Miracle-dz/UniFAR-FTUs huggingface dataset:
Effect of Low-Dose Intracoronary Alteplase During Primary Percutaneous Coronary Intervention on Microvascular Obstruction in Patients With Acute Myocardial Infarction: A Randomized Clinical Trial

Importance Microvascular obstruction commonly affects patients with acute ST-segment elevation myocardial infarction (STEMI) and is associated with adverse outcomes. Objective To determine whether a therapeutic strategy involving low-dose intracoronary fibrinolytic therapy with alteplase infused early after coronary reperfusion will reduce microvascular obstruction. Design, Setting, and Participants Between March 17, 2016, and December 21, 2017, 440 patients presenting at 11 hospitals in the United Kingdom within 6 hours of STEMI due to a proximal–mid-vessel occlusion of a major coronary artery were randomized in a 1:1:1 dose-ranging trial design. Patient follow-up to 3 months was completed on April 12, 2018. Interventions Participants were randomly assigned to treatment with placebo (n = 151), alteplase 10 mg (n = 144), or alteplase 20 mg (n = 145) by manual infusion over 5 to 10 minutes. The intervention was scheduled to occur early during the primary PCI procedure, after reperfusion of the infarct-related coronary artery and before stent implant. Main Outcomes and Measures The primary outcome was the amount of microvascular obstruction (% left ventricular mass) demonstrated by contrast-enhanced cardiac magnetic resonance imaging (MRI) conducted from days 2 through 7 after enrollment. The primary comparison was the alteplase 20-mg group vs the placebo group; if not significant, the alteplase 10-mg group vs the placebo group was considered a secondary analysis. Results Recruitment stopped on December 21, 2017, because conditional power for the primary outcome based on a prespecified analysis of the first 267 randomized participants was less than 30% in both treatment groups (futility criterion). Among the 440 patients randomized (mean age, 60.5 years; 15% women), the primary end point was achieved in 396 patients (90%), 17 (3.9%) withdrew, and all others were followed up to 3 months. In the primary analysis, the mean microvascular obstruction did not differ between the 20-mg alteplase and placebo groups (3.5% vs 2.3%; estimated difference, 1.16%; 95% CI, −0.08% to 2.41%; P = .32) nor in the analysis of 10-mg alteplase vs placebo groups (2.6% vs 2.3%; estimated difference, 0.29%; 95% CI, −0.76% to 1.35%; P = .74). Major adverse cardiac events (cardiac death, nonfatal MI, unplanned hospitalization for heart failure) occurred in 15 patients (10.1%) in the placebo group, 18 (12.9%) in the 10-mg alteplase group, and 12 (8.2%) in the 20-mg alteplase group. Conclusions and Relevance Among patients with acute STEMI presenting within 6 hours of symptoms, adjunctive low-dose intracoronary alteplase given during the primary percutaneous intervention did not reduce microvascular obstruction. The study findings do not support this treatment. Trial Registration ClinicalTrials.gov Identifier: NCT02257294
National Performance on the Medicare SEP-1 Sepsis Quality Measure.

OBJECTIVES The Centers for Medicare and Medicaid Services requires hospitals to report compliance with a sepsis treatment bundle as part of its Inpatient Quality Reporting Program. We used recently released data from this program to characterize national performance on the sepsis measure, known as SEP-1. DESIGN Cross-sectional study of United States hospitals participating in the Centers for Medicare and Medicaid Services Hospital Inpatient Quality Reporting Program linked to Centers for Medicare and Medicaid Services' Healthcare Cost Reporting Information System. SETTING General, short-stay, acute-care hospitals in the United States. MEASUREMENTS AND MAIN RESULTS We examined the hospital factors associated with reporting SEP-1 data, the hospital factors associated with performance on the SEP-1 measure, and the relationship between SEP-1 performance and performance on other quality measures related to time-sensitive medical conditions. A total of 3,283 hospitals were eligible for the analysis, of which 2,851 (86.8%) reported SEP-1 performance data. SEP-1 reporting was more common in larger, nonprofit hospitals. The most common reason for nonreporting was an inadequate case volume. Among hospitals reporting SEP-1 performance data, overall bundle compliance was generally low, but it varied widely across hospitals (mean and SD: 48.9% ± 19.4%). Compared with hospitals with worse SEP-1 performance, hospitals with better SEP-1 performance tended to be smaller, for-profit, nonteaching, and with intermediate-sized ICUs. Better hospital performance on SEP-1 was associated with higher rates of timely head CT interpretation for stroke patients (rho = 0.16; p < 0.001), more frequent aspirin administration for patients with chest pain or heart attacks (rho = 0.24; p < 0.001) and shorter median time to electrocardiogram for patients with chest pain (rho = -0.12; p < 0.001). CONCLUSIONS The majority of eligible hospitals reported SEP-1 data, and overall bundle compliance was highly variable. SEP-1 performance was associated with structural hospital characteristics and performance on other measures of hospital quality, providing preliminary support for SEP-1 performance as a marker of timely hospital sepsis care.
Are you ready for retirement? The influence of values on membership in voluntary organizations in midlife and old age

Membership in voluntary organizations is associated with individual and social benefits. Due to the negative consequences of the global pandemic on older people, and the governmental challenges posed by population aging, voluntary membership is of great importance to society. To effectively promote volunteering among older people, it is necessary to understand the determinants of voluntary membership. This study analyses the influence of individual values—secular/traditional and survival/self-expression–on voluntary membership among European adults (N = 31,985). Specifically, it examines which values orient two age groups (middle age: 50–64 and old age: 65–79), as well as men and women toward a certain type of association (Social Awareness; Professional and Political; Education and Leisure; Religion). The sample of 31,985 comprises 60% of adults aged 50–64 and 40% aged 65–79; of which 56% are women and 44% men. The empirical estimation considers different levels of data aggregation: individual, national and welfare system, therefore multilevel analysis is used as an analytical strategy. Individual-level variables from the Integrated Values Survey (2005/09, 2010/14, and 2017/20) and national-level variables (Gini Index and Gross Domestic Product Per Capita) from the World Bank and Eurostat are used. The results indicate that traditional and self-expression values promote membership in voluntary organizations in general more than secular and survival values. However, there are differences according to the type of organization. Furthermore, values are found to moderate the effect of age and gender on voluntary membership.
The Link between Activities of Daily Living and Cortisol in Late-Life Depression

ABSTRACT Objectives Dysregulated cortisol in older individuals is associated with neurodegeneration and executive dysfunction, among other negative health outcomes. Executive functioning deficits are believed to underlie declines in functioning among older adults. Despite these associations, there is limited research examining the relationship between cortisol and impaired functional status. Methods The present study examined the relationship between cortisol and functional status in a community sample of 51 older adults with depression. Pearson correlations and ordinal regressions were used to determine whether greater cortisol dysregulation was associated with ADL and IADL impairment. Results Results indicated that individuals who had higher levels of cortisol also tended to demonstrate greater functional deficits. These findings remained true when functional status was measured by either a clinician-rated tool or a self-report measure. Conclusions The results of this study provide preliminary support for the hypothesis that elevated cortisol, in the context of depression, is associated with functional status deficits in older adults. Clinical Implications Findings from this study begin to fill the gap in research examining the relationship between cortisol and functional impairment in older adults and suggest that unique information can be gathered with the use of different functional status measures.
Tart Cherry Prevents Bone Loss through Inhibition of RANKL in TNF-Overexpressing Mice

Current drugs for the treatment of rheumatoid arthritis-associated bone loss come with concerns about their continued use. Thus, it is necessary to identify natural products with similar effects, but with fewer or no side effects. We determined whether tart cherry (TC) could be used as a supplement to prevent inflammation-mediated bone loss in tumor necrosis factor (TNF)-overexpressing transgenic (TG) mice. TG mice were assigned to a 0%, 5%, or 10% TC diet, with a group receiving infliximab as a positive control. Age-matched wild-type (WT) littermates fed a 0% TC diet were used as a normal control. Mice were monitored by measurement of body weight. Bone health was evaluated via serum biomarkers, microcomputed tomography (µCT), molecular assessments, and mechanical testing. TC prevented TNF-mediated weight loss, while it did not suppress elevated levels of interleukin (IL)-1β and IL-6. TC also protected bone structure from inflammation-induced bone loss with a reduced ratio of receptor activator of nuclear factor kappa-B ligand (RANKL)/osteoprotegerin (OPG) to a degree comparable to infliximab. Furthermore, unlike with infliximab, TC exhibited a moderate improvement in TNF-mediated decline in bone stiffness. Thus, TC could be used as a prophylactic regimen against future fragility fractures in the context of highly chronic inflammation.
How Does CEO’s Environmental Awareness Affect Technological Innovation?

In this paper, we conduct an empirical study on the impact of CEOs’ environmental awareness on technological innovation. To this end, we obtain a large sample with 7615 observations from Chinese A-share listed firms between the years of 2003 and 2014. Our empirical results show that a CEO’s environmental awareness has a significant positive impact on technological innovation of his/her enterprise. Environmentally conscious CEOs will invest more in R&D and obtain more patents. This will help their enterprises achieve higher efficiency of technological innovation. Furthermore, the environmental awareness of a CEO has a more significant impact on technological innovation if his/her enterprise is subject to a higher level of monitoring. We also conduct robustness check of our findings and provide managerial insights and proactive government policies to raise the environmental awareness of CEOs and improve the innovation vitality of enterprises.
Testing for AB-PINACA in human hair: Distribution in head hair versus pubic hair.

Synthetic cannabinoid receptor agonists were first identified in herbal products in 2008 advertised as a legal replacement for cannabis. These herbal incense are usually called "spice" and among these, one product in particular has gained popularity: AB-PINACA (N-[(2S)-1-Amino-3-methyl-1-oxobutan-2-yl]-1-pentyl-1H-indazole-3-carboxamide). This drug has been discovered to have a stronger binding to human cannabinoid CB1 and CB2 receptors than ∆9 -THC.While some articles have been published regarding the presence of AB-PINACA in biological fluids such as blood and urine, none reports the presence of AB-PINACA in hair. We have developed and validated a method for detection of AB-PINACA in hair using a liquid chromatography-tandem mass spectrometry system and applied it to head and pubic hair obtained in a case of intoxication. The validation procedure demonstrated a limit of detection and a limit of quantification of 0.5 and 1 pg/mg, respectively and acceptable linearity, repeatability, and reproducibility. AB-PINACA tested positive in the blood (5.7 ng/mL) and less than 1 ng/mL was found in urine. The analysis of the hair specimens resulted in an unusual distribution of the drug between head and pubic hair. AB-PINACA was identified at a higher concentration in head hair (195 pg/mg) versus in pubic hair (5 pg/mg). The very low concentration of AB-PINACA in the urine after consumption, due to rapid metabolism, could explain this infrequent distribution, as pubic hair can be contaminated by urine. In any case, it cannot be excluded that the high concentration in head hair may be due to environmental contamination.
Validation of a New Clinical Tool for Post‐Intensive Care Syndrome

Background Post‐intensive care syndrome is defined as the long‐term cognitive, physical, and psychological impairments due to critical illness. Objective To validate the self‐report version of the Healthy Aging Brain Care Monitor as a clinical tool for detecting post‐intensive care syndrome. Methods A total of 142 patients who survived a stay in an intensive care unit completed the Healthy Aging Brain Care Monitor Self‐report and standardized assessments of cognition, psychological symptoms, and physical functioning. Cronbach &agr; was used to measure the internal consistency of the scale items. Validity between the Healthy Aging Brain Care Monitor and comparison tests was measured by using Spearman correlation coefficients. Patients with post‐intensive care syndrome were compared with a sample of primary care patients (known groups validity) by using the Mann‐Whitney test. General linear models were used to adjust for age, sex, and education level. Results The total scale and all subscales had good to excellent internal consistency (Cronbach &agr;, 0.83‐0.92). Scores on the psychological subscale strongly correlated with standardized measures of psychological symptoms (Spearman correlation coefficient, 0.68‐0.74). Results on the cognitive subscale correlated with the delayed memory measure (−0.51). Scores on the physical subscale correlated with the Physical Self‐Maintenance Scale (−0.26). Patients with post‐intensive care syndrome had significantly worse scores on subscales and total scores on the Healthy Aging Brain Care Monitor than did primary care patients. Conclusion The self‐report version of the Healthy Aging Brain Care Monitor is a valid clinical tool for assessing symptoms of post‐intensive care syndrome.
Differential evolution utilizing a handful top superior individuals with bionic bi-population structure for the enhancement of optimization performance

ABSTRACT In this paper, we propose a new DE variant incorporating a new mutation strategy and a bionic bi-population structure to enhance the overall performance of the canonical DE algorithm. As it is known to all that the guidance of a handful top superior elites is usually better than the guidance of only one elite in many cases, therefore, a handful top superior individuals are employed in the newly proposed mutation strategy for individual evolution. Moreover, hybridization of two populations of a certain species can improve the adaptation to the environment, and business and information exchanges between tribes can help their economical and technological development, so a bionic bi-population structure is also employed in the new DE variant for information exchanges. Both of the two aspects make the new algorithm achieve an overall better performance, and experiment results show that a handful top superior individuals with bionic bi-population structure has better performances on optimization accuracy, convergence speed and success rate under these tested benchmark functions especially those other algorithms may be trapped into local optima.
The Role of Disturbed Small-World Networks in Patients with White Matter Lesions and Cognitive Impairment Revealed by Resting State Function Magnetic Resonance Images (rs-fMRI)

Background Leukoaraiosis is characterized by white matter lesions (WMLs) on magnetic resonance imaging (MRI) and is associated with cognitive impairment. The small-world network is viewed as the optimal brain network with maximal efficiency in information processing. Patients with cognitive impairment are thought to have disrupted small-world networks. In this study, we compared the small-world network attributes between controls (study participants without memory complaints) and patients with WMLs with cognitive impairment. Material/Methods All study participants were prescreened using MRI and neuropsychological tests. Patients with WMLs were further divided into 2 groups according to the result of Montreal Cognitive Assessment (MoCA), i.e., WMLs with non-dementia vascular cognitive impairment (WMLs-VCIND) and WMLs with vascular dementia (WMLs-VaD). Resting-state functional MRI data were collected and applied with graph theoretical analysis to compare small-world properties between the 3 groups. Results We found that the overall functional connectivity strength was lowest in the WMLs-VaD patients but highest in the normal control study participants. Patients in both the WMLs-VCIND and the WMLs-VaD groups had decreased small-world properties compared with the group of normal control study participants. Moreover, the small-world properties significantly correlated with MoCA scores. Conclusions These findings suggest potential constructive reorganization of brain networks secondary to WMLs, and provides novel insights into the role of small-world properties in cognitive dysfunction in WMLs.
Rapid detection of internalizing diagnosis in young children enabled by wearable sensors and machine learning

There is a critical need for fast, inexpensive, objective, and accurate screening tools for childhood psychopathology. Perhaps most compelling is in the case of internalizing disorders, like anxiety and depression, where unobservable symptoms cause children to go unassessed–suffering in silence because they never exhibiting the disruptive behaviors that would lead to a referral for diagnostic assessment. If left untreated these disorders are associated with long-term negative outcomes including substance abuse and increased risk for suicide. This paper presents a new approach for identifying children with internalizing disorders using an instrumented 90-second mood induction task. Participant motion during the task is monitored using a commercially available wearable sensor. We show that machine learning can be used to differentiate children with an internalizing diagnosis from controls with 81% accuracy (67% sensitivity, 88% specificity). We provide a detailed description of the modeling methodology used to arrive at these results and explore further the predictive ability of each temporal phase of the mood induction task. Kinematical measures most discriminative of internalizing diagnosis are analyzed in detail, showing affected children exhibit significantly more avoidance of ambiguous threat. Performance of the proposed approach is compared to clinical thresholds on parent-reported child symptoms which differentiate children with an internalizing diagnosis from controls with slightly lower accuracy (.68-.75 vs. .81), slightly higher specificity (.88–1.00 vs. .88), and lower sensitivity (.00-.42 vs. .67) than the proposed, instrumented method. These results point toward the future use of this approach for screening children for internalizing disorders so that interventions can be deployed when they have the highest chance for long-term success.
XOR learning by spiking neural network with infrared communications

A Spiking Neural Network (SNN), which expresses information by spike trains, has an ability to process information with low energy like a human brain. Hardware implementation of a SNN is an important research problem. If the neurons are linked by wireless communications, SNNs can obtain the spatial degree of freedom, which may extend application area dramatically. Additionally, such SNNs can process information with low energy, owing to wireless communication by the spike trains. Therefore, it is regarded as low power-consumption wireless sensor networks (WSNs) with adding the functions of SNN neurons to wireless sensor nodes. This “Wireless Neural Sensor Networks” can distribute information processing like a brain on the WSN nodes. This paper presents a SNN with infrared(IR) communications as the first step of the above concept. Neurons are implemented by field programmable gate array, which are linked by IR communications. The implemented SNN succeeded in acquiring the XOR function through reinforcement learning.
Clinical significances of detecting the tumor necrosis factor-α,lactate dehydrogenase and its isoenzyme in cerebrospinal fluid in patients with meningitis

Objective To investigate the clinical significance of detecting the tumor necrosis factor (TNF)-α,lactate dehydrogenase (LDH) and its isoenzyme in cerebrospinal fluid (CSF) in patients with meningitis.Methods The CSF specimens were collected from 53 patients with purulent meningitis (PM group),58 patients with viral meningitis (VM group),49 patients with tubercular meningitis(TM group) and 60 patients with non-infectious central nervous system diease(control group). The content of TNF-α was measured by enzyme-linked immunosorbent assay (ELISA),the LDH activity was measured by rate of speed method and its isoenzymes were detected by agarose gel electrophoresis method. All the results were compared and analyzed.Results CSF TNF-α levels in 3 meningitis groups were significantly higher than that of control group[(25.64±20.08)pg/L]; while,in PM group [(462.24±369.13) pg/L] was significantly higher than VM group [(73.47±68.74 )pg/L]and TM group [(62.97±40.58) pg/L](all P0.01). There was no significantly difference between the VM group and the TM group. The CSF LDH level in the PM group [(201.37±148.06) U/L]was also significantly higher than other 3 groups; the TM group [(170.32±86.45 )U /L]was significantly higher than the VM group [(79.54±43.71 )U/L] (all P0.01); but there was no significant difference between VM group [(79.54±43.71) U /L] and the control group [64.56±49.68 )U/L]. The levels of LDH4[(22.83±2.08)U/L]and LDH5[(35.26±2.18)U/L] in PM group were significantly higher than other 3 groups,while the levels of LDH1[(7.84±1.15)U/L]and LDH2 [(13.01±1.46)U/L] were significantly lower than those in other groups(all P0.01). The level of LDH3 [(29.48±3.24)U/L]in TM group was significantly higher than control group [(16.13±3.95)U/L] (P0.01). But there was no significant difference of isoenzyme levels between the VM group and control group.Conclusion Detection the levels of TNF-α,LDH and its isoenzymes in CSF can help the differential diagnosis of different type meningitis.