Miracle-dz/UniFAR-FTUs huggingface dataset:
Resection rates and intention-to-treat outcomes in borderline and locally advanced pancreatic cancer: real-world data from a population-based, prospective cohort study (NORPACT-2)

Abstract Background Systemic chemotherapy is the initial treatment strategy for borderline resectable and locally advanced pancreatic cancer to facilitate curative resection. The aim of this study was to investigate the resection rates and overall survival in patients with borderline resectable pancreatic cancer and locally advanced pancreatic cancer. Methods Consecutive patients with borderline resectable pancreatic cancer/locally advanced pancreatic cancer discussed by Oslo University Hospital multidisciplinary team between 2018 and 2020, serving a population of 3.1 million within a geographically defined area in south-eastern Norway, were included in this prospective Norwegian Pancreatic Cancer Trial-2 study, according to intention-to-treat principles. The total number of patients with pancreatic cancer was sought from the Cancer Registry of Norway. Results A total of 1178 patients were diagnosed with pancreatic cancer, of whom 618 were referred to Oslo University Hospital. After multidisciplinary team evaluation, 230 patients were considered to have borderline resectable pancreatic cancer/locally advanced pancreatic cancer. The final study group consisted of 188 patients (borderline resectable pancreatic cancer n = 96, locally advanced pancreatic cancer n = 92) who were fit to receive primary chemotherapy. Resection rates were 46.9% (45 of 96) for borderline resectable pancreatic cancer and 13% (12 of 92) for locally advanced pancreatic cancer (P <0.001). Median overall survival was 14.6 months (borderline resectable pancreatic cancer 16.4 months; locally advanced pancreatic cancer 13.7 months, (P = 0.2)). Adjusted for immortal time bias, median overall survival for patients undergoing resection versus only chemotherapy was 24.4 months versus 10.1 months (P <0.001) for borderline resectable pancreatic cancer and 28.4 months versus 12.6 months for locally advanced pancreatic cancer (P = 0.001). Conclusion Resection rates and survival in patients with borderline resectable pancreatic cancer and locally advanced pancreatic cancer treated at a high-volume centre in a universal healthcare system compare well with those treated at international expert centres. Registration number: NCT04423731 (http://www.clinicaltrials.gov)
Right Ventricular/Pulmonary Artery Coupling in Patients With Heart Failure With Preserved Ejection Fraction: A Clue for Pulmonary Hypertension?

, other conditions, such as atrial fibrillation and myocardial ischemia, are associated with RV dysfunction. 3 This is not completely unexpected, because heart failure with reduced ejection fraction and HFpEF may exhibit a similar pulmonary hemodynamic profile (and similar outcomes) but are characterized by important differences in the underlying clinical causes, in comorbidities, in triggers, and in molecular pathways for pulmonary vascular injury and, finally, in type and extent of remodeling of the left ventricular and the RV chambers. 4,5 In clinical practice, PH in advanced heart failure is a contraindication for heart transplantation as the RV of the new heart could not be able to adapt toward the high afterload of the native pulmonary circulation.
Increased A1 astrocyte activation‐driven hippocampal neural network abnormality mediates delirium‐like behavior in aged mice undergoing cardiac surgery

Abstract Delirium is the most common neurological complication after cardiac surgery with adverse impacts on surgical outcomes. Advanced age is an independent risk factor for delirium occurrence but its underlying mechanisms are not fully understood. Although increased A1 astrocytes and abnormal hippocampal networks are involved in neurodegenerative diseases, whether A1 astrocytes and hippocampal network changes are involved in the delirium‐like behavior of aged mice remains unknown. In the present study, a mice model of myocardial ischemia–reperfusion mimicking cardiac surgery and various assessments were used to investigate the different susceptibility of the occurrence of delirium‐like behavior between young and aged mice and the underlying mechanisms. The results showed that surgery significantly increased hippocampal A1 astrocyte activation in aged compared to young mice. The high neuroinflammatory state induced by surgery resulted in glutamate accumulation in the extrasynaptic space, which subsequently decreased the excitability of pyramidal neurons and increased the PV interneurons inhibition through enhancing N‐methyl‐D‐aspartate receptors' tonic currents in the hippocampus. These further induced the abnormal activities of the hippocampal neural networks and consequently contributed to delirium‐like behavior in aged mice. Notably, the intraperitoneal administration of exendin‐4, a glucagon‐like peptide‐1 receptor agonist, downregulated A1 astrocyte activation and alleviated delirium‐like behavior in aged mice, while IL‐1α, TNF‐α, and C1q in combination administered intracerebroventricularly upregulated A1 astrocyte activation and induced delirium‐like behavior in young mice. Therefore, our study suggested that cardiac surgery increased A1 astrocyte activation which subsequently impaired the hippocampal neural networks and triggered delirium development.
Bilateral absence of inferior thyroid artery: A rare variation

Background: There are reports regarding the origin of the inferior thyroid artery from the vertebral artery and internal thoracic artery. The absence of inferior thyroid artery has been reported in studies, but most of these studies have reported the unilateral absence of inferior thyroid artery. Objective: The objective of the study was to identify and variations in origin (especially presence or absence of artery) and branches of inferior thyroid artery. Materials and Methods: A total of 96 cadavers were dissected and observed for origin and branching pattern of inferior thyroid artery. Results: Inferior thyroid artery originated from thyrocervical trunk in 94 cadavers, in one cadaver there are bilateral absence of inferior thyroid artery and in one case unilateral absence of Rt. inferior thyroid artery. Multiple variations of relations of recurrent laryngeal nerve and inferior thyroid artery are found. Conclusion: Knowledge of arterial variation is extremely important while carrying out surgical procedures in the neck region. During operations of the thyroid gland, surgeries of neck region, carotid angiographies any misinterpretation can lead to life-threatening complications. This study is not only focusing on the presence of different branching pattern but also the absence of major arteries. Studies like these can help surgeons to look closely for variations in both cases either presence or absence of main arteries.
Association of Abnormal Lung Function and Its Subtypes With Arterial Stiffness: A Longitudinal Cohort Study

Background Prior studies have reported the cross‐sectional relationship between lung function and arterial stiffness, while the longitudinal association remains unclear to date. This study aimed to investigate whether abnormal lung function and its subtypes at baseline are associated with increased arterial stiffness using a cohort. Methods and Results This was a secondary analysis extracting 2461 participants from Beijing Health Management Cohort as baseline and annually followed for development of arterial stiffness. Abnormal lung function was defined by forced expiratory volume in 1s <80% of the predicted value, forced vital capacity of the predicted value, or forced expiratory volume in 1s/forced vital capacity ratio <70%. Increased arterial stiffness was determined by brachial‐ankle pulse wave velocity ≥1400 cm/s. Cox proportional hazards model was used to calculate the hazard ratio and population attributable fraction. The mean age was 42.8±8.1 years, and 444 (18.0%) cases developed increased arterial stiffness during a median follow‐up of 3.0 years. The adjusted hazard ratio (95% CI) of arterial stiffness was 1.47 (95% CI, 1.10–1.96) for abnormal lung function, with a population attributable fraction of 3.9% (95% CI, 0.8–7.1). Of subtypes, only obstructive ventilatory dysfunction was significantly associated with arterial stiffness (adjusted hazard ratio, 2.06 [95% CI, 1.27–3.36]), not restricted ventilatory dysfunction (adjusted hazard ratio, 0.95 [95% CI, 0.54–1.65]). Consistent results were observed on multiple sensitivity analyses. Conclusions Our study indicated a longitudinal association of abnormal lung function with increased arterial stiffness using a large cohort, especially for the obstructive ventilatory dysfunction.
A cohort study comparing the effects of medical cannabis for anxiety patients with and without comorbid sleep disturbance

Abstract Background Research on cannabis‐based medicinal products (CBMPs) in anxiety remains inconclusive due to a paucity of high‐quality evidence. Studies indicate a bidirectional relationship between generalized anxiety disorder (GAD) and sleep disruption, but it is unclear how this affects CBMP treatment outcomes. This study aims to compare the patient‐reported outcome measures (PROMs) of patients prescribed CBMPs for GAD, with and without impaired sleep. Methods Changes in PROMs were recorded from baseline to 1, 3, 6, and 12 months between those with impaired or unimpaired sleep. Multivariate logistic regression was applied to compare factors associated with a clinically significant improvement in GAD‐7 at 12 months. Secondary outcomes included adverse event incidence and frequency. Results Of the 302 patients that fit the inclusion criteria, mean GAD‐7, single‐item sleep quality, and EQ‐5D‐5L index values improved at all time points (p < 0.001). A relationship between sleep impairment and clinically significant changes in GAD‐7 at 1 and 3 months was identified (p ≤ 0.01). On multivariate regression, only baseline GAD severity was associated with an increased likelihood of observing a clinically significant improvement in anxiety (p < 0.001). Seven hundred and seven (234%) adverse events were reported by 55 (18.21%) participants. Conclusions This study observed an association between CBMP treatment and improvements in anxiety in patients with GAD. While patients with comorbid sleep disruption had greater improvements in anxiety, the differences were not maintained in a multivariate analysis. Baseline anxiety severity may be a predictor for CBMP treatment outcomes.
Kikuchi-Fujimoto's disease: case report and review

Kikuchi-Fujimoto's disease is a rare, benign and self-limited disorder. It is characterized by regional cervical lymphadenopathy with tenderness, usually accompanied by symptoms such as fever, sweats, nausea, vomiting, sore throat and cutaneous manifestations. Its aetiology is unknown. A definitive diagnosis can only be made histologically on lymph node biopsy tissue. In this study, we report a case of Kikuchi-Fujimoto's disease in a Greek child and present a review of the literature.
A High-Resolution Modeling Strategy to Assess Impacts of Climate Change for Mesoamerica and the Caribbean

Mesoamerica and the Caribbean are low-latitude regions at risk for the effects of climate change. Global climate models provide large-scale assessment of climate drivers, but, at a horizontal resolution of 100 km, cannot resolve the effects of topography and land use as they impact the local temperature and precipitation that are keys to climate impacts. We developed a robust dynamical downscaling strategy that used the WRF regional climate model to downscale at 4 - 12 km resolution GCM results. Model verification demonstrates the need for such resolution of topography in order to properly simulate temperatures. Precipitation is more difficult to evaluate, being highly variable in time and space. Overall, a 36 km resolution is inadequate; 12 km appears reasonable, especially in regions of low topography, but the 4 km resolution provides the best match with observations. This represents a tradeoff between model resolution and the computational effort needed to make simulations. A key goal is to provide climate change specialists in each country with the information they need to evaluate possible future climate change impacts.
New-onset movement disorder in the immediate postpartum period

This case report describes a woman who developed involuntary, uncoordinated movements of her face and limbs following a spontaneous vaginal delivery, complicated by postpartum haemorrhage. Using systematic assessment with multidisciplinary team input, a differential diagnosis was proposed and relevant investigations were undertaken. Atypical eclamptic or generalised seizures were excluded clinically and neuroimaging ruled out an intracranial vascular event such as stroke or venous sinus thrombosis. Local anaesthetic systemic toxicity was managed empirically with intravenous lipid emulsion and intravenous fluids. A diagnosis of drug-induced dyskinesia was made, most likely secondary to ondansetron, with which dystonias and myoclonus have been described. This woman’s symptoms were transient and resolved within 2 hours. This case presented a complex differential diagnosis, highlighting the paucity of guidance available. We propose a diagnostic algorithm to aid in the identification of acute involuntary movements in pregnancy and the puerperium.
Comparative efficacy of silver alginate dressings versus standard gauze in enhancing wound healing post‐mastectomy for triple‐negative breast cancer: A systematic review and meta‐analysis

Abstract This meta‐analysis evaluates the efficacy of silver alginate dressings (SAD) compared to standard gauze (SG) in enhancing wound healing and reducing scar formation post‐mastectomy in patients with triple‐negative breast cancer. From an initial pool of 1245 articles, five studies met the inclusion criteria. The analysis revealed that SAD significantly improve early wound healing 1 week post‐mastectomy, as indicated by lower Redness, Edema, Ecchymosis, Discharge, and Approximation (REEDA) scales (I 2 = 85%; Random: SMD: −7.08, 95% CI: −8.26 to −5.98, p < 0.01), compared to SG. Additionally, long‐term scar outcomes measured by the Manchester Scar Scale (MSS) 5 months post‐mastectomy showed a notable reduction in scar formation (I 2 = 95%; Random: SMD: −12.97, 95% CI: −16.20 to −9.75, p < 0.01)) in the silver alginate group. The findings support the use of SAD in post‐mastectomy care for triple‐negative breast cancer patients but highlight the need for further research on long‐term safety and cost‐effectiveness.
Correlation of Beta Trace Protein Levels with Serum Creatinine-Based Estimated Glomerular Filtration Rate Equations in Chronic Kidney Disease.

Background. Estimated GFR (eGFR) is calculated using serum creatinine (SCr) based equations which have their own limitations. Novel biomarkers like beta trace protein (BTP) are studied for eGFR estimation. The aim of this study is to determine the serum levels of BTP in healthy controls and chronic kidney disease (CKD) cases and to find out the correlation of BTP levels with that of SCr and SCr-based eGFR formulas. Methods. The control group comprised of 20 healthy adults. The cases comprised of 20 patients each in CKD stages 3, 4, and 5, categorized based on eGFR calculated using MDRD formula. Baseline characteristics of the study population were recorded. BTP was measured by ELISA (Enzyme Linked Immunosorbent Assay) method and SCr by modified Jaffe's method. The statistical analyses were performed with the SPSS for Windows, version 16.0. Results. The median value of blood urea nitrogen (BUN) in the cases was 26.50 mg/dL (IQR 19.25-37) and for control it was 9.5 mg/dL (IQR 8-12). The median value of SCr in the cases was 2.75 mg/dL (IQR 1.725-4.45) and in the controls, it was 0.7mg/dL (IQR 0.6 -0.8). The median value of BTP in cases was 6389.25 ng/ml (IQR 5610.875-10713.75) and in controls, it was 1089.5 ng/ml (IQR 900.5-1309.75). Conclusion. Serum BTP levels correlated with SCr levels and renal function. We could establish the relationship between the two biomarkers, SCr and BTP, and derive a regression equation.
Causal Effects of Basal Metabolic Rate on Cardiovascular Disease: A Bidirectional Mendelian Randomization Study

Background Despite the health effects of basal metabolic rate (BMR), the causal effect of BMR on cardiovascular diseases (CVDs) remains undetermined. To elucidate the causal nature, Mendelian randomization (MR) analyses were performed. Methods and Results Summary genome‐wide association statistics regarding BMR and 5 CVDs were obtained from European databases. A 2‐sample bidirectional MR was performed to assess the causal association between BMR and CVDs. The causal effects were estimated using inverse variance weighting. Simultaneously, multiple sensitivity analyses were performed to validate the robustness and reliability of the results. Our results indicated that genetically predicted BMR was significantly positively associated with the risk of heart failure (odds ratio, 1.53 [95% CI, 1.39–1.67]; P<0.001), atrial fibrillation and flutter (odds ratio, 2.12 [95% CI, 1.87–2.40]; P<0.001), and aortic aneurysm (odds ratio, 1.64 [95% CI, 1.41–1.92]; P<0.001). Genetically predicted BMR may not be causally associated with coronary artery disease and ischemic stroke risk. Furthermore, a significant causal effect of CVDs on BMR was not found in the reverse MR analysis. Multivariable MR was applied to further assess the direct effect of BMR on CVDs. Multivariable MR indicated that a high level of BMR still increased the risk of heart failure and atrial fibrillation and flutter after adjustment independent of possible confounders. However, the P value of aortic aneurysm was not significant. Conclusions The present study provides robust evidence that genetically predicted BMR is independently causally associated with heart failure and atrial fibrillation and flutter but not vice versa. These findings have implications for the prevention and treatment of CVDs in clinical practice.
Britholite-hellandite intergrowths and associated REE-minerals from the alkali-syenitic ejecta of the Vico volcanic complex (Latium, Italy); petrological implications bearing on REE mobility in volcanic systems

This paper describes the occurrence of Th-rich hellandite-(Ce) and britholite-(Ce) within a volcanic ejectum from a pyroclastic formation of the Vico volcanic complex, north of Rome, Italy. The host rock is a saturated alkali-syenite which consists mainly of potassium feldspar and plagioclase, together with fluor-biotite, plagioclase, titanite, clinopyroxene and magnetite. Hellandite-(Ce) and britholite-(Ce) are associated with this mineral assemblage which contains also several accessory phases including zircon, fluorapatite, allanite, and silico-phosphates of Th, U, REE close in composition to cheralite-brabantite. Hellandite-(Ce) and britholite-(Ce) are typically intergrown with hellandite in all case observed rimming britholite. These unusual REE, Th, U minerals are secondary to the formation of the host rock and the compositions of the associated minerals suggest that they originated from fluids rich in F, P, and possibly S and C. The presence of fractures filled by clays containing dispersed REE-minerals, probably fluorocarbonates, suggests a very late-stage hydrothermal remobilization, transportation and redeposition of the REE. An important implication of such widespread secondary mineralization is that great care should be exerted when using bulk-rock trace-element data from these volcanic samples for geochemical modelling.
Lenvatinib Suppresses Protein Kinase B Signaling and Induces Apoptosis in Osteosarcoma Cells

Background/Aim: Lenvatinib, an oral multikinase inhibitor, has demonstrated promising activity in patients with osteosarcoma (OS). Therefore, it is worth exploring the inhibitory efficacy and mechanism of action of lenvatinib in osteosarcoma. The primary goal of this study was to examine the inhibitory effectiveness and mechanism of lenvatinib on the growth and invasion of OS cells. Materials and Methods: The effects of lenvatinib on cell viability, apoptosis, protein kinase B (AKT) activation, its downstream effector proteins involved in tumor progression, and invasion capability were assessed using MTT assay, flow cytometry, western blotting, and invasion/migration assay on U-2 OS and MG63 cells. Results: Lenvatinib effectively induced cytotoxicity, apoptosis, as well as extrinsic and intrinsic apoptotic signaling in OS cells. Lenvatinib also significantly decreased the invasion/migration capability, AKT activation, and downstream effector proteins. Conclusion: The anti-OS effect of lenvatinib may be associated with the induction of apoptosis and the inactivation of AKT.
Self‐contained local broadband seismogeodetic early warning system: Detection and location

Earthquake and local tsunami early warning is critical to mitigating adverse impacts of large‐magnitude earthquakes. An optimal system must rely on near‐source data to maximize warning time. To this end, we have developed a self‐contained seismogeodetic early warning system employing an optimal combination of high‐frequency information from strong‐motion accelerometers and low‐frequency information from collocated Global Navigation Satellite Systems (GNSS) instruments to estimate real‐time displacements and velocities. Like GNSS, and unlike broadband seismometers, seismogeodetic stations record the full waveform, including static offset, without clipping in the near‐field or saturating for large magnitude earthquakes. However, GNSS alone cannot provide a self‐contained system and requires an external seismic trigger. Seismogeodetic stations detect P wave arrivals with the same sensitivity as strong‐motion accelerometers and thus provide a stand‐alone system. We demonstrate the utility of near‐source seismogeodesy for event detection and location with analysis of the 2010 Mw7.2 El Mayor‐Cucapah, Baja, California and 2014 Mw6.0 Napa, California strike‐slip events, and the 2014 Mw8.2 Iquique, Chile subduction zone earthquake using observatory‐grade accelerometers and GPS data. We present lessons from the 2014 Mw4.0 Piedmont, California and 2016 Mw5.2 Borrego Springs, California earthquakes, recorded by our seismogeodetic system with Micro‐Electro Mechanical System (MEMS) accelerometers and GPS data and reanalyzed retrospectively. We conclude that our self‐contained seismogeodetic system is suitable for early warning for earthquakes of significance (>M5) using either observatory‐grade or MEMS accelerometers. Finally, we discuss the effect of network design on hypocenter location and suggest the deployment of additional seismogeodetic stations for the western U.S.