Miracle-dz/UniFAR-FTUs huggingface dataset:
Cognitive Rehabilitation With Mobile Technology and Social Support for Veterans With TBI and PTSD: A Randomized Clinical Trial

Objective: To investigate effects of cognitive rehabilitation with mobile technology and social support on veterans with traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD). Participants: There were 112 dyads, comprised by a veteran and a family member or friend (224 participants in total). Design: Dyads were randomized to the following: (1) a novel intervention, Cognitive Applications for Life Management (CALM), involving goal management training plus mobile devices for cueing and training attentional control; or (2) Brain Health Training, involving psychoeducation plus mobile devices to train visual memory. Main Measures: Executive dysfunction (disinhibition, impulsivity) and emotional dysregulation (anger, maladaptive interpersonal behaviors) collected prior to randomization and following intervention completion at 6 months. Results: The clinical trial yielded negative findings regarding executive dysfunction but positive findings on measures of emotion dysregulation. Veterans randomized to CALM reported a 25% decrease in anger over 6 months compared with 8% reduction in the control (B = −5.27, P = .008). Family/friends reported that veterans randomized to CALM engaged in 26% fewer maladaptive interpersonal behaviors (eg, aggression) over 6 months compared with 6% reduction in the control (B = −2.08, P = .016). An unanticipated result was clinically meaningful change in reduced PTSD symptoms among veterans randomized to CALM (P < .001). Conclusion: This preliminary study demonstrated effectiveness of CALM for reducing emotional dysregulation in veterans with TBI and PTSD.
Combination of dihydromyricetin and ondansetron strengthens antiproliferative efficiency of adriamycin in K562/ADR through downregulation of SORCIN: A new strategy of inhibiting P‐glycoprotein

Though the advancement of chemotherapy drugs alleviates the progress of cancer, long‐term therapy with anticancer agents gradually leads to acquired multidrug resistance (MDR), which limits the survival outcomes in patients. It was shown that dihydromyricetin (DMY) could partly reverse MDR by suppressing P‐glycoprotein (P‐gp) and soluble resistance‐related calcium‐binding protein (SORCIN) independently. To reverse MDR more effectively, a new strategy was raised, that is, circumventing MDR by the coadministration of DMY and ondansetron (OND), a common antiemetic drug, during cancer chemotherapy. Meanwhile, the interior relation between P‐gp and SORCIN was also revealed. The combination of DMY and OND strongly enhanced antiproliferative efficiency of adriamycin (ADR) because of the increasing accumulation of ADR in K562/ADR‐resistant cell line. DMY could downregulate the expression of SORCIN and P‐gp via the ERK/Akt pathways, whereas OND could not. In addition, it was proved that SORCIN suppressed ERK and Akt to inhibit P‐gp by the silence of SORCIN, however, not vice versa. Finally, the combination of DMY, OND, and ADR led to G2/M cell cycle arrest and apoptosis via resuming P53 function and restraining relevant proteins expression. These fundamental findings provided a promising approach for further treatment of MDR.
Evaluation of a randomized clinical trial comparing the effectiveness of a culturally targeted and non-targeted smoking cessation intervention for lesbian, gay, bisexual and transgender (LGBT) smokers.

Purpose To examine the benefits of a culturally targeted compared to a non-targeted smoking cessation intervention on smoking cessation outcomes among LGBT smokers. Methods A prospective randomized design was used to evaluate the added benefits of an LGBT culturally targeted Courage to Quit (CTQ-CT) smoking cessation treatment (N = 172) compared to the standard intervention (CTQ) (N=173). The smoking cessation program consisted of six treatment sessions combined with 8 weeks of nicotine replacement therapy. The primary smoking cessation outcome was 7-day point prevalence quit rates. Secondary outcomes examined included changes in nicotine dependence, nicotine withdrawal, cigarettes per day, smoking urges, self-efficacy and readiness to quit. Results Overall quit rates were 31.9% at 1 month, 21.1% at 3 months, 25.8% at 6 months and 22.3% at 12-months. Quit rates did not differ between treatment groups (1 month OR=0.81 (0.32, 2.09), 3 months OR=0.65 (0.23, 1.78), 6 months OR=0.45 (0.17, 1.21), 12 months OR=0.70 (0.26, 1.91)). Compared to baseline levels, all secondary smoking cessation outcomes measured were improved at 1-month and were maintained at 12-month follow-up. Compared to the CTQ, the CTQ-CT intervention was more highly rated on program effectiveness (d=0.2, p =.011), intervention techniques (d=0.2, p = .014), the treatment manual (d=0.3, p <.001), and being targeted to the needs of LGBT smokers (d=0.5, p < .0001). Conclusions LGBT smokers receiving the CTQ intervention achieved smoking cessation outcomes in the range reported for other demographic groups. Cultural targeting improved the acceptability of the intervention but did not confer any additional benefit for smoking cessation outcomes. Implications Study results have implications for understanding the benefits of culturally targeted compared to non-targeted smoking cessation interventions for improving smoking cessation outcomes among LGBT smokers. Short and longer-term 7-day point prevalence quit rates associated with the targeted and non-targeted interventions were modest but comparable to other group based interventions delivered in a community setting. Although cultural targeting improved the overall acceptability of the intervention, no added benefits were observed for the culturally targeted intervention on either the primary or secondary outcomes.
Clinical utility of fractional exhaled nitric oxide and blood eosinophils counts in the diagnosis of asthma–COPD overlap

Background Asthma–COPD overlap (ACO) is difficult to diagnose because it is characterized by persistent airflow limitation, and patients present with several manifestations that are usually associated with both asthma and COPD. In this retrospective study, we aimed to evaluate the diagnostic accuracy of fractional exhaled nitric oxide (FeNO) and blood eosinophil counts for the clinical diagnosis of ACO. Patients and methods A total of 121 patients were divided into two study groups, COPD alone or ACO, which was based on criteria from the joint document by the Global Initiative for Asthma and the Global initiative for chronic Obstructive Lung Disease. From July 2014 to April 2017, FeNO levels and blood eosinophil counts were measured in specimens from patients naïve to inhaled corticosteroids (ICS) and those using ICS. Receiver operating characteristic curve analysis was used to determine the cutoff values of FeNO and blood eosinophil levels that provided the best differential diagnosis between ACO and COPD. Results Among a total of 121 patients, 65 patients were diagnosed with COPD and 56 patients with ACO. The FeNO level was higher in patients with ACO than in patients with COPD (median 24.5 vs 16.0 ppb, respectively; P<0.01). Among patients naïve to ICS, the area under the receiver operating characteristic curve of FeNO values was 0.726, and the optimal diagnostic cutoff level of FeNO was 25.0 ppb, with 60.6% sensitivity and 87.7% specificity for differentiating ACO from COPD. FeNO (≥25.0 ppb) combined with blood eosinophil counts (≥250/μL) showed 96.1% specificity. Conclusion These results demonstrate that the FeNO level combined with blood eosinophil count is useful for the differential diagnosis between ACO and COPD.
Does a Nurse-Led Program of Support and Lifestyle Management for patients with coronary artery disease significantly improve psychological outcomes among the patients?

Background: Nowadays, secondary prevention of coronary heart disease (CHD) is commonly provided by nurse-coordinated prevention programs (NCPPs). NCPPs were recommended to be incorporated into the healthcare systems by the European Society of Cardiology (ESC) as stated in their 2012 European Guideline. Even if Nurse-Led Programs of Support and Lifestyle Management are beneficial to the patients with CHD, it is not clear whether these programs significantly improve psychological outcomes among the patients. Therefore, in this analysis, we aimed to systematically compare anxiety and depression reported among CHD patients who were assigned to a Nurse-Led Programs of Support and Lifestyle Management versus patients who were assigned to a normal usual care setting. Methods: Online databases were searched for English publications assessing anxiety and depression in CHD patients who were assigned to a Nurse Interventional program versus patients who were assigned to a normal usual care setting. This analysis was carried out by RevMan software (version 5.3). For dichotomous data, odds ratios (ORs) and 95% confidence intervals (CIs) were generated whereas for continuous data, weight mean difference (WMDs) and 95% CIs were calculated. Results: A total number of 3110 patients were analyzed (1526 participants were assigned to the Nurse Interventional group whereas 1584 participants were assigned to the normal usual care group). Patients’ enrollment time period varied from the year 2008 to the year 2015. Results of this analysis showed that depression among participants who were assigned to a Nurse-Led Program of Support and Lifestyle Management was not significantly different (OR: 0.90, 95% CI: 0.68–1.20; P = .47) compared to participants who were assigned to the normal usual care setting. When continuous data were used, still no significant difference was observed (WMD: −0.83, 95% CI: −1.68–0.02; P = .06). A similar result was obtained even when anxiety was assessed (WMD: −1.38, 95% CI: −3.21–0.45; P = .14). Conclusions: The current analysis did not show any significant improvement in reduction of depression and anxiety among CHD patients who were assigned to a Nurse-Led Program of Support and Lifestyle Management versus those patients who were assigned to a normal usual care setting. Therefore, according to this analysis, even if a Nurse-Led Program of Support and Lifestyle Management might be clinically effective, it does not improve mental well-being in these patients with CHD.
Inconsistent Weight Communication Among Prenatal Healthcare Providers and Patients: A Narrative Review.

Importance Gestational weight gain (GWG) is an independent and modifiable factor for a healthy pregnancy. Gestational weight gain above or below the Institute of Medicine Guidelines has been shown to impact both maternal and fetal health (eg, gestational diabetes, hypertension, downstream obesity). Healthcare providers (HCPs) have the potential to be reliable sources of evidence-based weight information and advice during pregnancy. Objective The aim of this study was to summarize the literature assessing GWG discussions between patients and their HCPs in a clinical setting to better understand the knowledge that is currently being exchanged. Evidence Acquisition A literature review was conducted by searching Ovid Medline, CINAHL, and Embase databases. All relevant primary research articles in English that assessed GWG discussions were included, whereas intervention studies were excluded. Results A total of 54 articles were included in this review. Although the overall prevalence and content of GWG counseling varied between studies, counseling was often infrequent and inaccurate. Healthcare providers tended to focus more on women experiencing obesity and excessive GWG, as opposed to the other body mass index categories or inadequate GWG. Women of higher socioeconomic status, older age, nulliparous, history of dieting, low physical activity, and those categorized as overweight/obese were more likely to receive GWG advice. Patients also reported receiving conflicting facts between different HCP disciplines. Conclusions The evidence regarding GWG counseling in prenatal care remains variable, with discrepancies between geographic regions, patient populations, and HCP disciplines. Relevance Healthcare providers should counsel their pregnant patients on GWG with advice that is concordant with the Institute of Medicine Guidelines.
Exercise, orthoses and splinting for treating Achilles tendinopathy: a systematic review with meta-analysis

Objectives To assess the efficacy of exercise, orthoses and splinting on function, pain and quality of life (QoL) for the management of mid-portion and insertional Achilles tendinopathy, and to compare different types, applications and modes of delivery within each intervention category. Design Systematic review and meta-analysis. Data sources Medline, CINAHL, Embase, AMED, WHO ICTRP, Web of Science, PEDro and Cochrane Library from inception to October 2017. Citation tracking of published studies and conference proceedings and contacting experts in the field. Study eligibility criteria Controlled clinical trials evaluating either exercise, orthoses or splinting for the management of Achilles tendinopathy. Methods Independent reviewers undertook searches, screening and risk of bias appraisal. Primary outcomes of interest were function, pain and QoL. Results Twenty-two studies were included (1137 participants). Moderate level evidence favoured eccentric exercise over control for improving pain and function in mid-portion tendinopathy. Moderate level evidence favoured eccentric exercise over concentric exercise for reducing pain. There was moderate level evidence of no significant difference in pain or function between eccentric exercise and heavy slow resistance exercise. There was low level evidence that eccentric exercise was not superior to stretching for pain or QoL. There was moderate level evidence that a combined exercise protocol was not superior to a lower dosage protocol for improving functional performance. There was moderate to low level evidence of a significant difference in pain (mean difference (MD) 6.3 mm, 95% CI −4.45 to 17.04, moderate) or function (MD 1.83 Victoria Institute of Sport Assessment points, 95% CI −7.47 to 11.12, low) between high-dose and low-dose eccentric training. There was high to moderate level evidence of no difference in pain (moderate) or function (high) between orthoses and control. There was low level evidence of no significant benefit in adding a night splint to an eccentric exercise programme for function, and moderate level evidence for no reduction in pain (MD −3.50, 95% CI −10.49 to 3.48). Eccentric exercise was not superior to splinting for pain (moderate evidence) or function (low level evidence). Summary We conditionally recommend exercise for improving pain and function in mid-portion Achilles tendinopathy. The balance of evidence did not support recommendation of one type of exercise programme over another. We conditionally recommend against the addition of a splint to an eccentric exercise protocol and we do not recommend the use of orthoses to improve pain and function in Achilles tendinopathy.
Comparing the impacts of macronutrients on life-history traits in larval and adult Drosophila melanogaster: the use of nutritional geometry and chemically defined diets

ABSTRACT Protein and carbohydrate are the two major macronutrients that exert profound influences over fitness in many organisms, including Drosophila melanogaster. Our understanding of how these macronutrients shape the components of fitness in D. melanogaster has been greatly enhanced by the use of nutritional geometry, but most nutritional geometric analyses on this species have been conducted using semi-synthetic diets that are not chemically well defined. Here, we combined the use of nutritional geometry and chemically defined diets to compare the patterns of larval and adult life-history traits expressed across 34 diets systematically varying in protein:carbohydrate (P:C) ratio and in protein plus carbohydrate (P+C) concentration. The shape of the response surfaces constructed for all larval and adult traits differed significantly from one another, with the nutritional optima being identified at P:C 1:4 for lifespan (P+C 120 g l−1), 1:2 for egg-to-adult viability (120 g l−1), 1:1 for female body mass at adult eclosion (240 g l−1) and lifetime fecundity (360 g l−1), 2:1 for larval developmental rate (60 g l−1) and 8:1 for egg production rate (120 g l−1). Such divergence in nutritional optima among life-history traits indicates that D. melanogaster confined to a single diet cannot maximize the expression of these traits simultaneously and thus may face a life-history trade-off. Our data provide the most comprehensive and nutritionally explicit analysis of the impacts of macronutrients on life-history traits in D. melanogaster and support the emerging notion that the fundamental trade-offs among life-history traits are mediated by macronutrients. Summary: Nutritional optima diverge among various life-history traits expressed at larval and adult stages in fruit flies, providing evidence for nutrient-mediated life-history trade-offs.
Improved mobility with metformin in patients with myotonic dystrophy type 1: a randomized controlled trial

Metformin, the well-known anti-diabetic drug, has been shown recently to improve the grip test performance of the DMSXL mouse model of myotonic dystrophy type 1. The drug may have positively affected muscle function via several molecular mechanisms, on RNA splicing, autophagia, insulin sensitivity or glycogen synthesis. Myotonic dystrophy remains essentially an unmet medical need. Since metformin benefits from a good toxicity profile, we investigated its potential for improving mobility in patients. Forty ambulatory adult patients were recruited consecutively at the neuromuscular reference centre of Henri-Mondor Hospital. Participants and investigators were all blinded to treatment until the end of the trial. Oral metformin or placebo was provided three times daily, with a dose-escalation period over 4 weeks up to 3 g/day, followed by 48 weeks at maximum dose. The primary outcome was the change in the distance walked during the 6-minute walk test, from baseline to the end of the study. Concomitant changes in muscle strength and effect on myotonia, gait variables, biological parameters and quality of life were explored. Patients randomized into two arms eventually revealed similar results in all physical measures and in the mean 6-minute walk test at baseline. For the 23/40 patients who fully completed the 1-year study, differences between the groups were statistically significant, with the treated group (n = 9) gaining a distance of 32.9 ± 32.7 m, while the placebo group (n = 14) gained 3.7 ± 32.4 m (P < 0.05). This improvement in mobility was associated with an increase in total mechanical power (P = 0.01), due to a concomitant increase in the cranial and antero-posterior directions suggesting an effect of the treatment on gait. Subanalysis revealed positive effects of metformin treatment on the 6-minute walk test at the first intermediate evaluation (after 16 weeks of treatment), quantitatively similar to those recorded at 1 year. In contrast, except for the expected limited weight loss associated to metformin treatment, there was no change in any of the other secondary endpoints, including myotonia and muscle strength. Patients in the treated group had a higher incidence of mild-to-moderate adverse effects, mostly gastrointestinal dysfunctions that required symptomatic treatment. Although results were statistically significant only for the per protocol population of patients and not in the intent-to-treat analysis, metformin at the maximal tolerated dose provided a promising effect on the mobility and gait abilities of myotonic patients. These encouraging results obtained in a small-scale monocentric phase II study call for replication in a well-powered multicentre phase III trial.
Dual Gene Repertoires for Larval and Adult Shells Reveal Molecules Essential for Molluscan Shell Formation

Abstract Molluscan shells, mainly composed of calcium carbonate, also contain organic components such as proteins and polysaccharides. Shell organic matrices construct frameworks of shell structures and regulate crystallization processes during shell formation. To date, a number of shell matrix proteins (SMPs) have been identified, and their functions in shell formation have been studied. However, previous studies focused only on SMPs extracted from adult shells, secreted after metamorphosis. Using proteomic analyses combined with genomic and transcriptomic analyses, we have identified 31 SMPs from larval shells of the pearl oyster, Pinctada fucata, and 111 from the Pacific oyster, Crassostrea gigas. Larval SMPs are almost entirely different from those of adults in both species. RNA-seq data also confirm that gene expression profiles for larval and adult shell formation are nearly completely different. Therefore, bivalves have two repertoires of SMP genes to construct larval and adult shells. Despite considerable differences in larval and adult SMPs, some functional domains are shared by both SMP repertoires. Conserved domains include von Willebrand factor type A (VWA), chitin-binding (CB), carbonic anhydrase (CA), and acidic domains. These conserved domains are thought to play crucial roles in shell formation. Furthermore, a comprehensive survey of animal genomes revealed that the CA and VWA–CB domain-containing protein families expanded in molluscs after their separation from other Lophotrochozoan linages such as the Brachiopoda. After gene expansion, some family members were co-opted for molluscan SMPs that may have triggered to develop mineralized shells from ancestral, nonmineralized chitinous exoskeletons.
Using Tools to Help Us Think: Actual but Also Believed Reliability Modulates Cognitive Offloading

Objective: A distributed cognitive system is a system in which cognitive processes are distributed between brain-based internal and environment-based external resources. In the current experiment, we examined the influence of metacognitive processes on external resource use (i.e., cognitive offloading) in such systems. Background: High-tech working environments oftentimes represent distributed cognitive systems. Because cognitive offloading can both support and harm performance, depending on the specific circumstances, it is essential to understand when and why people offload their cognition. Method: We used an extension of the mental rotation paradigm. It allowed participants to rotate stimuli either internally as in the original paradigm or with a rotation knob that afforded rotating stimuli externally on a computer screen. Two parameters were manipulated: the knob’s actual reliability (AR) and an instruction altering participants’ beliefs about the knob’s reliability (believed reliability; BR). We measured cognitive offloading proportion and perceived knob utility. Results: Participants were able to quickly and dynamically adjust their cognitive offloading proportion and subjective utility assessments in response to AR, suggesting a high level of offloading proficiency. However, when BR instructions were presented that falsely described the knob’s reliability to be lower than it actually was, participants reduced cognitive offloading substantially. Conclusion: The extent to which people offload their cognition is not based solely on utility maximization; it is additionally affected by possibly erroneous preexisting beliefs. Application: To support users in efficiently operating in a distributed cognitive system, an external resource’s utility should be made transparent, and preexisting beliefs should be adjusted prior to interaction.