Miracle-dz/UniFAR-FTUs huggingface dataset:
Canadian Stroke Best Practice Recommendations: Rehabilitation, Recovery, and Community Participation following Stroke. Part One: Rehabilitation and Recovery Following Stroke; 6th Edition Update 2019

The sixth update of the Canadian Stroke Best Practice Recommendations: Rehabilitation, Recovery, and Reintegration following Stroke. Part one: Rehabilitation and Recovery Following Stroke is a comprehensive set of evidence-based guidelines addressing issues surrounding impairments, activity limitations, and participation restrictions following stroke. Rehabilitation is a critical component of recovery, essential for helping patients to regain lost skills, relearn tasks, and regain independence. Following a stroke, many people typically require rehabilitation for persisting deficits related to hemiparesis, upper-limb dysfunction, pain, impaired balance, swallowing, and vision, neglect, and limitations with mobility, activities of daily living, and communication. This module addresses interventions related to these issues as well as the structure in which they are provided, since rehabilitation can be provided on an inpatient, outpatient, or community basis. These guidelines also recognize that rehabilitation needs of people with stroke may change over time and therefore intermittent reassessment is important. Recommendations are appropriate for use by all healthcare providers and system planners who organize and provide care to patients following stroke across a broad range of settings. Unlike the previous set of recommendations, in which pediatric stroke was included, this set of recommendations includes primarily adult rehabilitation, recognizing many of these therapies may be applicable in children. Recommendations related to community reintegration, which were previously included within this rehabilitation module, can now be found in the companion module, Rehabilitation, Recovery, and Community Participation following Stroke. Part Two: Transitions and Community Participation Following Stroke.
Intraclonal competitive fitness of longitudinal cystic fibrosis Pseudomonas aeruginosa airway isolates in liquid cultures.

The metabolically versatile Pseudomonas aeruginosa inhabits biotic and abiotic environments including the niche of cystic fibrosis (CF) airways. This study investigated how the adaptation to CF lungs affects the within-clone fitness of P. aeruginosa to grow and persist in liquid cultures in the presence of the clonal ancestors. Longitudinal clonal P. aeruginosa isolates that had been collected from 12 CF donors since the onset of colonization for up to 30 years were subjected to within-clone competition experiments. The relative quantities of individual strains were determined by marker-free amplicon sequencing of multiplex PCR products of strain-specific nucleotide sequence variants, a novel method that is generally applicable to studies in evolutionary genetics and microbial ecology with real-world strain collections. For ten of the twelve examined patient courses, P. aeruginosa isolates of the first years of colonization grew faster in the presence of their clonal progeny than alone. Single growth of individual strains showed no temporal trend with colonization time, but in co-culture the early isolates out-competed their clonal progeny. Irrespective of the genetic make-up of the clone and its genomic microevolution in CF lungs the early isolates expressed fitness traits to win the within-clone competition that were absent in their progeny. This article is protected by copyright. All rights reserved.
Is mortality readmissions bias a concern for readmission rates under the Hospital Readmissions Reduction Program?

OBJECTIVE To determine whether the exclusion of patients who die from adjusted 30-day readmission rates influences readmission rate measures and penalties under the Hospital Readmission Reduction Program (HRRP). DATA SOURCES/STUDY SETTING 100% Medicare fee-for-service claims over the period July 1, 2012, until June 30, 2015. STUDY DESIGN We examine the 30-day readmission risk across the three conditions targeted by the HRRP: acute myocardial infarction (AMI), congestive heart failure (CHF), and pneumonia. Using logistic regression, we estimate the readmission risk for three samples of patients: those who survived the 30-day period after their index admission, those who died over the 30-day period, and all patients who were admitted to see how they differ. DATA COLLECTION/EXTRACTION METHODS We identified and extracted data for Medicare fee-for-service beneficiaries admitted with primary diagnoses of AMI (N = 497 931), CHF (N = 1 047 552), and pneumonia (N = 850 552). RESULTS The estimated hospital readmission rates for the survived and nonsurvived patients differed by 5%-8%, on average. Incorporating these estimates into overall readmission risk for all admitted patients changes the likely penalty status for 9% of hospitals. However, this change is randomly distributed across hospitals and is not concentrated amongst any one type of hospital. CONCLUSIONS Not accounting for variations in mortality may result in inappropriate penalties for some hospitals. However, the effect of this bias is low due to low mortality rates amongst incentivized conditions and appears to be randomly distributed across hospital types.
Azithromycin Partially Mitigates Dysregulated Repair of Lung Allograft Small Airway Epithelium

Supplemental Digital Content is available in the text. Background. Dysregulated airway epithelial repair following injury is a proposed mechanism driving posttransplant bronchiolitis obliterans (BO), and its clinical correlate bronchiolitis obliterans syndrome (BOS). This study compared gene and cellular characteristics of injury and repair in large (LAEC) and small (SAEC) airway epithelial cells of transplant patients. Methods. Subjects were recruited at the time of routine bronchoscopy posttransplantation and included patients with and without BOS. Airway epithelial cells were obtained from bronchial and bronchiolar brushing performed under radiological guidance from these patients. In addition, bronchial brushings were also obtained from healthy control subjects comprising of adolescents admitted for elective surgery for nonrespiratory-related conditions. Primary cultures were established, monolayers wounded, and repair assessed (±) azithromycin (1 µg/mL). In addition, proliferative capacity as well as markers of injury and dysregulated repair were also assessed. Results. SAEC had a significantly dysregulated repair process postinjury, despite having a higher proliferative capacity than large airway epithelial cells. Addition of azithromycin significantly induced repair in these cells; however, full restitution was not achieved. Expression of several genes associated with epithelial barrier repair (matrix metalloproteinase 7, matrix metalloproteinase 3, the integrins β6 and β8, and β-catenin) were significantly different in epithelial cells obtained from patients with BOS compared to transplant patients without BOS and controls, suggesting an intrinsic defect. Conclusions. Chronic airway injury and dysregulated repair programs are evident in airway epithelium obtained from patients with BOS, particularly with SAEC. We also show that azithromycin partially mitigates this pathology.
Treatment compliance of adolescent orthodontic patients with headgear activator and twin-block appliance assessed prospectively using microelectronic wear-time documentation.

BACKGROUND Success of orthodontic removable appliance treatment relies on patient compliance. The aim of this quantitative and qualitative study was to explore the compliance and self-reported experience of adolescents in orthodontic treatment with headgear activator (HGA) or twin-block (TB) appliance. MATERIALS/METHODS The study group comprised 52 adolescents with a mean age of 12.6 (±1.3) years at the start of the treatment. The patients were treated at a free-of-charge public dental clinic. Participants were randomly allocated to two equal groups to be treated with either HGA or TB. Patient compliance was evaluated as appliance wear time and subjective experience. Appliance wear time was recorded with Theramon® microchip, and the self-reported subjective experience using a questionnaire. RESULTS In total, 30 patients completed the treatment during the follow-up period. HGA was worn on average 7 hours per day and TB 9 hours per day by those patients, who successfully completed the treatment. During a mean observation period of 13 months (range 7-23 months), the mean actual wear time was 43 per cent less than the advised 12 or 18 hours per day in the whole patient group, and 55 per cent in those patients, who completed the treatment. Compliance level was unrelated to the appliance type. LIMITATIONS Study assessed a relatively small number of patients. CONCLUSIONS/IMPLICATIONS Adolescent patients wear HGA and TB less than advised. Individual variation in treatment adherence is considerable. Thereby, microelectronic wear-time documentation can be a cost-effective mean of identifying non-compliance.
Childhood Neglect History, Depressive Symptoms, and Intimate Partner Violence Perpetration by College Students

College students experience intimate partner violence (IPV) at an alarming rate, and preventing such violence depends on identifying factors that contribute to perpetration. Although there is extensive research that has established a link between childhood neglect and later physical IPV perpetration, less is known about the specific mechanisms through which childhood neglect leads to IPV perpetration. In the present study, we examined potential mediators of the relationship between childhood neglect and IPV perpetration by college students, with special emphasis on the role of depressive symptoms and IPV victimization. A total of 302 college students reported on their experiences of childhood maltreatment, depressive symptoms, and IPV victimization and perpetration. Results indicate that increasing levels of childhood emotional and physical neglect correspond with increasing rates of IPV perpetration, after accounting for the effect of childhood emotional, physical, and sexual abuse. This effect between childhood neglect and IPV perpetration was fully mediated by the combination of IPV victimization and depressive symptoms for the overall sample. However, when examining the model for men and women separately, only the indirect effect through victimization remained statistically significant for men. Our findings suggest that research on the link between childhood neglect and IPV perpetration should also consider the impact of IPV victimization, as neglect may lead to IPV perpetration within the context of a mutually aggressive relationship. Furthermore, these findings indicate that childhood neglect leads to long-term emotional consequences that contribute to later IPV perpetration, and treating depressive symptoms may help prevent IPV perpetration against college students who experienced childhood neglect.
An analysis of resilience in dental students using the Resilience Scale for Adults.

OBJECTIVES Resilience is the ability to bounce back or recover from major life stressors. The aim of this study was to investigate resilience in dental students and how it may or may not vary across demographic characteristics such as gender, socioeconomic status, race/ethnicity, self-reported health, and parental educational level. METHODS Data were collected from 151 dental students at Virginia Commonwealth University School of Dentistry with an anonymous survey that included the Resilience Scale for Adults (RSA) and various demographic variables. Associations between RSA and variables of interest were assessed using linear models. RESULTS Dental students demonstrated relatively high levels of resilience. Resilience was significantly associated with gender (with females showing more resilience than males (P = 0.0395)), race (P = 0.0025), overall health (P = 0.0101), and mental health (P < 0.0001). Results from Exploratory Factor Analysis (EFA) supported a 5-factor solution that explained 82.6% of the variability of resilience in the sample of dental students. The 5 factors were nearly identical to the 5 subscales originally described by the RSA demonstrating validity in this population. Overall health ratings were significantly related to resilience, suggesting that perceived resilience in dental students may protect against negative health outcomes. This study can inform internal and external support systems of dental students as well as institutional programmatic development to better support their educational experiences.
French Red Cross Volunteer Rescue Workers

Abstract Few studies have explored the psychological consequences of terrorism on volunteer rescuers. We examined the psychological characteristics of volunteer rescuers after the January 2015 terrorist attacks in France. We analyzed the results of the IMPACTS study regarding the somatic, psychological, and social characteristics of the French Red Cross volunteer rescuers who intervened during these terrorist attacks. We used a standardized questionnaire during a face-to-face interview, 6 to 9 months after the attacks. Forty-one volunteers were included. Nine were presenting anxiety disorders, 11 were displaying recurrent depressive episodes, and five were displaying abusive alcohol consumption. Twenty-seven were provided with a debriefing after their intervention. Half of the most exposed volunteers had no contact with mental health professional 9 months after their intervention. A healthcare protocol, covering short-, medium-, and long-term care, should be systematically proposed to volunteer rescue workers to minimize the risk of chronic psychic posttraumatic disorders.
GAN-Based Key Secret-Sharing Scheme in Blockchain

In this article, we propose a key secret-sharing technology based on generative adversarial networks (GANs) to address three major problems in the blockchain: 1) low security; 2) hard recovery of lost keys; and 3) low communication efficiency. In our scheme, the proposed network plays the role of a dealer and treats the secret-sharing process as a classification issue. The key idea is to view the secret as an image during the secret-sharing process. If the user’s private key is text, we can covert the key text into an image called the original image. Specifically, we first divide the original image into original subimages by the image segmentation. Next, we encode each original subimage by DNA coding. Finally, we train the proposed network to find the key secret-sharing results. Our proposed scheme is not only a significant extension of the GANs but also a new direction for the key secret-sharing technology. The simulation results show that the scheme is secure, and both flexible and efficient in communication.
Hydrophobization of cellulose nanocrystals for aqueous colloidal suspensions and gels.

Surface hydrophobization of cellulose nanomaterials has been used in the development of nanofiller reinforced polymer composites and formulations based on Pickering emulsions. Despite well known effect of hydrophobic domains on self assembly or association of water soluble polymer amphiphiles, very few studies have addressed the behavior of hydrophobized cellulose nanomaterials in aqueous media. In this study, we investigate the properties of hydrophobized cellulose nanocrystals (CNCs) and their self assembly and amphiphilic properties in suspensions and gels. CNCs of different hydrophobicity were synthesized from sulfated CNCs by coupling primary alkylamines of different alkyl chain lengths (6, 8 and 12 carbon atoms). The synthetic route permitted the retention of surface charge, ensuring good colloidal stability of hydrohobized CNCs in aqueous suspensions. We compare surface properties (surface charge, Zeta potential), hydrophobicity (water contact angle, microenvironment probing using pyrene fluorescence emission) and surface activity (tensiometry) of different hydrophobized CNCs and hydrophilic CNCs. Association of hydrophobized CNCs driven by hydrophobic effects is confirmed by X ray scattering (SAXS) and autofluorescent spectroscopy experiments. As a result of CNC association, CNCs suspensions/gels can be produced with a wide range of rheological properties depending on the hydrophobic/hydrophilic balance. In particular, sol gel transitions for hydrophobized CNCs occur at lower concentrations then hydrophilic CNCs and more robust gels are formed by hydrophobized CNCs. Our work illustrates that amphiphilic CNCs can complement associative polymers as modifiers of rheological properties of water based systems.
Drought stress modulates cuticular wax composition of the grape berry

Abstract Drought events are a major challenge for many horticultural crops, including grapes, which are often cultivated in dry and warm climates. It is not understood how the cuticle contributes to the grape berry response to water deficit (WD); furthermore, the cuticular waxes and the related biosynthetic pathways are poorly characterized in this fruit. In this study, we identified candidate wax-related genes from the grapevine genome by phylogenetic and transcriptomic analyses. Developmental and stress response expression patterns of these candidates were characterized across pre-existing RNA sequencing data sets and confirmed a high responsiveness of the pathway to environmental stresses. We then characterized the developmental and WD-induced changes in berry cuticular wax composition, and quantified differences in berry transpiration. Cuticular aliphatic wax content was modulated during development and an increase was observed under WD, with wax esters being strongly up-regulated. These compositional changes were related to up-regulated candidate genes of the aliphatic wax biosynthetic pathway, including CER10, CER2, CER3, CER1, CER4, and WSD1. The effect of WD on berry transpiration was not significant. This study indicates that changes in cuticular wax amount and composition are part of the metabolic response of the grape berry to WD, but these changes do not reduce berry transpiration.
MiR-532-3p inhibits metastasis and proliferation of non-small cell lung cancer by targeting FOXP3.

PURPOSE To investigate the potential effect of microRNA-532-5p (miR-532-3p) on the development of non-small cell lung cancer (NSCLC) and the relevant mechanism. METHODS Thirty-seven patients who underwent primary NSCLC resection were studied. To examine the role of miR-532-3p in NSCLC development, we detected the level of miR-532-3p expression in NSCLC tissues and the para-cancer tissues by qRT-PCR. In order to investigate the potential target of miR-532-3p, we checked it in three publicly available algorithms, TargetScan, miRDB and microRNA, to elucidate the putative and possible targets of miR-532-3p. To test the function of miR-532-3p on the proliferation of NSCLC cell, we performed MTT assay to detect the cell proliferation rates. Migration and invasion were also studied. RESULTS The expression level of miR-532-3p were detected in NSCLC tissues and cells by qRT-PCR, which indicated that the expression of miR-532-3p was low in both tissue and cell levels. Online prediction websites and luciferase reporter assay indicated that FOXP3 is a direct target of miR-532-3p in NSCLC cells. Further results showed that this miR significantly decreased the expression level of FOXP3. MTT assay showed that miR-532-3D remarkably suppressed the proliferation of NSCLC cells. Furthermore, transwell and scratch healing experiments suggested that miR-532-3p inhibited the invasion and migration of NSCLC cells. CONCLUSIONS Our research discovered the suppressive function of miR-532-3p in NSCLC by targeting FOXP3, revealing that miR-532-3p/FOXP3 axis might be a potential therapeutic target for the treatment of NSCLC.
A single-centre cohort and short-term follow-up of patients who developed persistent new onset left bundle branch block after transcatheter aortic valve replacement

Abstract Background: The most common conduction abnormality after transcatheter aortic valve replacement (TAVR) is new-onset left bundle branch block (LBBB) with an exact frequency that varies based on the valve system used for TAVR. PPM implantation in patients with persistent new onset LBBB post TAVR is controversial. The primary objective of this study is to report PPM utilisation and mortality in this patient population. Methods: A TAVR registry included patients older than 18 years who underwent TAVR between March 2012 and June 2015 at University of Minnesota Medical Centre. After exclusion, 151 patients were divided into two groups; patients with persistent new onset LBBB after TAVR (new LBBB, n = 47) and patients without persistent new onset LBBB (no new LBBB, n = 104). Results: Among the 151 patients, 47 (31.1%) patients developed new-onset LBBB after the procedure and persisted at discharge. Left ventricular ejection fraction (LVEF) (52.5 ± 11.1 vs. 56.4 ± 10.8, p: .047) and mean aortic valve gradient (40.6 ± 11.5 vs. 45.7 ± 14.1, p: .022) were significantly higher in no new LBBB group. Among those with new LBBB, there was a significantly higher rate of PPM implant during index hospitalisation (14.9%, vs. 0%, p < .001). LVEF remained significantly lower at 1 year follow up in new LBBB group compared to no new LBBB group (51.8 ± 11.2 vs. 57.6 ± 8.3, p: .002). Also in new LBBB group, there was a non-significantly higher rate of all-cause mortality in 1 year compared to no new LBBB group (14.9% vs. 9.6% p: .34). There were no significant differences between patients with and without new LBBB with respect to PPM implant after discharge in 1 year (2.13% vs. 3.8% p: .58), length of stay (7.3 ± 7.3 vs. 5.9 ± 2.7 p: .09), post-op atrial fibrillation (AF) (16.3% vs. 8.5% p: .20). Conclusions: New onset LBBB was frequent conduction problem post TAVR and one-third of patients with new onset LBBB persisted at discharge. New LBBB after TAVR was associated with a higher risk of PPM implantation during the index hospitalisation but not after discharge. Our findings suggest that early PPM implantation for post-TAVR LBBB is not indicated without complete or high degree AV block. Further research is required to identify the patients with new LBBB who would progress to advanced AV block or heart failure.
Comparison of symptomatic and functional responses to vagus nerve stimulation in ANTHEM‐HF, INOVATE‐HF, and NECTAR‐HF

Clinical studies of vagal nerve stimulation (VNS) for heart failure with reduced ejection fraction have had mixed results to date. We sought to compare VNS delivery and associated changes in symptoms and function in autonomic regulation therapy via left or right cervical vagus nerve stimulation in patients with chronic heart failure (ANTHEM‐HF), increase of vagal tone in heart failure (INOVATE‐HF), and neural cardiac therapy for heart failure (NECTAR‐HF) for hypothesis generation.