Miracle-dz/UniFAR-FTUs huggingface dataset:
Cerclage for women with twin pregnancies: a systematic review and metaanalysis.

OBJECTIVE DATA This study was conducted to estimate whether cerclage could extend the prolongation of pregnancy, reduce the risk of preterm birth, and improve perinatal outcomes in women with twin pregnancies. STUDY ELIGIBILITY CRITERIA We included randomized controlled trials and cohort studies comparing the efficacy of cerclage with no cerclage for women with twin pregnancies. STUDY APPRAISAL AND SYNTHESIS METHODS The following databases were searched for all published studies that compared cerclage placement with expectant management in twin pregnancies from inception to July 2018: Medline, EMBASE, Scopus, ClinicalTrials.gov, Web of Science, and Cochrane Library. Each report was reviewed for inclusion or exclusion standard, and data extraction was performed by 2 authors independently. RESULTS A total of 16 studies with 1211 women that met the inclusion criteria were included in the final analysis. Our outcomes indicated that cerclage placement for twin pregnancies with a cervical length of <15 mm was associated with significant prolongation of pregnancy by a mean difference of 3.89 weeks of gestation (95% confidence interval, 2.19-5.59; P=.000; I2=0%) and a reduction of preterm birth at <37 weeks of gestation (risk ratio, 0.86; 95% confidence interval, 0.74-0.99; P=.040; I2=0%), <34 weeks of gestation (risk ratio, 0.57; 95% confidence interval, 0.43-0.75; P=.000; I2=0%) and <32 weeks of gestation (risk ratio, 0.61; 95% confidence interval, 0.41-0.90; P=.010; I2=0%), compared with those pregnancies in the control group. For women with a dilated cervix of >10 mm, cerclage placement was associated with significant prolongation of pregnancy by a mean difference of 6.78 weeks of gestation (95% confidence interval, 5.32-8.24; P=.000; I2=0%); a reduction of preterm birth at <34 weeks of gestation (risk ratio, 0.56; 95% confidence interval, 0.45-0.69; P=.000; I2=28%), <32 weeks of gestation (risk ratio, 0.50; 95% confidence interval, 0.38-0.65; P=.000; I2=14%), <28 weeks of gestation (risk ratio, 0.41; 95% confidence interval, 0.20-0.85; P=.030; I2=80%), and <24 weeks of gestation (risk ratio, 0.35; 95% confidence interval, 0.18-0.67; P=.001; I2=24%), and improvement of perinatal outcomes compared with those in the control group. However, for twin pregnancies with a normal cervical length (eg, cerclage for an indication for women with a history of preterm birth or twin alone), the efficacy of cerclage placement was less certain because of the limited data. CONCLUSION Our metaanalysis indicates that cerclage placement is beneficial for the reduction of preterm birth and the prolongation of pregnancy in twin pregnancies with a cervical length of <15 mm or dilated cervix of >10 mm. However, the benefit of history-indicated or twin alone-indicated cerclage is less certain in twin pregnancies with normal cervical length according to current literature. Further high-quality studies were needed to confirm the findings.
ACUTE GASTROENTERITIS ASSOCIATED WITH NOROVIRUS GII.4 VARIANTS.

BACKGROUND Norovirus (NoV) is an important etiologic agent of acute gastroenteritis and infects individuals of all ages, especially children in Brazil and worldwide. NoV GII.4 was the most prevalent genotype worldwide because of your extensive genetic diversity. In Brazil, especially in the Northeast, few studies have been developed for identify and molecularly characterize NoV. OBJECTIVE The present study aimed to detect and describe the molecular epidemiology of NoV associated with acute gastroenteritis. METHODS The viral RNA extracted from stool samples were subjected to Nested RT-PCR and the genotypes were determined by nucleotide sequences analysis. In total, 278 stool samples assisted at Aliança Hospital in the city of Salvador, with acute gastroenteritis were examined, between March 2009 and July 2012. RESULTS A high NoV rate (54.2%) was identified in children under 5 years of age. We detected the circulation of different NoV GII.4 variants in Salvador, during the study period as Den Haag 2006b, New Orleans 2009 and Sydney 2012. CONCLUSION These findings reinforce the need to study the molecular epidemiology of NoV infections in acute gastroenteritis.
Hypertension Is an Independent Predictor of Multivessel Coronary Artery Disease in Young Adults with Acute Coronary Syndrome

Background Risk factors of multivessel coronary artery disease (CAD) among young acute coronary syndrome (ACS) patients remain elusive now. Methods This retrospective study analyzed data from 187 consecutive young (age ≤45 years) ACS patients (75 STEMI, 30 NSTEMI, and 72 unstable angina) hospitalized in our hospital from January 2012 to December 2016. Thirty-six young male patients with normal coronary angiography (CAG) findings (no-CAD), who underwent CAG due to suspected chest pain in this period, served as control group. There were 83 patients with single-vessel disease (SVD) and 104 patients with multiple-vessel disease (MVD) among ACS patients. Patients were followed up for a mean of 267±124 days by clinical visit or telephone calls. Results All included patients were male. Prevalence of hypertension (57.2% vs. 30.6%, p=0.002) and smoking (70.6% vs. 52.8%, p=0.049) was significantly higher in ACS patients than in no-CAD patients. Prevalence of hypertension (72.1% vs. 38.6%, p<0.001) and body mass index (BMI) were significantly higher in MVD group than in SVD group. Multivariable analysis revealed that hypertension was an independent risk factor for MVD after adjustment for age, gender, BMI, smoking, family history of premature CAD, hyperlipidemia, left ventricular ejection fraction, and brain natriuretic peptide (odds ratio=3.71, 95% confidence interval=1.84-7.46, p<0.001). Rate of major adverse cardiovascular events (MACE) during follow-up (20.2% vs. 4.8%) was significantly higher in MVD group compared with SVD group. Conclusions Hypertension is an independent predictor of MVD and MVD is associated with increased MACE rate compared to SVD in young ACS patients during the short-term follow-up.
Evidence of Bias Against Girls and Women in Contexts That Emphasize Intellectual Ability

Despite the numerous intellectual contributions made by women, we find evidence of bias against them in contexts that emphasize intellectual ability. In the first experiment, 347 participants were asked to refer individuals for a job. Approximately half of the participants were led to believe that the job required high-level intellectual ability; the other half were not. A Bayesian mixed-effects logistic regression revealed that the odds of referring a woman were 38.3% lower when the job description mentioned intellectual ability, consistent with the possibility of gender bias. We also found evidence of gender bias in Experiment 2, which was a preregistered direct replication of Experiment 1 with a larger and more diverse sample (811 participants; 44.6% people of color). Experiment 3 provided a developmental investigation of this bias by testing whether young children favor boys over girls in the context of intellectually challenging activities. Five- to 7-year-olds (N = 192) were taught how to play a team game. Half of the children were told that the game was for “really, really smart” children; the other half were not. Children then selected 3 teammates from among 6 unfamiliar children. Children’s initial selections were driven by ingroup bias (i.e., girls chose girls and boys chose boys), but children subsequently showed bias against girls, choosing girls as teammates for the “smart” game only 37.6% of the time (vs. 53.4% for the other game). Bias against women and girls in contexts where brilliance is prized emerges early and is a likely obstacle to their success.
Interspinous process decompression is associated with a reduction in opioid analgesia in patients with lumbar spinal stenosis

Background Lumbar spinal stenosis (LSS) causes significant pain and functional impairment, and medical management has increasingly included the prescription of opioid-based analgesics. Interspinous process decompression (IPD) provides a minimally-invasive treatment option for LSS. Methods This study estimated the type, dosage, and duration of opioid medications through 5 years of follow-up after IPD with the Superion Indirect Decompression System (Vertiflex Inc., Carlsbad, CA USA). Data were obtained from the Superion-treatment arm of a randomized controlled noninferiority trial. The prevalence of subjects using opiates was determined at baseline through 60 months. Primary analysis included all 190 patients randomized to receive the Superion device. In a subgroup of 98 subjects, we determined opioid-medication prevalence among subjects with a history of opioid use. Results At baseline, almost 50% (94 of 190) of subjects were using opioid medication. Thereafter, there was a sharp decrease in opioid-medication prevalence from 25.2% (41 of 163) at 12 months to 13.3% (20 of 150) at 24 months to 7.5% (8 of 107) at 60 months. Between baseline and 5 years, there was an 85% decrease in the proportion of subjects using opioids. A similar pattern was also observed among subjects with a history of opiates prior to entering the trial. Conclusion Stand-alone IPD is associated with a marked decrease in the need for opioid medications to manage symptoms related to LSS. In light of the current opiate epidemic, such alternatives as IPD may provide effective pain relief in patients with LSS without the need for opioid therapy.
Web-based CBT for the prevention of anxiety symptoms among medical and health science graduate students

ABSTRACT Medical and health science graduate students report greater anxiety problems than the general population, but they are less likely to seek treatment due to cultural and logistical barriers. One preventative approach that overcomes these barriers is web-based cognitive behavioral therapy (webCBT). It is unknown whether webCBT is effective for preventing anxiety escalation within this population. A randomized controlled trial was conducted, comparing the effects of webCBT versus a control group (CG). Medical university students (n=594; Mage=27; 67% female; 80% Caucasian) completed online baseline measures and four assigned online activities. Measures were re-administered after approximately three months. There was a small interaction effect between time of assessment and treatment condition. Anxiety severity was lower in the webCBT (M[SD]=2.88[3.36]) versus CG condition (M[SD]=3.69 [3.35]) at follow-up. This effect was moderate for students with mild, versus minimal, anxiety at baseline. The proportion of students with possible anxiety disorder was lower in the webCBT (4.5%) versus CG (8.5%) condition, and the proportion of mildly anxious students with a clinically significant increase in symptoms was lower in the webCBT (10%) versus CG (20%) condition. WebCBT may aid in preventing anxiety escalation in this population, particularly for at-risk students who report mild anxiety symptoms.
Recommendations for iliosacral screw placement in dysmorphic sacrum based on modified in‐out‐in corridors

(1) Can iliosacral osseous corridor diameters in sacral dysmorphism be enlarged by in‐out‐in screw placement at the posterior iliosacral recessus? (2) Are lumbosacral transitional vertebra (LSTV) the anatomical cause for sacral dysmorphism? (3) Are there sex‐specific differences in sacral dysmorphism? 594 multislice CT scans were screened for sacral dysmorphism and 55 data‐sets selected. Each pelvis was segmented manually and cylindrical iliosacral corridors (on the level of S1 and S2 vertebra) were semi‐automatically determined. Corridor trajectories, −diameters and −lengths were measured. LSTV (Castellvi‐type IIIb and IV) were found in 3 of 55 pelves and these lumbosacral variations are therefore not the anatomical basis for sacral dysmorphism. The prevalence of transsacral osseous corridors with diameters of <7.5 mm in axial CT images correlates with qualitative and quantitative criteria of sacral dysmorphism. Enlarging the osseous corridor diameters by penetration of the posterior iliosacral recessus increase the safe corridor diameters (females versus males) by 26% versus 15% at the level of S1‐ and 50% versus 48% at the level of S2‐vertebra. Sex‐specific differences for both corridors (osseous and in‐out‐in) were only found for the osseous corridor diameters at the level of S1 vertebra, being smaller in females (females versus males: 13.3 ± 3.6 mm versus 15.5 ± 3.8 mm, p = 0.04). Dysmorphic sacra can be reliably detected on standard axial CT slice images. Modified in‐out‐in corridors on the level of S1‐vertebra allow screw placement in all patients, but is still demanding compared to non‐dysmorphic sacra, due to the oblique corridor axis. Recommendations for intraoperative orientation for oblique screw placement are defined. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res
Acetylation of HMGB1 by JNK1 Signaling Promotes LPS-Induced Peritoneal Mesothelial Cells Apoptosis

Increased high mobility group box 1 (HMGB1) in dialysis effluence is associated with the presence of peritoneal dialysis-related peritonitis in patients and peritoneal dysfunction in acute peritonitis mice model, but it remains unclear whether HMGB1 is involved in peritoneal mesothelial cell injury and functions via molecular posttranslational modifications by acetylation in this process. Here we first showed correlation between HMGB1 acetylation level in dialysis effluence of patients and occurrence of Gram-negative peritonitis. The increased level of acetylated HMGB1 was similarly observed under the lipopolysaccharides (LPS) treatment in both human peritoneal mesothelial cell line (HMrSV5) and mice visceral peritoneum tissue. Overexpression of wild-type, but not hypoacetylation mutant of HMGB1, enhanced LPS-induced apoptosis in HMrSV5 cells, which was accompanied by elevated protein levels of BAX and cleaved-caspase 3 compared to the control. Pretreatment of HMrSV5 cell with JNK inhibitor attenuated LPS-induced HMGB1 acetylation. Consistently, primary peritoneal mesothelial cells from Jnk1-/- mice showed a lower protein contents of acetylated HMGB1, fewer apoptosis, and decreased protein expression of BAX and cleaved-caspase3 after LPS exposure, as compared to those from wild-type mice. In conclusion, our data demonstrated HMGB1 promotes LPS-induced peritoneal mesothelial cells apoptosis, which is associated with JNK1-mediated upregulation of HMGB1 acetylation.
The methanolic extract of Guibourtia tessmannii (caesalpiniaceae) and selenium modulate cytosolic calcium accumulation, apoptosis and oxidative stress in R2C tumour Leydig cells: Involvement of TRPV1 channels

This study evaluated the effects of the methanolic extract of Guibourtia tessmannii (GT) and selenium (Se) on cell viability, intracellular calcium concentration ([Ca2+]i), apoptosis and oxidative stress through transient receptor potential vanilloid 1 (TRPV1) channel activity in CCL‐97 (R2C) tumour Leydig cells. The cells were divided into nine groups and treated as follows: (a)‐Control, (b)‐Capsazepine (CPZ, 0.1 mM, a TRPV1 channel blocker), (c)‐Capsaicin (CAP, 0.01 mM, a TRPV1 channel activator), (d)‐GT (500 μg/ml), (e)‐GT+CPZ, (f)‐GT+CAP, (g)‐Se (200 nM), (h)‐Se+CPZ and (i)‐Se+CAP. After treatments, cell viability, [Ca2+]i, apoptosis, caspase 3/9, reactive oxygen species (ROS) and mitochondrial membrane depolarisation (MMD) were evaluated. The [Ca2+]i, apoptosis, caspase 3/9, MMD and ROS levels were significantly (p < 0.001) increased in CAP group, but lowered in CPZ group. Interestingly, these parameters were significantly (p < 0.001) improved by GT and Se, compared to the CAP group. Moreover, the co‐administration of GT+CAP or Se+CAP inhibited the cytotoxicity of CAP. Thus, the modulatory properties of GT and Se on Ca2+ influx, apoptosis and oxidative stress require the integrity of TRPV1 channel in CCL‐97 Leydig cells. These results suggest that GT and Se might be used in the management of cytotoxicity in the testes, involving TRPV1 channel activity.
Glucose deprivation promotes apoptotic response to S1 by enhancing autophagy in human cervical cancer cells

Background S1 is a novel BH3 mimetic that can induce death in some types of cancer cells, such as melanoma B16, ovarian cancer SKOV3, and U251 glioma cells. S1 inhibits Bcl-2 and Mcl-1 expression and induces cancer cell apoptosis. Cancer cell survival is highly dependent on glucose. Here, we observed the effect of glucose deprivation on the apoptotic response to S1 in human cervical cancer (HeLa) cells. Materials and methods Earle’s balanced salt solution (EBSS) was used to simulate glucose deprivation. MTT assay was used to analyze the cell survival rate, and Hoechst 33342 dye was used to detect the apoptosis in HeLa cells. Western blotting was used to detect the expression of ER stress and autophagy relative proteins. In addition, lysosomes were observed with Lyso-Tracker staining by confocal microscopy. Results S1 decreased cell distribution density and survival rate, and MTT assay showed that EBSS enhanced the inhibitory effects of S1 on HeLa cell growth. Hoechst 33342 dye showed that S1 led to pyknosis, fragmentation, and strong staining in HeLa cell nuclei, and EBSS enhanced these effects. Western blotting indicated that EBSS enhanced the expression of apoptosis-related proteins (cytochrome C, caspase-3, and poly[ADP-ribose] polymerase 1) induced by S1 in HeLa cells. S1 decreased p62 expression and increased the autophagosome-associated protein LC3-II expression, which indicated that S1 induced autophagy in HeLa cells. EBSS enhanced S1-induced autophagy in HeLa cells. Furthermore, autophagy inhibitor chloroquine enhanced S1-induced apoptosis in HeLa cells. Conclusion These results indicate that EBSS exacerbates S1-induced autophagy and severe autophagy induced by EBSS and S1 could lead to apoptosis in HeLa cells. The results also suggest that EBSS enhances the sensitivity of HeLa cells to S1-induced apoptosis and that autophagy plays an important role in this process.
Drosophila kinesin-8 stabilizes the kinetochore–microtubule interaction

Kinesin-8 is required for proper chromosome alignment in a variety of animal and yeast cell types. However, it is unclear how this motor protein family controls chromosome alignment, as multiple biochemical activities, including inconsistent ones between studies, have been identified. Here, we find that Drosophila kinesin-8 (Klp67A) possesses both microtubule (MT) plus end–stabilizing and –destabilizing activity, in addition to kinesin-8's commonly observed MT plus end–directed motility and tubulin-binding activity in vitro. We further show that Klp67A is required for stable kinetochore–MT attachment during prometaphase in S2 cells. In the absence of Klp67A, abnormally long MTs interact in an “end-on” fashion with kinetochores at normal frequency. However, the interaction is unstable, and MTs frequently become detached. This phenotype is rescued by ectopic expression of the MT plus end–stabilizing factor CLASP, but not by artificial shortening of MTs. We show that human kinesin-8 (KIF18A) is also important to ensure proper MT attachment. Overall, these results suggest that the MT-stabilizing activity of kinesin-8 is critical for stable kinetochore–MT attachment.
Multivariate base rates for the assessment of executive functioning among children and adolescents

ABSTRACT This study provides observed base rates of low executive functioning test scores among healthy children and adolescents, stratifies those base rates by narrow intellectual functioning and age groupings, and provides normative classification ranges to aid the interpretation of performances on the Delis-Kaplan Executive Function System (D-KEFS) in clinical practice and research. Participants included 875 children and adolescents between 8 and 19 years old from the D-KEFS normative sample (48% male; 52% female). Among these participants, 838 had complete data and were included in the current study. The racial/ethnic composition of the sample was: White (73.7%), African American (12.4%), Hispanic (11.1%), and other racial/ethnic backgrounds (2.7%). The Overall Test Battery Mean (OTBM) and the prevalence of low scores at various clinical cut-offs were calculated for the 13 primary scores from the D-KEFS Trail Making Test, Verbal Fluency Test, and Color-Word Interference Test. The OTBM and base rates were also calculated separately for those scores reflecting executive functioning (n = 7) and processing speed (n = 6). Healthy children and adolescents commonly obtained low scores on the D-KEFS tests considered here. Younger age, lower estimated full-scale intelligence quotient, and more test scores interpreted were associated with a greater frequency of low scores. Clinicians and researchers are encouraged to consider these multivariate base rates when assessing and attempting to identify executive functioning impairment among children and adolescents with the D-KEFS.
Attitudes of Iranian Nurses Toward Spirituality and Spiritual Care

ABSTRACT: Spirituality and spiritual care play a crucial role in providing more effective treatment for patients. The purpose of this study was to determine nurses' attitudes toward spirituality and spiritual care in an educational hospital in Iran. A significant association was found between nurses' spirituality/spiritual care attitudes and age, education level, and type of hospital ward employment (noncritical vs. critical care). Nurses' scores on attitudes toward spirituality and spiritual care suggest the need for more education in this area.
Changes in Running Economy During a 65-km Ultramarathon

Purpose: Running economy (RE), expressed as oxygen cost (O2 cost) and energy cost of running (Cr) is important in ultramarathon (UM) running as it can help predict race performance. Controversy remains if RE increases, decreases, or remains stable in UM running. We examined RE before, during, and after a 65-km UM. Methods: 15 male UM runners (mean age 45 ± 5.7 years) completed a standard exercise test (mean VO2max 48.8 ± 3.4 ml⋅kg-1⋅min-1) for determination of the individual testing speed (60% VO2max: mean speed 9.4 ± 0.7 km/h). This was followed by a 65-km UM (elevation ± 1093 m) consisting of three laps (each 21.7 km). Pre and post indirect calorimetry measurements at individual running speed on the treadmill at UM-specific slopes (average percentage of positive and negative elevation) at -3, +3%, and level grade were performed in randomized order on a motorized treadmill in the laboratory for calculation of RE. Additionally after each lap, testing at +3% took place. Results: The O2 cost, Cr, and RER increased significantly pre to post UM (p < 0.01). During the uphill running, a main effect of distance indicated a gradual, linear increase in O2 cost, F(2,28) = 5.81, p < 0.01, ηp2 = 0.29, and Cr, F(2,28) = 5.96, p = 0.01, ηp2 = 0.30. Conclusion: O2 cost and Cr increased significantly pre to post UM in all testing conditions as well as during the uphill testing throughout the UM. This is the first study to demonstrate a consistent increase in O2 cost and Cr among a range of different slopes, at individual running speeds and race-specific slopes giving further evidence that these measures of RE increase in UM running.