Miracle-dz/UniFAR-FTUs huggingface dataset:
Multidiscipline Stroke Post-Acute Care Transfer System: Propensity-Score-Based Comparison of Functional Status

Few studies have investigated the characteristics of stroke inpatients after post-acute care (PAC) rehabilitation, and few studies have applied propensity score matching (PSM) in a natural experimental design to examine the longitudinal impacts of a medical referral system on functional status. This study coupled a natural experimental design with PSM to assess the impact of a medical referral system in stroke patients and to examine the longitudinal effects of the system on functional status. The intervention was a hospital-based, function oriented, 12-week to 1-year rehabilitative PAC intervention for patients with cerebrovascular diseases. The average duration of PAC in the intra-hospital transfer group (31.52 days) was significantly shorter than that in the inter-hospital transfer group (37.1 days) (p < 0.001). The intra-hospital transfer group also had better functional outcomes. The training effect was larger in patients with moderate disability (Modified Rankin Scale, MRS = 3) and moderately severe disability (MRS = 4) compared to patients with slight disability (MRS = 2). Intensive post-stroke rehabilitative care delivered by per-diem payment is effective in terms of improving functional status. To construct a vertically integrated medical system, strengthening the qualified local hospitals with PAC wards, accelerating the inter-hospital transfer, and offering sufficient intensive rehabilitative PAC days are the most essential requirements.
Running Time Analysis of MOEA/D on Pseudo-Boolean Functions

Decomposition-based multiobjective evolutionary algorithms (MOEAs) are a class of popular methods for solving the multiobjective optimization problems (MOPs), and have been widely studied in numerical experiments and successfully applied in practice. However, we know little about these algorithms from the theoretical aspect. In this paper, we present running time analysis of a simple MOEA with mutation and crossover based on the MOEA/D framework (MOEA/D-C) on five pseudo-Boolean functions. Our rigorous theoretical analysis shows that by properly setting the number of subproblems, the upper bounds of expected running time of MOEA/D-C obtaining a set of solutions to cover the Pareto fronts (PFs) of these problems are apparently lower than those of the one with mutation-only (MOEA/D-M). Moreover, to effectively obtain a set of solutions to cover the PFs of these problem, MOEA/D-C only needs to decompose these MOPs into several subproblems with a set of simple weight vectors while MOEA/D-M needs to find $\Omega (n)$ optimally decomposed weight vectors. This result suggests that the use of crossover in decomposition-based MOEA can simplify the setting of weight vectors for different problems and make the algorithm more efficient. This paper provides some insights into the working principles of MOEA/D and explains why some existing decomposition-based MOEAs work well in computational experiments.
Towards Real World HDRTV Reconstruction: A Data Synthesis-based Approach

Existing deep learning based HDRTV reconstruction methods assume one kind of tone mapping operators (TMOs) as the degradation procedure to synthesize SDRTV-HDRTV pairs for supervised training. In this paper, we argue that, although traditional TMOs exploit efficient dynamic range compression priors, they have several drawbacks on modeling the realistic degradation: information over-preservation, color bias and possible artifacts, making the trained reconstruction networks hard to generalize well to real-world cases. To solve this problem, we propose a learning-based data synthesis approach to learn the properties of real-world SDRTVs by integrating several tone mapping priors into both network structures and loss functions. In specific, we design a conditioned two-stream network with prior tone mapping results as a guidance to synthesize SDRTVs by both global and local transformations. To train the data synthesis network, we form a novel self-supervised content loss to constraint different aspects of the synthesized SDRTVs at regions with different brightness distributions and an adversarial loss to emphasize the details to be more realistic. To validate the effectiveness of our approach, we synthesize SDRTV-HDRTV pairs with our method and use them to train several HDRTV reconstruction networks. Then we collect two inference datasets containing both labeled and unlabeled real-world SDRTVs, respectively. Experimental results demonstrate that, the networks trained with our synthesized data generalize significantly better to these two real-world datasets than existing solutions.
Ulcer‐free survival days and ulcer healing in patients with diabetic foot ulcers: A prospective cohort study

Healing rates may not give a complete indication of the effectiveness and management of diabetic foot ulcers because of high recurrence rates. The most important outcome for patients is remaining ulcer‐free; however, this has hardly been investigated. The aim of our study was to prospectively investigate ulcer‐free survival days and ulcer healing in patients with diabetic foot ulcers. This was a prospective cohort study of all referrals to our diabetic foot expertise centre from December 2014 to April 2017. Outcomes were determined after a minimum follow‐up period of 12 months. Primary outcomes were ulcer‐free survival days and 12‐month healing percentages. Predictors for ulcer‐free survival days and healing were investigated in multivariate analyses. A total of 158 patients were included. Median ulcer‐free survival days in the healed group were 233 days (interquartile range [IQR] 121‐312) and 131 days (IQR 0–298) in the overall population. The healing rate at 12‐month follow up was 67% (106/158), and the recurrence rate was 31% (33/106). Independent predictors of ulcer‐free survival days were duration of diabetes, peripheral artery disease (PAD), cardiovascular disease, end‐stage renal disease (ESRD), and infection. Ulcer‐free survival days are related to PAD and cardiovascular disease, and ulcer‐free survival days should be the main outcome when comparing the effectiveness of management and prevention of the diabetic foot ulcers.
The Effect of Varying Test Administration and Scoring Procedures on Three Tests of (Central) Auditory Processing Disorder

Abstract Background: There is currently no widely accepted objective method used to identify (central) auditory processing disorder ([C]APD). Audiologists often rely on behavioral test methods to diagnose (C)APD, which can be highly subjective. This is problematic in light of relevant literature that has reported a lack of adequate graduate-level preparation related to (C)APD. This is further complicated when exacerbated by the use of inconsistent test procedures from those used to standardize tests of (C)APD, resulting in higher test variability. The consequences of modifying test administration and scoring methods for tests of (C)APD are not currently documented in the literature. Purpose: This study aims to examine the effect of varying test administration and scoring procedures from those used to standardize tests of (C)APD on test outcome. Research Design: This study used a repeated-measures design in which all participants were evaluated in all test conditions. The effects of varying the number of test items administered and the use of repetitions of missed test items on the test outcome score were assessed for the frequency patterns test (FPT), competing sentences test (CST), and the low-pass filtered speech test (LPFST). For the CST only, two scoring methods were used (a strict and a lax criterion) to determine whether or not scoring method affected test outcome. Study Sample: Thirty-three native English-speaking adults served as participants. All participants had normal hearing (as defined by thresholds of 25-dB HL or better) at all octave band frequencies from 500 to 4000 Hz, with thresholds of 55-dB HL or better at 8000 Hz. All participants had normal cognitive function as assessed by the Mini-Mental State Examination. Data Collection and Analysis: Paired samples t-tests were used to evaluate the differences in test outcome when varying the CST scoring method. A 3 × 2 × 2 repeated-measures factorial analysis of variance (ANOVA) was used to determine the effects of test, length, and repetitions on outcome score for all three tests of auditory processing ability. Individual 2 × 2 repeated-measures two-way ANOVAs were subsequently conducted for each test to further evaluate interactions. Results: There was no effect of scoring method on the CST outcome. There was a significant main effect of repetition use for the FPT and LPFST, in that test scores were greater when corrected for repetitions. An interaction between test length and repetitions was found for the LPFST only, such that there was a greater effect of repetition use when a shorter test was administered compared with a longer test. Conclusions: Test outcome may be affected when test administration procedures are varied from those used to standardize the test, lending itself to the broader possibility that the overall diagnosis of (C)APD may be subsequently affected.
Dielectric and Thermal Conductivity of Epoxy Resin Impregnated Nano-h-BN Modified Insulating Paper

Epoxy resin-impregnated insulation paper (RIP) composites are used as the inner insulation of dry condenser bushing in the ultra-high voltage direct current (UHVDC) power transmission system. To improve the dielectric properties and heat conductivity of RIP, hexagonal boron nitride (h-BN) nano-flakes are added to the insulation paper at concentrations of 0–50 wt % before impregnation with pure epoxy resin. X-ray diffraction (XRD), scanning electron microscopy (SEM) observations, thermal conductivity as well as the typical dielectric properties of direct current (DC) volume conductivity. DC breakdown strength and space charge characteristics were obtained. The maximum of nano-h-BN modified heat conductivity reach 0.478 W/(m·K), increased by 139% compared with unmodified RIP. The DC breakdown electric field strength of the nano-h-BN modified RIP does not reduce much. The conductivity of nano-h-BN modified is less sensitive to temperature. As well, the space charge is suppressed when the content is 50 wt %. Therefore, the nano-h-BN modified RIP is potentially useful in practical dry DC bushing application.
Population Pharmacokinetics of Ganciclovir in Critically Ill Patients.

BACKGROUND The pharmacokinetic (PK) data of ganciclovir (GCV), a first-line antiviral treatment for cytomegalovirus infections, in critically ill patients is limited. This study aimed at characterizing GCV population PK and inter-individual variability (IIV) in ICU patients. Secondary objectives were to identify patient characteristics responsible for IIV and simulate GCV exposure for different dosing regimens. METHOD In this retrospective observational study, clinical data and serum GCV levels were collected from ICU patients on intravenous GCV. PK modeling, covariate analyses, and explorative Monte Carlo dosing simulations (MCS) were performed using nonlinear mixed-effects modeling. Bootstrap and visual predictive checks were used to determine model adequacy. RESULTS In total, 128 GCV measurements were obtained from 34 patients. GCV PK conformed to a one-compartment model with first-order elimination. After multivariate analyses, only the estimated glomerular filtration rate calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD- EPI) formula (p<0.001) was included as a covariate. In the final model, the estimated clearance (CL) and volume of distribution (V1) were 2.3 L/h and 42 L, respectively, for a patient with the median CKD-EPI of the population (65 ml/min per 1.73 m). The association between CKD-EPI and CL decreased the residual variability from 0.56 to 0.43 and V1-IIV from 114% to 80%, while CL-IIV changed from 43% to 47%. MCS revealed that a substantial number of patients may not achieve the GCV PK/pharmacodynamic target trough level(>1.5 mg/L) when administering the label-recommended dose reductions for patients with CKD-EPI <50 mL/min. CONCLUSION A large IIV was observed in GCV PK among ICU patients. CKD-EPI could partially explain the IIV, though a large part of the variability remains unclear. MCS suggested that recommended dose reductions for CKD-EPI <50 mL/min may lead to subtherapeutic plasma GCV levels in these patients.
0.5 - 1 Fold Intervertebral Distraction is a Protective Factor for Adjacent Segment Degeneration in Single-Level Anterior Cervical Discectomy and Fusion.

STUDY DESIGN Retrospective analysis. OBJECTIVE This study aimed to compare the clinical and radiological outcomes of different degrees of distraction in anterior cervical discectomy and fusion (ACDF) and evaluate the risk factors for adjacent segment degeneration (ASD). SUMMARY OF BACKGROUND DATA ASD is a common complication following ACDF. Inadequate distraction of the intervertebral space during surgery is associated with ASD, however, there is still an ongoing debate regarding what degree of distraction is appropriate. METHODS This retrospective study enrolled 130 patients who underwent single-level ACDF for cervical degenerative disc disease and were followed up at least 2 years. The patients were divided into the following three groups according to the degree of distraction (≤0.5, 0.5-1, ≥1): insufficient distraction group (ID group), appropriate distraction group (AD group) and excessive distraction group (ED group). The clinical outcomes and radiological parameters were evaluated before and after operation and at the last follow-up. Risk factors for ASD were identified through logistic regression analysis. RESULTS A significant difference was found in the Visual Analog Scale values between the AD group and ED group at the final follow-up. Moreover, the highest upper segmental disc height, highest lower segmental disc height and lowest incidence of ASD were found in the AD group among the three groups at last follow up. Logistic regression analysis revealed that segmental kyphosis (odds ratio = 2.821, P = 0.020) was a risk factor for the occurrence of ASD and 0.5 - 1 fold distraction (odds ratio = 0.350, P = 0.025) was a protective factor. CONCLUSIONS Good clinical and radiological outcomes were achieved in ACDF with 0.5 - 1 fold distraction. Segmental kyphosis is a risk factor for ASD in ACDF, while 0.5 - 1 fold distraction is a protective factor of ASD. LEVEL OF EVIDENCE 4.
Blockade of EGFR Activation Promotes TNF-Induced Lung Epithelial Cell Apoptosis and Pulmonary Injury

Pneumonitis is the leading cause of death associated with the use of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (EGFR-TKIs) against non-small cell lung cancer (NSCLC). However, the risk factors and the mechanism underlying this toxicity have not been elucidated. Tumor necrosis factor (TNF) has been reported to transactivate EGFR in pulmonary epithelial cells. Hence, we aimed to test the hypothesis that EGFR tyrosine kinase activity regulates TNF-mediated bronchial epithelial cell survival, and that inhibition of EGFR activity increases TNF-induced lung epithelial cell apoptosis. We used surfactant protein C (SPC)-TNF transgenic (tg) mice which overexpress TNF in the lungs. In this model, gefitinib, an EGFR-TKI, enhanced lung epithelial cell apoptosis and lymphocytic inflammation, indicating that EGFR tyrosine kinase prevents TNF-induced lung injury. Furthermore, IL-17A was significantly upregulated by gefitinib in SPC-TNF tg mice and p38MAPK activation was observed, indicative of a pathway involved in lung epithelial cell apoptosis. Moreover, in lung epithelial cells, BEAS-2B, TNF stimulated EGFR transactivation via the TNF-α-converting enzyme in a manner that requires heparin binding (HB)-EGF and transforming growth factor (TGF)-α. These novel findings have significant implications in understanding the role of EGFR in maintaining human bronchial epithelial cell homeostasis and in NSCLC treatment.
Fluoxetine and Fractures After Stroke.

Background and Purpose- The FOCUS trial (Fluoxetine or Control Under Supervision) showed that fluoxetine did not improve modified Rankin Scale scores (mRS) but increased the risk of fractures. We aimed to describe the fractures, their impact on mRS and factors associated with fracture risk. Methods- A United Kingdom, multicenter, parallel-group, randomized, placebo-controlled trial. Patients ≥18 years with a clinical stroke and persisting deficit assessed 2 to 15 days after onset were eligible. Consenting patients were allocated fluoxetine 20 mg or matching placebo for 6 months. The primary outcome was the mRS at 6 months and secondary outcomes included fractures. Results- Sixty-five of 3127 (2.1%) patients had 67 fractures within 6 months of randomization; 43 assigned fluoxetine and 22 placebo. Fifty-nine (90.8%) had fallen and 26 (40%) had fractured their neck of femur. The effect of fluoxetine on mRS (common odds ratio =0.951) was not significantly altered by excluding fracture patients (common odds ratio =0.961). Cox proportional hazards modeling showed that only age >70 year (hazard ratio =1.97; 95% CI, 1.13-3.45; P=0.017), female sex (hazard ratio =2.13; 95% CI, 1.29-3.51; P=0.003), and fluoxetine (hazard ratio =2.00; 95% CI, 1.20-3.34; P=0.008) were independently associated with fractures. Conclusions- Most fractures resulted from falls. Although many fractures were serious, and likely to impair patients' function, the increased fracture risk did not explain the lack of observed effect of fluoxetine on mRS. Only increasing age, female sex, and fluoxetine were independent predictors of fractures. Clinical Trial Registration- URL: http://www.controlled-trials.com. Unique identifier: ISRCTN83290762.
Ankyrin-G induces nucleoporin Nup358 to associate with the axon initial segment of neurons

ABSTRACT Nup358 (also known as RanBP2) is a member of the large nucleoporin family that constitutes the nuclear pore complex. Depending on the cell type and the physiological state, Nup358 interacts with specific partner proteins and influences distinct mechanisms independent of its role in nucleocytoplasmic transport. Here, we provide evidence that Nup358 associates selectively with the axon initial segment (AIS) of mature neurons, mediated by the AIS scaffold protein ankyrin-G (AnkG, also known as Ank3). The N-terminus of Nup358 is demonstrated to be sufficient for its localization at the AIS. Further, we show that Nup358 is expressed as two isoforms, one full-length and another shorter form of Nup358. These isoforms differ in their subcellular distribution in neurons and expression level during neuronal development. Overall, the present study highlights an unprecedented localization of Nup358 within the AIS and suggests its involvement in neuronal function. This article has an associated First Person interview with the first author of the paper. Highlighted Article: In cultured neurons, Nup358 is present at the nuclear rim associated with nuclear pore complex proteins, as well in the cytoplasm and the axon initial segment (AIS), dependent on the AIS scaffold Ankyrin-G.
Increased Vascular Pathology in Older Veterans With a Purple Heart Commendation or Chronic Post-Traumatic Stress Disorder

The goal of this retrospective cohort study was to determine whether stressors related to military service, determined by a diagnosis of chronic post-traumatic stress disorder (cPTSD) or receiving a Purple Heart (PH), are associated with an increased risk of vascular risk factors and disease, which are of great concern for veterans, who constitute a significant portion of the aging US population. The Veterans Integrated Service Network (VISN) 16 administrative database was searched for individuals 65 years or older between October 1, 1997 to September 30, 1999 who either received a PH but did not have cPTSD (PH+/cPTSD−; n = 1499), had cPTSD without a PH (PH−/cPTSD+; n = 3593), had neither (PH−/cPTSD−; n = 5010), or had both (PH+/cPTSD+; n = 153). In comparison to the control group (PH−/cPTSD−), the PH+/cPTSD− group had increased odds ratios for incidence and prevalence of diabetes mellitus, hypertension, and hyperlipidemia. The PH−/cPTSD+ group had increased odds ratios for prevalence of diabetes mellitus and for the incidence and prevalence of hyperlipidemia. The PH−/cPTSD+ and PH+/cPTSD− groups were associated with ischemic heart disease and cerebrovascular disease, but not independently of the other risk factors. The PH+/cPTSD+ group was associated only with an increase in the incidence and prevalence of hyperlipidemia, though this group’s much smaller sample size may limit the reliability of this finding. We conclude that certain physical and psychological stressors related to military service are associated with a greater incidence of several vascular risk factors in veterans aged 65 years or older, which in turn are associated with greater rates of ischemic heart disease and cerebrovascular disease.
Effects of Lactobacillus plantarum and Lactobacillus paracasei on the Peripheral Immune Response in Children with Celiac Disease Autoimmunity: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial

Two Lactobacillus strains have proven anti-inflammatory properties by reducing pro-inflammatory responses to antigens. This randomized double-blind placebo-controlled trial tested the hypothesis that L. plantarum HEAL9 and L. paracasei 8700:2 suppress ongoing celiac disease autoimmunity in genetically at risk children on a gluten-containing diet in a longitudinally screening study for celiac disease. Seventy-eight children with celiac disease autoimmunity participated of whom 40 received 1010 CFU/day of L. plantarum HEAL9 and L. paracasei 8700:2 (probiotic group) and 38 children maltodextrin (placebo group) for six months. Blood samples were drawn at zero, three and six months and phenotyping of peripheral blood lymphocytes and IgA and IgG autoantibodies against tissue transglutaminase (tTG) were measured. In the placebo group, naïve CD45RA+ Th cells decreased (p = 0.002) whereas effector and memory CD45RO+ Th cells increased (p = 0.003). In contrast, populations of cells expressing CD4+CD25highCD45RO+CCR4+ increased in the placebo group (p = 0.001). Changes between the groups were observed for NK cells (p = 0.038) and NKT cells (p = 0.008). Median levels of IgA-tTG decreased more significantly over time in the probiotic (p = 0.013) than in the placebo (p = 0.043) group whereas the opposite was true for IgG-tTG (p = 0.062 respective p = 0.008). In conclusion, daily oral administration of L. plantarum HEAL9 and L. paracasei 8700:2 modulate the peripheral immune response in children with celiac disease autoimmunity.