Miracle-dz/UniFAR-FTUs huggingface dataset:
Chronic pain after total knee arthroplasty

Despite a good outcome for many patients, approximately 20% of patients experience chronic pain after total knee arthroplasty (TKA). Chronic pain after TKA can affect all dimensions of health-related quality of life, and is associated with functional limitations, pain-related distress, depression, poorer general health and social isolation. In both clinical and research settings, the approach to assessing chronic pain after TKA needs to be in-depth and multidimensional to understand the characteristics and impact of this pain. Assessment of this pain has been inadequate in the past, but there are encouraging trends for increased use of validated patient-reported outcome measures. Risk factors for chronic pain after TKA can be considered as those present before surgery, intraoperatively or in the acute postoperative period. Knowledge of risk factors is important to guide the development of interventions and to help to target care. Evaluations of preoperative interventions which optimize pain management and general health around the time of surgery are needed. The causes of chronic pain after TKA are not yet fully understood, although research interest is growing and it is evident that this pain has a multifactorial aetiology, with a wide range of possible biological, surgical and psychosocial factors that can influence pain outcomes. Treatment of chronic pain after TKA is challenging, and evaluation of combined treatments and individually targeted treatments matched to patient characteristics is advocated. To ensure that optimal care is provided to patients, the clinical- and cost-effectiveness of multidisciplinary and individualized interventions should be evaluated. Cite this article: EFORT Open Rev 2018;3:461-470. DOI: 10.1302/2058-5241.3. 180004
Individual Differences in Executive Function: The Role of Parental Monitoring as a Moderator

Objective: Parental monitoring is a factor which affects verbal and nonverbal inhibition components of children’s executive functions. ,. Method: 112 sixth-grade Kurdish children (mean age: 11 years 5 months) participated in the study. Children were matched on level of hyperactivity. Parents completed the Parental Monitoring Assessment (PMA) and the Strengths and Difficulties Questionnaire (SDQ). Children completed theStop-Signal task, Modified Opposite Worlds and a challenging star puzzle in order to assess executive function components. PROCESS analysis was also used to perform the moderation analysis. Results: Children characterized by poor parental monitoring had deficits in inhibitory control and had significantly slower processing speeds and made significantly more errors than their matched controls. Furthermore, children with high levels of hyperactivity had difficulties in inhibitory control, accuracy, processing speed, and task persistence compared with the control group.Contrary to our prediction, there were no significant differences in reaction times compared with the control group. PROCESS analysis showed a significant moderating role of parental monitoring in the association between each of accuracy, verbal inhibition, and task persistence with hyperactivity. Conclusion: the current study suggests that, similar to hyperactivity, children with poor parental monitoring appear to have difficulties in executive function.
High Schizotypal Individuals Are More Creative? The Mediation Roles of Overinclusive Thinking and Cognitive Inhibition

Although a theoretical link between positive schizotypy and heightened creativity has been established in the literature, little empirical research has been conducted to examine the underlying cognitive processes that contribute to this association. In addition, previous studies found a negative relationship between positive schizotypy and cognitive inhibition; however, they often used the paradigm of latent inhibition. This study used the paradigm of prepotent response inhibition indicated by Stroop interference effect and examined the mediation effects of overinclusive thinking (OT) and cognitive inhibition on the creativity of schizotypal individuals. Two groups of low and high schizotypal individuals (N = 78) participated in the study. Each participant completed one OT task, one color-word Stroop task, three other executive functioning (EF) control tasks, and two creativity tasks. The results indicated that the high schizotypal group outperformed the low schizotypal group in the creativity tasks. They also exhibited higher OT as indicated by faster reaction time and higher cognitive inhibition as indicated by lower Stroop interference effect. Further, participant’s levels of OT and cognitive inhibition partially mediated the relationship between schizotypy and creativity. The results were discussed under the context of schizotypy and creativity research and implications for rehabitation were further provided.
Guanidinoacetic Acid Regulates Myogenic Differentiation and Muscle Growth Through miR-133a-3p and miR-1a-3p Co-mediated Akt/mTOR/S6K Signaling Pathway

Guanidinoacetic acid (GAA), an amino acid derivative that is endogenous to animal tissues including muscle and nerve, has been reported to enhance muscular performance. MicroRNA (miRNA) is a post-transcriptional regulator that plays a key role in nutrient-mediated myogenesis. However, the effects of GAA on myogenic differentiation and skeletal muscle growth, and the potential regulatory mechanisms of miRNA in these processes have not been elucidated. In this study, we investigated the effects of GAA on proliferation, differentiation, and growth in C2C12 cells and mice. The results showed that GAA markedly inhibited the proliferation of myoblasts, along with the down-regulation of cyclin D1 (CCND1) and cyclin dependent kinase 4 (CDK4) mRNA expression, and the upregulation of cyclin dependent kinase inhibitor 1A (P21) mRNA expression. We also demonstrated that GAA treatment stimulated myogenic differentiation 1 (MyoD) and myogenin (MyoG) mRNA expression, resulting in an increase in the myotube fusion rate. Meanwhile, GAA supplementation promoted myotube growth through increase in total myosin heavy chain (MyHC) protein level, myotubes thickness and gastrocnemius muscle cross-sectional area. Furthermore, small RNA sequencing revealed that a total of eight miRNAs, including miR-133a-3p and miR-1a-3p cluster, showed differential expression after GAA supplementation. To further study the function of miR-133a-3p and miR-1a-3p in GAA-induced skeletal muscle growth, we transfected miR-133a-3p and miR-1a-3p mimics into myotube, which also induced muscle growth. Through bioinformatics and a dual-luciferase reporter system, the target genes of miR-133a-3p and miR-1a-3p were determined. These two miRNAs were shown to modulate the Akt/mTOR/S6K signaling pathway by restraining target gene expression. Taken together, these findings suggest that GAA supplementation can promote myoblast differentiation and skeletal muscle growth through miR-133a-3p- and miR-1a-3p-induced activation of the AKT/mTOR/S6K signaling pathway.
What's the Risk? Older Women Report Fewer Symptoms for Suspected Acute Coronary Syndrome than Younger Women

Abstract The purpose of the study was to determine whether older (≥65 years) and younger (<65 years) women presenting to the emergency department (ED) with symptoms suggestive of acute coronary syndrome (ACS) varied on risk factors, comorbid conditions, functional status, and symptoms that have implications for emergent cardiac care. Women admitted to five EDs were enrolled. The ACS Symptom Checklist was used to measure symptoms. Comorbid conditions and functional status were measured with the Charlson Comorbidity Index and Duke Activity Status Index. Logistic regression models were used to evaluate symptom differences in older and younger women adjusting for ACS diagnosis, functional status, body mass index (BMI), and comorbid conditions. Analyses were stratified by age, and interaction of symptom by age was tested. Four hundred women were enrolled. Mean age was 61.3 years (range 21–98). Older women (n = 163) were more likely to have hypertension, hypercholesterolemia, never smoked, lower BMI, more comorbid conditions, and lower functional status. Younger women (n = 237) were more likely to be members of minority groups, be college-educated, and have a non-ACS discharge diagnosis. Younger women had higher odds of experiencing chest discomfort, chest pain, chest pressure, shortness of breath, nausea, sweating, and palpitations. Lack of chest symptoms and shortness of breath (key symptoms triggering a decision to seek emergency care) may cause older women to delay seeking treatment, placing them at risk for poorer outcomes. Younger African American women may require more comprehensive risk reduction strategies and symptom management.
Towards End-to-End ECG Classification With Raw Signal Extraction and Deep Neural Networks

This paper proposes deep learning methods with signal alignment that facilitate the end-to-end classification of raw electrocardiogram (ECG) signals into heartbeat types, i.e., normal beat or different types of arrhythmias. Time-domain sample points are extracted from raw ECG signals, and consecutive vectors are extracted from a sliding time-window covering these sample points. Each of these vectors comprises the consecutive sample points of a complete heartbeat cycle, which includes not only the QRS complex but also the P and T waves. Unlike existing heartbeat classification methods in which medical doctors extract handcrafted features from raw ECG signals, the proposed end-to-end method leverages a deep neural network for both feature extraction and classification based on aligned heartbeats. This strategy not only obviates the need to handcraft the features but also produces optimized ECG representation for heartbeat classification. Evaluations on the MIT-BIH arrhythmia database show that at the same specificity, the proposed patient-independent classifier can detect supraventricular- and ventricular-ectopic beats at a sensitivity that is at least 10% higher than current state-of-the-art methods. More importantly, there is a wide range of operating points in which both the sensitivity and specificity of the proposed classifier are higher than those achieved by state-of-the-art classifiers. The proposed classifier can also perform comparable to patient-specific classifiers, but at the same time enjoys the advantage of patient independence.
The Functionality of Communal Coping in Chronic Uncertainty Environments: The Context of Palestinian Refugees in Lebanon

ABSTRACT Most research suggests that communal coping, where a group of people own and act upon a shared stressor or uncertainty together, enhances mental health and fosters coping efficacy. The majority of this research, however, has been conducted in the United States in contexts where stress and uncertainty are relatively short-lived and with samples that are economically secure and moderately to highly educated. The purpose of this study was to understand how socio-emotional conditions, such as exposure to trauma and interparental conflict, influence the functionality of communal coping for adolescents in Palestinian refugee camps in Lebanon, where chronic uncertainty is normative. One hundred eighty-five Palestinian adolescents (M age = 15.75) residing in two refugee camps in Beirut, Lebanon completed a cross-sectional survey. The results showed that communal coping with immediate family members was only beneficial for adolescents’ mental health and hopelessness when their parents had moderate to little conflict and not high levels of conflict. Similarly, when adolescents had experienced trauma, engaging in high levels of communal coping accentuated, as opposed to buffered, the harmful effects of uncertainty on mental health.
An epidemiological survey of HBV infection and low-level HBsAg in military camps in eastern China

Abstract This study aimed to investigate hepatitis B virus (HBV) infection in military personnel in eastern China, which will provide a basis for the prevention of HBV infection. A total of 15,508 soldiers and 2386 officers were recruited from military camps in eastern China. The markers, deoxyribonucleic acid, serotypes, and genotypes of HBV in serum were detected and analyzed. Hepatitis B surface antigen (HBsAg) positive rate was 0.44% in soldiers, in whom the low-level HBsAg accounted for 88.24%. The HBsAg positive rate was 1.72% in officers in whom the low-level HBsAg accounted for 12.20%. There were significant differences in the prevalence of high-level and low-level HBsAg, HBV serotypes, HBV DNA positive rate, and mean log HBV DNA between officers and soldiers (P < .05). Compared with the conventional method for HBV DNA extraction, the enrichment method for HBV DNA extraction could significantly improve the positive rate and quantification of HBV DNA by real-time fluorescence quantitative polymerase chain reaction (P < .05). Sequencing of S gene in HBV was used for the determination of serotype and genotype of HBV. The sequencing success rate was significantly different between soldiers and officers (P < .05) as well as between high-level HBsAg group and low-level HBsAg group (P < .05). Significant difference was also observed in the genotype distribution between soldiers and officers (P < .05). HBV infection displays a low prevalence and a low epidemic state, and the prevalence of low-level HBsAg is higher in soldiers. We should pay attention to improve the quality of conscription examination as well as emphasize the surveillance, prevention, and protection of HBV infection in military officers.
Lack of APC somatic mutation is associated with early-onset colorectal cancer in African Americans

African Americans (AAs) have higher incidence and mortality rates of colorectal cancer (CRC) compared with other US populations. They present with more right-sided, microsatellite stable disease and are diagnosed at earlier ages compared with non-Hispanic Whites (NHWs). To gain insight into these trends, we conducted exome sequencing (n = 45), copy number (n = 33) and methylation analysis (n = 11) of microsatellite stable AA CRCs. Results were compared with data from The Cancer Genome Atlas (TCGA). Two of the 45 tumors contained POLE mutations. In the remaining 43 tumors, only 27 (63%) contained loss-of-function mutations in APC compared with 80% of TCGA NHW CRCs. APC-mutation-negative CRCs were associated with an earlier onset of CRC (P = 0.01). They were also associated with lower overall mutation burden, fewer copy number variants and a DNA methylation signature that was distinct from the CpG island methylator phenotype characterized in microsatellite unstable disease. Three of the APC-mutation-negative CRCs had loss-of-function mutations in BCL9L. Mutations in driver genes identified by TCGA exome analysis were less frequent in AA CRC cases than TCGA NHWs. Genes that regulate the WNT signaling pathway, including SOX9, GATA6, TET1, GLIS1 and FAT1, were differentially hypermethylated in APC-mutation-negative CRCs, suggesting a novel mechanism for cancer development in these tumors. In summary, we have identified a subtype of CRC that is associated with younger age of diagnosis, lack of APC mutation, microsatellite and chromosome stability, lower mutation burden and distinctive methylation changes.
Oropharyngeal Trichomonosis Due to Trichomonas gypaetinii in a Cinereous Vulture (Aegypius monachus) Fledgling in Spain

Abstract: A juvenile Cinereous Vulture (Aegypius monachus) fledgling was found disorientated on the roof of a building in Madrid City, Spain, in October 2016. A veterinary examination revealed multiple plaques distributed throughout the oropharyngeal cavity. Lesions were located under the tongue and at the choanal slit, hard palate, and esophagus opening and ranged from 2 to 7 mm, coalescing in areas up to 2 cm, with a yellowish color of the surface. Motile trichomonad trophozoites were detected in fresh wet mount smears from the lesions. Sequence analysis of the internal transcribed spacer (ITS)1/5.8S/ITS2 and small subunit ribosomal RNA confirmed that Trichomonas gypaetinii was the etiologic agent. Microbiologic cultures did not reveal any pathogenic bacteria or fungi. The animal recovered successfully after treatment with metronidazole and trimethoprim-sulfamethoxazole and was later released in a suitable habitat. Avian trichomonosis lesions caused by T. gypaetinii have not been reported.
Effects of temperature on bacterial microbiome composition in Ixodes scapularis ticks

Ixodes scapularis, the blacklegged deer tick, is the principal vector of Lyme disease in North America. Environmental factors are known to influence regional and seasonal incidence of Lyme disease and possibly the endemicity of the disease to the northeastern and upper mid‐western regions of the United States. With a goal to understand the impact of environmental temperature on microbial communities within the tick, we investigated the bacterial microbiome of colony‐reared I. scapularis ticks statically incubated at different temperatures (4, 20, 30, and 37°C) at a constant humidity in a controlled laboratory setting by comparison of sequenced amplicons of the bacterial 16S V4 rRNA gene to that of the untreated baseline controls. The microbiomes of colony‐reared I. scapularis males were distinct than that of females, which were entirely dominated by Rickettsia. In silico removal of Rickettsia sequences from female data revealed the underlying bacterial community, which is consistent in complexity with those seen among male ticks. The bacterial community composition of these ticks changes upon incubation at 30°C for a week and 37°C for more than 5 days. Moreover, the male ticks incubated at 30 and 37°C exhibited significantly different bacterial diversity compared to the initial baseline microbiome, and the change in bacterial diversity was dependent upon duration of exposure. Rickettsia‐free data revealed a significantly different bacterial diversity in female ticks incubated at 37°C compared to that of 4 and 20°C treatments. These results provide experimental evidence that environmental temperature can impact the tick bacterial microbiome in a laboratory setting.
Benchmarking Reinforcement Learning Algorithms on Real-World Robots

Through many recent successes in simulation, model-free reinforcement learning has emerged as a promising approach to solving continuous control robotic tasks. The research community is now able to reproduce, analyze and build quickly on these results due to open source implementations of learning algorithms and simulated benchmark tasks. To carry forward these successes to real-world applications, it is crucial to withhold utilizing the unique advantages of simulations that do not transfer to the real world and experiment directly with physical robots. However, reinforcement learning research with physical robots faces substantial resistance due to the lack of benchmark tasks and supporting source code. In this work, we introduce several reinforcement learning tasks with multiple commercially available robots that present varying levels of learning difficulty, setup, and repeatability. On these tasks, we test the learning performance of off-the-shelf implementations of four reinforcement learning algorithms and analyze sensitivity to their hyper-parameters to determine their readiness for applications in various real-world tasks. Our results show that with a careful setup of the task interface and computations, some of these implementations can be readily applicable to physical robots. We find that state-of-the-art learning algorithms are highly sensitive to their hyper-parameters and their relative ordering does not transfer across tasks, indicating the necessity of re-tuning them for each task for best performance. On the other hand, the best hyper-parameter configuration from one task may often result in effective learning on held-out tasks even with different robots, providing a reasonable default. We make the benchmark tasks publicly available to enhance reproducibility in real-world reinforcement learning.
Proton-pump Inhibitor Use and Fracture Risk: An Updated Systematic Review and Meta-analysis

Background This study's objective was to evaluate the association between proton-pump inhibitor (PPI) use and bone fracture incidence and bone mineral density (BMD) by meta-analyzing the estimates reported by epidemiological and cohort studies. Methods Data were acquired from studies identified after a literature search in electronic databases. Odds ratios (ORs), hazard ratios (HRs), and risk ratios (RRs) between PPI use and bone fracture incidence were pooled under the random effects model, and meta-analysis of standardized mean differences between PPI users and controls in cross-sectional values and BMD changes was conducted. Results Thirty-three studies fulfilled the eligibility criteria. These studies provided data from 2,714,502 individuals with a mean age of 66.91 years (95% confidence interval [CI], 63.37–70.46); 33.21% (95% CI, 30.44–35.99) were males and 64.61% (95% CI, 60.73–68.49) were females. Overall, fracture incidence was 22.04% (95% CI, 16.10–27.97) in PPI users and 15.57% (95% CI, 12.28–18.86) in controls. The overall effect size of the point estimate was 1.28 (95% CI, 1.22–1.35) between PPI use and bone fracture incidence. There was a trend towards increased fracture incidence from short duration use: OR 1.29 (95% CI, 1.19–1.40), medium duration use: OR 1.33 (95% CI, 1.12–1.55) and long duration use: OR 1.62 (95% CI, 1.33–1.90). There was no significant difference in the standardized mean differences between PPI users and controls, either in cross-sectional BMD values or in the BMD change observed in longitudinal studies. Conclusions Pooling of ORs, HRs, and RRs suggested that PPI use might increase fracture risk. However, there was no effect of PPI use on BMD.
Health care utilization by veterans prescribed chronic opioids

Purpose Ambulatory resources such as telephone calls, secure messages, nurse visits, and telephone triage are vital to the management of patients on chronic opioid therapy (COT). They are also often overlooked as health care services and yet to be broadly studied. The aim of the present study was to describe the Veterans Affairs (VA) health care utilization by patients based on COT, type, and amount of opioids prescribed. Patients and methods A retrospective chart review was done on 617 patients on COT at a VA primary care clinic. Instances of health care utilization (emergency department visits [EDVs], hospitalizations, clinic visits, telephone triage calls, telephone calls/secure messages/nurse visits) were obtained. Results Patients were likely to have more telephone calls, secure messages, or nurse visits if they were prescribed a schedule II opioid or if they were on more than one opioid. Model-based results found that patients on COT were more likely to have EDVs, telephone triage calls, and clinic contact compared to patients who were not on chronic opioids. Conclusion The results are despite having a Patient Aligned Care Team, which is the VA’s patient-centered medical home. This suggests that reducing health care utilization for patients on COT may not be possible with just a primary care involvement.
White matter diffusion alterations precede symptom onset in autosomal dominant Alzheimer’s disease

See Jacobs and Buckley (doi:10.1093/brain/awy243) for a scientific commentary on this article. Despite the prevalence of white matter alterations in Alzheimer's disease, their occurrence in the presymptomatic phase is poorly understood. Araque-Caballero et al. report that diffusivity alterations occur first within the anterior and posterior callosal fibres approximately 10 years before the onset of dementia symptoms in autosomal dominant Alzheimer's disease.