Miracle-dz/UniFAR-FTUs huggingface dataset:
Multidisciplinary Proactive Psychiatric Consultation Service: Impact on Length of Stay for Medical Inpatients

Background: Mental illness correlates with an increased length of stay (LOS) for patients hospitalized for medical conditions. While psychiatric consultations help manage mental illness among those hospitalized for medical conditions, consultations initiated by nonpsychiatric mental disease may lack maximum effectiveness. Methods: In a before-and-after design, in 2 contiguous years LOS for internist-initiated, conventional consultation (CC) as usual treatment was compared to LOS of a proactive, mental health professional-initiated, multidisciplinary intervention delivered by the behavioral intervention team (BIT) on the same units. The patient populations included general medical patients with a variety of illnesses. Patients were treated in 3 different inpatient settings with a total capacity of 92 beds serving 15,858 patient visits over 3 comparison years. BIT comprised a psychiatrist, a nurse, and a social worker, each of whom performed the specific tasks of their professional discipline, while collaborating among themselves and their health-care colleagues. BIT provided timely, appropriate, and effective patient care alongside consultative advice and education to their corresponding professional peers. BIT was compared to CC on the outcome of LOS. Results: There was a statistically significant reduction of LOS favoring BIT over CC for patients with an LOS of <31 days which persisted while controlling for multiple co-morbid factors. Also, a statistically significant spillover effect was suggested by the overall improvement of LOS on units implementing BIT. Conclusion: BIT is a promising means of lowering LOS on general medical units while providing a high level of care and staff support.
Urbanization Altered Bacterial and Archaeal Composition in Tidal Freshwater Wetlands Near Washington DC, USA, and Buenos Aires, Argentina

Urban expansion causes coastal wetland loss, and environmental stressors associated with development can lead to wetland degradation and loss of ecosystem services. This study investigated the effect of urbanization on prokaryotic community composition in tidal freshwater wetlands. Sites in an urban, suburban, and rural setting were located near Buenos Aires, Argentina, and Washington D.C., USA. We sampled soil associated with two pairs of functionally similar plant species, and used Illumina sequencing of the 16S rRNA gene to examine changes in prokaryotic communities. Urban stressors included raw sewage inputs, nutrient pollution, and polycyclic aromatic hydrocarbons. Prokaryotic communities changed along the gradient (nested PerMANOVA, Buenos Aires: p = 0.005; Washington D.C.: p = 0.001), but did not differ between plant species within sites. Indicator taxa included Methanobacteria in rural sites, and nitrifying bacteria in urban sites, and we observed a decrease in methanogens and an increase in ammonia-oxidizers from rural to urban sites. Functional profiles in the Buenos Aires communities showed higher abundance of pathways related to nitrification and xenobiotic degradation in the urban site. These results suggest that changes in prokaryotic taxa across the gradient were due to surrounding stressors, and communities in urban and rural wetlands are likely carrying out different functions.
Stimulated thyroglobulin and Thyroglobulin Reduction Index Predict Excellent Response in Differentiated Thyroid Cancers.

INTRODUCTION Despite its good prognosis, differentiated thyroid cancer (DTC) is characterized by a high risk of disease persistence and/or recurrence. Estimation of long-term remission (excellent response) thanks to specific parameters could help to personalize the schedule of active surveillance. OBJECTIVE Evaluation of the value of stimulated thyroglobulin and thyroglobulin reduction index (TRI) to predict long-term remission in patients with DTC managed by thyroidectomy and radioactive iodine (RAI) remnant ablation. PATIENTS AND METHODS Observational retrospective study on 1093 patients managed for DTC between 1995 and 2010. Preablation stimulated thyroglobulin (Pre-sTg) was measured under thyroid hormone withdrawal (THW) just before RAI. rhTSH®-stimulated thyroglobulin (sTg) was measured at first evaluation of the initial management 6-12 months after RAI. TRI was calculated based on pre-Tg and sTg. RESULTS After uni- and multi-variate analyses, lymph node invasion (N1, OR=2.08;IC:1.19-3.64), pre-sTg (OR=4.04;IC:2.56-6.38), sTg (OR=2.62;IC:2.05-3.34), and TRI (0R=0.43;IC:0.21-0.88) were identified as independent prognostic factors influencing the rate of disease persistence/recurrence after the initial management. ROC analysis identified pre-sTg cutoff (<10µg/l) to predict excellent response with a NPV of 94%, and validated for higher stages (T3/T4, N1). Furthermore, sTg<1µg/l predicts excellent response. TRI higher than 60% for all the cohort, and 62.5% for locally advanced disease (T3/T4, N1) was sensitive predictor for excellent response. CONCLUSION This study identifies pre-sTg, sTg, and TRI as highly sensitive predictors for excellent response in patients with DTC, and subsequently disease-free status. The cutoff of such parameters is also adapted for patients with higher tumor stages (T3/T4,N1).
Management of Patients with Brain Metastases Receiving Trastuzumab Treatment for Metastatic Breast Cancer

Background: With the more effective control of visceral metastases in patients with metastatic breast cancer (MBC), an increasing number of patients face brain metastases (BM). The aim of this retrospective analysis was to investigate the incidence and factors affecting the prognosis of patients with BM under trastuzumab treatment for MBC. Patients and Methods: A total of 75 HER2positive patients treated with trastuzumab for MBC were included. Results are discussed in the context of the current literature. Results: Patients who developed BM (n = 29) had longer median progression-free survival (PFS) during first-line chemotherapy and longer overall survival (OS) after diagnosis of MBC than 46 patients without BM (PFS: 27 vs. 14 months, p = 0.039; OS: 46 vs. 18 months, p = 0.067). Median survival of patients with continuation of trastuzumab after diagnosis of BM was longer than survival of patients with discontinuation of trastuzumab treatment after BM (18 vs. 3 months, p = 0.006). Survival of patients who were treated with surgery and radiotherapy for BM was better compared with radiotherapy alone (9 vs. 5 months, p = not significant) or best supportive care (9 vs. 2 months, p = 0.049). Conclusions: Continuation of trastuzumab treatment as well as resection of BM seem to give further benefit in the treatment of patients with HER2-overexpressing MBC.
Targeted Co-Delivery of siRNA and Methotrexate for Tumor Therapy via Mixed Micelles

A combination of chemotherapeutic drugs and siRNA is emerging as a new modality for cancer therapy. A safe and effective carrier platform is needed for combination drug delivery. Here, a functionalized mixed micelle-based delivery system was developed for targeted co-delivery of methotrexate (MTX) and survivin siRNA. Linolenic acid (LA) was separately conjugated to branched polyethlenimine (b-PEI) and methoxy-polyethyleneglycol (mPEG). MTX was then conjugated to LA-modified b-PEI (MTX-bPEI-LA) to form a functionalized polymer-drug conjugate. Functionalized mixed micelles (M-MTX) were obtained by the self-assembly of MTX-bPEI-LA and LA-modified mPEG (mPEG-LA). M-MTX had a narrow particle size distribution and could successfully condense siRNA at an N/P ratio of 16/1. M-MTX/siRNA was selectively taken up by HeLa cells overexpressing the folate receptor (FR) and facilitated the release of the siRNA into the cytoplasm. In vitro, M-MTX/siRNA produced a synergy between MTX and survivin siRNA and markedly suppressed survivin protein expression. In tumor-bearing mice, M-MTX/Cy5-siRNA showed an elevated tumor uptake. In addition, M-MTX/siRNA inhibited tumor growth. Immunohistochemistry and a western blot analysis showed a significant target gene downregulation. In conclusion, M-MTX/siRNA was highly effective as a delivery system and may serve as a model for the targeted co-delivery of therapeutic agents.
A Peptide from Kiwifruit Exerts Anti-Inflammatory Effects in Celiac Disease Mucosa

Abstract Objective: Celiac disease is an immune-mediated disease of the intestine triggered by gluten. Gluten elicits, in genetically susceptible individuals, cytokine responses that are then transmitted to the immunocompetent cells. Vegetables and fruit have anti-inflammatory and antioxidant properties with a protective effect on intestinal epithelium. Kiwifruit is known to have beneficial effects on the intestinal tissues, and it is the only plant food containing the peptide kissper, with anti-inflammatory properties. The aim of this study was the evaluation of the kissper effect on the gluten-induced inflammation in celiac disease. Methods: We used an in vitro model of intestinal culture explant from celiac disease patients and non-celiac disease patients, cultured for 24 hours with the toxic gliadin peptide P31-43 and kissper preincubation. Results: Our data showed HLA-DR and TG2 reduction in the celiac disease mucosa pretreated with kissper, as well as a reduction of COX-2 in two patients. No differences we observed for the TGF-b1 and IL-15 levels in supernatants upon kissper pretreatment. Conclusions: The preliminary results suggest that kissper has a potential anti-inflammatory role in celiac disease.
Surgical margins in oral squamous cell cancer: intraoperative evaluation and prognostic impact

Purpose of review To summarize recent findings regarding surgical management of oral squamous cell cancer (OSCC) through analysis of different intraoperative techniques for assessment of margins, evaluate the pros and cons of each, and ensuing prognostic impact. Recent findings ‘En bloc’ OSCC resection and histopathologic evaluation of margins on the formalin-fixed specimen remain the ‘gold standard’ for oral oncologic surgery, whereas assessment of intraoperative surgical margins and its overall clinical value are still questioned and debated in the literature. The commonly applied evaluation of frozen sections still raises concerns regarding its efficacy and reproducibility; therefore, several ancillary diagnostic methods have entered the field of head and neck oncology in the last decades, aiming to support the surgeon in achieving tumor-free margins during ablative procedures. Summary Poor prognosis of OSCC is strongly associated with residual tumor after surgery. Negative surgical margins are one of the strongest prognosticators for disease-free survival and locoregional control, but their intraoperative determination seems still to be suboptimal and needs better refinement. The most studied techniques to assess intraoperative margins include fluorescence, Raman spectroscopy, narrow band imaging, optical coherence tomography, and cytological bone margins analysis; each has its unique characteristics that are described in detail herein.
A SIFT-Based DEM Extraction Approach Using GEOEYE-1 Satellite Stereo Pairs

A module for Very High Resolution (VHR) satellite stereo-pair imagery processing and Digital Elevation Model (DEM) extraction is presented. A large file size of VHR satellite imagery is handled using the parallel processing of cascading image tiles. The Scale-Invariant Feature Transform (SIFT) algorithm detects potentially tentative feature matches, and the resulting feature pairs are filtered using a variable distance threshold RANdom SAmple Consensus (RANSAC) algorithm. Finally, point cloud ground coordinates for DEM generation are extracted from the homologous pairs. The criteria of average point spacing irregularity is introduced to assess the effective resolution of the produced DEMs. The module is tested with a 0.5 m × 0.5 m Geoeye-1 stereo pair over the island of Crete, Greece. Sensitivity analysis determines the optimum module parameterization. The resulting 1.5-m DEM has superior detail over reference DEMs, and results in a Root Mean Square Error (RMSE) of about 1 m compared to ground truth measurements.
A tractable, simplified ex vivo human skin model of wound infection

The prevalence of infection in chronic wounds is well documented in the literature but not optimally studied due to the drawbacks of current methodologies. Here, we describe a tractable and simplified ex vivo human skin model of infection that addresses the critical drawbacks of high costs and limited translatability. Wounds were generated from excised abdominal skin from cosmetic procedures and cultured, inoculated with Staphylococcus aureus strain UAMS‐1, or under aseptic conditions. After three days, the infected wounds exhibited biofilm formation and significantly impaired reepithelialization compared to the control. Additionally, promigratory and proreparative genes were significantly downregulated, while proinflammatory genes were significantly upregulated, demonstrating molecular characterizations of impaired healing as in chronic wounds. This model allows for a simplified and versatile tool for the study of wound infection and subsequent development of novel therapies.
Analysis of anterior tibial subluxation to the femur at maximum extension in anterior cruciate ligament-deficient knees

Purpose: The factors affecting anterior tibial subluxation (ATS) have not yet been well examined. To assess the factors affecting ATS in anterior cruciate ligament (ACL)-deficient knees. Methods: One hundred twenty-four patients with unilateral ACL injuries were included. True lateral views of the ACL-deficient knee and contralateral normal knee were obtained during maximum extension using fluoroscopy under general anesthesia, and ATS was calculated as the side-to-side difference in the tibial position relative to the femur. Patients were divided into four groups according to the time from injury to surgery. To identify the factors affecting ATS, the following possible factors were assessed: (1) the time from injury to surgery, (2) presence of a medial meniscal injury, and (3) posterior tibial slope angle. Results: There was a positive correlation between the ATS ratio and the time from injury to surgery (r = 0.52). The ratio of the presence of a medial meniscus injury was significantly higher in patients who underwent anterior tibial subluxation reconstruction (ACL-R) more than 12 months after an injury than in other patients who underwent ACL-R within 12 months after an injury. The ATS ratio was significantly higher in patients with a medial meniscus injury than in those without a medial meniscus injury (5.6% vs. 4.1%). Conclusions: Our results suggested that ACL-R should be performed within 6 months after injury if surgeons prefer to avoid an increase in ATS in maximum knee extension and at the latest within 12 months to avoid medial meniscal injury at the time of ACL-R.
The Reactive Plasticity of Hippocampal Ionotropic Glutamate Receptors in Animal Epilepsies

Ionotropic glutamate receptors (iGluRs) mediate the synaptic and metabolic actions of glutamate. These iGluRs are classified within the α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA)-type, kainate-type, and N-methyl-d-aspartate (NMDA)-type functional receptor families. The iGluR assemblies are regulated by transcription, alternative splicing, and cytoplasmic post-translational modifications. The iGluR subunit proteins are transported from the endoplasmic reticulum, inserted into the synaptic membranes, and anchored at their action site by different scaffolding and interacting proteins. The functional properties of iGluRs depend on their subunit composition, the amino acid sequence of the protein domains, and the scaffolding proteins in the synaptic membranes. The iGluRs are removed from the membranes by enzymatic action and endocytosis. Hippocampal iGluRs are rearranged through the upregulation and downregulation of the subunits following deafferentation and epileptic seizures. The rearrangement of iGluRs and the alteration of their subunit composition transform neurons into “pathological” cells, determining the further plasticity or pathology of the hippocampal formation. In the present review, we summarize the expression of AMPA, kainate, and NMDA receptor subunits following deafferentation, repeated mild seizures, and status epilepticus. We compare our results to literature descriptions, and draw conclusions as to the reactive plasticity of iGluRs in the hippocampus.
Effect of Crisis Response Planning on Patient Mood and Clinician Decision Making: A Clinical Trial With Suicidal U.S. Soldiers.

OBJECTIVE The study examined the immediate effect of crisis interventions on the emotional state of acutely suicidal soldiers and clinician decision making. METHODS Soldiers (N=97) presenting to a military emergency department or behavioral health clinic were randomly assigned to receive a contract for safety (N=32), standard crisis response plan (S-CRP; N=32), or enhanced crisis response plan (E-CRP; N=33). Soldiers completed self-report scales before and after the intervention. Clinicians blinded to treatment group assignment rated participants' suicide risk level and made a decision about inpatient psychiatric admission. RESULTS Larger reductions in negative emotional states occurred in S-CRP and E-CRP. Larger increases in positive emotional states occurred in E-CRP. Clinician suicide risk ratings did not differ across treatment groups. Participants in E-CRP were less likely to be psychiatrically admitted. CONCLUSIONS The CRP immediately reduces negative emotional states among acutely suicidal soldiers. Discussing a patient's reasons for living during a CRP also reduces the likelihood of inpatient psychiatric admission.
Radiological and clinical outcomes following extreme lateral interbody fusion.

OBJECT Extreme lateral interbody fusion (ELIF) is a popular technique for anterior fixation of the thoracolumbar spine. Clinical and radiological outcome studies are required to assess safety and efficacy. The aim of this study was to describe the functional and radiological impact of ELIF in a degenerative disc disease population with a longer follow-up and to assess the durability of this procedure. METHODS Demographic and perioperative data for all patients who had undergone ELIF for degenerative lumbar disorders between 2007 and 2011 were collected. Trauma and tumor cases were excluded. For radiological outcome, the preoperative, immediate postoperative, and latest follow-up coronal Cobb angle, lumbar sagittal lordosis, bilateral foraminal heights, and disc heights were measured. Pelvic incidence (PI) and PI-lumbar lordosis (PI-LL) mismatch were assessed in scoliotic patients. Clinical outcome was evaluated using the Oswestry Disability Index (ODI) and visual analog scale (VAS), as well as the Macnab criteria. RESULTS One hundred forty-five vertebral levels were surgically treated in 90 patients. Pedicle screw and rod constructs and lateral plates were used to stabilize fixation in 77% and 13% of cases, respectively. Ten percent of cases involved stand-alone cages. At an average radiological follow-up of 12.6 months, the coronal Cobb angle was 10.6° compared with 23.8° preoperatively (p < 0.0001). Lumbar sagittal lordosis increased by 5.3° postoperatively (p < 0.0001) and by 2.9° at the latest follow-up (p = 0.014). Foraminal height and disc height increased by 4 mm (p < 0.0001) and 3.3 mm (p < 0.0001), respectively, immediately after surgery and remained significantly improved at the last follow-up. Separate evaluation of scoliotic patients showed no statistically significant improvement in PI and PI-LL mismatch either immediately postoperatively or at the latest follow-up. Clinical evaluation at an average follow-up of 17.6 months revealed an improvement in the ODI and the VAS scores for back, buttock, and leg pain by 21.1% and 3.7, 3.6, and 3.7 points, respectively (p < 0.0001). According to the Macnab criteria, 84.8% of patients had an excellent, good, or fair functional outcome. New postoperative thigh numbness and weakness was detected in 4.4% and 2.2% of the patients, respectively, which resolved within the first 3 months after surgery in all but 1 case. CONCLUSIONS This study provides what is to the authors' knowledge the most comprehensive set of radiological and clinical outcomes of ELIF in a fairly large population at a midterm follow-up. Extreme lateral interbody fusion showed good clinical outcomes with a low complication rate. The procedure allows for at least midterm clinically effective restoration of disc and foraminal heights. Improvement in coronal deformity and a small but significant increase in sagittal lordosis were observed. Nonetheless, no significant improvement in the PI-LL mismatch was achieved in scoliotic patients.
Toe Flexor Muscle Strength and Morphological Characteristics of the Foot in Judo Athletes

Abstract Whether practicing in judo influences the muscle strength and morphological characteristics of the foot is unknown. The purpose of this study was to determine the toe flexor muscle strength and morphological characteristics of the foot in judo athletes. Judo athletes (JUDO, men=24) and age-, gender- and body mass-matched physically active healthy subjects (CON, men=24) were recruited, and their toe flexor strength and morphological characteristics of the foot were compared. The maximum isometric toe flexor strength and foot intrinsic muscle thicknesses were measured using a toe grip dynamometer and a B-mode ultrasound, respectively. Foot arch height was assessed as the distance between the navicular tuberosity of the foot and the floor in the sitting and standing positions. JUDO showed a significantly lower foot arch height and smaller foot arch index than CON, whereas foot length and muscle thickness did not significantly differ between groups. The toe flexor strength relative to total muscle thickness was significantly larger in JUDO than CON. The foot arch dynamics was significantly larger in JUDO than CON. This study suggests that exercise training specific to judo may affect the force-generating capacity, morphological structure and arch function of the foot.