Miracle-dz/UniFAR-FTUs huggingface dataset:
Lack of Benefit and Potential Harm of Induction Therapy in Simultaneous Liver‐Kidney Transplants

The number of simultaneous liver‐kidney transplantations (SLKTs) and use of induction therapy for SLKT have increased recently, without much published evidence, especially in the context of maintenance immunosuppression containing tacrolimus (TAC) and mycophenolic acid (MPA). We queried the Organ Procurement and Transplant Network registry for SLKT recipients maintained on TAC/MPA at discharge in the United States for 2002–2016. The cohort was divided into 3 groups on the basis of induction type: rabbit antithymocyte globulin (r‐ATG; n = 831), interleukin 2 receptor antagonist (IL2RA; n = 1558), and no induction (n = 2333). Primary outcomes were posttransplant all‐cause mortality and acute rejection rates in kidney and liver allografts at 12 months. Survival rates were analyzed by the Kaplan‐Meier method. A propensity score analysis was used to control potential selection bias. Multivariate inverse probability weighted Cox proportional hazard and logistic regression models were used to estimate the hazard ratios (HRs) and odds ratios. Among SLKT recipients, survival estimates at 3 years were lower for recipients receiving r‐ATG (P = 0.05). Compared with no induction, the multivariate analyses showed an increased mortality risk with r‐ATG (HR, 1.29; 95% confidence interval [CI], 1.10‐1.52; P = 0.002) and no difference in acute liver or kidney rejection rates at 12 months across all induction categories. No difference in outcomes was noted with IL2RA induction over the no induction category. In conclusion, there appears to be no survival benefit nor reduction in rejection rates for SLKT recipients who receive induction therapy, and r‐ATG appears to increase mortality risk compared with no induction.
Conventional MRI to detect the differences between mass-like tuberculosis and lung cancer.

Background The aim of this study was to investigate differences in the imaging features of mass-like tuberculosis and lung cancer on conventional MR sequences to improve the diagnostic ability for pulmonary masses. Methods Thirty patients with suspicious pulmonary lesions were enrolled and diagnosed with tuberculosis by pathology or comprehensive clinical diagnoses. Twenty-six cases of lung cancer were retrospectively analyzed. Transverse fat-suppressed T2-weighted (T2W) imaging and T1-weighted (T1W) imaging were obtained at 1.5 Tesla. The imaging characteristics of lesions on the T2W and T1W images were compared between the two groups. The imaging features of enlarged mediastinal lymph nodes on T2W images were studied and compared. Results On T2W images, there was a higher percentage of lesions containing hypointensity in the tuberculosis group (GTB) than in the lung cancer group (GLC) (P=0.004). The incidence of lesions demonstrating heterogeneous intensity was significantly greater in the GTB than in the GLC (70.0% vs. 7.7%, P=0.001). Approximately 92.3% of the lung cancer cases showed hyperintensity, a proportion substantially greater than that in the GTB (6.7%). On T1W images, more cases showed hyperintensity in the GTB than in the GLC (43.3% vs. 7.7%, P=0.003). The signal intensity ratios (SIRs) of the lesion to rhomboid muscle on T2W and T1W images were significantly different between the two groups. The mean intrasubject standard deviation (SD) of lesions in the GTB was markedly greater than that in the GLC on both T2W and T1W images. Benign mediastinal lymph nodes in the GTB showed a variety of signals on T2W images, whereas 80% of metastatic mediastinal lymph nodes displayed slight homogeneous hyperintensity, and this difference between the two groups was statistically significant. Conclusions Conventional MR sequences can reveal the essential differences between mass-like tuberculosis and lung cancer and may be helpful for discriminating pulmonary masses.
Male Infertility Re : Dietary Patterns and Semen Quality in Young Men

Study Question: Are different dietary patterns associated with semen parameters in young men? Study Answer: The consumption of a Prudent dietary pattern was significantly associated with higher progressive sperm motility and unrelated to sperm concentration and morphology. The consumption of a Western dietary pattern was unrelated to conventional semen quality parameters. What is Known Already: Over the past decades there has been evidence of a concomitant decline in sperm and diet quality. Yet whether diet composition influences semen quality remains largely unexplored. Study Design, Size, Duration: The Rochester Young Men’s Study (n 188) was a cross-sectional study conducted between 2009 and 2010 at the University of Rochester. Participants, Setting, Methods: Men aged 18–22 years were included in this analysis. Diet was assessed via food frequency questionnaire and dietary patterns were identified by factor analysis. Linear regression was used to analyze the relation between diet patterns and conventional semen quality parameters (sperm concentration, progressive motility and morphology) adjusting for abstinence time, multivitamin use, race, smoking status, BMI, recruitment period, moderate-to-intense exercise and total calorie intake. Results: Two dietary patterns were identified by factor analysis. The ‘Western’ pattern was characterized by high intake of red and processed meat, refined grains, pizza, snacks, high-energy drinks and sweets. The ‘Prudent’ pattern was characterized by high intake of fish, chicken, fruit, vegetables, legumes and whole grains. The Prudent pattern was positively associated with percent progressively motile sperm in multivariate models (P-trend 0.04). Men in the highest quartile of the Prudent diet had 11.3% (95% CI 1.3, 21.3) higher % progressively motile sperm compared with men in the lowest quartile. The Prudent pattern was unrelated to sperm concentration and morphology. The Western pattern was not associated with any semen parameter. Limitations: This was a cross-sectional and observational study, which limited our ability to determine causality of diet on semen quality parameters. Wider Implications of the Findings: Our findings support the suggestion that a diet rich in fruits, vegetables, chicken, fish and whole grains may be an inexpensive and safe way to improve at least one measure of semen quality.
The effects of 5‐azacytidine and cadmium on global 5‐methylcytosine content and secondary metabolites in the freshwater microalgae Chlamydomonas reinhardtii and Scenedesmus quadricauda

Epigenetic changes are important mechanisms in the regulation of chromatin structure and gene expression. Cytosine methylation is one of the major epigenetic modifications, mediated by DNA methyltransferases, which transfer methyl groups from S‐adenosyl‐L‐methionine (SAM) to the fifth carbon of cytosine. Various external environmental conditions can change the global hypo/hypermethylation pattern of DNA. These alterations may affect the organism's response to stress conditions. In this study, for the first time, we investigated the effects of 5‐azacytidine, a DNA methyltransferase inhibitor, and cadmium, a toxic metal and environmental pollutant, on the growth, biosynthesis of secondary metabolites (phenols, flavonoids, carotenoids), SAM, S‐adenosylhomocysteine, 5′‐methylthioadenosine and global 5‐methylcytosine (5‐mC) in the green microalgae Chlamydomonas reinhardtii and Scenedesmus quadricauda. The studied species showed major differences in 5‐mC content, secondary metabolite content, and antioxidant activity. Cadmium increased GSH (glutathione) content in C. reinhardtii by 60% whereas 5‐azacytidine did not affect GSH. The biosynthesis of GSH in S. quadricauda in response to the stressors was the opposite. Global 5‐mC content of C. reinhardtii was 1%–1.5%, and the content in S. quadricauda was 3.5%. Amount of some investigated methionine cycle metabolites (SAM, S‐adenosyl homocysteine [SAH], methionine) in S. quadricauda distinctly exceeded C. reinhardtii as well. However, chlorophylls a and b, carotenoids, total phenolic content, total flavonoid content and, antioxidant activity were significantly higher in C. reinhardtii than S. quadricauda. Therefore, in further studies it would be advisable to verify whether methylation of cytosine affects the expression of genes encoding certain secondary metabolites.
Contact Geometry Affects Lesion Formation in Radio-Frequency Cardiac Catheter Ablation

One factor which may be important for determining proper lesion creation during atrial ablation is catheter-endocardial contact. Little information is available that relates geometric contact, depth and angle, to ablation lesion formation. We present an electrothermal computer model of ablation that calculated lesion volume and temperature development over time. The Pennes bioheat equation was coupled to a quasistatic electrical problem to investigate the effect of catheter penetration depth, as well as incident catheter angle as may occur in practice. Biological experiments were performed to verify the modelling of electrical phenomena. Results show that for deeply penetrating tips, acute catheter angles reduced the rate of temperature buildup, allowing larger lesions to form before temperatures elevated excessively. It was also found that greater penetration did not lead to greater transmurality of lesions. We conclude that catheter contact angle plays a significant role in lesion formation, and the time course must be considered. This is clinically relevant because proper identification and prediction of geometric contact variables could improve ablation efficacy.
A flexible and economical barcoding approach for highly multiplexed amplicon sequencing of diverse target genes

High throughput sequencing of phylogenetic and functional gene amplicons provides tremendous insight into the structure and functional potential of complex microbial communities. Here, we introduce a highly adaptable and economical PCR approach to barcoding and pooling libraries of numerous target genes. In this approach, we replace gene- and sequencing platform-specific fusion primers with general, interchangeable barcoding primers, enabling nearly limitless customized barcode-primer combinations. Compared to barcoding with long fusion primers, our multiple-target gene approach is more economical because it overall requires lower number of primers and is based on short primers with generally lower synthesis and purification costs. To highlight our approach, we pooled over 900 different small-subunit rRNA and functional gene amplicon libraries obtained from various environmental or host-associated microbial community samples into a single, paired-end Illumina MiSeq run. Although the amplicon regions ranged in size from approximately 290 to 720 bp, we found no significant systematic sequencing bias related to amplicon length or gene target. Our results indicate that this flexible multiplexing approach produces large, diverse, and high quality sets of amplicon sequence data for modern studies in microbial ecology.
Struck: Structured output tracking with kernels

Adaptive tracking-by-detection methods are widely used in computer vision for tracking arbitrary objects. Current approaches treat the tracking problem as a classification task and use online learning techniques to update the object model. However, for these updates to happen one needs to convert the estimated object position into a set of labelled training examples, and it is not clear how best to perform this intermediate step. Furthermore, the objective for the classifier (label prediction) is not explicitly coupled to the objective for the tracker (accurate estimation of object position). In this paper, we present a framework for adaptive visual object tracking based on structured output prediction. By explicitly allowing the output space to express the needs of the tracker, we are able to avoid the need for an intermediate classification step. Our method uses a kernelized structured output support vector machine (SVM), which is learned online to provide adaptive tracking. To allow for real-time application, we introduce a budgeting mechanism which prevents the unbounded growth in the number of support vectors which would otherwise occur during tracking. Experimentally, we show that our algorithm is able to outperform state-of-the-art trackers on various benchmark videos. Additionally, we show that we can easily incorporate additional features and kernels into our framework, which results in increased performance.
Early Caffeine Administration and Neurodevelopmental Outcomes in Preterm Infants

Preterm neonates who received caffeine (within 2 days of birth) had lower odds of sNDI at 18 to 24 months’ CA. BACKGROUND: Although caffeine use for apnea of prematurity is well studied, the long-term safety and benefit of routine early caffeine administration has not been explored. Our objective was to determine the association between early (within 2 days of birth) versus late caffeine exposure and neurodevelopmental outcomes in preterm infants. METHODS: Infants of <29 weeks’ gestation born between April 2009 and September 2011 and admitted to Canadian Neonatal Network units and then assessed at Canadian Neonatal Follow-up Network centers were studied. Neonates who received caffeine were divided into early- (received within 2 days of birth) and late-caffeine (received after 2 days of birth) groups. The primary outcome was significant neurodevelopmental impairment, defined as cerebral palsy, or a Bayley Scales of Infant and Toddler Development, Third Edition composite score of <70 on any component, hearing aid or cochlear implant, or bilateral visual impairment at 18 to 24 months’ corrected age. RESULTS: Of 2108 neonates who were eligible, 1545 were in the early-caffeine group and 563 were in the late-caffeine group. Rates of bronchopulmonary dysplasia, patent ductus arteriosus, and severe neurologic injury were lower in the early-caffeine group than in the late-caffeine group. Significant neurodevelopmental impairment (adjusted odds ratio 0.68 [95% confidence interval 0.50–0.94]) and odds of Bayley Scales of Infant and Toddler Development, Third Edition cognitive scores of <85 (adjusted odds ratio 0.67 [95% confidence interval 0.47–0.95]) were lower in the early-caffeine group than in the late-caffeine group. Propensity score–based matched-pair analyses revealed lower odds of cerebral palsy and hearing impairment only. CONCLUSIONS: Early caffeine therapy is associated with better neurodevelopmental outcomes compared with late caffeine therapy in preterm infants born at <29 weeks’ gestation.
Metabolic Syndrome and Insulin Resistance Syndrome among Infertile Women with Polycystic Ovary Syndrome: A Cross-Sectional Study from Central Vietnam

Background Polycystic ovarian syndrome (PCOS) is one of the most common endocrinopathies among reproductive-age women. Its metabolic features often overlap with those associated with metabolic syndrome (MS) and insulin resistance syndrome (IRS). The objective of this study was to determine the prevalence and predictors of MS and IRS in infertile Vietnamese women with PCOS. Methods A cross-sectional study was conducted at a tertiary fertility centre at Hue University Hospital from June 2016 to November 2017. A total of 441 infertile women diagnosed with PCOS based on the revised 2003 Rotterdam consensus criteria were enrolled. MS and IRS were defined based on the National Heart, Lung, and Blood Institute/American Heart Association Adult Treatment Panel III 2005 and American College of Endocrinology IRS 2003 criteria, respectively. Complete clinical and biochemical measurements of 318 women were available for analysis. Independent predictors of MS and IRS were identified using multivariate logistic regression. Results The overall prevalence of MS and IRS in women with PCOS was 10.4% and 27.0%, respectively. We identified older age (>30 years) and obesity as independent predictors of MS and IRS. Elevated anti-Müllerian hormone levels increased the risk of IRS, but not that of MS. Conclusion MS and IRS are prevalent disorders among infertile Vietnamese women with PCOS. PCOS is not solely a reproductive problem. Screening and early intervention for MS and/or IRS based on anthropometric, metabolic, and reproductive hormone risk factors should be an integral part of fertility care.
Phospho-AXL is widely expressed in glioblastoma and associated with significant shorter overall survival

Receptor tyrosine kinase AXL (RTK-AXL) is regarded as a suitable target in glioblastoma (GBM) therapy. Since AXL kinase inhibitors are about to get approval for clinical use, patients with a potential benefit from therapy targeting AXL need to be identified. We therefore assessed the expression pattern of Phospho-AXL (P-AXL), the biologically active form of AXL, in 90 patients with newly diagnosed GBM, which was found to be detectable in 67 patients (corresponding to 74%). We identified three main P-AXL expression patterns: i) exclusively in the tumor vasculature (13%), ii) in areas of hypercellularity (35%), or iii) both, in the tumor vasculature and in hypercellular areas of the tumor tissue (52%). Pattern iii) is associated with significant decrease in overall survival (Hazard ratio 2.349, 95% confidence interval 1.069 to 5.162, *p=0.03). Our data suggest that P-AXL may serve as a therapeutic target in the majority of GBM patients.
A pilot study investigating circulating trimethylamine N‐oxide and its precursors in dogs with degenerative mitral valve disease with or without congestive heart failure

Background Pathophysiologic mechanisms for the development and progression of degenerative mitral valve disease (DMVD) remain elusive. Increased concentrations of circulating trimethylamine N‐oxide (TMAO) and its precursors choline and l‐carnitine are associated with the presence and severity of heart disease in people. Objectives To determine if differences exist in plasma concentrations of TMAO, choline, or l‐carnitine among dogs with DMVD and congestive heart failure (CHF), dogs with asymptomatic DMVD, and healthy control dogs. Animals Thirty client‐owned dogs: 10 dogs with CHF secondary to DMVD, 10 dogs with asymptomatic DMVD, and 10 healthy control dogs. Methods A pilot cross‐sectional study in which echocardiography was performed and fasting plasma concentrations of TMAO, choline, and l‐carnitine (total and fractions) were measured. Results TMAO (P = .03), total l‐carnitine (P = .03), carnitine esters (P = .05), and carnitine esters to free carnitine ratio (E/F ratio; P = .05) were significantly higher in dogs with CHF compared to those with asymptomatic DMVD. TMAO (P = .02), choline (P = .01), total l‐carnitine (P = .01), carnitine esters (P = .02), free carnitine (P = .02), and E/F ratio (P = .009) were significantly higher in dogs with CHF compared to healthy controls. Conclusions and Clinical Importance Dogs with CHF secondary to DMVD had higher concentrations of TMAO compared to both asymptomatic DMVD dogs and healthy controls. Larger prospective studies are warranted to determine if TMAO plays a role in the development or progression of DMVD or CHF.
Perampanel in patients with brain tumor-related epilepsy in real-life clinical practice: a retrospective analysis

Abstract Introduction: Epilepsy occurs in 35–70% of patients with gliomas; glutamate plays a central role via AMPA-receptor activation, which is involved both in seizure activity and tumor growth. We conducted a retrospective study on brain tumor-related epilepsy patients (BTRE) treated with perampanel in add-on (PER) for 12 months, to evaluate efficacy and tollerability, according to real-life clinical practice. Materials and methods: Medical records of eleven patients (9 males, mean age 54 years) with glioma and epilepsy treated with PER in add-on, for inadequate seizure control or adverse events (AEs) from previous antiepileptic drugs (AEDs) therapy, were reviewed. Data collected included: tumor history, molecular factors, systemic therapy, type and number of seizures and concomitant AEDs, and AEs. Results: After 12 months of PER therapy, five patients were seizure-free, 4 had a seizure reduction ≥50% and the seizure frequency was unchanged in 2 patients. Responder rate was 81.8%. Two patients reported AEs; PER dose was reduced only in the one case. The final median dose of PER was 7.3 mg/day. We didn’t find statistically significant differences in the comparison between mean values pre, mean values post and the average of decreasing number of seizures related to: histology, presence/absence of chemotherapy, radiotherapy, progression disease, KPS, IDH1, MGMT. Discussion: Despite the limitations due to small number of patients in a retrospective study, the high rate of responder and seizure-free patients suggest that PER could be a therapeutic option in BTRE. Prospective controlled studies are needed to confirm our data.
Daclatasvir plus sofosbuvir for HCV infection.

To the Editor: With regard to the article by Sulkowski et al. (Jan. 16 issue)1: a sustained virologic response that is defined as undetectable hepatitis C virus (HCV) RNA 24 weeks after the end of interferon-based therapy corresponds to a definitive cure of HCV in 99.1% of cases.2 A sustained virologic response that is defined as undetectable HCV RNA 12 weeks after treatment has a concordance of 99.0% with a sustained virologic response 24 weeks after treatment and hence is clinically equally relevant.3 It is well known that after a sustained virologic response, residual HCV RNA persists in mononuclear cells, lymphocytes, and macrophages.4,5 The definitions of a sustained virologic response at 12 weeks and at 24 weeks after treatment have been tested only in interferonbased regimens that are associated with longterm immunomodulation in treated patients, so that once suppressed, the virus remains so in the years to come, even without the drug. Data are lacking on the long-term relevance of these end points in patients who received interferonfree regimens that inhibit the virus by interfering with its life cycle without altering the immune responses (which could be helpful once the patient is no longer receiving the drugs). Similarly, the concept of a sustained virologic response is not applicable in patients with hepatitis B virus (HBV) and human immunodeficiency virus (HIV) infection, to whom oral drugs (that only inhibit viral replication) are administered on a long-term and usually lifelong basis.
A moment-free nonparametric quantity-of-quality approach to optimal portfolio selection: A role for endogenous shortfall and windfall boundaries?

Abstract This article proposes a Quantity-of-Quality (QoQ) approach to optimal portfolio selection, which builds on the intuition of the widely applied h-index and e-index from the bibliometric literature. While moment-free and nonparametric, the method embraces quantity-of-high-quality returns and upside potential while simultaneously avoiding quantity-of-low-quality returns and downside risk. A non-standard measure of central tendency is also present, which functions in a way similar to a portfolio mean or median. The method delivers attractive and intuitively appealing results, and appears to be less susceptible to overfitting issues than the stylized Sharpe Ratio portfolio. The method is demonstrated with an established data set, and out-of-sample performance is gauged using training-holdout analysis in two distinct data sets. Because the proposed method uses a fundamentally different portfolio selection objective function than standard moment-based methods, the QoQ approach extracts information about the data-generating process that is perhaps overlooked or deemphasized by traditional moment-based methods, and as such may serve as a capable complement to standard moment-based portfolio selection criteria.