Miracle-dz/UniFAR-FTUs huggingface dataset:
Endoscopic Stapedectomy: Collective Experience From a Large Australian Center.

INTRODUCTION Endoscopic stapes surgery is a technically demanding procedure that is increasing in popularity. Surgical outcomes and complication rates have been demonstrated to be comparable to traditional microscopic techniques. The surgical outcomes for patients undergoing stapes surgery performed by the Sydney Endoscopic Ear Surgery Research Group are presented. STUDY DESIGN Retrospective review from prospectively gathered database. SETTING Tertiary referral centers. PATIENTS A retrospective case review of patients undergoing endoscopic stapes surgery performed by four surgeons between February 2015 and July 2019 was carried out. Sixty nine patients were identified, and assessed for demographics, functional results, and postoperative complications. INTERVENTION Endoscopic stapedotomy. MAIN OUTCOME MEASURE Postoperative hearing results. RESULTS Sixty eight of 69 patients (98.6%) achieved an air-bone gap (ABG) closure of less than 20 dB. Sixty of 69 patients (87%) achieved and ABG closure of less than 10 dB. The average improvement of the ABG over four frequencies achieved was 26.5 dB (range, 0-61). Postoperative complications were infrequent and self-limiting. Six patients experienced dysgeusia without obvious chorda tympani injury, four patients developed short lived vertigo, and two patients experienced tinnitus. CONCLUSIONS Endoscopically assisted stapes surgery represents a safe alternative to traditional microscopic techniques, with similar morbidity and audiological outcomes.
Switch from Signal Amplification to COBAS® AmpliPrep/COBAS® TaqMan 48: Is There a Need to Re-Baseline?

Background: Accurate quantitation of plasma Human immunodeficiency virus-1 (HIV) RNA levels is required for clinical management of HIV-1-infected patients. Several assays are used to quantify HIV RNA, and prior to implementing a change in viral load method, continuity in reported values is addressed by the laboratory and communicated to clinicians. Methods: We initially compared COBAS® AmpliPrep-COBAS® TaqMan 48 (TaqMan) v.1. 0 (Roche) to prior methodology, branched-chain DNA (bDNA) v.3. 0 (Siemens) to determine if establishment of new patient baselines were necessary. Study data from 81 specimens run by both assays were compared using nonparametric tests, e.g., Wilcoxon signed-rank, Spearman. Subsets for comparison included only those that fell into overlapping ranges for both assays. Results: The methods correlated (Spearman correlation, rs = 0.91), but TaqMan values were significantly higher than those of bDNA (p<0.0001). Based upon this, new baselines (n=768) collected over 6-months were determined by running bDNA on all specimens that could be quantitated by TaqMan (n=308). Of those with sufficient quantity to establish new baselines with the TaqMan, 308 and 272 were quantifiable by TaqMan and bDNA, respectively. Parallel data within overlapping ranges (n=262) were again highly correlated (rs =0.89), but still were statistically different (p=0.0044). Additional analyses for regression and pair differences by range were run on combined (study and parallel) data. Conclusion: Our data demonstrate non-equivalence in HIV-1 RNA values of TaqMan v.1. 0 as compared to bDNA v.3. 0, and that new baselines for HIV viral load RNA HIV-1 should be re-established. New baselines for those patients missed by parallel testing can be calculated using regression analysis.
Prevalence of Chronic Skin Wounds and Their Risk Factors in an Inpatient Hospital Setting in Northern China

ABSTRACT OBJECTIVE To gain insight into the magnitude of the problem of chronic skin wounds in a hospital in northern China. METHODS Researchers conducted a retrospective analysis of electronic health records of cases and controls, including 1,977 patients with chronic skin wounds admitted to the hospital’s medical wards over 5 years. Multiple logistic regression was used to establish factors correlating with the development of chronic wounds. RESULTS The total prevalence of chronic wounds increased over the study period, and the occurrence of these wounds was significantly correlated with male sex, married status, unemployment, autumn season, and older age. The primary causes of chronic wounds were infection and diabetic ulcer. There were proportionally more wounds secondary to disease than traumatic wounds. The mean duration of hospitalization for patients with wounds was 13 days, and patients were readmitted an average of 10 times. CONCLUSIONS With the rapidly aging population in China, disability and chronic wounds are significant problems. Reducing hospital lengths of stay and readmissions remains a challenge. Palliative care may be appropriate for the management of some chronic wounds to prevent and treat further complications. Establishing funding guarantees and the reasonable allocation of health resources is required.
Rapid senescence‐like response after acute injury

Cellular senescence is a state of irreversible growth arrest. Short‐term programmed senescence such as in embryonic development and slowly progressing senescence as in aging are both well described. However, acute senescence in living organisms is not well understood. We hypothesized that hemorrhagic shock injury (HI) caused by whole body hypoxia and nutrient deprivation, resulting in organ dysfunction due to severe blood loss, could lead to acute senescence in vivo. Our experiments, for the first time, demonstrate a rapidly emerged, senolytics‐responsive, senescence‐like response in the rat liver in less than five hr following hemorrhagic shock. We conclude that the senescence, or pseudosenescence, observed is necessary to maintain tissue homeostasis following the injury.
Commentary: Developing best-practice guidelines for the reporting of E-values

We would like to thank Blum et al. for their interesting analysis of the current reporting practices around the use of the E-value to evaluate sensitivity to unmeasured confounding. As with nearly any quantitative tool, the Evalue is potentially subject to misuse, examples of which are indeed documented in their paper. This arguably also points to the need for the development of best-practice guidelines for the reporting and interpretation of E-values. We will here offer some reflections on potential reporting guidelines.
Heuristics versus statistics in discriminant validity testing: a comparison of four procedures

Purpose The purpose of this paper is to review and extend recent simulation studies on discriminant validity measures, contrasting the use of cutoff values (i.e. heuristics) with inferential tests. Design/methodology/approach Based on a simulation study, which considers different construct correlations, sample sizes, numbers of indicators and loading patterns, the authors assess each criterion’s sensitivity to type I and type II errors. Findings The findings of the simulation study provide further evidence for the robustness of the heterotrait–monotrait (HTMT) ratio of correlations criterion as an estimator of disattenuated (perfectly reliable) correlations between constructs, whose performance parallels that of the standard constrained PHI approach. Furthermore, the authors identify situations in which both methods fail and suggest an alternative criterion. Originality/value Addressing the limitations of prior simulation studies, the authors use both directional comparisons (i.e. heuristics) and inferential tests to facilitate the comparison of the HTMT and PHI methods. Furthermore, the simulation considers criteria that have not been assessed in prior research.
Gene expression changes associated with malignant transformation of oral potentially malignant disorders.

BACKGROUND A large number of oral squamous cell carcinomas (OSCCs) are believed to be preceded by oral potentially malignant disorders (OPMD) that have an increased likelihood of malignant transformation compared to clinically normal mucosa. This study was performed to identify differentially expressed genes between OPMDs that underwent malignant transformation (MT) and those that did not, termed 'non-transforming' (NT) cases. METHODS Total RNA was extracted from formalin-fixed paraffin-embedded tissue biopsies of 20 OPMD cases with known clinical outcomes (10 MT vs. 10 NT). Samples were assessed for quantity, quality and integrity of RNA prior to sequencing. Analysis for differential gene expression between MT and NT was performed using statistical packages in R. Genes were considered to be significantly differentially expressed if the False Discovery Rate corrected p-value was < 0.05. RESULTS RNA yield was variable but RNA purity was good (A260/A280 >1.90). Analysis of RNA-Sequencing outputs revealed 41 genes (34 protein-coding; 7 non-coding) that were significantly differentially expressed between MT and NT cases. The log2 fold change for the statistically significant differentially expressed genes ranged from -2.63 to 2.48, with 23 protein-coding genes being downregulated and 11 protein-coding genes being upregulated in MT cases compared to NT cases. CONCLUSION Several candidate genes that may play a role in malignant transformation of OPMD have been identified. Experiments to validate these candidates are underway. It is anticipated that this work will contribute to better understanding of the aetiopathogenesis of OPMD and development of novel biomarkers.
Land use mix in the neighbourhood and childhood obesity

Land use mix (LUM) in the neighbourhood is an important aspect for promoting healthier lifestyles and consequently reducing the risk for childhood obesity. However, findings of the association between LUM and childhood obesity remain controversial. A literature search was conducted on Cochrane Library, PubMed and Web of Science for articles published before 1 January 2019. In total, 25 cross‐sectional and two longitudinal studies were identified. Among them, Geographic Information Systems were used to measure LUM in 15 studies, and perceived LUM was measured in 12 studies. Generally, most studies revealed an association between a higher LUM and higher PA levels and lower obesity rates, although some studies also reported null or negative associations. The various exposure and outcome assessment have limited the synthesis to obtain pooled estimates. The evidence remains scare on the association between LUM and children's weight status, and more longitudinal studies are needed to examine the independent pathways and causality between LUM and weight‐related behaviours/outcomes.
Frass produced by the primary pest Rhyzopertha dominica supports the population growth of the secondary stored product pests Oryzaephilus surinamensis, Tribolium castaneum, and T. confusum

Abstract Primary pests such as Rhyzoperta dominica may increase the contents of dockage, dust, and frass in grain mass. Although it has been suggested that frass can affect the population growth of stored product pests and ecological interactions among primary and secondary pests in stored grain, this has not been validated experimentally. Therefore, this work experimentally tested the hypothesis that R. dominica wheat frass may support population increases in secondary pests such as Tribolium confusum, T. castaneum, and Oryzaephilus surinamensis for the first time. The effect of frass on secondary pest performance was compared with the effects of various physical qualities of wheat grain (i.e., intact grain kernels, grain fragments, flour, grain + frass) and an artificially enriched control diet (milled wheat kernels, oat flakes, and yeast). The results showed that the clean intact grain kernels did not support the population growth of any tested species, and the nutrient-rich control diet provided the best support. Frass was a significantly better food medium for O. surinamensis and T. castaneum than flour or cracked grain, while T. confusum performed equally well on flour and frass. Our results showed that in terms of food quality and suitability for the tested species, frass occupied an intermediate position between the optimized breeding diet and simple uniform cereal diets such as cracked grain or flour. The results suggest that (i) the wheat frass of primary pest R. dominica is a riskier food source for the development of the tested secondary pests than intact or cracked wheat grain or flour; (ii) frass has the potential to positively influence interspecific interactions between R. dominica and the tested secondary pests; and (iii) wheat grain should be cleaned if increases in R. dominica populations and/or accumulated frass are detected.
Application of body volume formula for predicting live weight in Ongole crossbred cows

Study was conducted to estimate the live weight in Ongole crossbred cow using chest girth, body length and body volume model represented by chest girth and body length dimensions in North Sulawesi province. Data on animal live weight (LW), body length (BL), chest girth (CG) and body volume were collected from cows (n=363) kept by traditional household farmers. Animal body volume was calculated using cylinder volume formula with CG and BL as the components of model. Regression analysis was carried out for LW with all linear body measurements. Data were classified based on age of animals which resulted from five age groups (2.5-3.5, 3.6-4.5, 4.6-5.5, 5.6-6.5, 6.6-7.5, 2.5-7.5). Age significantly (P<0.05) influenced all body measurements. Correlations between all pairs of measurements were highly significant (P<0.001) for all age groups, except between BL and CG as well as LW at ages of 3.5 to 7.5 years old. Regression analysis showed that live weight could be predicted accurately from body volume (R2=0.96). Simple regression model being recommended to predict live weight of Ongole crossbred cows based on body volume with their age groups ranging from 2.5 to ≥7.5 years old is as follows: Live weight (kg) = 1.26016 * body volume (liters) - 3.06084. Key words: Ongole crossbred cows, live weight estimation, body linear measurements.
The Hospitalist Model and Oncology: Oncologist Opinions about Inpatient Cancer Care Delivery.

Hospitalists, rather than oncologists, are increasingly providing inpatient medical care to hospitalized cancer patients, yet the opinions of oncologists regarding this model of care delivery are unknown. A survey was conducted assessing these opinions and experiences with inpatient cancer care delivery at a tertiary cancer center. Only thirty percent of oncologists agreed that caring for hospitalized cancer patients was an efficient use of their time, and most believed a hospitalist service allowed them to pursue other interests. Most had a positive experience with hospitalists, agreeing that hospitalists can diagnose and manage toxicities of cancer therapy, exhibit professionalism, and communicate with them and their patients appropriately. Hematologic malignancy specialists were more likely to value inpatient service time and had less confidence in the ability of hospitalists. Overall, the hospitalist model was generally accepted by oncologists and will continue to be an important part of oncologic care delivery.
The Effect of Creatine Supplementation on Muscle Function in Childhood Myositis: A Randomized, Double-blind, Placebo-controlled Feasibility Study

Objective. To evaluate the feasibility of studying creatine in juvenile dermatomyositis (JDM). Secondary objectives were to determine the effect of creatine on muscle function and metabolism, aerobic capacity, fatigue, physical activity, and quality of life (QOL), as well as its safety. Methods. We conducted a 6-month, double-blind, randomized, multiple-baseline design; patients were assigned to creatine or placebo. Feasibility was assessed using attended study visits, completed study procedures, and adherence. Muscle function, aerobic capacity, and muscle strength were assessed with standardized exercise tests. Muscle metabolism was assessed using a 31-Phosphorus Magnetic Resonance Spectroscopy protocol. Fatigue, physical activity, and QOL were assessed by questionnaires. Statistical significance was estimated using a randomization (permutation) test. Changes in outcome measures taken at baseline and end-of-study were calculated using paired t-tests. Results. Median (range) adherence to the study drug was 88.5% (20.5–95.5%) and the proportion of subjects with 80% adherence or higher was 76.9%. There were no missed study visits. There were no statistically significant changes in muscle function, strength, aerobic capacity, disease activity, fatigue, physical activity, or QOL while subjects were receiving creatine compared to placebo. There were statistically significant adaptations in muscle metabolism (e.g., decrease in change in muscle pH following exercise, and decrease in phosphate/phosphocreatine ratio) at the end-of-study compared to baseline. There were no significant adverse effects. Conclusion. Creatine supplementation in children with JDM is feasible to study, and is safe and well-tolerated; it may lead to improvements in muscle metabolism.
Prucalopride in diabetic and connective tissue disease‐related gastroparesis: Randomized placebo‐controlled crossover pilot trial

Gastroparesis, defined by delayed gastric emptying in the absence of mechanical outlet obstruction, is a frequent neuropathic complication of diabetes mellitus, and effective treatments are lacking. Prucalopride is a pan‐gut prokinetic with selective agonist effects on serotonin 5‐HT4 receptors in the gut. This study aimed to assess the effect of prucalopride 4 mg daily on Gastroparesis Cardinal Symptom Index (GCSI), meal‐related symptom score (MRSS), and gastric emptying rate in diabetic or connective tissue disease (CTD)‐related gastroparesis patients.
Characteristics and outcomes of adults with cytomegalovirus‐associated thrombocytopenia: a case series and literature review

Cytomegalovirus (CMV) is a ubiquitous virus that infects people worldwide. CMV is known to trigger thrombocytopenia, but this association is probably underdiagnosed since CMV infection in healthy adults is usually either asymptomatic or causes only mild symptoms. A systematic literature review was carried out and yielded 23 publications that reported 25 patients. All haematology centres in Israel were searched for adult immunocompetent patients with CMV‐associated thrombocytopenia, and five new cases were identified. The median age of the combined 30 patients was 33 years (range 18–80), 73% were men, 77% presented with CMV‐related symptoms, 48% had enlarged spleens, 95% had atypical lymphocytes in peripheral blood and 68% had elevated transaminase levels. The response rate to first‐line steroid‐containing regimens was only 31%, whereas 11 patients who were treated with an anti‐CMV agent had a response rate of 82%. Moreover, four patients received thrombopoietin receptor agonists (TPO‐RA) to which three (75%) responded. Taken together, these distinctive features of a case with thrombocytopenia should alert to CMV infection as the source. While steroids were effective in less than one‐third of the cases, both anti‐CMV therapy and TPO‐RA exhibited excellent efficacy, suggesting that those agents should be introduced earlier in the therapeutic course.
Adoptive transfers of CD4+CD25+ Tregs partially alleviate mouse premature ovarian insufficiency

This study was designed to investigate the protective effect of CD4+CD25+ regulatory T cells (Tregs) against zona pellucida glycoprotein 3 peptide (pZP3) immunization‐induced premature ovarian insufficiency (POI) in mice. A mouse POI model was induced by two subcutaneous injections of pZP3 (50 nmol/L). Mice in the pZP3‐Treg group were intraperitoneally injected with 5 × 105 CD4+CD25+ Tregs after the POI model was established. Sex hormone levels, follicle numbers, apoptotic events, and the Akt/FOXO3a signaling pathway molecules in the ovaries were assessed. Compared with control group, the weight of ovaries in both pZP3 group and pZP3‐Treg group was decreased and no difference was found between them. The number of follicles in the Treg transferred mice, like in pZP3 group, was significantly reduced compared to the control group, but showed a modest improvement when compared the pZP3 group alone. Significantly lower serum concentrations of follicle‐stimulating hormone, luteinizing hormone, and anti‐zona pellucida antibodies (AZPAbs) were found, while the concentrations of estradiol and anti‐Mullerian hormone increased. In mechanism, Treg cell transfer to ZP3 treated mice restored the levels of Caspase3 to control levels, and partially restored Bax, however, had no effect on Bcl‐2. Moreover, Treg cell transfer to ZP3 treated mice partially restored the levels of Akt and FOXO3a, and partially restored the ratios of p‐Akt/Akt and p‐FOXO3a/FOXO3a. In conclusion, Treg cells improved some aspects of ZP3‐induced POI which may be mediate by suppressing ovarian cells apoptosis and involving the Akt/FOXO3a signaling pathway. Therefore, Treg cells may be protective against autoimmune POI.
Breath testing for the diagnosis of pancreatic disease.

PURPOSE OF REVIEW Pancreatic function tests are mainly used for the diagnosis of exocrine pancreatic insufficiency (EPI) in patients with pancreatic diseases or after pancreatic or gastric surgery. Breath tests evaluate not just pancreatic secretion but the digestion capacity of the pancreas. These tests are good candidates for the diagnosis of EPI as they are noninvasive, accurate and easy to apply to clinical practice. RECENT FINDINGS The C-labelled mixed triglyceride (MTG) breath test has been optimized and validated against adequate reference methods for the diagnosis of EPI in patients with chronic pancreatitis and for the evaluation of the efficacy of pancreatic enzyme replacement therapy (PERT). In addition, reported C-MTG breath test results in patients with other pancreatic diseases and after pancreatic and gastric surgery support the accuracy and clinical applicability of this test. The evidence of pancreatic function breath tests with other C-labelled substrates is limited. SUMMARY Increasing evidence supports the accuracy and clinical usefulness of the C-MTG breath test for the diagnosis of EPI and the evaluation of the efficacy of PERT in different clinical conditions. Commercial availability of this test is required for a wide clinical use. The use of optimized and validated breath test protocols is mandatory.
First report on brorphine: the next opioid on the deadly new psychoactive substances' horizon?

New psychoactive substances (NPS) continue to appear on the drug market. Until recently, new synthetic opioids, which are amongst the most dangerous NPS, primarily encompassed analogues of the potent analgesic fentanyl. Lately, also other new synthetic opioids have increasingly started to surface. This is the first report on the identification and full chemical characterization of brorphine, a novel potent synthetic opioid with a piperidine benzimidazolone structure. Brorphine was identified in a powder and in the serum of a patient seeking medical help for detoxification. Liquid chromatography-high resolution mass spectrometry (LC-HRMS) identified an exact mass of m/z 400.1020 and 402.1005 for the compound, corresponding to both bromine isotopes. Further chemical characterization was performed by gas chromatography-mass spectrometry (GC-MS), LC-diode array detection (DAD) and Fourier-transform infrared (FT-IR) spectroscopy analyses. Finally, the structure was confirmed by performing 1H- and 13C-NMR spectroscopy. In vitro biological activity of brorphine was determined by a cell-based µ-opioid receptor (MOR) activation assay, resulting in an EC50 of 30.9 nM (13.5 ng/mL) and an Emax of 209% relative to hydromorphone, confirming the high potency and efficacy of this compound. In a serum sample of the patient, brorphine and a hydroxy-metabolite were found using the LC-HRMS screening method. The presence of opioid activity in the serum was also confirmed via the activity-based opioid screening assay. The occurrence of brorphine is yet another example of how the illicit drug market is continuously evolving in an attempt to escape international legislation. Its high potency poses a serious and imminent health threat for any user.