Miracle-dz/UniFAR-FTUs huggingface dataset:
Bone, subcutaneous tissue and plasma pharmacokinetics of cefuroxime in total knee replacement patients – a randomized controlled trial comparing continuous and short‐term infusion

Cefuroxime is widely used as antibiotic prophylaxis for orthopaedic procedures. We evaluated bone, subcutaneous tissue (SCT) and plasma pharmacokinetics of cefuroxime in male patients undergoing total knee replacement (TKR) after both traditional short‐term infusion (STI) and continuous infusion (CI). Eighteen male patients undergoing TKR were randomly assigned to STI or CI of 1.5 g of cefuroxime. Measurements were obtained in plasma, SCT, cancellous and cortical bone every 30 min for 8 h following surgery. For sampling in solid tissues, microdialysis was applied. Population pharmacokinetic modelling was performed in order to estimate pharmacokinetic parameters, and to assess the probability of attaining cefuroxime concentrations above clinically relevant minimal inhibitory concentrations (MICs) for 65% and 90% of the 8 h dosing interval. Low SCT and cortical bone penetration were found in both the STI and the CI group, but the findings were only significant in the STI group. Irrespective of MIC, tissue and target, CI leads to improved probability of attaining relevant pharmacokinetic targets compared with STI. For the Staphylococcus aureus MIC breakpoint (4 μg/mL), STI leads to inadequate probability of target attainment. CI of 1.5 g of cefuroxime leads to improved probability of attaining relevant pharmacokinetic targets in male TKR patients compared with traditional STI. These findings suggest that application of CI may improve antibiotic prophylaxis for male TKR patients.
A Double-Variational Bayesian Framework in Random Fourier Features for Indefinite Kernels

Random Fourier features (RFFs) have been successfully employed to kernel approximation in large-scale situations. The rationale behind RFF relies on Bochner’s theorem, but the condition is too strict and excludes many widely used kernels, e.g., dot-product kernels (violates the shift-invariant condition) and indefinite kernels [violates the positive definite (PD) condition]. In this article, we present a unified RFF framework for indefinite kernel approximation in the reproducing kernel Kreĭn spaces (RKKSs). Besides, our model is also suited to approximate a dot-product kernel on the unit sphere, as it can be transformed into a shift-invariant but indefinite kernel. By the Kolmogorov decomposition scheme, an indefinite kernel in RKKS can be decomposed into the difference of two unknown PD kernels. The spectral distribution of each underlying PD kernel can be formulated as a nonparametric Bayesian Gaussian mixtures model. Based on this, we propose a double-infinite Gaussian mixture model in RFF by placing the Dirichlet process prior. It takes full advantage of high flexibility on the number of components and has the capability of approximating indefinite kernels on a wide scale. In model inference, we develop a non-conjugate variational algorithm with a sub-sampling scheme for the posterior inference. It allows for the non-conjugate case in our model and is quite efficient due to the sub-sampling strategy. Experimental results on several large classification data sets demonstrate the effectiveness of our nonparametric Bayesian model for indefinite kernel approximation when compared to other representative random feature-based methods.
Prevalence, Characteristics and Association of Obstructive Sleep Apnea with Blood Pressure Control in Patients with Resistant Hypertension.

RATIONALE Obstructive sleep apnea (OSA) is associated with poor blood pressure (BP) control and resistant hypertension (RH). Nevertheless, studies assessing its prevalence, characteristics and association with BP control in RH patients are limited. OBJECTIVE The aim of this multicenter study was to assess the prevalence of OSA in a large cohort of RH subjects and to evaluate the association of OSA with BP control. METHODS We recruited consecutive RH subjects from 3 countries. A formal sleep test and blood pressure measurements, including 24-h ambulatory blood pressure monitoring (ABPM) were performed in all participants. RESULTS In total, 284 RH subjects were included in the final analysis. Of these, 83.5% (CI 95%; 78.7 to 87.3) had OSA (apnea-hypopnea index (AHI) ≥5 events/h); 31.7% (26.5 to 37.3) had mild OSA, 25.7% (21 to 31.1) had moderate OSA and 26.1% (21.3 to 31.5) had severe OSA. Patients with severe OSA had higher BP values than mild-moderate or non-OSA subjects. A greater effect was observed on the average nighttime BP, with an adjusted effect of 5.72 (1.08 to 10.35) mmHg in severe OSA compared to non-OSA participants. A dose-response association between the severity of OSA and BP values was observed. The prevalence of severe OSA was slightly higher in uncontrolled participants (adjusted OR 1.69 (0.97 to 2.99)) but was not statistically significant. CONCLUSIONS The present study confirms the high prevalence of OSA in RH participants. Furthermore, it shows a dose-response association between OSA severity and BP measurements, especially in the nighttime. Clinical trial registered with ClinicalTrials.gov (NCT03002558).
Racial Differences in Cardiovascular Biomarkers in the General Population

Background The incidence and clinical manifestations of cardiovascular disease (CVD) differ between blacks and whites. Biomarkers that reflect important pathophysiological pathways may provide a window to allow deeper understanding of racial differences in CVD. Methods and Results The study included 2635 white and black participants from the Dallas Heart Study who were free from existing CVD. Cross‐sectional associations between race and 32 biomarkers were evaluated using multivariable linear regression adjusting for age, traditional CVD risk factors, imaging measures of body composition, renal function, insulin resistance, left ventricular mass, and socioeconomic factors. In fully adjusted models, black women had higher lipoprotein(a), leptin, d‐dimer, osteoprotegerin, antinuclear antibody, homoarginine, suppression of tumorigenicity‐2, and urinary microalbumin, and lower adiponectin, soluble receptor for advanced glycation end products and N‐terminal pro‐B‐type natriuretic peptide versus white women. Black men had higher lipoprotein(a), leptin, d‐dimer, high‐sensitivity C‐reactive protein, antinuclear antibody, symmetrical dimethylarginine, homoarginine, high‐sensitivity cardiac troponin T, suppression of tumorigenicity‐2, and lower adiponectin, soluble receptor for advanced glycation end products, and N‐terminal pro‐B‐type natriuretic peptide versus white men. Adjustment for biomarkers that were associated with higher CVD risk, and that differed between blacks and whites, attenuated the risk for CVD events in black women (unadjusted hazard ratio 2.05, 95% CI 1.32, 3.17 and adjusted hazard ratio 1.15, 95% CI 0.69, 1.92) and black men (unadjusted hazard ratio 2.39, 95% CI 1.64, 3.46, and adjusted hazard ratio 1.21, 95% CI 0.76, 1.95). Conclusions Significant racial differences were seen in biomarkers reflecting lipids, adipokines, and biomarkers of endothelial function, inflammation, myocyte injury, and neurohormonal stress, which may contribute to racial differences in the development and complications of CVD.
Outbreak of Electronic-Cigarette–Associated Acute Lipoid Pneumonia — North Carolina, July–August 2019

On September 6, 2019, this report was posted as an MMWR Early Release on the MMWR website (https://www.cdc.gov/mmwr). Electronic cigarettes (e-cigarettes) produce an aerosol by heating a liquid that usually contains nicotine, flavorings, and other chemicals that users inhale, a behavior commonly referred to as "vaping. " E-cigarettes can also be used to deliver marijuana and other drugs. In recent months, more than 200 possible cases of acute lung injury potentially associated with vaping were reported from 25 states (1). During July and August 2019, five patients were identified at two hospitals in North Carolina with acute lung injury potentially associated with e-cigarette use. Patients were adults aged 18-35 years and all experienced several days of worsening dyspnea, nausea, vomiting, abdominal discomfort and fever. All patients demonstrated tachypnea with increased work of breathing on examination, hypoxemia (pulse oximetry <90% on room air), and bilateral lung infiltrates on chest x-ray. All five patients shared a history of recent use of marijuana oils or concentrates in e-cigarettes. All of the products used were electronic vaping pens/e-cigarettes that had refillable chambers or interchangeable cartridges with tetrahydrocannabinol (THC) vaping concentrates or oils, which were all purchased on the street. Three of the patients also used nicotine-containing e-cigarettes, and two of the patients smoked marijuana or conventional cigarettes, although none used other illicit drugs. All five patients were hospitalized for hypoxemic respiratory failure; three required intensive care for acute respiratory distress syndrome, one of whom required intubation and mechanical ventilation. All of the patients survived.
Online Interpersonal Victimization as a Mechanism of Social Control of Women: An Empirical Examination

Cyber space is an ever-expanding mode of perpetrating sexualized violence toward women. This article empirically examines the applicability of Susan Brownmiller’s adaptation of the theory of social control to online interpersonal victimization (OIV) against women. Multiple regression analysis identified predictors of behaviors indicative of social control among a Canadian sample. Findings suggest that the theory of social control, which has been applied to violence against women in physical space, is applicable to OIV. This study also provides insights into the separate and compound effects of physical space and cyber space victimizations on women and identifies implications for improving methods and building theories for addressing violence against women in cyber space.
Dyadic effects of distress on sleep duration in advanced cancer patients and spouse caregivers

Short sleep duration is a common problem for both advanced cancer patients and their spouse caregivers. Sleep and distress have been shown to be interdependent in patient‐caregiver and spouse dyads, yet virtually, no work has explored the dyadic effects of psychological distress on sleep in advanced cancer patients and spouse caregivers. The goal of the present study was to examine the dyadic impact of anxiety and depression on sleep duration in a sample of advanced cancer patients and their spouse caregivers. It was hypothesized that, for both patients and caregivers, anxiety and depression in individuals would be associated with sleep duration in both themselves (actor effects) and in their spouses (partner effects).
Human mesenchymal stromal cells ameliorate complement induced inflammatory cascade and improve renal functions in a rat model of ischemia-reperfusion induced acute kidney injury

Introduction The primary rational for using mesenchymal stromal cells (MSCs) to rejuvenate damaged tissue is mostly based on their capacity to trans-differentiate and repair injured organs. However, previous studies have demonstrated that MSCs are beneficial even at very early stages, before differentiation and proliferation can be expected. The aim of the current study was to investigate the multifaceted immunological effects of systemically administrating MSCs in the setting of acute kidney injury (AKI) induced by ischemic-reperfusion (I/R). Methods A rat model of I/R induced AKI was used. The rats underwent a unilateral nephrectomy with simultaneously clamping the contralateral kidney for 60 minutes. Four treatment groups received intravenously, increasing doses of human MSCs and after 48 hours, the rats were sacrificed. Blood was taken to evaluate renal functions and to measure systemic inflammatory markers. Kidneys were taken for histopathologic examinations and evaluations of intra-renal complement activation and inflammatory mediators. Results Renal functions improved in U shaped dose dependent manner. Mean serum creatinine levels were 4.5, 2.9, 2.6, 1.7 and 4.1 mg/dL in I/R + placebo, I/R + 150x103 cells, I/R + 250x103 cells, I/R + 500x103 cells and I/R + 1,000x103 cells respectfully (p-values<0.05). Urea demonstrated consistent results with the same U shape improvement manner. The extensive activation of the complement system was ameliorated in the MSCs treatment groups. In addition, MSCs significantly decreased intra-renal levels of IL-1β and TNF-α. It should be noted that the highest doses of MSCs induced renal hypoxia, marked by the Hypoxy-probe staining. Conclusions The early beneficial effect of MSCs in the setting of AKI may be attributed to their immunomodulatory effects. Safe treatment with MSCs can block the deleterious activation of the complement cascade and alleviate the hazardous inflammatory mediator-related cascade.
Remaining challenges in predicting patient outcomes for diffuse large B-cell lymphoma

ABSTRACT Introduction: Diffuse large B-cell lymphoma (DLBCL) is the most common non-Hodgkin lymphoma and is an aggressive malignancy with heterogeneous outcomes. Diverse methods for DLBCL outcomes assessment ranging from clinical to genomic have been developed with variable predictive and prognostic success. Areas covered: The authors provide an overview of the various methods currently used to estimate prognosis in DLBCL patients. Models incorporating cell of origin, genomic features, sociodemographic factors, treatment effectiveness measures, and machine learning are described. Expert opinion: The clinical and genetic heterogeneity of DLBCL presents distinct challenges in predicting response to therapy and overall prognosis. Successful integration of predictive and prognostic tools in clinical trials and in a standard clinical workflow for DLBCL will likely require a combination of methods incorporating clinical, sociodemographic, and molecular factors with the aid of machine learning and high-dimensional data analysis.
Pregnancy does not adversely impact diagnostic tests for HTLV-1/2 infection

Mother-to-child-transmission (MTCT) of human T-cell lymphotropic virus type-1(HTLV-1) contributes disproportionately to the burden of HTLV-1 associated diseases. All preventive measures to avoid MTCT rely on the identification of infected mothers. However, the impact of pregnancy on HTLV-1 diagnosis has not been clearly assessed. Paired samples from 21 HTLV-1 infected women taken during pregnancy and while not pregnant were analysed by CMIA and PCR. The signal-to-cut-off values (S/CO) were higher during pregnancy than in the paired non-pregnant samples. HTLV-1 proviral load did not alter significantly by pregnant state. S/CO positively correlated with HTLV proviral load. Pregnancy does not impair the diagnosis of HTLV-1/2, by either immunological (CMIA) or molecular (qPCR/nPCR) tests.
Oral health of high-cost patients and evaluation of oral health measures as predictors for high-cost patients in South Korea: a population-based cohort study

Objective To examine the oral health conditions and oral health behaviour of high-cost patients and evaluate oral health measures as predictors of future high-cost patients. Design A retrospective, population-based cohort study using administrative healthcare records. Setting The National Health Insurance Service (NHIS) medical check-up database (a.k.a. NHIS—national health screening cohort database) in South Korea. Participants 131 549 individuals who received biennial health check-ups including dental check-ups in 2011 or 2012, aged 49–88. Primary outcome measures Current and subsequent year high-cost patient status. Results High-cost patients, on average, incur higher dental costs, suffer more from periodontal disease, brush their teeth less and use secondary oral hygiene products less. Some of the self-reported oral health behaviours and oral symptom variables show statistically significant associations with subsequent year high-cost patient indicators, even after adjusting for demographic, socioeconomic, medical conditions, and prior healthcare cost and utilisation. Conclusions We demonstrate that oral health measures are associated with an increased risk of becoming a high-cost patient.
Levels of serum eosinophil cationic protein are associated with hookworm infection and intensity in endemic communities in Ghana

Background The eosinophil cationic protein (ECP) is a cytotoxic protein mainly secreted by eosinophils granulocytes and plays a role in host defense against parasitic infections. Infection with Necator americanus (hookworm) is traditionally diagnosed by the Kato-Katz method which is inherently tedious, subjective and known to underestimate infection intensity. This study aimed to assess levels of serum ECP in relation to hookworm infection intensity. Methods Stool samples from 984 (aged 4 to 80 years) participants in a cross-sectional study conducted in the Kintampo North Municipality of Ghana were examined using the Kato-Katz and formol-ether concentration methods. Serum ECP levels were measured by ECP assay kit and compared between 40 individuals infected with hookworm only, 63 with hookworm- Plasmodium falciparum co-infection, 59 with P. falciparum infection and 36 with no infection. Results Hookworm infection prevalence was 18.1% (178/984). ECP levels were significantly higher in individuals infected with hookworm only (β = 2.96, 95%CI = 2.69, 3.23, p<0.001) or co-infected with P. falciparum (β = 3.15, 95%CI = 2.91, 3.39, p<0.001) compared to the negative control. Levels of ECP were similar between those with only P. falciparum infection and the uninfected control (p>0.05). Increased hookworm intensity was associated with a significant increase in ECP level (β = 4.45, 95%CI = 2.25, 9.11, rs = 0.193, n = 103, p<0.01). ECP threshold of 84.98ng/ml was associated with a positive predictive value (PPV) of 98% (95% CI = 92, 100), and negative predictive value (NPV) of 76% (95% CI = 62, 87) in classifying hookworm infection status with an AUROC of 96.3%. Conclusion Serum ECP level may be a good biomarker of hookworm infection and intensity and warrant further investigations to help improve current hookworm diagnosis.
Introducing Information Extraction to Radiology Information Systems to Improve the Efficiency on Reading Reports

Abstract Background Radiology reports are a permanent record of patient's health information often used in clinical practice and research. Reading radiology reports is common for clinicians and radiologists. However, it is laborious and time-consuming when the amount of reports to be read is large. Assisting clinicians to locate and assimilate the key information of reports is of great significance for improving the efficiency of reading reports. There are few studies on information extraction from Chinese medical texts and its application in radiology information systems (RIS) for efficiency improvement. Objectives The purpose of this study was to explore methods for extracting, grouping, ranking, delivering, and displaying medical-named entities in radiology reports which can yield efficiency improvement in RISs. Methods A total of 5,000 reports were obtained from two medical institutions for this study. We proposed a neural network model called Multi-Embedding-BGRU-CRF (bidirectional gated recurrent unit-conditional random field) for medical-named entity recognition and rule-based methods for entity grouping and ranking. Furthermore, a methodology for delivering and displaying entities in RISs was presented. Results The proposed neural named entity recognition model has achieved a good F1 score of 95.88%. Entity ranking achieved a very high accuracy of 99.23%. The weakness of the system is the entity grouping approach which yield accuracy of 91.03%. The effectiveness of the overall solution was proved by an evaluation task performed by two clinicians based on the setup of actual clinical practice. Conclusions The neural model shows great potential in extracting medical-named entities from radiology reports, especially for languages, that lack lexicons and natural language processing tools. The pipeline of extracting, grouping, ranking, delivering, and displaying medical-named entities could be a feasible solution to enhance RIS functionality by information extraction. The integration of information extraction and RIS has been demonstrated to be effective in improving the efficiency of reading radiology reports.
Inhibitor eradication and bleeding management of acquired hemophilia A: a single center experience in China

ABSTRACT Objectives: Acquired hemophilia A (AHA) is a rare disease resulting from autoantibodies against coagulation factor VIII that leads to spontaneous bleeding. This study reports the clinical characteristics and treatment outcomes of a relatively sizable cohort of patients with AHA. Methods: We retrospectively analyzed the characteristics and outcomes of 42 patients with AHA diagnosed in our center from January 2014 through December 2018. Results: The FVIII activity (FVIII: C) was significantly suppressed (median 1.5%; interquartile range [IQR]: 0.9–3.5) by FVIII inhibitor (median 8 BU/mL; IQR: 4.0–16.0). Bypassing agents, PCC or FVIIa, were used in 14 patients for bleeding control without any adverse reaction; and most patients (90.5%, 38/42) were placed on immunosuppressive regimen, corticosteroid alone or in combination with cyclophosphamide. Patients treated with corticosteroids alone had a lower median inhibitor titer (8 BU/mL) than those treated with combination corticosteroids of cyclophosphamide (16 BU/mL) (p < 0.001). 97.4% (37/38) patients achieved complete remission (CR) after immunosuppression therapy, and the median time to CR in patients treated with corticosteroids alone was shorter than those with combination corticosteroids of cyclophosphamide (median 40 days; IQR: 31–65 vs. 51 days; IQR: 38–83, p = 0.301). 10 (26.3%) patients relapsed thereafter and were placed on combined corticosteroid and cyclophosphamide treatment, which yielded second remission in 8 patients (80%). Two patients died, one from uncontrolled post-surgical retroperitoneal hemorrhage and one from sepsis complicating corticosteroid therapy. Conclusion: The corticosteroid achieves a satisfactory outcome, particularly with low inhibitors titers; and combination of cyclophosphamide will facilitate remission in sever patients with high titers of inhibitors.