Miracle-dz/UniFAR-FTUs huggingface dataset:
Isometric Exercise with Large Muscle Mass Improves Redox Balance and Blood Pressure in Hypertensive Adults

ABSTRACT Purpose The aim of this study was to investigate the hemodynamic, oxidative stress (OS), and nitric oxide (NO−) responses to a submaximal isometric exercise session (IES) involving large muscle mass. Methods Fourteen hypertensive (HTG: age = 35.9 ± 8.1 yr, height = 1.73 ± 0.10 m, total body mass = 78.0 ± 15.8 kg) and 10 normotensive (NTG: age = 41.1 ± 9.4 yr, height = 1.71 ± 0.12 m, total body mass = 82.3 ± 22.4 kg) participants performed two experimental sessions in the leg press and bench press: (i) control session and (ii) 8 sets × 1 min contraction at 30% maximal voluntary isometric contraction with 2-min rest interval. Blood pressure (BP) was measured at rest and during 60 min postexercise. Blood samples were collected at rest, immediately after the session, and 60 min postexercise. NO− was obtained through the Griess reaction method. OS parameters were analyzed using commercial kits. A repeated-measures ANOVA with Bonferroni post hoc test was used to analyze all dependent variables. Results A significant decrease in systolic BP was observed only for HTG at 45 and 60 min postexercise (baseline vs 45 min: P = 0.03, Δ% = 4.44%; vs 60 min: P = 0.018, Δ% = 5.58%). NO− increased immediately postexercise only for HTG (P = 0.008, Δ% = 16.44%). Regarding OS parameters, thiobarbituric acid reactive substances presented a significant reduction 60 min after the IES for NTG and HTG; catalase increased in both groups. Conclusions The data showed that only 8 min of IES with a large muscle mass elicits an elevated pro-oxidant activity leading to a greater NO− bioavailability, increases antioxidant reaction, and consequently reduces BP in hypertensive patients.
Isolation and Analysis of Mouse and Human Skin γδ T Cells

Skin‐resident and infiltrating γδ T lymphocytes are components of the cutaneous immune system that provide the first line of defense against pathogens and the environment. Research that employs the isolation and culture of T cells from murine and human skin can help delineate the molecular and cellular mechanisms utilized by T lymphocytes in skin‐specific immunity. However, obtaining high numbers of T cells from epithelial tissue without resorting to long‐term culture or transformation can be difficult. Here, specific approaches are described for the isolation and culture of γδ T lymphocytes from murine skin and human skin explant cultures. In addition, a protocol to assess the morphology and activation of epidermal γδ T cells in situ using immunofluorescent microscopy is detailed. These techniques can be used to analyze resident and infiltrating γδ T lymphocytes in the skin via flow cytometry, RNA‐seq, or proteomics to further study inflammatory diseases, cancer, or autoimmunity. © 2019 by John Wiley & Sons, Inc.
HLA Allo-immunization Following Ventricular Assist Device Support Across the Age Spectrum.

BACKGROUND Ventricular assist device (VAD) therapy has become an important tool for end-stage heart failure. VAD therapy has increased survival but is associated with complications including the development of human leukocyte antigen (HLA) antibodies. We sought to determine the incidence of HLA antibody development post-VAD insertion, across the age spectrum, in patients receiving leukocyte-reduced blood products, with standardized HLA antibody detection methods and to investigate factors associated with antibody development. METHODS This was a retrospective analysis of all patients who underwent durable VAD placement between 2005-2014. Inclusion criteria included availability of pre- and post-VAD HLA antibody results. Associations between HLA antibody development in the first year post implant and patient factors were explored. RESULTS 39 adult and 25 pediatric patients made up the study cohort. Following implant, 31% and 8% of patients developed new Class I and Class II antibodies. The proportion of newly sensitized patients was similar in adult and pediatric patients. The Class I HLA panel reactive antibody (PRA) only significantly increased in adults. Pre-VAD sensitization, age, sex (pediatrics), and transfusion were not associated with the development of HLA antibodies. CONCLUSION In a cohort of VAD patients receiving leukocyte-reduced blood products and standardized HLA antibody testing, roughly one-third developed new Class I antibodies in the first year post implant. Adults showed significantly increased Class I PRA following VAD support. No patient-related factors were associated with HLA antibody development. Larger prospective studies are required to validate these findings and determine the clinical impact of these antibodies following VAD insertion.
A randomized controlled trial

Background: Anticholinergic administration prior to flexible bronchoscopy has been investigated, but studies have not yielded consistent results. Methods: Patients were randomized 1:1 to receive nebulized 4ml ipratropium bromide (1mg, n=125) or placebo (n=125) for 15minutes as premedication, 20 to 40minutes before bronchoscopy. Airway secretions, bleeding, patient discomfort, procedure time, and procedure-related adverse events were compared between the groups. Results: Nebulized ipratropium bromide prior to bronchoscopy could reduce airway secretions and patient discomfort (P= .02; P< .001, respectively), but not tracheobronchial bleeding or procedure time (P= .51, P= .36, respectively). Chest nodule or mass was the most common indication for performing bronchoscopy. The adverse events were higher in ipratropium bromide group, and hypertension was the most common complication. Conclusion: Nebulized ipratropium bromide prior to bronchoscopy is a more effective regimen that shows a practical benefit on the airway secretions and patient comfort, though these effects may not translate into any marked reduction in bleeding or of procedure time under general anesthesia. We suggest that routine nebulized ipratropium bromide premedication for bronchoscopy could be useful and beneficial. Trial Registration: chictr.org. cn: ChiCTR1800016881. Abbreviations: BP = blood pressure, TBNA = transbronchial needle aspiration.
Promoting Parent Partnership in Developmentally Supportive Care for Infants in the Pediatric Cardiac Intensive Care Unit.

BACKGROUND Limited opportunities for parents to care for their critically ill infant after cardiac surgery can lead to parental unpreparedness and distress. PURPOSE This project aimed to create and test a bedside visual tool to increase parent partnership in developmentally supportive infant care after cardiac surgery. METHODS The Care Partnership Pyramid was created by a multidisciplinary team and incorporated feedback from nurses and parents. Three Plan-Do-Study-Act (PDSA) cycles tested its impact on parent partnership in care. Information about developmentally supportive care provided by parents during each 12-hour shift was extracted from nursing documentation. A staff survey evaluated perceptions of the tool and informed modifications. RESULTS Changes in parent partnership during PDSA 1 did not reach statistical significance. Staff perceived that the tool was generally useful for the patient/family but was sometimes overlooked, prompting its inclusion in the daily goals checklist. For PDSA 2 and 3, parents were more often observed participating in rounds, asking appropriate questions, providing environmental comfort, assisting with the daily care routine, and changing diapers. IMPLICATIONS FOR PRACTICE Use of a bedside visual tool may lead to increased parent partnership in care for infants after cardiac surgery. IMPLICATIONS FOR RESEARCH Future projects are needed to examine the impact of bedside care partnership interventions on parent preparedness, family well-being, and infant outcomes.
QUALITY ASSESSMENT OF INTERNAL RESIDENTS IN TEHRAN UNIVERSITY OF MEDICAL SCIENCES (HEMMAT CAMPUS) IN 2010-2011 (BRIEF COMMUNICATION)

Assessment is one of the major domains in medical education and the only means that makes the resident’s capability observable during the residency training period. The data obtained from the quality assessment of residents in Tehran University of Medical Sciences (Hemmat campus) were reported in three categories, including of lack of assessment of clinical skills, assessment methods and assessment frequencies.
Motion‐compensated b‐tensor encoding for in vivo cardiac diffusion‐weighted imaging

Motion is a major confound in diffusion‐weighted imaging (DWI) in the body, and it is a common cause of image artefacts. The effects are particularly severe in cardiac applications, due to the nonrigid cyclical deformation of the myocardium. Spin echo‐based DWI commonly employs gradient moment‐nulling techniques to desensitise the acquisition to velocity and acceleration, ie, nulling gradient moments up to the 2nd order (M2‐nulled). However, current M2‐nulled DWI scans are limited to encode diffusion along a single direction at a time.
Selective afferent renal denervation mitigates renal and splanchnic sympathetic nerve overactivity and renal function in chronic kidney disease-induced hypertension.

BACKGROUND Clinical and experimental evidence have shown that renal denervation, by removing both the sympathetic and afferent nerves, improves arterial hypertension and renal function in chronic kidney disease (CKD). Given the key role of renal sympathetic innervation in maintaining sodium and water homeostasis, studies have indicated that the total removal of renal nerves leads to impaired compensatory mechanisms during hemodynamic challenges. METHOD In the present study, we hypothesized that afferent (or sensory) fibers from the diseased kidney contribute to sympathetic overactivation to the kidney and other target organ, such as the splanchnic region, contributing to hypertension in CKD. We used a method to remove selectively the afferent renal fibers (periaxonal application of 33 mmol/l capsaicin) in a rat model of CKD, the 5/6 nephrectomy. RESULTS Three weeks after afferent renal denervation (ARD), we found a decrease in mean arterial pressure (∼15%) and normalization in renal and splanchnic sympathetic nerve hyperactivity in the CKD group. Interestingly, intrarenal renin--angiotensin system, as wells as renal fibrosis and function and proteinuria were improved after ARD in CKD rats. CONCLUSION The findings demonstrate that afferent fibers contribute to the maintenance of arterial hypertension and reduced renal function that are likely to be mediated by increased sympathetic nerve activity to the renal territory as well as to other target organs in CKD.
Dynamics of tumor‐specific cfDNA in response to therapy in multiple myeloma patients

Progress in multiple myeloma treatment allows patients to achieve deeper responses, for which the assessment of minimal residual disease (MRD) is critical. Typically, bone marrow samples are used for this purpose; however, this approach is site‐limited. Liquid biopsy represents a minimally invasive and more comprehensive technique that is not site‐limited, but equally challenging.
small cell lung cancer: a cost-effec tiveness analysis from China

afety of adding atezolizumab or placebo to first-line treatment with Background: IMpower 133 trial first confirmed the efficacy and s chemotherapy in patients with extensive-stage small-cell lung cancer (SCLC). While, overprice limited its broad use in clinical. The aim of this study was to evaluate the cost-effectiveness of atezolizumab plus chemotherapy in treatment of extensive SCLC as first line in China. Methods: AMarkov model was established by extracting data from the IMpower 133 trial with untreated extensive SCLC patients. Utility values were obtained from published studies, and the costs were acquired from real world and literature. Additionally, sensitivity analyses based on a willingness-to-pay (WTP) threshold were performed to identify the uncertain parameters of Markov model. Results: Total costs of atezolizumab group were $48,129, while cost of chemotherapy alone was just $12,920 in placebo group. The quality-adjusted life-years (QALYs) in atezolizumab group was just 0.072 higher than that in placebo group (0.858 QALYs vs. 0.786 QALYs). The cost-effectiveness ratio between atezolizumab combination with chemotherapy and chemotherapy alone was $489,013/QALY in China. The net benefit of placebo group was significantly higher than atezolizumab group. One-way sensitivity analyses highlighted that utilities of the progression-free survival (PFS) and progression disease state in placebo group were the most influential parameter. Conclusions: Atezolizumab combination therapy was not more cost-effective than chemotherapy alone at a WTP threshold of $25,929/QALY in China.
Reducing the use of opioids by patients with chronic pain: an effectiveness study with long-term follow-up.

This paper addresses the problem of long-term opioid use by chronic pain patients. The study involved a secondary analysis of unanalysed data from a published study of two versions of CBT-based interdisciplinary treatment for chronic pain. In this paper we examined whether the use of opioids by 140 chronic pain patients could be ceased sustainably over 12-months following participation in the comprehensive interdisciplinary pain management program aimed at enhancing pain self-management. On admission to the treatment there were no significant differences between those patients taking or not taking opioids on usual pain, pain interference in daily activities, pain-related disability, depression severity, as well as in pain cognitions. Following the treatment the use of opioids was significantly reduced, both in numbers taking any and in mean doses, and these gains were maintained over the 12-month follow-up. Finally, cessation of opioids during treatment was associated with more substantial and consistent improvements in usual pain, depression severity, pain interference, pain-related disability, and pain cognitions, relative to those who reduced their opioids but did not cease them. These findings support the idea of using training in pain self-management strategies as a viable alternative to long-term opioid use by patients with chronic pain.
Head magnetomyography (hMMG): A novel approach to monitor face and whole head muscular activity

Muscular activity recording is of high basic science and clinical relevance and is typically achieved using electromyography (EMG). While providing detailed information about the state of a specific muscle, this technique has limitations such as the need for a-priori assumptions about electrode placement and difficulty with recording muscular activity patterns from extended body areas at once. For head and face muscle activity, the present work aimed to overcome these restrictions by exploiting magnetoencephalography (MEG) as a whole-head myographic recorder (head magnetomyography, hMMG). This is in contrast to common MEG studies, which treat muscular activity as artifact in electromagnetic brain activity. In a first proof-of-concept step, participants imitated emotional facial expressions performed by a model. Exploiting source projection algorithms, we were able to reconstruct muscular activity, showing spatial activation patterns in accord with the hypothesized muscular contractions. Going one step further, participants passively observed affective pictures with negative, neutral, or positive valence. Applying multivariate pattern analysis to the reconstructed hMMG signal, we were able to decode above chance the valence category of the presented pictures. Underlining the potential of hMMG, a searchlight analysis revealed that generally neglected neck muscles exhibit information on stimulus valence. Results confirm the utility of hMMG as a whole-head electromyographic recorder to quantify muscular activation patterns including muscular regions that are typically not recorded with EMG. This key advantage beyond conventional EMG has substantial scientific and clinical potential.
Effect of Cedar (Ziziphus spina-christi) topical solution in mild to moderate acne vulgaris: a randomized clinical study

Abstract Background Acne is the most prevalent skin disease in the world and antibiotics as its standard treatments have limited and also adverse effects. Cedar (Ziziphus spina-christi) has medicinal properties like antibacterial activity and is used topically for treatment of some kinds of skin problems in Persian medicine. The aim of this study was to evaluation the efficacy of topical cedar solution of acne vulgaris. Methods Eighty patients aged between 15–45 years with mild to moderate acne vulgaris were conducted in this randomized, double blind trial. The participants were allocated to receive the topical cedar solution plus clindamycin 1% or topical placebo plus 1% clindamycin solution for six weeks. Patients were evaluated at the beginning of the study, second, sixth and eighth weeks after intervention for the acne severity index (ASI) and total acne lesions counting (TLC). Data was analyzed by SPSS software with Mann–Whitney U test. Results From 105 subjects 68 people completed the study (33 persons in cedar group and 35 persons in placebo group). The mean and standard deviation of the age was 26.1 ± 7.5 years and 22 subjects (32.4%) were male. TLC and ASI in the sixth and eighth weeks in cedar group were significantly less than in placebo group (p < 0.001). Topical cedar solution had no serious side effects. Conclusion The topical cedar solution plus clindamycin 1% was more effective and safe than placebo plus 1% clindamycin for the treatment of acne vulgaris.
Long-Term Survival Rates and Prognostic Factors of Cervix Cancer Treated by Different Modalities

Objective: To assess the overall survival (OS) and prognostic factors in patients with cervix cancer treated by different modalities. Material and Methods: The authors studied a cohort of patients with cervix cancer International Federation of Gynecology and Obstetrics stage I-IVa treated in the last 15 years. Patients were treated with surgery followed by radiotherapy (S+RT), or surgery plus chemoradiation (S+CRT), or radiotherapy alone (RT), or chemoradiation alone (CRT). Univariate and multivariate analyses were conducted to identify significant prognostic factors (P<0.05). Results: A total of 380 patients with cervix cancer were included. The treatment groups were S+CRT (37.5%), CRT (33%), RT (20%), and S+RT (9.5%). The median follow-up was 7.6 years, the OS in 5 and 10 years according to the treatment groups was 43.3%, and 17.3% for S+RT, 47.8% and 41.9% for S+CRT, 40.7% and 27.9% for CRT, and 29.1% and 19.4% for RT (P<0.0001). The stage IIb-IVa, age 60 years or older, RT, and 2DRT were significant factors in the univariate and multivariate analyses. In stage I-IIa, no significant difference was found among the treatment groups (P=0.907). In stage IIb-IVa, a significant difference was observed (P=0.0001). CRT versus RT had significance, and no difference between S+RT versus S+CRT, and S+CRT versus CRT was seen for stage IIb-IVa. Conclusions: In a long-term follow-up, no significant difference among the treatment modalities was found for early disease. For stage IIb-IVa, significant differences were observed, with RT having the worst survival, and CRT similar to S+CRT. These outcomes show that tumor and patients characteristics can be used to decide the best treatment option outside a clinical trial.
The Acute:Chronic Workload Ratio Is Associated with Injury in Junior Tennis Players

ABSTRACT Purpose Session RPE (sRPE) is used to track internal training/competition load in athletes using a metric known as the acute to chronic workload ratio (ACWR). Research that reported on team sports has determined that if the acute load is higher than the chronic load, athletes are likely to sustain injury. No studies, however, have attempted to investigate internal load and injury in a tennis population despite the rigorous training loads. Therefore, the purpose of this study was to investigate if sRPE ACWR is associated with injury in junior tennis players over a 7-month time period. Methods Forty-two junior tennis players were recruited to participate, 26 were included in the final analysis. Players provided a rating of RPE as an estimate of training intensity every day after training/match sessions. sRPE, a measure of internal and external training load was calculated by multiplying the training/match sRPE by the session duration in minutes. Players self-reported all injuries. The ACWR was the primary independent variable. Acute load was determined as the total sRPE for 1 wk, whereas a 4-wk rolling average sRPE represented chronic load. Results Seventeen players sustained injuries. The model indicated that ACWR from the previous week (P < 0.001) and previous injury history (P = 0.003) were significant predictors of injury the following week. In the week preceding injury, the average ACWR was 1.57 (SD, 0.90). Conclusion Injured players had on average 1.5 times more training load in the past week compared with the previous 4 wk. A majority of players who went on to sustain an injury were not prepared for the load endured. These results were similar to previous studies investigating ACWR where an acute increase in load was associated with increased injury risk.
Aberrant Mesenteric Migration of Spirocerca lupi Larvae Causing Necrotizing Eosinophilic Arteritis, Thrombosis, and Intestinal Infarction in Dogs

This report presents a novel canine condition in 32 dogs in which aberrant migration of Spirocerca lupi larvae through mesenteric arteries, instead of gastric arteries, led to small or large intestinal infarction. This form of spirocercosis was first recognized in Israel in 2013 and is currently ongoing. Typical clinical signs were anorexia and weakness of 3 to 4 days and, less frequently, vomiting and diarrhea, followed by collapse, bloody diarrhea, and severe vomiting. Exploratory laparotomy showed 1 or more infarcted and often perforated intestinal segments in all cases. Microscopically, there was intestinal mucosal to transmural coagulative necrosis and mesenteric multifocal necrotizing eosinophilic arteritis, thrombosis, hemorrhage, and early fibroplasia. Third-stage S. lupi larvae were identified by morphologic features in 9 of 32 (28%) cases, and the species was confirmed by polymerase chain reaction in 4 cases. Nearly 50% of the dogs had been receiving prophylactic therapy, which did not prevent this form of spirocercosis.
Different Methods of Measuring Neutron Dose/Fluence Generated During Radiation Therapy with Megavoltage Beams

Abstract Medical linear accelerators (linacs) are the most frequently applied radiation therapy machines in the locoregional treatment of cancers by producing either high-energy electron or photon beams. However, with high-energy photons (>8 MeV), interaction of these photons with different high-Z nuclei of materials in components of the linac head unavoidably generates neutrons. On the other hand, the average energy of these generated neutrons has almost the highest radiation-weighting factor. Therefore, the produced neutrons should not be neglected. There are various tools for the measurement of neutron dose/fluence generated in a megavoltage linac, including thermoluminescent dosimeters, solid-state nuclear track detectors, bubble detectors, activation foils, Bonner sphere systems, and ionization chamber pairs. In this review article, each of the above-mentioned dosimetric methods will be described in detail.