Miracle-dz/UniFAR-FTUs huggingface dataset:
Effects of Secondhand Smoke Exposure and Noise Exposure on Tinnitus Occurrence in College Students and Adolescents

Abstract Background Recent research indicated that young adults and adolescents reported tinnitus in higher numbers than previously. Thus, it is important to fully investigate risk factors for tinnitus in adolescents and young adults. Purpose The current study examined the influence of two environmental risk factors, secondhand smoke (SHS) exposure and noise exposure on tinnitus occurrence as self-reported by U.S. adolescents and young adults. Research Design A nonexperimental, cross-sectional design was used for this survey study. Study Sample Of 265 surveys received, 43 were excluded due to ineligibility. The remaining 222 surveys constituted the study sample. Participant respondents included 80 high school students (ages 14–17) and 142 college students (ages 18–30). The sample was primarily female (n = 160). Data Collection and Analysis Three (3) yes/no survey questions regarding SHS exposure, noise exposure, and tinnitus occurrence were analyzed. Statistical analyses included logistic regression, chi-square follow-up tests, and Pearson bivariate correlation analysis. Results Results revealed that 40% of young adults and adolescents surveyed reported that they experienced tinnitus. Regression analysis revealed significant main effects for noise (p = 0.004), gender (p = 0.017), and the interaction of SHS and noise (p = 0.001). There was no main effect of SHS exposure nor age on tinnitus occurrence. Follow-up chi-square analysis conducted to probe the gender effect revealed that females (45.1%) were more likely to experience tinnitus than males (27.7%). Chi-square testing to examine the significant interaction effect revealed statistical significance (p = 0.001) for individuals with reported noise exposure but not for individuals without noise exposure. In the noise-exposed group, individuals who also reported SHS exposure had a lower occurrence of tinnitus (23.6%). In contrast, the noise-exposed individuals without SHS exposure had a higher prevalence of tinnitus (57.9%). An additional chi-square follow-up analysis to examine the main effect of noise revealed no significance (p = 0.199). However, there was a significant (p < 0.01) negative correlation (r = -0.244) of noise exposure with age. Conclusion The current study results suggest there is a higher than expected report of tinnitus incidence in adolescents and young adults. The relationship between tinnitus occurrence and a combined exposure to noise and secondhand smoke revealed a unique effect in adolescents and young adults.
Esophageal Motor Dysfunctions in Gastroesophageal Reflux Disease and Therapeutic Perspectives

Gastroesophageal reflux disease (GERD) is a very common disease, and the prevalence in the general population has recently increased. GERD is a chronic relapsing disease associated with motility disorders of the upper gastrointestinal tract. Several factors are implicated in GERD, including hypotensive lower esophageal sphincter, frequent transient lower esophageal sphincter relaxation, esophageal hypersensitivity, reduced resistance of the esophageal mucosa against the refluxed contents, ineffective esophageal motility, abnormal bolus transport, deficits initiating secondary peristalsis, abnormal response to multiple rapid swallowing, and hiatal hernia. One or more of these mechanisms result in the reflux of stomach contents into the esophagus, delayed clearance of the refluxate, and the development of symptoms and/or complications. New techniques, such as 24-hour pH and multichannel intraluminal impedance monitoring, multichannel intraluminal impedance and esophageal manometry, high-resolution manometry, 3-dimensional high-resolution manometry, enoscopic functional luminal imaging probe, and 24-hour dynamic esophageal manometry, provide more information on esophageal motility and have clarified the pathophysiology of GERD. Proton pump inhibitors remain the preferred pharmaceutical option to treat GERD. The ideal target of GERD treatment is to restore esophageal motility and reconstruct the anti-reflux mechanism. This review focuses on current advances in esophageal motor dysfunction in patients with GERD and the influence of these developments on GERD treatment.
Soil heterogeneity increases plant diversity after twenty years of manipulation during grassland restoration.

The 'environmental heterogeneity hypothesis' predicts that variability in resources promotes species coexistence, but few experiments support this hypothesis in plant communities. A previous 15-y test of this hypothesis in a prairie restoration experiment demonstrated a weak effect of manipulated soil resource heterogeneity on plant diversity. This response was attributed to a transient increase in richness following a post-restoration supplemental propagule addition, occasionally higher diversity under nutrient enrichment, and reduced cover of a dominant species in a subset of soil treatments. Here, we report community dynamics under continuous propagule addition in the same experiment, corresponding to 16-20 y of restoration, in response to altered availability and heterogeneity of soil resources. We also quantified traits of newly added species to determine if heterogeneity increases the amount and variety of niches available for new species to exploit. The heterogeneous treatment contained a factorial combination of altered nutrient availability and soil depth; control plots had no manipulations. Total diversity and richness were higher in the heterogeneous treatment during this 5 y study due to higher cover, diversity, and richness of previously established forbs, particularly in the N-enriched subplots. All new species added to the experiment exhibited unique trait spaces, but there was no evidence that heterogeneous plots contained a greater variety of new species representing a wider range of trait spaces relative to the control treatment. The richness and cover of new species was higher in N-enriched soil, but the magnitude of this response was small. Communities assembling under long-term N addition were dominated by different species among subplots receiving added N, leading to greater dispersion of communities among the heterogeneous relative to control plots. Contrary to the deterministic mechanism by which heterogeneity was expected to increase diversity (greater variability in resources for new species to exploit), higher diversity in the heterogeneous plots resulted from destabilization of formerly grass-dominated communities in N-enriched subplots. While we do not advocate increasing available soil N at large scales, we conclude that the positive effect of environmental heterogeneity on diversity can take decades to materialize and depend on development of stochastic processes in communities with strong establishment limitation.
Cerebrovascular complications in tuberculous meningitis—A magnetic resonance imaging study in 90 patients from a tertiary care hospital

Background Cerebrovascular complications of tuberculous meningitis (TBM) are associated with increased morbidity and mortality. We retrospectively reviewed clinicoradiological findings of 90 TBM patients who presented to a tertiary care hospital, with emphasis on frequency and distribution of infarcts on diffusion imaging and pattern of vascular involvement on magnetic resonance (MR) angiography (MRA). Materials and methods MR images of 90 TBM patients at presentation (2012–2018) were coanalyzed by two radiologists for tuberculomas, leptomeningeal enhancement (LM), hydrocephalus, infarct and vascular abnormalities. Infarcts were categorized based on location (“tubercular” (TB) or “ischemic” zones) and arterial supply (perforators and cortical branches). Clinical and laboratory findings were correlated with imaging data. Results Ninety TBM patients (age 10–82 years) were enlisted after application of inclusion criteria. Tuberculomas were most common (100%) followed by LM (84.4%), cerebral infarcts (57.7%) and hydrocephalus (29%). Location-wise, 35% infarcts were in ischemic, 13% in TB and 15% in both zones. According to arterial supply, infarcts equally (50%) involved perforators from the lateral lenticulostriate and posterior cerebral (PCA)/basilar artery (BA) followed by medial lenticulostriate arteries (23%). MRA was available in 74.4% and abnormal in 43.2%. The middle cerebral artery was frequently involved (76%) followed by the anterior cerebral artery (38%), internal carotid artery (31%), PCA and BA. Six had diffuse narrowing with a paucity of distal vessels. Cerebral infarction was associated with hydrocephalus (p = .0019) and vasculitis (p < .001). Conclusion In TBM, strokes are common and mainly involve the perforators and cortical branches. MR is the imaging modality of choice for early diagnosis and timely management.
The effect of ozone therapy in root canal disinfection: a systematic review.

AIM To answer the following focused question: "As regards microorganism load reduction for patients undergoing root canal treatment, is the use of ozone therapy comparable to conventional chemomechanical techniques using sodium hypochlorite (NaOCl)? ". DATA SOURCES A systematic review was conducted using controlled vocabulary and free-text key words in the following databases: PubMed, Science Direct, Scopus, Web of Science and Open Grey until November 2nd, 2018. Additional studies were sought through hand searching of endodontic journals. STUDY ELIGIBILITY CRITERIA, PARTICIPANTS AND INTERVENTIONS The inclusion criteria comprised studies that compared microbial reduction in root canals after treatments with ozone and NaOCl in extracted mature human teeth or randomized clinical trials. STUDY APPRAISAL AND SYNTHESIS METHODS The quality assessment of included laboratory studies was performed with the following parameters: (1) Sample size calculation, (2) Samples with similar dimensions, (3) Control group, (4) Standardization of procedures, (5) Statistical analysis and (6) Other risk of bias. For randomized clinical trials, the qualitative analysis of the studies was performed from the bias risk assessment using the tool "Bias Risk Assessment of Randomized Controlled Studies" Cochrane Handbook 5.0. 2. RESULTS The search resulted in 180 published studies. After removal of duplicate studies and full text analysis, 8 studies were selected and 7 were considered low risk of bias (7 ex vivo studies and 1 random clinical trial). Overall the results demonstrated that ozone therapy provides significantly less microbial load reduction significantly lower than NaOCl. As an adjunct in chemomechanical preparation, ozone was ineffective in increasing the antimicrobial effect of NaOCl. Ozone performance was strongly associated with the application protocol used: it is dose-, time- and bacterial strain-dependent, besides the correlation with the use of complementary disinfection sources. LIMITATIONS A restricted number of randomized clinical trial was found and the difference among the methodology of the studies did not allow a meta-analysis to be performed. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS Although the selected studies had limitations, this review reached a satisfactory methodological and moderate evidence quality contributing to preliminary important information regarding ozone therapy. As regards load reduction of microorganisms for patients undergoing root canal treatment, ozone is not indicated neither to replace or to complement the antimicrobial action of NaOCl.
Sodium glycerophosphate and prescribed calcium concentrations in pediatric parenteral nutrition: a retrospective observational study and economic evaluation

Abstract Background The risk of precipitation limits calcium and phosphate concentrations that can be administered parenterally to pediatric patients. As an alternative to dipotassium phosphate, sodium glycerophosphate (NaGlyP) is claimed to reduce the risk of precipitation in solutions for parenteral administration. Objectives To determine the calcium concentrations, NaGlyP, and dipotassium phosphate prescribed in pediatric parenteral nutrition orders and the cost–benefit of the organic phosphate. Methods We retrospectively collected cross-sectional data for parenteral nutrition orders from September 2014 to August 2015 for pediatric patients including neonates and children aged <18 years who were admitted to King Chulalongkorn Memorial Hospital, Bangkok, Thailand. Calcium concentration, calcium concentration adjustments, and costs of phosphate used per bag were analyzed. Results Of 2,192 parenteral nutrition orders, NaGlyP was used in 2,128 (97.1%) with calcium concentrations in the range of 0.84–139.91 mmol/L, which were significantly higher than calcium concentrations used with dipotassium phosphate (0.00–12.21 mmol/L, P < 0.001). There was no report of visible precipitation. Median costs of NaGlyP and dipotassium phosphate used per unit bag were not significantly different (35.88 and 41.25 Thai baht [THB] or 1.04 and 1.20 USD per bag, respectively, P>0.99; (1 USD equivalent to 34.241 THB U.S. Federal Reserve Bank G5.A annual average rate 2015). Conclusions Higher calcium concentrations could be achieved without increasing the direct cost per unit bag significantly as a result of using NaGlyP, an alternative to dipotassium phosphate as a source of phosphate for patients who require high amounts of calcium in parenteral nutrition.
Characterization of an engineered water-soluble variant of the full-length human mu opioid receptor

Abstract A water-soluble variant of the transmembrane domain of the human mu opioid receptor (wsMOR-TM) was previously characterized. This study explored whether the full-length version of the engineered water-soluble receptor, (wsMOR-FL), could be overexpressed in Escherichia coli and if it would retain water solubility, binding capability and thermostability. wsMOR was over-expressed and purified in E. coli BL21(DE3) cells (EMD/Novagen) as we reported previously for the wsMOR-TM. Both native N and C termini were added back to the highly engineered wsMOR-TM. Six His-tag was added in the N terminus for purification purposes. The wsMOR-FL was characterized using atomic force microscope for its monomeric state, circular dichroism for its secondary structure and thermostability. Its binding with naltrexone is also determined. Compared to the native human MOR, wsMOR-FL displays similar helical secondary structure content and comparable affinity (nM) for the antagonist naltrexone. The secondary structure of the receptor remains stable within a wide range of pH (6–9). In contrast to the transmembrane portion, the secondary structure of full-length receptor tolerated a wide range of temperature (10–90 °C). The receptor remains predominantly as a monomer in solution, as directly imaged using atomic force microscopy. This study demonstrated that functional full-length water-soluble variant of human mu receptor can be over-expressed and purified using an E. coli over-expression system. This provides a novel tool for the investigation of structural and functional properties of the human MOR. N- and C-termini strengthened the thermostability of the protein in this specific water soluble variant. Communicated by Ramaswamy H. Sarma
Oral Delivery of Anticancer Agents using Nanoparticulate Drug Delivery System.

BACKGROUND Conventionally, most of the anticancer agents are administered via the intravenous route. However, the need for hospitalization, nursing care, and severe side effects have directed the researchers to find an alternative means for administration of anticancer agents. Advantages offered by oral route has attracted tremendous interest among the scientific fraternity for anticancer drug delivery. Although seemingly easy, the issues like reduced drug bioavailability due to pre-systemic metabolism and transmembrane efflux of the drug, and high inter-subject variability constraints the delivery of anticancer agents through oral route. The present review elaborates the challenges as well as nanoformulation strategies employed therein to assist anticancer drug delivery via the oral route. METHODS A comprehensive literature search was performed to have useful insights on various aspects pertaining to recent advances in oral delivery of anticancer agents using nanoparticles. Information from various literary sources was studied and summarized in order to familiarize the readers about the current status and the recent relevant advancements. RESULTS Oral delivery of anti-cancer agents by employing nano-drug delivery systems not only improve the quality of life of patients but also provide a pharmacoeconomic advantage, leading to a reduced overall cost of cancer treatment. CONCLUSION The review highlights recent approaches employed by nano-drug delivery systems to facilitate oral delivery of anticancer agents.
On Steady Two-dimensional Free-surface Flows with Spatially-varied Discharges

Abstract In an open-channel, the transition of a flow from a subcritical to a supercritical state may occur as a result of a lateral inflow or outflow that produces a streamwise discharge variation. Apparently, such a transition cannot be modeled accurately by a conventional hydrostatic pressure approach. In this study, a depth-averaged model that accounts for the effects of a spatially-varied discharge and a non-hydrostatic pressure distribution was developed and applied to simulate the transcritical flow in a lateral-spillway channel and the subcritical flow in a main channel fitted with side weirs. The model results for the axial free-surface profile and variation of discharge in the main channel were compared with the results of a shallow-flow model and experimental data, thereby resulting in a closer match to the measurements than the shallow-flow model. Overall, the investigation results confirmed the efficiency and validity of the non-hydrostatic depth-averaged model in simulating the mean flow characteristics of the subcritical and transcritical free-surface flows with spatially increasing or decreasing discharges, thus demonstrating its potential to be used as a numerical tool in engineering practice.
Clinical consequences of developmental programming of low nephron number

Nephron number in humans varies up to 13‐fold, likely reflecting the impact of multiple factors on kidney development, including inherited body size and ethnicity, as well as maternal health and nutrition, fetal exposure to gestational diabetes or preeclampsia and other environmental factors, which may potentially be modifiable. Such conditions predispose to low or high offspring birth weight, growth restriction or preterm birth, which have all been associated with increased risks of higher blood pressures and/or kidney dysfunction in later life. Low birth weight, preterm birth, and intrauterine growth restriction are associated with reduced nephron numbers. Humans with hypertension and chronic kidney disease tend to have fewer nephrons than their counterparts with normal blood pressures or kidney function. A developmentally programmed reduction in nephron number therefore enhances an individual's susceptibility to hypertension and kidney disease in later life. A low nephron number at birth may not lead to kidney dysfunction alone except when severe, but in the face of superimposed acute or chronic kidney injury, a kidney endowed with fewer nephrons may be less able to adapt, and overt kidney disease may develop. Given that millions of babies are born either too small, too big or too soon each year, the population impact of altered renal programming is likely to be significant. Many gestational exposures are modifiable, therefore urgent attention is required to implement public health measures to optimize maternal, fetal, and child health, to prevent or mitigate the consequences of developmental programming, to improve the health future generations.
Prevalence of unsuspected abnormal echocardiograms in adolescents with down syndrome

The purpose of this article is to describe the prevalence of cardiac disease previously undiagnosed in healthy asymptomatic children and adolescents with Down syndrome (DS). Subjects with DS ages 10–20 years were recruited from two sites, the Children's Hospital of Philadelphia (Philadelphia, PA) and Children's National Health System (Washington, DC) for a cross‐sectional study of body composition and cardiometabolic risk. Echocardiographic and clinical data were collected from patients enrolled in the parent study of cardiometabolic risk. Nine (6%) new cardiac diagnoses were identified out of 149 eligible patients. All new findings resulted in outpatient referrals to pediatric cardiology. Current guidelines recommend screening all newborns with DS for congenital heart disease. Older patients with DS may benefit from rescreening.
Treatment planning optimization with beam motion modeling for dynamic arc delivery of SBRT using Cyberknife with multileaf collimation

Purpose The use of dynamic arcs for delivery of stereotactic body radiation therapy (SBRT) on Cyberknife is investigated, with a view to improving treatment times. This study investigates the required modeling of robot and multileaf collimator (MLC) motion between control points in the trajectory and then uses this to develop an optimization method for treatment planning of a dynamic arc with Cyberknife. The resulting plans are compared in terms of dose‐volume histograms and estimated treatment times with those produced by a conventional beam arrangement. Methods Five SBRT patient cases (prostate A — conventional, prostate B — brachytherapy‐type, lung, liver, and partial left breast) were retrospectively studied. A suitable arc trajectory with control points spaced at 5° was proposed and treatment plans were produced for typical clinical protocols. The optimization consisted of a fluence optimization, segmentation, and direct aperture optimization using a gradient descent method. Dose delivered by the moving MLC was either taken to be the dose delivered discretely at the control points or modeled using effective fluence delivered between control points. The accuracy of calculated dose was assessed by recalculating after optimization using five interpolated beams and 100 interpolated apertures between each optimization control point. The resulting plans were compared using dose‐volume histograms and estimated treatment times with those for a conventional Cyberknife beam arrangement. Results If optimization is performed based on discrete doses delivered at the arc control points, large differences of up to 40% of the prescribed dose are seen when recalculating with interpolation. When the effective fluence between control points is taken into account during optimization, dosimetric differences are <2% for most structures when the plans are recalculated using intermediate nodes, but there are differences of up to 15% peripherally. Treatment plan quality is comparable between the arc trajectory and conventional body path. All plans meet the relevant clinical goals, with the exception of specific structures which overlap with the planning target volume. Median estimated treatment time is 355 s (range 235–672 s) for arc delivery and 675 s (range 554–1025 s) for conventional delivery. Conclusions The method of using effective fluence to model MLC motion between control points is sufficiently accurate to provide for accurate inverse planning of dynamic arcs with Cyberknife. The proposed arcing method produces treatment plans with comparable quality to the body path, with reduced estimated treatment delivery time.