Miracle-dz/UniFAR-FTUs huggingface dataset:
Effects of vestibular rehabilitation, with or without betahistine, on managing residual dizziness after successful repositioning manoeuvres in patients with benign paroxysmal positional vertigo: a protocol for a randomised controlled trial

Introduction Benign paroxysmal positional vertigo (BPPV) is recognised as the leading cause of peripheral vertigo in adults. The canalith repositioning procedure (CRP) can be used for effective treatment of BPPV. However, some patients experience residual dizziness (RD) even after successful CRP, resulting in a significant negative impact on their daily function and quality of life. Exercise-based vestibular rehabilitation (VR) has been proven as an effective method for managing dizziness and has been applied in patients with various vestibular disorders. However, the efficacy of VR to specifically target RD post-BPPV is unknown. This study aims to investigate the efficacy of VR, compared with betahistine or VR plus betahistine treatment, in the treatment of patients experiencing RD after successful CRP. Methods and analysis A randomised single-blinded controlled trial will be carried out to determine the efficacy of VR compared with betahistine or VR plus betahistine treatment in mitigating RD and improving balance function. Patients with BPPV who experience RD after successful CRP will be recruited. Participants will be randomised into one of three groups to receive VR, betahistine or VR plus betahistine. There will be 61 participants in each group. The primary outcomes will be changes in the patient’s daily function as measured by the Vestibular Activities and Participation questionnaire and balance ability assessed by computerised dynamic posturography. The secondary outcomes will be dizziness-related handicap, otolith function and duration of RD symptoms. Outcome measures will be noted at baseline and at 2, 4 and 8 weeks post-randomisation. This study has the potential to reduce unnecessary anti-vertigo drug prescriptions and may lead to a general consensus regarding the use of VR as a first-line treatment for RD in patients with BPPV. Ethics and dissemination This trial received ethical approval from the Institutional Review Board of Eye and ENT Hospital of Fudan University (reference number 2017046). The study results will be disseminated via peer-reviewed journals and conferences. Trial registration number NCT03624283; Pre-results.
Soil respiration and its Q10 response to various grazing systems of a typical steppe in Inner Mongolia, China

Background As one of the important management practices of grassland ecosystems, grazing has fundamental effects on soil properties, vegetation, and soil microbes. Grazing can thus alter soil respiration (Rs) and the soil carbon cycle, yet its impacts and mechanisms remain unclear. Methods To explore the response of soil carbon flux and temperature sensitivity to different grazing systems, Rs, soil temperature (ST), and soil moisture (SM) were observed from December 2014 to September 2015 in a typical steppe of Inner Mongolia under three grazing systems: year-long grazing, rest-rotation grazing, and grazing exclusion. In addition, plant aboveground and root biomass, soil microbial biomass and community composition, and soil nutrients were measured during the pilot period. Results Soil respiration was significantly different among the three grazing systems. The average Rs was highest under rest-rotation grazing (1.26 μmol·m−2·s−1), followed by grazing exclusion (0.98 μmol·m−2·s−1) and year-long grazing (0.94 μmol·m−2·s−1). Rs was closely associated with ST, SM, potential substrate and root, and soil microbe activity. The effects of grazing among two grazing systems had generality, but were different due to grazing intensity. The root biomass was stimulated by grazing, and the rest-rotation grazing system resulted in the highest Rs. Grazing led to decreases in aboveground and microbial biomass as well as the loss of soil total nitrogen and total phosphorus from the steppe ecosystem, which explained the negative effect of grazing on Rs in the year-long grazing system compared to the grazing exclusion system. The temperature sensitivity of Rs (Q10) was higher in the rest-rotation and year-long grazing systems, likely due to the higher temperature sensitivity of rhizosphere respiration and higher “rhizosphere priming effect” in the promoted root biomass. The structural equation model analysis showed that while grazing inhibited Rs by reducing soil aeration porosity, ground biomass and SM, it increased Q10 but had a lower effect than other factors. A better understanding of the effects of grazing on soil respiration has important practical implications.
Simulating the sensitivity of evapotranspiration and streamflow to large-scale groundwater depletion

Groundwater declines caused by pumping over the 20th century decrease streamflow and plant water availability. Groundwater pumping has caused marked aquifer storage declines over the past century. In addition to threatening the viability of groundwater-dependent economic activities, storage losses reshape the hydrologic landscape, shifting groundwater surface water exchanges and surface water availability. A more comprehensive understanding of modern groundwater-depleted systems is needed as we strive for improved simulations and more efficient water resources management. Here, we begin to address this gap by evaluating the impact of 100 years of groundwater declines across the continental United States on simulated watershed behavior. Subsurface storage losses reverberate throughout hydrologic systems, decreasing streamflow and evapotranspiration. Evapotranspiration declines are focused in water-limited periods and shallow groundwater regions. Streamflow losses are widespread and intensify along drainage networks, often occurring far from the point of groundwater abstraction. Our integrated approach illustrates the sensitivity of land surface simulations to groundwater storage levels and a path toward evaluating these connections in large-scale models.
A North American Expert Opinion Statement on Sarcopenia in Liver Transplantation

Loss of muscle mass and function, or sarcopenia, is a common feature of cirrhosis and contributes significantly to morbidity and mortality in this population. Sarcopenia is a main indicator of adverse outcomes in this population, including poor quality of life, hepatic decompensation, mortality in patients with cirrhosis evaluated for liver transplantation (LT), longer hospital and intensive care unit stay, higher incidence of infection following LT, and higher overall health care cost. Although it is clear that muscle mass is an important predictor of LT outcomes, many questions remain, including the best modality for assessing muscle mass, the optimal cut‐off values for sarcopenia, the ideal timing and frequency of muscle mass assessment, and how to best incorporate the concept of sarcopenia into clinical decision making. For these reasons, we assembled a group of experts to form the North American Working Group on Sarcopenia in Liver Transplantation to use evidence from the medical literature to address these outstanding questions regarding sarcopenia in LT. We believe sarcopenia assessment should be considered in all patients with cirrhosis evaluated for liver transplantation. Skeletal muscle index (SMI) assessed by computed tomography constitutes the best‐studied technique for assessing sarcopenia in patients with cirrhosis. Cut‐off values for sarcopenia, defined as SMI < 50 cm2/m2 in male and < 39 cm2/m2 in female patients, constitute the validated definition for sarcopenia in patients with cirrhosis. Conclusion: The management of sarcopenia requires a multipronged approach including nutrition, exercise, and additional pharmacological therapy as deemed necessary. Future studies should evaluate whether recovery of sarcopenia with nutritional management in combination with an exercise program is sustainable as well as how improvement in muscle mass might be associated with improvement in clinical outcomes.
Phrase Structure and Grammatical Relations in Tagalog

Over the last twenty years or so, most of the work on the syntax of Philippine languages has been focused on the question of whether or not these languages can be said to have grammatical subjects, and if so which argument of a basic transitive clause should be analysed as being the subject. Paul Kroeger's contribution to this debate asserts that grammatical relations such as subject and object are syntactic notions, and must be identified on the basis of syntactic properties, rather than by semantic roles or discourse functions. A large number of syntactic processes in Tagalog uniquely select the argument which bears the nominative case. On the other hand, the data which have been used in the debate to assert the ambiguity of subjecthood are best analysed in terms of semantic rather than syntactic constraints. Together these facts support an analysis that takes the nominative argument as the subject. Kroeger examines the history of the subjecthood debate and uses data from Tagalog to test the theories that have been put forth. His conclusions entail consequences for certain linguistic concepts and theories, and lead Kroeger to assert that grammatical relations are not defined in terms of surface phrase structure configurations, contrary to the assumptions of many approaches to syntax including the Government-Binding theory. Paul Kroeger is presently doing fieldwork in Austronesian languages and teaching linguistics to fieldworkers from around the world.
Cross cultural adaptation, reliability and construct validity of the Boston Carpal Tunnel Questionnaire in standard Arabic language

Abstract Purpose To perform cross cultural adaptation of Boston Carpal Tunnel Questionnaire in standard Arabic language and assess the reliability and construct validity of the new tool. Materials and methods Cross cultural adaptation was performed according to guidelines. One hundred and one Arabic patients with carpal tunnel syndrome agreed to participate in the study and filled the questionnaire. Cronbach’s alpha was calculated to assess internal consistency. Test–retest reliability was assessed after two weeks by calculating Intraclass correlation coefficient. To assess construct validity; Spearman correlation coefficient with the Disabilities of the Arm, Shoulder and Hand Questionnaire was calculated. Results Arabic Boston Carpal Tunnel Questionnaire version had excellent internal consistency, Cronbach's Alpha was 0.877 for Symptoms Severity Scale and 0.895 for Functional Status Scale. Test–retest reliability was excellent (Interclass Correlation Coefficient was 0.899 for Symptoms Severity Scale and 0.944 for Functional Status Scale). Correlation with the Disabilities of the Arm, Shoulder and Hand Questionnaire was high which reflects excellent construct validity. All results were similar to the results of previous studies. Conclusions Arabic Boston Carpal Tunnel Questionnaire was produced. The tool demonstrated excellent internal consistency, test–retest reliability and construct validity. The questionnaire is suitable for use with carpal tunnel syndrome patients in the Middle East and North Africa region. Implications for rehabilitation Carpal tunnel syndrome is the most common peripheral neuropathy worldwide with many affected in Arabic speaking countries. Specific outcome measures like Boston Carpal Tunnel Questionnaire are important in evaluating the impact of different interventions on patients’ wellbeing. The Arabic Boston carpal tunnel questionnaire is a valid and reliable tool to use with Arabic speaking people with Carpal Tunnel Syndrome.
Dynamic modeling and tracking control of a nonholonomic wheeled mobile manipulator with two robotic arms

This paper develops methodologies for modeling and tracking control of two robotic arms mounted on a wheeled mobile robot subject to nonholonomic constraints. Utilizing the Lagrange's equation and the MATHEMATICA package, the exact system dynamic model and structural properties of the vehicle are acquired. With backstepping technique, a nonlinear tracking controller proved by the Lyapunov direct method is proposed to tackle with the nonholonomic effect and dynamic interactions between mobile platform and two manipulators. The proposed controller not only ensures that the entire state of the system asymptotically tracks the desired state trajectories, but also fully compensates the coupled dynamics among subsystems. Simulation results illustrate validity of the derived model as well as effectiveness of the proposed control strategy.
MiR-26a-5p enhances cells proliferation, invasion, and apoptosis resistance of fibroblast-like synoviocytes in rheumatoid arthritis by regulating PTEN/PI3K/AKT pathway

Behavior alterations in fibroblast-like synoviocytes (FLS) contribute to a pivotal role in pathogenesis of rheumatoid arthritis (RA). MiRNAs are closely involved in a variety of pathologic conditions. In the present study, we aimed to screen for the aberrant expression of miRNAs in rheumatoid arthritis fibroblast-like synoviocytes (RA-FLS) to further identify the altered expression of miR-26a-5p in RA-FLS and to investigate the role of miR-26a-5p in RA. The altered expression of miR-26a-5p in RA-FLS was screened by microarray analysis and confirmed by quantitative real time PCR. The effect of miR-26a-5p on proliferation, cell cycle, apoptosis, and invasion in RA-FLS were studied. The verification of miR-26a-5p target mRNA and downstream signaling pathway was elucidated by bioinformatics analysis, dual luciferase reporter assay, and western blot. Expression of miR-26a-5p was higher in RA-FLS than in fibroblast-like synoviocytes from osteoarthritis patients and trauma patients. Overexpression of miR-26a-5p RA-FLS promoted cells proliferation, G1/S transition, cells invasion, and resisted apoptosis in RA-FLS, whereas it led to contrary effects when inhibiting the expression of miR-26a-5p. The 3′UTR of tensin homolog (PTEN) was directly targetted by miR-26a-5p and activation of phosphoinositide 3-kinase (PI3K)/AKT pathway was observed when overexpression of miR-26a-5p. Our study suggested that miR-26a-5p has a complementary role in cells proliferation, invasion, and apoptosis of RA-FLS, which may be attributed to its activation effect on PI3K/AKT signaling pathway via targetting PTEN. MiR-26a-5p is likely to be a clinically helpful target for novel therapeutic strategies in RA.
Everolimus for cognition/autism in children with tuberous sclerosis complex

Tuberous sclerosis complex (TSC) has been recognized as an important clinical entity for well over 150 years. The recent pace of discovery has been thrilling, with gene identification (TSC1 and TSC2), insights into cellular signaling (dysregulation of mTOR kinase), and the subsequent rational application of the mTOR inhibitors sirolimus and everolimus to treat various aspects of TSC. These advances culminated in Food and Drug Administration (FDA) approval of everolimus for TSC-associated subependymal giant cell astrocytomas in 2010,1 the angiomyolipomas in 2012, and complex partial seizures in 2018.2 Sirolimus is effective for seizures in TSC3 and is FDA-approved for the treatment of lymphangioleiomyomatosis, a progressive lung disease largely seen in adult women with TSC. Both agents have shown efficacy for cutaneous hamartomas and cardiac rhabdomyomas.
Cervical Spine Injury Risk Factors in Children With Blunt Trauma

In this multicenter, prospective observational study of 4091 children who experienced blunt trauma, we identified 14 risk factors for CSI. BrightcoveDefaultPlayer10.1542/6138649654001PEDS-VA_2018-3221 Video Abstract BACKGROUND: Adult prediction rules for cervical spine injury (CSI) exist; however, pediatric rules do not. Our objectives were to determine test accuracies of retrospectively identified CSI risk factors in a prospective pediatric cohort and compare them to a de novo risk model. METHODS: We conducted a 4-center, prospective observational study of children 0 to 17 years old who experienced blunt trauma and underwent emergency medical services scene response, trauma evaluation, and/or cervical imaging. Emergency department providers recorded CSI risk factors. CSIs were classified by reviewing imaging, consultations, and/or telephone follow-up. We calculated bivariable relative risks, multivariable odds ratios, and test characteristics for the retrospective risk model and a de novo model. RESULTS: Of 4091 enrolled children, 74 (1.8%) had CSIs. Fourteen factors had bivariable associations with CSIs: diving, axial load, clotheslining, loss of consciousness, neck pain, inability to move neck, altered mental status, signs of basilar skull fracture, torso injury, thoracic injury, intubation, respiratory distress, decreased oxygen saturation, and neurologic deficits. The retrospective model (high-risk motor vehicle crash, diving, predisposing condition, neck pain, decreased neck mobility (report or exam), altered mental status, neurologic deficits, or torso injury) was 90.5% (95% confidence interval: 83.9%–97.2%) sensitive and 45.6% (44.0%–47.1%) specific for CSIs. The de novo model (diving, axial load, neck pain, inability to move neck, altered mental status, intubation, or respiratory distress) was 92.0% (85.7%–98.1%) sensitive and 50.3% (48.7%–51.8%) specific. CONCLUSIONS: Our findings support previously identified pediatric CSI risk factors and prospective pediatric CSI prediction rule development.
Factors Related to Patient Dissatisfaction Versus Objective Failure After Arthroscopic Shoulder Stabilization for Instability.

BACKGROUND After arthroscopic stabilization procedures for recurrent anterior shoulder instability, patients are not always satisfied with their shoulder, even when the operation successfully restored stability. The aim of this study was to evaluate the factors associated with subjective patient dissatisfaction after arthroscopic stabilization procedures for recurrent anterior shoulder instability and to compare these factors with those associated with objective surgical failure. METHODS A total of 195 patients who underwent an arthroscopic stabilization procedure for recurrent anterior shoulder instability were included in this study. At the 2-year postoperative visit, subjective patient dissatisfaction was assessed with a 15-point scale. Objective surgical failure was defined as postoperative dislocation or subluxation events requiring revision surgery. Several factors, including age at the first dislocation, age at the time of the operation, presence of an off-track Hill-Sachs lesion, width of the Hill-Sachs lesion, size of the glenoid bone defect, and number of instability events, were recorded. Multivariable linear regression analysis and multivariable logistic regression analysis were performed using a backward stepwise procedure as the variable selection method. RESULTS Fifteen patients (7.7%) had recurrent instability requiring revision surgery. In the group of 180 patients without surgical failure, the width of the Hill-Sachs lesion (regression coefficient: 0.052, p = 0.011) and number of instability events (regression coefficient: 0.103, p = 0.029) were positively correlated with subjective patient dissatisfaction, whereas concomitant repair of a SLAP (superior labrum anterior-posterior) lesion showed negative correlation (regression coefficient: -0.926, p = 0.004). In the total cohort of patients, objective surgical failure was correlated with the age at the time of the operation (odds ratio [OR]: 0.851, p = 0.042), size of the glenoid bone defect (OR: 1.172, p < 0.001), and number of instability events (OR: 1.147, p = 0.048). Other variables, including an off-track Hill-Sachs lesion or a concomitant remplissage procedure, were not correlated with subjective patient dissatisfaction or objective surgical failure. CONCLUSIONS Factors related to subjective patient dissatisfaction differed from those related to objective surgical failure. For a better understanding of the clinical outcomes after surgery, surgeons should assess the factors that correlate with subjective patient dissatisfaction and objective surgical failure. LEVEL OF EVIDENCE Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Clinical significance of myocardial involvement in acute idiopathic pericarditis

Background Acute idiopathic pericarditis (AIP) is frequently accompanied by myocardial involvement (AIPM). Although in acute myocarditis, the myocardial inflammation can lead to life-threatening complications, the outcome of patients with AIPM has been described as good. It remains unclear if a good prognosis of patients with AIPM reflects mild myocardial involvement or good medical management. Methods A retrospective analysis of life-threatening complications and life-saving interventions in a cohort of 248 consecutive patients admitted to a single medical center between 2006 and 2017 with AIP (n = 169) or AIPM (n = 79). Major adverse cardiac events (MACE) included cardiac tamponade, cardiogenic shock, ventricular tachycardia, pericardiocentesis, pericardiectomy, large pericardial effusion and death. Results Patients with AIPM were younger than patients with AIP (p < 0.001), and more often had left ventricular dysfunction (31.6% vs. 1.2%, p < 0.001) and less often had large pericardial effusion (1.3% vs. 13.6%, p = 0.002), and MACE (5.1% vs. 14.8%, p = 0.014). Cardiac tamponade occurred in 5.3% of the patients with AIP as opposed to 1.3% of the patients with AIPM (p = 0.176). Severe left ventricular dysfunction with cardiogenic shock occurred exclusively among patients with AIPM but the rate was low (2.5%). Life-saving interventions were used in both groups at comparable rates (2.5% vs. 5.3%, p = 0.510). There were no in-hospital deaths. Conclusions Myocardial involvement in acute pericarditis is associated with a low rate of severe left ventricular dysfunction and cardiogenic shock and a reduced rate of large pericardial effusion, resulting in a lower rate of MACE. Life-saving interventions were used at comparable rates in patients with and without myocardial involvement having excellent survival rates.
Americium biodistribution in rats after wound contamination with different physicochemical forms in the presence or absence of plutonium: analyses using STATBIODIS

Americium (Am) biodistribution data obtained after wound contamination in rats were analysed to evaluate and quantify the influence of different physicochemical forms of Am in the presence or absence of plutonium (Pu). The biodistribution data were individual Am daily urinary excretion and tissue retention. The data were analysed with STATBIODIS, a statistical tool developed in the laboratory and based on the R language. Non-parametric methods were selected to comply with the data characteristics. Am systemic tissue retention and urinary excretion data were much greater for contamination with soluble physicochemical forms than insoluble forms. Meanwhile, Am relative biodistribution between the main retention tissues (skeleton, liver and kidney) remained the same. Hence, after absorption into blood the radionuclide behaviour was independent of the physicochemical form. The presence of Pu did not change the Am biodistribution. Comparisons of the biodistribution data from the laboratory with mean values published by other laboratories showed that soluble to moderately soluble forms of Am resulted in similar urine excretion after contamination, whether it was intravenous, intramuscular, subcutaneous injection or incision. Findings from this work will contribute to improve the understanding and interpretation of wound contamination cases with different physicochemical forms and mixtures of actinides including Am.