Miracle-dz/UniFAR-FTUs huggingface dataset:
Loop Analysis of the Anal Sphincter Complex in Fecal Incontinent Patients using Functional Luminal Imaging Probe.

BACKGROUND AND AIMS Cardiac loops have been used extensively to study myocardial function. With changes in cardiac pump function, loops are shifted to the right or left. Functional luminal imaging probe (FLIP) recordings allow for loop analysis of anal sphincter and puborectalis (PRM) function. The goal was to characterize anal sphincter area-pressure/tension loop changes in fecal incontinence (FI) patients. METHODS 14 healthy subjects and 14 patients with FI were studied. Custom-designed FLIP was placed in the vagina and then in the anal canal, and deflated in 20ml steps, from 90-30ml. At each volume, subjects performed maximal voluntary squeezes. Area-pressure (AP) and area-tension (AT) loops were generated for each squeeze cycle. 3D-US imaging of the anal sphincter and PRM were obtained to determine the relationship between anal sphincter muscle damage and loop movements. RESULTS With an increase in bag volume, AP-loops and AT-loops shifted to the right and upwards in normal subjects (both anal and vaginal). The shift to the right was greater, and upwards movement less in FI patients. The difference in the location of AP-loops and AT-loops was statistically significant at volumes of 50ml to 90ml (p<0.05). Similar trends were found in the vaginal loops. There is a significant relationship between the damage to the anal sphincter and PRM, and loop location of FI patients. CONCLUSION We propose AP and AT-loops as novel ways to assess anal sphincter and PRM function. Such loops can be generated by real-time measurement of pressure and area within the anal canal.
Platelet-to-Lymphocyte Ratio (PLR) Is Associated with Immune Thrombocytopenia (ITP) Recurrence: A Retrospective Cohort Study

Background Current guidelines are inadequate for use in predicting ITP recurrence. Therefore, our primary goal in this study was to investigate the association of platelet-to-lymphocyte ratio (PLR) at diagnosis with ITP recurrence in Chinese patients. Material/Methods We performed a historical cohort study and non-selectively enrolled 233 patients with newly-identified ITP from March 2013 to June 2017. The independent variable was PLR recorded at diagnosis and the dependent variable was recurrence-free survival (RFS) at 6 months. Data on the following variables were also collected for establishing a multivariate Cox regression model: demographic details, general details, and variables found to be closely related to PLR in previous studies, as well as risk factors for ITP recurrence. Results During follow-up, 85 patients had an event within 6 months. At the range of 0.86–9.7 of PLR, a 1-unit increase in PLR was associated with a 13% decrease in ITP recurrence (hazard ratio: 0.87; 95% confidence interval: 0.78–0.97), whereas no association was detected at the range of 9.7–33.75 of PLR (hazard ratio: 0.99; 95% confidence interval: 0.95–1.04). An interaction test indicated that patients with HP infection (0.91 (0.86–1.97)) or diabetes history (0.86 (0.78–0.96)) showed a stronger association compared with patients without HP infection (1.01 (0.95–1.04) and those without diabetes (1.01 (0.97–1.04)). Conclusions Our findings suggest that PLR is a useful parameter to consider when hematologists attempt to assess the risk of recurrence in ITP patients receiving first-line therapy, and the nonlinearity of PLR and ITP recurrence risk must be fully considered when constructing predictive models.
Identifying Disadvantaged Groups for Cochlear Implantation: Demographics from a Large Cochlear Implant Program

Objective: To identify demographic predictors of patients undergoing cochlear implantation evaluation and surgery. Methods: Consecutive adult patients between 2009 and 2018 who underwent cochlear implantation evaluation at a university cochlear implantation program were retrospectively identified to determine (1) cochlear implantation qualification rate and (2) pursuit of surgery rate with respect to age, gender, race, primary spoken language, marital status, insurance type, and distance to the cochlear implantation center. Results: A total of 823 cochlear implantation evaluations were analyzed. Overall, 76.3% of patients qualified for cochlear implantation and 61.5% of these patients pursued surgery. Age was the only independent predictor for cochlear implantation qualification, such that, for each year younger, the odds of qualifying for cochlear implantation increased by 2.5% (OR 0.98; 95% CI: 0.96-0.99). Age, race, marital status, and insurance type were each independent predictors of the decision to pursue surgery. The odds of pursuing surgery increased by 2.8% for each year younger (OR 1.03; 95% CI: 1.01-1.05). Compared to White patients, non-Whites were half as likely to pursue surgery (OR 0.47; 95% CI: 0.25-0.88). Single (OR 0.49; 95% CI: 0.26-0.94) and widowed patients (OR 0.46; 95% CI: 0.23-0.95) were about half as likely to pursue surgery as compared to married patients. Patients with military insurance were 13 times more likely to pursue surgery as compared to patients with Medicare (OR 13.0; 95% CI: 1.67-101.4). Conclusion: Younger age is an independent predictor for a higher cochlear implantation qualification rate, suggesting the possibility for delayed candidacy referral. Rate of surgical pursuit in qualified cochlear implantation candidates is lower for racial minorities, single and widowed patients, and older patients.
Early experience with meropenem-vaborbactam for treatment of carbapenem-resistant Enterobacteriaceae infections.

Twenty patients with carbapenem-resistant Enterobacteriaceae (CRE) infections were treated with meropenem-vaborbactam. Thirty-day clinical success and survival rates were 65% (13/20) and 90% (18/20), respectively. Thirty-five percent of patients had microbiologic failures within 90 days. One patient developed a recurrent infection due to meropenem-vaborbactam non-susceptible, ompK36 porin mutant Klebsiellapneumoniae.
Can donor narratives yield insights? A natural language processing proof of concept to facilitate kidney allocation

Although expedited placement could ameliorate stagnant kidney utilization, precisely identifying difficult‐to‐place organs is crucial to mitigate potential harms associated with this policy. Existing algorithms have only leveraged structured data from the Organ Procurement and Transplantation Network (OPTN); however, detailed, free text case information about a donor exists. No known research exists about the utility of these data. We developed a model to predict the probability of delay or discard for adult deceased kidney donors between 2010 and 2018, leveraging donor free text data. The resultant model had a c‐statistic of 0.75 compared to 0.80 ( Reduced Probability of Delay or Discard [model], r‐PODD) and 0.77 ( Kidney Donor Profile Index, KDPI) on the test dataset. Analysis of the top predictive words suggest both known and potentially novel clinical factors (ie, a known factor such as hypertension vs a novel factor such as stents), and nuanced social factors (intravenous drug use) could negatively affect kidney utilization. These findings suggest that donor narratives have utility; the natural language processing (NLP) model is only moderately correlated with existing indices and provides directional evidence about additional cardiovascular risk factors that may affect kidney utilization. More research is needed to understand the potential to enhance existing indices of kidney utilization to better enable and mitigate the effects of policy interventions such as expedited placement.
Fuzhuan brick tea attenuates high-fat diet-induced obesity and associated metabolic disorders by shaping gut microbiota.

An increasing amount of evidence suggests that the metabolic improvement of high-fat diet (HFD)-induced obese mice by Fuzhuan brick tea (FBT) are associated with gut microbiota. However, the causalities between FBT and gut microbiota have not yet been elucidated and the underlying mechanisms of action remained unclear. To impart direct evidence for the essential role of gut microbiota in the attenuation of obesity by FBT, the effects of FBT on healthy mice and microbiota-depleted mice that were treated with antibiotics were compared in a HFD-induced obesity mouse model. The results showed that FBT dramatically ameliorated obesity, serum lipid parameters, blood glucose homeostasis, hepatic steatosis, adipocyte hypertrophy, and tissue inflammation. However, the microbiota-depleted mice with single bacterium (Escherichia-Shigella) after antibiotic treatment were resistant to FBT-induced anti-obesity and metabolic improvement. The beneficial effects of FBT were resulted from its shift on gut microbiota composition and structure in mice. HFD-induced increase in phyla Firmicutes/Bacteroidetes (F/B) ratio was remarkably restored by FBT. Furthermore, FBT-induced increase in abundances of beneficial bacteria Clostridiaceae, Bacteroidales, and Lachnospiraceae, and decreases in harmful Ruminococcaceae, Peptococcaceae, Peptostreptococcaceae, and Erysipelotrichaceae were causal antecedents for FBT to reduce obesity and improve metabolic disorders.
The B1 defective type of bifurcated right upper lobe bronchus.

Background As the more application of high-resolution computed tomography (HRCT), a great number of ground glass opacity (GGO) is identified. Video-assisted thoracoscopic surgery (VATS) segmentectomy is technically more difficult than lobectomy because of the anatomical complexity. Three-dimensional computed tomography bronchography angiography (3D-CTBA) is a powerful tool for thoracic surgeons to analyze pulmonary anatomy, allowing a better understanding of the pulmonary anatomy in each patient. Here we encountered seven cases of bifurcated right upper bronchus (B1 defective). The variation in vascular pattern of these patients is analyzed. Methods Between October 2018 and December 2018, a consecutive 162 patients with pulmonary lesions were admitted and underwent 3D-CTB prior to surgery. A total of seven cases of bifurcated right upper bronchus (B1 Defective) were identified. Then 3D-CTBA reconstruction was performed by Syngo MultiModality Workplace (Software: Syngo MMWP, Version: VF40A). Radiology colleagues processed all 3D images and thoracic surgeons confirmed the validity of all reconstructions. Results The mean age of the seven patients (3 females and 4 males) is 54 years. According to the branches of artery, they are divided into two types: "Tr. sup + A. asc" (2/7, 28.6%) and "Tr. sup + Tr. inf + A. asc" (5/7, 71.4%). According to the branches of A2 asc, another two types can be divided: type A, two branches of A2a asc + A2b asc (4/7, 57.1%) and type B, only one branch of A2b asc (3/7, 42.9%). Types can also be divided according to the branches of A2 rec: A, no A2 rec (4/7, 57.1%); B, one branch of A2a rec (2/7, 28.6%); C, two branches of A2a rec + A2b rec (1/7, 14.3%). According to the origins of A3, three types can be divided: A, A3 origins from Tr. inf (1/7, 14.3%); B, A3 origins from Tr. sup (2/7, 28.6%); C, A3 origins from both Tr. sup and Tr. inf (4/7, 57.1%). Conclusions The "defective B1" type of bifurcated right upper lobe (RUL) bronchus is relatively rare. A pre-operative understanding of its anatomical features, especially the vascular variation patterns, may be helpful for completing a satisfactory segmentectomy. 3D-CTBA is a powerful tool, allowing a better understanding of the pulmonary anatomy in each patient before and during surgical procedures.
Zika virus threshold determines transmission by European Aedes albopictus mosquitoes

ABSTRACT Since its emergence in Yap Island in 2007, Zika virus (ZIKV) has affected all continents except Europe. Despite the hundreds of cases imported to European countries from ZIKV-infested regions, no local cases have been reported in localities where the ZIKV-competent mosquito Aedes albopictus is well established. Here we analysed the vector competence of European Aedes (aegypti and albopictus) mosquitoes to different genotypes of ZIKV. We demonstrate that Ae. albopictus from France was less susceptible to the Asian ZIKV than to the African ZIKV. Critically we show that effective crossing of anatomical barriers (midgut and salivary glands) after an infectious blood meal depends on a viral load threshold to trigger: (i) viral dissemination from the midgut to infect mosquito internal organs and (ii) viral transmission from the saliva to infect a vertebrate host. A viral load in body ≥4800 viral copies triggered dissemination and ≥12,000 viral copies set out transmission. Only 27.3% and 18.2% of Ae. albopictus Montpellier mosquitoes meet respectively these two criteria. Collectively, these compelling results stress the poor ability of Ae. albopictus to sustain a local transmission of ZIKV in Europe and provide a promising tool to evaluate the risk of ZIKV transmission in future outbreaks.
Cervical intraepithelial neoplasia during pregnancy

Objectives: The aim was to analyze the unaffected course of cervical intraepithelial neoplasia (CIN) in pregnant women and to compare the rates of lesion persistence, progression, and regression. Materials and Methods: Patients with abnormal cytology included in the study underwent colposcopy, followed by a biopsy of the cervix. At the end of the postpartum period, all patients underwent Pap smear, colposcopy, and endocervical curettage to obtain tissue samples. The findings were compared to the baseline to assess the rates of persistence, regression, and progression of CIN. Results: The study group were 53 pregnant women. CIN was confirmed in 35 (66%) of them: CIN1 (n = 8, 22.9%); CIN 2+ (n = 26, 74.3%); and stage IA1 cervical cancer (n = 1, 2.9%). At the end of the postpartum period in 50% cases, there was no change compared to the baseline. Progression was seen in 2.9% and regression in 47.1%. A tendency for persistence and spontaneous regression of the lesions was observed. Conclusions: Although in many cases CIN tends to regress spontaneously after delivery, such outcome is not to be expected in all patients. When invasive cervical cancer has been excluded, definitive treatment for cervical dysplasia may be deferred to the postpartum period without any harm to the mother.
Evidence for efficacy of new developments in reconstructive upper limb surgery for tetraplegia

Nerve transfers are increasingly utilized for upper limb reconstruction in tetraplegia. We reviewed the literature for results achieved by nerve transfers for elbow extension, wrist control and finger and thumb flexion and extension. Muscle strength grading was the only outcome measure consistently reported. The results confirm that nerve transfers can effectively reanimate muscles in selected cases, with comparable strength with those achieved with tendon transfer for elbow extension but inferior strength for finger and thumb flexion. Transfer of supinator nerve branches to the posterior interosseous nerve appears to be reliable and offers increased span and better hand opening than is observed after tendon transfers. Only one publication demonstrated how reinnervation of muscles with nerve transfers translated into improved function, activity and participation for patients. More prospective studies, using standardized outcome measures, are needed to define the precise role of nerve transfers.
The psychology of portfolio withdrawal rates.

This study investigates how personality and psychological characteristics shape portfolio withdrawal rates (PWR) within a sample of 3,678 U.S. individuals age 50 and over from the Health and Retirement Study. Structural equation model results revealed that those with greater conscientiousness, extraversion, positive affect, and financial self-efficacy have lower PWR; whereas those with greater openness, agreeableness, neuroticism, and negative affect have higher PWR. Findings from this study break new ground by establishing a link between psychological characteristics and PWR. Moreover, results provide insight to financial planning practitioners as they explore retirement income planning beyond its technical aspects and seek to maximize their clients' satisfaction from the consumption of their retirement portfolios. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
Decision-making on birth choices following a caesarean delivery in Taiwan

A qualitative research aimed to explore decision-making on birth choices following a caesarean delivery in Taiwan. Safety and risk management were the major influences for both Taiwanese women’s and obstetricians’ decisions. Biased information provision regarding birth options and over-medicalisation of the birth environment contributed to women seeking repeat caesarean delivery.
Mechanisms of soil bacterial and fungal community assembly differ among and within islands.

The study of islands has made substantial contributions to the development of evolutionary and ecological theory. However, we know little about microbial community assembly on islands. Using soil microbial data collected from 29 lake islands and nearby mainland, we examined the assembly mechanisms of soil bacterial and fungal communities among and within islands. We found that deterministic processes, especially homogeneous selection, tended to be more important in shaping the assembly of soil bacterial communities among islands, while stochastic processes tended to be more important within islands. Moreover, increasing island area increased the importance of homogeneous selection, but reduced the importance of variable selection, for soil bacterial community assembly within islands. By contrast, stochastic processes tended to dominate soil fungal community assembly both among and within islands, with dispersal limitation playing a more important role within than among islands. Our results highlight the scale- and taxon-dependence of insular soil microbial community assembly, suggesting that spatial scale should be explicitly considered when evaluating the influences of habitat fragmentation on soil microbial communities. This article is protected by copyright. All rights reserved.
Mapping the Current and Future Noncommunicable Disease Burden in Kenya by Human Immunodeficiency Virus Status: A Modeling Study

Abstract Background The noncommunicable disease (NCD) burden in Kenya is not well characterized, despite estimates needed to identify future health priorities. We aimed to quantify current and future NCD burden in Kenya by human immunodeficiency virus (HIV) status. Methods Original systematic reviews and meta-analyses of prevalence/incidence of cardiovascular disease (CVD), chronic kidney disease, depression, diabetes, high total cholesterol, hypertension, human papillomavirus infection, and related precancerous stages in Kenya were carried out. An individual-based model was developed, simulating births, deaths, HIV disease and treatment, aforementioned NCDs, and cancers. The model was parameterized using systematic reviews and epidemiological national and regional surveillance data. NCD burden was quantified for 2018–2035 by HIV status among adults. Results Systematic reviews identified prevalence/incidence data for each NCD except ischemic heart disease. The model estimates that 51% of Kenyan adults currently suffer from ≥1 NCD, with a higher burden in people living with HIV (PLWH) compared to persons not living with HIV (62% vs 51%), driven by their higher age profile and partly by HIV-related risk for NCDs. Hypertension and high total cholesterol are the main NCD drivers (adult prevalence of 20.5% [5.3 million] and 9.0% [2.3 million]), with CVD and cancers the main causes of death. The burden is projected to increase by 2035 (56% in persons not living with HIV; 71% in PLWH), with population growth doubling the number of people needing services (15.4 million to 28.1 million) by 2035. Conclusions NCD services will need to be expanded in Kenya. Guidelines in Kenya already support provision of these among both the general and populations living with HIV; however, coverage remains low.
Systematic Evaluation of Levodopa Effect on Visual Improvement in Amblyopia: A Meta-analysis.

PURPOSE This study aims to evaluate the effectiveness of levodopa as a therapeutic drug in the treatment of children and adults with amblyopia. METHODS We performed a systematic review and meta-analysis with randomized controlled trials of levodopa and placebo in the treatment of amblyopia. All data were identified and extracted from the PubMed, EMBASE, Cochrane libraries, and the Chinese knowledge resource integration database. RESULTS After screening the literature and evaluating the quality, 11 studies met the criteria from 308 studies. The mean difference of LogMAR visual acuity between levodopa and the placebo group was -0.1031 (95% confidence interval, -0.11 to -0.09; P < 0.0001). The improvement of visual acuities of the subgroup of younger patients with amblyopia was significantly higher than that of the placebo group (P < 0.0001). Increasing the dosage of levodopa and prolonging the treatment can significantly improve the curative effect. CONCLUSIONS Levodopa is effective in the treatment of amblyopia by prolonging the treatment, especially for young patients.
Long‐term dementia risk prediction by the LIBRA score: A 30‐year follow‐up of the CAIDE study

As no causal treatment for dementia is available yet, the focus of dementia research is slowly shifting towards prevention strategies. Therefore, this study aimed to examine the predictive accuracy of the “LIfestyle for BRAin Health” (LIBRA) score, a weighted compound score of 12 modifiable risk and protective factors, for dementia and mild cognitive impairment (MCI) in midlife and late‐life, and in individuals with high or low genetic risk based on presence of the apolipoprotein (APOE) ε4 allele.
Effect of Streptomyces probiotics on the gut microbiota of Litopenaeus vannamei challenged with Vibrio parahaemolyticus

This study assessed the intestinal microbiota of juveniles of the White shrimp Litopenaus vannamei, whose feed was enriched with three probiotic formulations: Streptomyces sp. RL8 (RL8); a mix of Lactobacillus graminis and Streptomyces spp. RL8 and N7 (Lac‐Strep); and a mix of Bacillus spp. and Streptomyces spp. RL8 and N7 (Bac‐Strep). The analysis was performed by sequencing the V3 region of the 16S rRNA gene of treated animals and the control group before and after Vibrio parahaemolyticus challenge. After challenge, the highest Shannon diversity indexes corresponded to RL8 and Bac‐Strep (3.94 ± 0.11 and 3.39 ± 0.3, respectively) and the lowest to the control group (2.58 ± 0.26). The most abundant phyla before and after challenge were Proteobacteria, Actinobacteria, and Bacteroidetes. The principal component analysis and Statistical Analysis of Metagenomic Profiles (STAMP) showed that the gut microbiota of the groups RL8 and Bac‐Strep after challenge was different from the other experimental groups, which was characterized by a higher bacterial diversity, as well as a significant stimulation of the Bacteriovorax population and other antimicrobial producing genera that protected shrimp from infection.
Nonlinear Relation Between Burst Dorsal Root Ganglion Stimulation Amplitude and Behavioral Outcome in an Experimental Model of Painful Diabetic Peripheral Neuropathy

Dorsal root ganglion stimulation (DRGS) has recently emerged as a neuromodulation modality in the treatment of chronic neuropathic pain. The objective of this study was to compare the efficacy of different Burst‐DRGS amplitudes in an experimental model of painful diabetic peripheral neuropathy (PDPN).