Miracle-dz/UniFAR-FTUs huggingface dataset:
Comparative evaluation of group-based mindfulness-based stress reduction and cognitive behavioural therapy for the treatment and management of chronic pain: A systematic review and network meta-analysis

Question This review compares mindfulness-based stress reduction (MBSR) to cognitive-behavioural therapy (CBT) in its ability to improve physical functioning and reduce pain intensity and distress in patients with chronic pain (CP), when evaluated against control conditions. Study selection and analysis Ovid MEDLINE, EmbaseClassic+Embase, PsycINFO and the Cochrane Library were searched to identify randomised controlled trials. The primary outcome measure was physical functioning. Secondary outcomes were pain intensity and depression symptoms. We used random and fixed effects (RE and FE) network meta-analyses (NMA) to compare MBSR, CBT and control interventions on the standardised mean difference scale. Findings Twenty-one studies were included: 13 CBT vs control (n=1095), 7 MBSR vs control (n=545) and 1 MBSR vs CBT vs control (n=341). Of the 21 articles, 12 were determined to be of fair or good quality. Findings from RE NMA for change in physical functioning, pain intensity and depression revealed clinically important advantages relative to control for MBSR and CBT, but no evidence of an important difference between MBSR and CBT was found. Conclusions This review suggests that MBSR offers another potentially helpful intervention for CP management. Additional research using consistent measures is required to guide decisions about providing CBT or MBSR.
Coexistence and Impact of Limb Muscle and Diaphragm Weakness at Time of Liberation from Mechanical Ventilation in Medical Intensive Care Unit Patients

Rationale: Intensive care unit (ICU)‐ and mechanical ventilation (MV)‐acquired limb muscle and diaphragm dysfunction may both be associated with longer length of stay and worse outcome. Whether they are two aspects of the same entity or have a different prevalence and prognostic impact remains unclear. Objectives: To quantify the prevalence and coexistence of these two forms of ICU‐acquired weakness and their impact on outcome. Methods: In patients undergoing a first spontaneous breathing trial after at least 24 hours of MV, diaphragm dysfunction was evaluated using twitch tracheal pressure in response to bilateral anterior magnetic phrenic nerve stimulation (a pressure <11 cm H2O defined dysfunction) and ultrasonography (thickening fraction [TFdi] and excursion). Limb muscle weakness was defined as a Medical Research Council (MRC) score less than 48. Measurements and Main Results: Seventy‐six patients were assessed at their first spontaneous breathing trial: 63% had diaphragm dysfunction, 34% had limb muscle weakness, and 21% had both. There was a significant but weak correlation between MRC score and twitch pressure (&rgr; = 0.26; P = 0.03) and TFdi (&rgr; = 0.28; P = 0.01), respectively. Low twitch pressure (odds ratio, 0.60; 95% confidence interval, 0.45‐0.79; P < 0.001) and TFdi (odds ratio, 0.84; 95% confidence interval, 0.76‐0.92; P < 0.001) were independently associated with weaning failure, but the MRC score was not. Diaphragm dysfunction was associated with higher ICU and hospital mortality, and limb muscle weakness was associated with longer duration of MV and hospital stay. Conclusions: Diaphragm dysfunction is twice as frequent as limb muscle weakness and has a direct negative impact on weaning outcome. The two types of muscle weakness have only limited overlap.
IL‐7 overexpression enhances therapeutic potential of rat bone marrow mesenchymal stem cells for diabetic wounds

This study was aimed to enhance the healing potential of rat bone marrow mesenchymal stem cells against chronic diabetic wounds through interleukin‐7 (IL‐7) transfection. IL‐7 plays an important role in wound healing and acts as a survival factor in some cell types. This study involves isolation, propagation, and characterization of mesenchymal stem cells (MSCs) and their modification with IL‐7 gene via retroviral transfection. Transfected MSCs were assessed for their effect on angiogenic genes by qPCR. Wound healing potential of transfected MSCs was analyzed by scratch assay in vitro and by transplanting these cells in rat diabetic wound models in vivo. Wound area was measured for a period of 15 days and subsequent histological analysis was performed. qPCR results showed increased expression of IL‐7 gene (p ≤ 0.05) and also principal angiogenic genes, vascular endothelial growth factor (VEGF), hepatocyte growth factor (HGF), VEGF receptor 1 (FLT‐1), and VEGF receptor 2 (FLK‐1) (p ≤ 0.05). Neuropilin‐1 (NRP‐1) did not show any significant change. In vitro analysis of IL‐7 MSCs showed intense cell–cell connections and tube formation as compared to the normal MSCs. Rate of wound closure was more (p ≤ 0.001) in case of diabetic group transplanted with IL‐7 MSCs. Histological examination revealed enhanced vascular supply in skin tissues of diabetic animals transplanted with IL‐7 transfected MSCs as compared to normal MSCs. Immunohistochemical results showed significantly higher expression of IL‐7 (p ≤ 0.001) and α‐smooth muscle actin(p ≤ 0.001) in the tissue sections of IL‐7 transfected group as compared to normal MSCs and the diabetic control group; the latter indicates increase in the number of blood vessels. It is concluded from this study that IL‐7 overexpression in MSCs can enhance the healing potential of MSCs and aid in wound closure in diabetic animals through the induction of angiogenic genes.
A physiological study to determine the mechanism of carbon dioxide clearance during apnoea when using transnasal humidified rapid insufflation ventilatory exchange (THRIVE)†

Clinical observations suggest that compared with standard apnoeic oxygenation, transnasal humidified rapid‐insufflation ventilatory exchange using high‐flow nasal oxygenation reduces the rate of carbon dioxide accumulation in patients who are anaesthetised and apnoeic. This suggests that active gas exchange takes place, but the mechanisms by which it may occur have not been described. We used three laboratory airway models to investigate mechanisms of carbon dioxide clearance in apnoeic patients. We determined flow patterns using particle image velocimetry in a two‐dimensional model using particle‐seeded fluorescent solution; visualised gas clearance in a three‐dimensional printed trachea model in air; and measured intra‐tracheal turbulence levels and carbon dioxide clearance rates using a three‐dimensional printed model in air mounted on a lung simulator. Cardiogenic oscillations were simulated in all experiments. The visualisation experiments indicated that gaseous mixing was occurring in the trachea. With no cardiogenic oscillations applied, mean (SD) carbon dioxide clearance increased from 0.29 (0.04) ml.min−1 to 1.34 (0.14) ml.min−1 as the transnasal humidified rapid‐insufflation ventilatory exchange flow rate was increased from 20 l.min−1 to 70 l.min−1 (p = 0.0001). With a cardiogenic oscillation of 20 ml.beat−1 applied, carbon dioxide clearance increased from 11.9 (0.50) ml.min−1 to 17.4 (1.2) ml.min−1 as the transnasal humidified rapid‐insufflation ventilatory exchange flow rate was increased from 20 l.min−1 to 70 l.min−1 (p = 0.0014). These findings suggest that enhanced carbon dioxide clearance observed under apnoeic conditions with transnasal humidified rapid‐insufflation ventilatory exchange, as compared with classical apnoeic oxygenation, may be explained by an interaction between entrained and highly turbulent supraglottic flow vortices created by high‐flow nasal oxygen and cardiogenic oscillations.
Interaction of obesity and atrial fibrillation: an overview of pathophysiology and clinical management

ABSTRACT Introduction: Obesity, defined as a Body Mass Index (BMI) of ≥30 kg/m2, is the most common chronic metabolic disease worldwide and its prevalence has been strongly increasing. Obesity is associated with various diseases such as cardiovascular disease, type 2 diabetes, and hypertension. Regarding heart rhythm disorders, obesity is associated with an increase in atrial fibrillation (AF), the most common arrhythmia in clinical practice. AF is associated with increased cardiovascular morbidity and mortality. Obesity, a novel risk factor, is responsible for a 50%-increased incidence of AF. Areas covered: We will briefly discuss the obesity paradox and its mechanisms regarding cardiac and hemodynamic function changes. In the first main part of this review, we will be discussing risk assessment studies, pathophysiology, genetic predisposition, epicardial adipose tissue, and ventricular adaptation in relation to obesity and development of AF. In the second part, we will discuss treatment strategies like conservative management and the effect of bariatric and metabolic surgery. Expert opinion: Cardiac arrhythmias, in particular, AF, in patients with obesity comprise complex pathophysiological mechanisms that remain poorly understood. In recent literature, there has been increased interest in the role of epicardial adipose tissue and structural remodeling in obese hearts.
On the diagnosis and treatment of cutaneous and soft tissue tumours misdiagnosed as scars: Lessons from four cases

Some types of skin and soft tissue tumours may be misdiagnosed as scars because of the scar‐like manifestation or the history of injury. It is generally believed that injuries will activate wound healing, ultimately ending in fibrosis. Because of the tumour‐promoting properties of both the microenvironment of the wound and the wound‐healing process that may go awry, there is a likelihood that injuries may trigger tumour growth. From 2012 to 2016, we treated four patients who underwent unsuccessful treatments because of the misdiagnosis of scars or keloids. Upon the pathological diagnoses of skin and soft tissue tumours in the four cases, extended resection of the tumours was performed. Recurrence was not observed up to the last follow up. Since then, soft tissue tumours have much greater visibility and are considered during diagnosis if a wound is presented with the atypical appearance of scar after injuries. Under these circumstances, biopsy should be conducted.
Immunotherapies in the management of epidermal growth factor receptor mutated non-small cell lung cancer: a role will be found?

Immunotherapies have been incorporated in the treatment strategy of advanced non-small cell lung cancer (NSCLC), with worldwide pembrolizumab approval as upfront single agent for tumors with programmed cell death-ligand 1 (PD-L1) tumor proportion score (TPS) of ≥50%, and recently with the US Food and Drug Administration (FDA) and the European Medicines Agency (EMA) approvals of pembrolizumab in combination with chemotherapy for non-squamous lung cancer, irrespective of PD-L1 status.
Association of androgen and estrogen receptor expression with prostate volume in benign prostatic hyperplasia

Background: The expression of androgen (AR) and estrogen receptors (ER-A, ER-B) in Prostate cancer is well documented, but there are limited data about the same in patients with BPH. Hence the present study was designed to analyse the gene and protein expression of androgen and estrogen receptors in patients with BPH. Materials and Methods: Prostatic tissues were obtained from 27 BPH patients aged between 55 to 85 years by transurethral resection of prostate. Based on prostate volume, BPH patients were divided into two groups, Group A (≤30mL) and Group B (>30mL). The mRNA and protein expression of AR, ER-A and B were assessed by Quantitative real time PCR, Western blotting and Immunohistochemistry. Results: AR gene (P < 0.05) and protein expression (P = 0.03) and ER-A gene (P < 0.05) and protein expression (P = 0.02) was significantly higher in BPH patients with larger prostate size compared to smaller prostate size. Immunohistochemistry showed that AR expression was predominate in ductal cells of larger volume prostate tissues while AR expression in stromal tissue was the dominant finding in patients with smaller prostate size. Also serum estradiol was significantly increased in patients with larger prostate size (P = 0.03). Conclusion: Androgen and Estrogen receptor expression increases with increase in prostate volume in BPH cases.
Prevalence of stuttering in primary school children in Cairo-Egypt

Abstract Purpose: To determine the prevalence of stuttering among primary school children in Cairo. Method: A cross-sectional design was employed. Using a multi-stage random sample from 10 schools in Cairo, a total of 8765 primary school students were enrolled in the study. The teacher referring method was initially used to detect stuttering students, which was then confirmed by a Speech Language Pathologist (SLP) using Diagnostic and Statistical Manual for Mental Disorders–Fourth Edition (DSM-IV) criteria. Personal data were collected for all students and separate questionnaires were administered to the parents of each stuttering child, inquiring about consanguinity, family history, presence of other disorders and family attitudes towards the child. Result: Prevalence of stuttering among primary school children in Cairo was 1.03%. The prevalence of stuttering showed a declining trend in the older age group. Stuttering was 7-fold more prevalent among left-handed students. Males had a higher prevalence of stuttering, but didn't reach statistical significance. Anxiety was expressed in 25% of the families of affected children. Positive family history was found in 28% of cases, mainly among first-degree relatives. Conclusion: The current study showed a prevalence of stuttering comparable to other areas of the world with some evidence of hereditary background, although lower than that reported by other studies.
Spastic co-contraction, rather that spasticity, is associated with impaired active function in adults with acquired brain injury: A pilot study.

OBJECTIVE To elucidate the adverse consequences of spasticity and spastic co-contraction of elbow flexors on motor impairment and upper limb functional limitation. DESIGN A pilot case-controlled prospective observational study. SUBJECTS Ten brain-injured adults, and 10 healthy controls. METHODS The co-contraction index was computed from electromyographic recordings of elbow flexors during sub-maximal (25% Maximal Voluntary Contraction) isometric elbow extension. Spasticity was assessed with the Tardieu scale, upper limb limitation using a goniometer during active elbow extension, motor selectivity with the Fugl-Meyer Assessment for the upper limb, and motor function with the Action Research Arm Test. RESULTS Greater co-contraction occurred in patients with brain injury compared with controls. In contrast to spasticity, strong associations were found between the co-contraction index, the limitation of active elbow extension, the Fugl-Meyer Assessment, and the Action Research Arm Test. CONCLUSION This pilot study suggests that spastic co-contraction rather than spasticity is an important factor in altered upper limb motricity in subjects with brain injury, leading to abnormal restricting arm movement patterns in subjects with more severe motor impairment. Practical applications directly concern the pre- and post-therapeutic evaluation of treatments aimed at improving motor skills in subjects with brain injury.
Seeking Formula for Misinformation Treatment in Public Health Crises: The Effects of Corrective Information Type and Source

ABSTRACT An increasing lack of information truthfulness has become a fundamental challenge to communications. Insights into how to debunk this type of misinformation can especially be crucial for public health crises. To identify corrective information strategies that increase awareness and trigger actions during infectious disease outbreaks, an online experiment (N = 700) was conducted, using a U.S. sample. After initial misinformation exposure, participants’ exposure to corrective information type (simple rebuttal vs. factual elaboration) and source (government health agency vs. news media vs. social peer) was varied, including a control group without corrective information. Results show that, if corrective information is present rather than absent, incorrect beliefs based on misinformation are debunked and the exposure to factual elaboration, compared to simple rebuttal, stimulates intentions to take protective actions. Moreover, government agency and news media sources are found to be more successful in improving belief accuracy compared to social peers. The observed mediating role of crisis emotions reveals the mechanism underlying the effects of corrective information. The findings contribute to misinformation research by providing a formula for correcting the increasing spread of misinformation in times of crisis.
Risk Factors for Anastomotic Leakage of Esophagojejunostomy after Laparoscopy-Assisted Total Gastrectomy for Gastric Cancer

Background/Aims: The study aimed to clarify the risk factors for anastomotic leakage after laparoscopy-assisted total gastrectomy (LATG) for gastric cancer. Methods: In this study, we enrolled 131 patients with preoperatively diagnosed early gastric cancer who underwent LATG by a single surgeon between June 2006 and February 2014 at the Department of Surgery, Gastroenterological Center, Yokohama City University. Risk factors for anastomotic leakage (esophagojejunostomy) after LATG were retrospectively evaluated by univariate and multivariate analyses. Results: Anastomotic leakage of the esophagojejunostomy was observed in 13 (9.9%) of 131 patients. Univariate analysis of risk factors for anastomotic leakage revealed that the prognostic nutritional index (PNI) is a risk factor for anastomotic leakage (<55, 11 of 63 vs. ≥55, 2 of 55; p = 0.039). Multivariate analysis revealed that PNI is an independent risk factor for anastomotic leakage (OR 0.208; 95% CI 0.044-0.981; p = 0.047). Conclusion: Gastric cancer patients with a low PNI have a higher risk for anastomotic leakage after LATG. The results of this study must be confirmed by a study with a large cohort of patients receiving LATG reconstructed using the same method by experienced surgeons in multiple institutions.
Shift Work Disrupts Circadian Regulation of the Transcriptome in Hospital Nurses

Circadian misalignment between sleep and behavioral/feeding rhythms is thought to lead to various health impairments in shift workers. Therefore, we investigated how shift work leads to genome-wide circadian dysregulation in hospital nurses. Female nurses from the University of Alabama at Birmingham (UAB) Hospital working night shift (n = 9; 29.6 ± 11.4 y) and day shift (n = 8; 34.9 ± 9.4 y) participated in a 9-day study measuring locomotor activity and core body temperature (CBT) continuously. Additionally, cortisol and melatonin were assayed and peripheral blood mononuclear cells (PBMCs) were harvested for RNA extraction every 3 h on a day off from work. We saw phase desynchrony of core body temperature, peak cortisol, and dim light melatonin onset in individual night-shift subjects compared with day-shift subjects. This variability was evident even though day- and night-shift nurses had similar sleep timing and scheduled meal times on days off. Surprisingly, the phase and rhythmicity of the expression of the clock gene, PER1, in PBMCs were similar for day-shift and night-shift subjects. Genome-wide microarray analysis of PBMCs from a subset of nurses revealed distinct gene expression patterns between night-shift and day-shift subjects. Enrichment analysis showed that day-shift subjects expressed pathways involved in generic transcription and regulation of signal transduction, whereas night-shift subjects expressed pathways such as RNA polymerase I promoter opening, the matrisome, and endocytosis. In addition, there was large variability in the number of rhythmic transcripts among subjects, regardless of shift type. Interestingly, the amplitude of the CBT rhythm appeared to be more consistent with the number of cycling transcripts for each of the 6 subjects than was melatonin rhythm. In summary, we show that shift-work patterns affect circadian alignment and gene expression in PBMCs.
Do investigational MET inhibitors have potential for the treatment of gastric cancer?

The receptor tyrosine kinase MET (or cMET) and its only known ligand, hepatocyte growth factor (HGF; also known as scatter factor), are vital for physiological processes such as embryonic development, tissue regeneration and wound healing [1]. The binding of HGF/SF to MET causes receptor dimerization, multiple tyrosine residue phosphorylations and downstream activation of signaling pathways leading to cell proliferation, survival, motility, invasiveness and stimulation of angiogenesis [1]. Oncogenic activation of this pathway and associated dysregulation can occur through multiple mechanisms such as gene amplification, gene mutation, protein overexpression, aberrant paracrine or autocrine ligand production and constitutive kinase activation by ligand-dependent and independent mechanisms [2]. Clinically, aberrant activation of MET signaling has been reported to be associated with a poor prognosis in several cancers such as non-small cell lung cancer (NSCLC) [3], gastric cancer [4] and breast cancer [5]. MET is also associated with resistance to therapies targeting other key oncogenic pathways such as epidermal growth factor receptor (EGFR) in lung [6] and colorectal cancer [7] and ERBB2 (HER2) in gastric and breast cancer [8,9], highlighting the significant functional cross talk between these signaling pathways.
Anlotinib, a novel small molecular tyrosine kinase inhibitor, suppresses growth and metastasis via dual blockade of VEGFR2 and MET in osteosarcoma

Osteosarcoma is the most common primary malignant bone tumor in children and adolescents, with highly aggressive behavior and early systemic metastasis. The survival rates for osteosarcoma remain unchanged over the past two decades. Studies aiming to find new or alternative therapies for patients with refractory osteosarcoma are urgently needed. Anlotinib, a novel multi‐targeted tyrosine kinase inhibitor (TKI), has exhibited encouraging clinical activity in NSLCC and soft tissue sarcoma, whereas its effect on osteosarcoma has not been studied. In our study, we investigated the anti‐tumor activity and underlying mechanism of anlotinib in osteosarcoma. Various in vitro and in vivo models of human osteosarcoma were used to determine the anti‐proliferative, anti‐angiogenesis and anti‐metastasis efficacy of anlotinib. Our results showed that anlotinib suppressed tumor growth and increased the chemo‐sensitivity of osteosarcoma. In addition, anlotinib inhibited migration and invasion in osteosarcoma cells. Furthermore, in order to explore the anti‐tumor mechanism of anlotinib, phospho‐RTK antibody arrays were performed. These analyses confirmed that anlotinib suppressed the phosphorylation of MET, VEGFR2 and the downstream signaling pathway activation. Moreover, we demonstrated that anlotinib blocked hepatocyte growth factor (HGF)‐induced cell migration, invasion and VEGF‐induced angiogenesis. Notably, a 143B‐Luc orthotopic osteosarcoma model further showed that anlotinib significantly inhibited growth and lung metastasis of implanted tumor cells. Our preclinical work indicates that anlotinib acts as a novel inhibitor of VEGFR2 and MET that blocks tumorigenesis in osteosarcoma, which could be translated into future clinical trials.