Miracle-dz/UniFAR-FTUs huggingface dataset:
Extracorporeal cardiopulmonary resuscitation in out-of-hospital cardiac arrest: a registry study.

AIMS Out-of-hospital cardiac arrest (OHCA) without return of spontaneous circulation (ROSC) despite conventional resuscitation is common and has poor outcomes. Adding extracorporeal membrane oxygenation (ECMO) to cardiopulmonary resuscitation (extracorporeal-CPR) is increasingly used in an attempt to improve outcomes. METHODS AND RESULTS We analysed a prospective registry of 13 191 OHCAs in the Paris region from May 2011 to January 2018. We compared survival at hospital discharge with and without extracorporeal-CPR and identified factors associated with survival in patients given extracorporeal-CPR. Survival was 8% in 525 patients given extracorporeal-CPR and 9% in 12 666 patients given conventional-CPR (P = 0.91). By adjusted multivariate analysis, extracorporeal-CPR was not associated with hospital survival [odds ratio (OR), 1.3; 95% confidence interval (95% CI), 0.8-2.1; P = 0.24]. By conditional logistic regression with matching on a propensity score (including age, sex, occurrence at home, bystander CPR, initial rhythm, collapse-to-CPR time, duration of resuscitation, and ROSC), similar results were found (OR, 0.8; 95% CI, 0.5-1.3; P = 0.41). In the extracorporeal-CPR group, factors associated with hospital survival were initial shockable rhythm (OR, 3.9; 95% CI, 1.5-10.3; P = 0.005), transient ROSC before ECMO (OR, 2.3; 95% CI, 1.1-4.7; P = 0.03), and prehospital ECMO implantation (OR, 2.9; 95% CI, 1.5-5.9; P = 0.002). CONCLUSIONS In a population-based registry, 4% of OHCAs were treated with extracorporeal-CPR, which was not associated with increased hospital survival. Early ECMO implantation may improve outcomes. The initial rhythm and ROSC may help select patients for extracorporeal-CPR.
Cognitive Enhancement via Network-Targeted Cortico-cortical Associative Brain Stimulation.

Fluid intelligence (gf) represents a crucial component of human cognition, as it correlates with academic achievement, successful aging, and longevity. However, it has strong resilience against enhancement interventions, making the identification of gf enhancement approaches a key unmet goal of cognitive neuroscience. Here, we applied a spike-timing-dependent plasticity (STDP)-inducing brain stimulation protocol, named cortico-cortical paired associative stimulation (cc-PAS), to modulate gf in 29 healthy young subjects (13 females-mean ± standard deviation, 25.43 years ± 3.69), based on dual-coil transcranial magnetic stimulation (TMS). Pairs of neuronavigated TMS pulses (10-ms interval) were delivered over two frontoparietal nodes of the gf network, based on individual functional magnetic resonance imaging data and in accordance with cognitive models of information processing across the prefrontal and parietal lobe. cc-PAS enhanced accuracy at gf tasks, with parieto-frontal and fronto-parietal stimulation significantly increasing logical and relational reasoning, respectively. Results suggest the possibility of using SPTD-inducing TMS protocols to causally validate cognitive models by selectively engaging relevant networks and manipulating inter-regional temporal dynamics supporting specific cognitive functions.
The evolution of the axonal transport toolkit

Neurons are highly polarized cells that critically depend on long‐range, bidirectional transport between the cell body and synapse for their function. This continual and highly coordinated trafficking process, which takes place via the axon, has fascinated researchers since the early 20th century. Ramon y Cajal first proposed the existence of axonal trafficking of biological material after observing that dissociation of the axon from the cell body led to neuronal degeneration. Since these first indirect observations, the field has come a long way in its understanding of this fundamental process. However, these advances in our knowledge have been aided by breakthroughs in other scientific disciplines, as well as the parallel development of novel tools, techniques and model systems. In this review, we summarize the evolution of tools used to study axonal transport and discuss how their deployment has refined our understanding of this process. We also highlight innovative tools currently being developed and how their addition to the available axonal transport toolkit might help to address key outstanding questions.
Predictors of Insomnia Severity Index Profiles in United States Veterans With Obstructive Sleep Apnea.

STUDY OBJECTIVES The Insomnia Severity Index (ISI) has been used to define insomnia symptoms in individuals with obstructive sleep apnea (OSA). However, whether distinct ISI profiles exist in individuals with OSA is unclear. The aims of this study were to determine (1) empirically-based ISI profiles in veterans with OSA and (2) predictors of these ISI profiles. METHODS Participants were 630 veterans with a new diagnosis of OSA over a 12-month period. Individuals completed the ISI and other questionnaires on the polysomnography (PSG) night. Latent profile analysis was performed to detect ISI subgroups based on individual ISI items. Age, Charlson Comorbidity Index, apnea-hypopnea index (AHI), mood disorder, posttraumatic stress disorder, and chronic pain diagnoses were used to predict between ISI profiles. RESULTS Latent profile analysis identified five ISI subgroups in veterans with OSA. The "asymptomatic" group (12% prevalence) had low scores across all ISI items. The "moderate insomnia" (30% prevalence) and "severe insomnia" (44% prevalence) groups had elevated scores for all ISI items but differing in severity. Last, the "moderate" (6% prevalence) and "severe daytime symptoms" groups (8% prevalence) were characterized by absence of nocturnal complaints but high scores on daytime impairment items. Age, AHI, mood disorder, posttraumatic stress disorder and chronic pain diagnoses discriminated between ISI profiles. CONCLUSIONS We describe data-driven ISI profiles in veterans with OSA. Older age was associated with lower insomnia and daytime symptom complaints whereas psychological comorbidities were related to more severe insomnia. Caution should be used in interpreting the ISI score in individuals with OSA because a subset had elevated total scores without insomnia.
Referrers' Perceived Utility and Outcomes of Clinical Neuropsychological Assessment in an Adolescent and Young Adult Public Mental Health Service

Despite frequent informal or anecdotal acknowledgement of the usefulness of neuropsychological services within various settings, including mental health settings, few studies have formally investigated the satisfaction, perceived utility, or outcomes associated with such a service. This survey‐based study evaluated referring clinicians’ (n = 35) perceptions of the usefulness and outcomes associated with the provision of clinical neuropsychological assessment and feedback within an adolescent and young adult public mental health service in Melbourne, Australia. The results suggest that referrers perceive the neuropsychological service, including formal neuropsychological assessment report and verbal and written feedbacks, as a highly useful adjunct to their clinical practice. In addition, referrers frequently reported clinically meaningful outcomes in association with the neuropsychological service, including diagnostic changes or additions (11% of clients referred), changes to approaches in treatment (52% of clients referred), and increased or appropriate access to services, education, or work (33% of clients referred). Referrers also reported that almost 60% of neuropsychological assessment reports were forwarded to other services or clinicians involved in the client's care. The findings suggest that mental health settings are likely to benefit from routine inclusion of specialist neuropsychology services. However, future research should also examine client and family perceptions regarding the satisfaction and usefulness of neuropsychological services.
Empirically defining treatment response and remission in body dysmorphic disorder

Abstract Background The number of clinical trials in body dysmorphic disorder (BDD) has steadily increased in recent years. As the number of studies grows, it is important to define the most empirically useful definitions for response and remission in order to enhance field-wide consistency and comparisons of treatment outcomes across studies. In this study, we aim to operationally define treatment response and remission in BDD. Method We pooled data from three randomized controlled trials of cognitive-behavior therapy (CBT) for BDD (combined n = 153) conducted at four academic sites in Sweden, the USA, and England. Using signal detection methods, we examined the Yale-Brown Obsessive Compulsive Scale modified for BDD (BDD–YBOCS) score that most reliably identified patients who responded to CBT and those who achieved remission from BDD symptoms at the end of treatment. Results A BDD–YBOCS reduction ⩾30% was most predictive of treatment response as defined by the Clinical Global Impression (CGI) – Improvement scale (sensitivity 0.89, specificity 0.91, 91% correctly classified). At post-treatment, a BDD–YBOCS score ⩽16 was the best predictor of full or partial symptom remission (sensitivity 0.85, specificity 0.99, 97% correctly classified), defined by the CGI – Severity scale. Conclusion Based on these results, we propose conceptual and operational definitions of response and full or partial remission in BDD. A consensus regarding these constructs will improve the interpretation and comparison of future clinical trials, as well as improve communication among researchers, clinicians, and patients. Further research is needed, especially regarding definitions of full remission, recovery, and relapse.
Prevalence of human malaria infection in District Jhal Magsi of Balochistan, Pakistan. -

Objective: To study the prevalence of malarial infections in human population of district Jhal Magsi areas of Pakistan. Patients and Methods: Malarial parasites were identified in the blood slides of suspected patients of the disease from July, 2006 to June, 2008, and encompassed 3402 subjects. Results: Out of 3402 suspected cases of malaria, 1189 (34.9%) were found to be positive for malarial parasite in blood smear slides. Out of positive cases,773 (65%) were identified as Plasmodium vivax infection, 416 (34.9%) cases with P. falciparum. However, seasonal variation was also noted with the highest (71.6%: 96/134) infection of P. vivax in March and lowest (54%: 40/74) in September. The prevalence was higher (65.3%) in males. Age wise, the prevalence of the disease was 66.9% and 65.4% for age group of 11-20 years and 1-10 years. There was no case of P. malariae and P. ovale detected in the present study. These results are compared with those of other studies conducted in Pakistan. Conclusion: Human Malaria is quite frequent in Jhal Magsi area, which is the hottest area s of Balochistan in Pakistan. In clinically suspected cases of malaria, there are very high slide positivity rate. The high prevalence rate 65% of P. vivax poses a significant health hazard but 34.9% of P. falciparum also may lead to serious complications like cerebral malaria. The high frequency of Human malaria infection should be of great concern for authorities at malaria control program in Pakistan. No association was found between types of infection and age groups.
Quantitative studies on the impaired filterability of erythrocytes from patients with liver cirrhosis

ated with LC. We have investigated erythrocyte filterability in relation to the severity of LC . The severity was assessed according to the Child-Pugh classification (grade A , B, and C). The mean erythrocyte filterability of the entire 31 patients with LC (64 .6 •} 14.5%) was significantly (P<0.03) decreased compared with that in 5 normal controls (80.5 •} 1 .7%). Comparing with the filterability in the controls, the filterability in the LC groups in grade A (70 .9 •} 9.6%) was not significantly decreased (p=0.053, n=8), but the filterability in the LC groups in grade B (65 .9 •} 11.0%: p < 0.01, n=19) and in grade C (45.9 •} 23 .8%: p < 0.02, n=4) were markedly decreased . We found that the impaired filterability reflects the severity of anemia and liver dysfunctions , suggesting that the impairment is one of the causes of anemia . Further, the present study suggested that the impaired filterability arises from the altered erythrocyte membrane properties and a possible mechanical
Health Information Seeking Through Social Media and Search Engines by Parents of Children With Orofacial Cleft in Nigeria

Objective: To ascertain the level of utilization of social media platforms and search engines by parents of children with orofacial cleft presenting to our clinic, with respect to information seeking about the condition and its treatment. Materials and Methods: All consenting parents of children attending the cleft outpatient clinic of the Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital, Idi-Araba, Lagos, within the study period were included in the sample population. Data collection was done using a 17-item interviewer-administered questionnaire. Results: A total of 50 parents participated in the study. Eighty-eight percent first sought information about their child’s condition from hospital medical staff. Sixty-eight percent of the parents are active users of social media for general purposes, with Facebook being the most used platform (62%). Forty percent of the total respondents have used search engines/social media to seek information on their child’s condition, with majority of those (80%) using Google to search for such information, 35% of the search was in relation to diagnosis, and 75% of the parents considered the information obtained very useful. Only 3 parents reported being part of a social media support group based on their child’s condition. Conclusion: The use of Internet resources for information seeking among the population studied is low. There is need to leverage on social media to provide support groups for families with children who have cleft.
Associations of accelerometer-measured sedentary time, sedentary bouts, and physical activity with adiposity and fitness in children

ABSTRACT Sedentary time (ST) has been inconsistently associated with adiposity and cardiorespiratory fitness in children in previous studies. We studied cross-sectional associations of ST, light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) with fat mass index (FMI) and cardiorespiratory fitness (estimated VO2max). Associations were evaluated with and without considering pattern of ST by bout length. We measured ST and activity by a wrist-worn accelerometer, FMI by bioelectrical impedance, and VO2max by Pacer test in 443 children (51.2% girls, 10.2 ± 0.6 years). Isotemporal substitution regression models estimated the effects of substituting ST, LPA, and MVPA on FMI and VO2max. Further models repeated analyses separating ST into short (<10 min) and long (≥10 min) bouts. Only replacing ST or LPA with MVPA was consistently associated with lower FMI and greater VO2max. When separated by bout length, only one unique association was found where replacing long ST bouts with short ST bouts was associated with lower FMI in girls only. In conclusion, activity pattern is associated with adiposity in girls and fitness in boys and girls. Separating ST into long and short ST bouts may be of minimal importance when assessing associations with adiposity and fitness using wrist-worn accelerometry in children.
Wound closure by means of free flap and arteriovenous loop: Development of flap autonomy in the long‐term follow‐up

Free flaps in combination with arterial reconstruction by means of arteriovenous loops or bypass have, meanwhile, been established as a therapeutic option in defect reconstruction for areas without recipient vessels. Our aim was to analyse the long‐term performance, flap autonomy, and the flap perfusion. Patients receiving this combined reconstruction at a single‐centre institution were included. During follow‐up examination, the patency of arterial reconstruction was investigated by duplex ultrasound. Flap micro‐circulation was assessed by laser Doppler flowmetry and white light tissue spectrometry (O2C) as well as by indocyanine green fluorescence angiography. Twenty‐three patients could be clinically followed up. Duplex ultrasound showed, in four cases, arterial pedicle occlusion in spite of vital flap. Comparison of the O2C perfusion parameters between flaps with occluded pedicles and those with intact inflow showed no significant difference (parameters sO2: P = .82; Flow: P = .31). Similar results were obtained by fluorescence angiography; no significant difference could be detected between both groups (parameters Ingress P = .13; Ingressrate P = .54). Combined vascular reconstruction with free tissue transfer is associated with a good long‐term outcome and wound closure. Even after flap transplantation to areas with critical tissue perfusion, the flap can develop autonomy and thus survive after pedicle occlusion.
THE EFFECT OF EXERCISE DURING DECOMPRESSION FROM INCREASED BAROMETRIC PRESSURES ON THE INCIDENCE OF DECOMPRESSION SICKNESS IN MAN.

Abstract : Twenty-seven divers in excellent physical condition were used as subjects for the studies. A total of 201 dives were made, 60 being of the saturation type (depths of 33 to 40 feet for 12 hours exposure) and 141 of them being of the short deep variety. Results: the adverse effect of exercise is similar after saturation dives or the deep dives. For the saturation dives the incidence of pain among 14 subjects who rested was 35.7T as compared to 71.4% when the same subjects exercised. For all deep dives, the incidence of pain was 16.36% among 55 subjects who rested as compared to 49.09% when the same subjects exercised. A summary of all singular dives, although not as significant for true comparison, reveals a similar increase of pain symptoms when exercise was performed. Recommendations: the performance of exercise by divers during their decompression period or immediately after reaching surface pressure is not recommended and its employment in current diving practice should be discontinued.
Monocular 3D Probe Tracking for Generating Sub-Surface Optical Property Maps From Diffuse Optical Spectroscopic Imaging

<italic>Objective:</italic> Diffuse optical spectroscopic imaging (DOSI) is a promising biophotonic technology for clinical tissue assessment, but is currently hampered by difficult wide area assessment. A co-integrative optical imaging system is proposed for dense sub-surface optical property spatial assessment. <italic>Methods:</italic> The proposed system fuses a co-aligned set of camera frames and diffuse optical spectroscopy measurements to generate spatial sub-surface optical property maps. A 3D rigid body motion estimation model was developed by fitting automatically detected target features to an <italic>a priori</italic> geometric model using a single overhead camera. Point-wise optical properties were measured across the tissue using frequency domain photon migration DOSI. The 3D probe trajectory and temporal optical property data were fused to generate 2D spatial optical property maps, which were projected onto the tissue image using pre-calibrated camera parameters. <italic>Results:</italic> The system demonstrated sub-millimeter positional accuracy (error 0.24 <inline-formula><tex-math notation="LaTeX">$ \pm $</tex-math></inline-formula> 0.35 mm) across different probe speeds (1.0–3.8 cm/s), and displacement accuracy in overhead (<inline-formula><tex-math notation="LaTeX">$-\text{0.42}\pm \text{0.33}$</tex-math></inline-formula> mm) and tilted (0.51 <inline-formula><tex-math notation="LaTeX">$\pm $</tex-math></inline-formula> 0.51 mm) camera orientations. Unstructured scans on a tumor inclusion phantom showed strong contrast under different probe paths, and significant (<inline-formula><tex-math notation="LaTeX">$p< 0.001$</tex-math></inline-formula>) changes in optical properties in an <italic>in vivo</italic> leg cuff occlusion protocol with spatial anatomy localization. <italic>Conclusion:</italic> The proposed co-integrative optical imaging system generated dense sub-surface optical property distributions across wide tissue areas with sub-millimeter accuracy at different probe speeds and trajectories, and does not require pre-planned probe route for tissue assessment. <italic>Significance:</italic> This system provides a valuable tool for real-time non-invasive tissue health and cancer screening, and enables longitudinal disease progression assessment through unstructured probe-based optical tissue assessment.
A Novel Machine Learning Model Developed to Assist in Patient Selection for Outpatient Total Shoulder Arthroplasty.

INTRODUCTION Patient selection for outpatient total shoulder arthroplasty (TSA) is important to optimizing patient outcomes. This study aims to develop a machine learning tool that may aid in patient selection for outpatient total should arthroplasty based on medical comorbidities and demographic factors. METHODS Patients undergoing elective TSA from 2011 to 2016 in the American College of Surgeons National Surgical Quality Improvement Program were queried. A random forest machine learning model was used to predict which patients had a length of stay of 1 day or less (short stay). A multivariable logistic regression was then used to identify which variables were significantly correlated with a short or long stay. RESULTS From 2011 to 2016, 4,500 patients were identified as having undergone elective TSA and having the necessary predictive features and outcomes recorded. The machine learning model was able to successfully identify short stay patients, producing an area under the receiver operator curve of 0.77. The multivariate logistic regression identified numerous variables associated with a short stay including age less than 70 years and male sex as well as variables associated with a longer stay including diabetes, chronic obstructive pulmonary disease, and American Society of Anesthesiologists class greater than 2. CONCLUSIONS Machine learning may be used to predict which patients are suitable candidates for short stay or outpatient TSA based on their medical comorbidities and demographic profile.