Finland (patients evaluated at 2-3-year intervals). METHODS We collected data from 16,327 colonoscopic examinations (conducted from 1984 through 2015) of 2747 patients with Lynch syndrome (pathogenic variants in the MLH1, MSH2, or MSH6 genes) from the German HNPCC Consortium, the Dutch Lynch Syndrome Registry, and the Finnish Lynch Syndrome Registry. Our analysis included 23,309 person-years of cumulative observation time. Time from the index colonoscopy to incident CRC or adenoma was analyzed using the Kaplan-Meier method; groups were compared using the log-rank test. We performed multivariable Cox regression analyses to identify factors associated with CRC risk (diagnosis of CRC before the index colonoscopy, sex, mutation, age, and presence of adenoma at the index colonoscopy). RESULTS The 10-year cumulative CRC incidence ranged from 4.1% to 18.4% in patients with low- and high-risk profiles, respectively, and varied with age, sex, mutation, and prior detection of CRC or adenoma. Observed colonoscopy intervals were largely in accordance with the country-specific recommendations. We found no significant differences in cumulative CRC incidence or CRC stage at detection among countries. There was no significant association between CRC stage and time since last colonoscopy. CONCLUSIONS We did not find a significant reduction in CRC incidence or stage of detection in Germany (annual colonoscopic surveillance) than in countries with longer surveillance intervals (the Netherlands, with 1-2-year intervals, and Finland, with 2-3-year intervals). Overall, we did not find a significant association of the interval with CRC risk, although age, sex, mutation, and prior neoplasia were used to individually modify colonoscopy intervals. Studies are needed to develop and validate risk-adapted surveillance strategies and to identify patients who benefit from shorter surveillance intervals.