Miracle-dz/UniFAR-FTUs huggingface dataset:
Characteristics and Mechanism of Acute Ischemic Stroke in NAVF Patients With Prior Oral Anticoagulant Therapy

Objectives: We aimed to analyze the characteristics and mechanisms of acute ischemic stroke (AIS) in patients with nonvalvular atrial fibrillation (NVAF) who received prior anticoagulant therapy. Methods: We retrospectively analyzed the data of patients with NVAF and AIS between January 2016 and December 2021. Patients were divided into non-anticoagulant, adequate anticoagulant, and insufficient anticoagulant groups according to their prior anticoagulant status. Patients with prior anticoagulant therapy were further divided into warfarin and direct oral anticoagulant groups. Results: A total of 749 patients (661 without anticoagulants, 33 with adequate anticoagulants, and 55 with insufficient anticoagulants) were included. Patients with adequate anticoagulant had a milder National Institute of Health Stroke Scale at presentation (P=0.001) and discharge (P=0.003), a higher proportion of Modified Rankin Scale (mRS) ≤2 at discharge (P=0.011), and lower rates of massive infarction (P=0.008) than patients without anticoagulant. Compared with the non-anticoagulant group, the proportion of intravenous thrombolysis was significantly lower in the adequate anticoagulant (P<0.001) and insufficient anticoagulant (P=0.009) groups. Patients in the adequate anticoagulant group had higher rates of responsible cerebral atherosclerotic stenosis (P=0.001 and 0.006, respectively) and competing large artery atherosclerotic mechanisms (P=0.006 and 0.009, respectively) than those in the other 2 groups. Compared with warfarin, direct oral anticoagulant was associated with higher rates of Modified Rankin Scale ≤2 at discharge (P=0.003). Conclusions: Adequate anticoagulant therapy may be associated with milder stroke severity and better outcomes at discharge in patients with NVAF. Competing large artery atherosclerotic mechanisms may be associated with anticoagulant failure in patients with NAVF with prior adequate anticoagulant therapy.
Stability study of selected veterinary drug residues spiked into extracts from different food commodities

Abstract Analyte stability is more commonly a confounding factor in analytical chemistry than many analysts recognize. In this study, we assessed the stability of 31 common veterinary drugs in water and final extracts of bovine (milk and kidney/liver) and chicken (muscle and egg) matrices. Two different sample preparation methods were evaluated for one-month storage of the final extracts at typical room, refrigerator, and freezer temperatures. Liquid chromatography – mass spectrometry (LC-MS) by triple quadrupole and high-resolution techniques was used for analysis of the extracts spiked at different relevant concentrations for general regulatory purposes (10–1000 ng/g sample equivalent). Comparison of results between two labs demonstrated that stable drugs (≤20% loss) at all tested conditions consisted of danofloxacin, enrofloxacin, florfenicol, flubendazole, hydroxy-flubendazole, flumequine, flunixin, 5-hydroxy-flunixin, lincomycin, and meloxicam. The tested drugs found to be the most unstable (>20% loss at room temperature within a matter of days) consisted of the β-lactams (ampicillin, cefalexin, cloxacillin, and penicillin G). Curiously, the following antibiotics (mostly macrolides) were apparently more stable in sample extracts than water: emamectin, erythromycin, ivermectin, lasalocid, monensin, tilmicosin, tulathromycin, and tylosin. Those and the other drug analytes (ciprofloxacin, doxycycline, florfenicol amine, 2-amino-flubendazole, oxytetracycline, sulfadiazine, sulfadimethoxine, sulfamethazine, and trimethoprim) were mostly stable for a month in refrigerated extracts, especially at higher concentrations, but not in all cases. In practice, freezer storage of extract solutions was found to be acceptable for at least a month, with a few exceptions.
Physical supply of nitrogen to phytoplankton in the Atlantic Ocean

Mechanisms supplying nitrogen (N) to phytoplankton, and thus constraining the levels of export production, over the oligotrophic subtropical Atlantic are assessed along a meridional transect. Stable nitrogen isotope signals reveal a localized region of N2 fixation over the northern subtropical gyre. Elsewhere, particulate organic nitrogen was isotopically enriched and there was no widespread evidence of a trophic bias. Thus phytoplankton are utilizing an enriched source of N along the transect through much of the oligotrophic Atlantic, which may reflect utilization of nitrate from the deep ocean or, possibly, a supply of dissolved organic nitrogen (DON) from a non‐N2 fixing source. While there is a significant supply of DON over the subtropical gyres, reaching 0.15 mol Nm−2 yr−1, less than 10% of the DON is semilabile and thus only implies a relatively small contribution to the nitrogen supply required for export production. Over the central part of the subtropical gyres, the supply of N to phytoplankton is probably from nitrate in the underlying thermocline, possibly from convection and diapycnic transfer, or more likely, from finescale upwelling by mesoscale eddies and frontal circulations. The lateral supply of dissolved organic phosphorus (DOP) appears to be a factor of 2–3 times more important than the lateral supply of semilabile DON, and thus might play a role in contributing to the phosphorus (P) supply for phytoplankton. The lateral supply of DON and DOP might also be important in closing the N and P budgets over the North Atlantic.
Clinical‐functional brain connectivity signature predicts longitudinal symptom improvement after acupuncture treatment in patients with functional dyspepsia

Whilst acupuncture has been shown to be an effective treatment for functional dyspepsia (FD), its efficacy varies significantly among patients. Knowing beforehand how each patient responds to acupuncture treatment will facilitate the ability to produce personalized prescriptions, therefore, improving acupuncture efficacy. The objective of this study was to construct the prediction model, based on the clinical‐neuroimaging signature, to forecast the individual symptom improvement of FD patients following a 4‐week acupuncture treatment and to identify the critical predictive features that could potentially serve as biomarkers for predicting the efficacy of acupuncture for FD. Clinical‐functional brain connectivity signatures were extracted from samples in the training‐test set (100 FD patients) and independent validation set (60 FD patients). Based on these signatures and support vector machine algorithms, prediction models were developed in the training test set, followed by model performance evaluation and predictive features extraction. Subsequently, the external robustness of the extracted predictive features in predicting acupuncture efficacy was evaluated by the independent validation set. The developed prediction models possessed an accuracy of 88% in predicting acupuncture responders, as well as an R2 of 0.453 in forecasting symptom relief. Factors that contributed significantly to stronger responsiveness of patients to acupuncture therapy included higher resting‐state functional connectivity associated with the orbitofrontal gyrus, caudate, hippocampus, and anterior insula, as well as higher baseline scores of the Symptom Index of Dyspepsia and shorter durations of the condition. Furthermore, the robustness of these features in predicting the efficacy of acupuncture for FD was verified through various machine learning algorithms and independent samples and remained stable in univariate and multivariate analyses. These findings suggest that it is both feasible and reliable to predict the efficacy of acupuncture for FD based on the pre‐treatment clinical‐neuroimaging signature. The established prediction framework will promote the identification of suitable candidates for acupuncture treatment, thereby improving the efficacy and reducing the cost of acupuncture for FD.
ROBUST INFERENCE IN STRUCTURAL VECTOR AUTOREGRESSIONS WITH LONG-RUN RESTRICTIONS

Long-run restrictions are a very popular method for identifying structural vector autoregressions, but they suffer from weak identification when the data is very persistent, i.e., when the highest autoregressive roots are near unity. Near unit roots introduce additional nuisance parameters and make standard weak-instrument-robust methods of inference inapplicable. We develop a method of inference that is robust to both weak identification and strong persistence. The method is based on a combination of the Anderson-Rubin test with instruments derived by filtering potentially nonstationary variables to make them near stationary using the IVX instrumentation method of Magdalinos and Phillips (2009). We apply our method to obtain robust confidence bands on impulse responses in two leading applications in the literature.
Generation of a novel ex-vivo model to study re-endothelialization

Abstract Endothelial dysfunction initiates the pathogenesis of a myriad of cardiovascular diseases, yet the precise underlying mechanisms remain unclear. Current model utilises mechanical denudation of arteries resulting in an arterial-injury model with onset of intimal hyperplasia (IH). Our study shows that 5 min enzymatic denudation of human umbilical artery (hUA) lumen at 37 °C efficiently denudes hUA while maintaining vessel integrity without significantly increase intima-media thickness after 7 days in culture. This ex-vivo model will be a valuable tool in understanding the mechanism of re-endothelialization prior to smooth muscle cells (SMC) activation thus placating IH at an early stage.
Institutions, violent conflict, windfall gains and economic development in Africa

Empirical evidence suggests that governance quality is a key driver of economic growth and that, in turn, higher incomes might have a positive causal effect on the quality of governance. Such complementarity could invite virtuous cycles of development. Using a measure of corruption as our proxy for the quality of governance, and rainfall as an instrument for income, we explore this issue and find evidence to the contrary. For a panel of African countries, positive income shocks on average tend to invite extra corruption. Closer inspection, however, reveals that this result can be attributed to the most corrupt countries. Conversely, countries with a sufficiently low level of corruption can escape the detrimental effect of income booms on corruption and may actually experience a virtuous cycle of development. Publication Information: Voors, M.J., Bulte, E.H. and R. Damania, 2011. Higher Incomes and Corruption in Africa: Does a Virtuous Cycle exist? , Journal of African Economies, 20 (3): 395-418
Deep Brain Stimulation Lead Localization Variability Comparing Intraoperative MRI Versus Postoperative Computed Tomography

BACKGROUND AND OBJECTIVES: Commercially available lead localization software for deep brain stimulation (DBS) often relies on postoperative computed tomography (CT) scans to define electrode positions. When cases are performed with intraoperative MRI, another imaging set exists with which to perform these localizations. To compare DBS localization error between postoperative CT scans and intraoperative MRI. METHODS: A retrospective cohort of patients who underwent MRI-guided placement of DBS electrodes using the ClearPoint platform was identified. Using Brainlab Elements, postoperative CT scans were coregistered to intraoperative magnetic resonance images visualizing the ClearPoint guidance sheaths and ceramic stylets. DBS electrodes were identified in CT scans using Brainlab's lead localization tool. Trajectory and vector errors were quantified between scans for each lead in each patient. RESULTS: Eighty patients with a total of 157 implanted DBS electrodes were included. We observed mean trajectory and vector errors of 0.78 ± 0.44 mm (range 0.1-2.0 mm) and 1.57 ± 0.79 mm (range 0.2-4.2 mm), respectively, between postoperative CT and intraoperative MRI. There were 7 patients with CT scans collected at multiple time points. Trajectory error increased by 0.15 ± 0.42 mm (P = .31), and vector error increased by 0.22 ± 0.53 mm (P = .13) in the later scans. Across all scans, there was no significant association between trajectory (P = .053) or vector (P = .98) error and the date of CT acquisition. DBS electrodes targeting the subthalamic nucleus had significantly greater trajectory errors (P = .02) than those targeting the globus pallidus pars internus nucleus. CONCLUSION: Commercially available software produced largely concordant lead localizations when comparing intraoperative MRIs with postoperative CT scans, with trajectory errors on average <1 mm. CT scans tend to be more comparable with intraoperative MRI in the immediate postoperative period, with increased time intervals associated with a greater magnitude of error between modalities.
Anti-thrombotics and major adverse cardiovascular events in anti-phospholipid syndrome: a cross-sectional study using the 2016–2018 National Inpatient Sample database

Objective This study assessed the relationship between anti-thrombotics and major adverse cardiovascular events (MACE) in patients with anti-phospholipid syndrome (APS). Method We included 13 947 subjects with APS from the National (Nationwide) Inpatient Sample (NIS) database for 2016–2018, and collected relevant covariates and demographic data using ICD-10 codes. Our two primary outcomes were MACE and death. We performed multivariate logistic regression analysis to assess the impact of various anti-thrombotic regimens on MACE/death in our primary cohort and high-risk subgroups. Results Patients on anti-coagulants had significantly reduced odds of MACE [odds ratio (OR) 0.68, 95% confidence interval (CI) 0.62–0.76, p < 0.001] as well as each of its subcomponents. Those not on any anti-coagulants had significantly increased odds of MACE (OR 1.47, 95% CI 1.24–1.72, p < 0.001). No significant association was found between anti-platelet use and the odds of MACE (p > 0.05). Patients on anti-coagulants were the only class that appeared to have a mortality benefit with reduced odds for death (OR 0.64, 95% CI 0.49–0.84, p = 0.001). In the subgroups at higher risk for MACE (those with atrial fibrillation and thrombocytopenia), full anti-coagulation therapy was also the only anti-thrombotic class that significantly affected the odds of MACE, with a protective effect on MACE, but had no mortality benefit. Conclusion Patients with APS are most likely to benefit from anti-coagulant therapy in reducing MACE. Furthermore, anti-platelets alone or in combination with anti-coagulants are probably not beneficial in MACE reduction and may even increase risk.
Rivaroxaban Versus Low-Molecular-Weight Heparins in a Broad Cohort of Patients With Cancer-Associated Venous Thromboembolism: An Analysis of the OSCAR-US Program

Cancer-associated venous thromboembolism (CAT) guidelines recommend direct oral anticoagulants as alternatives to low-molecular-weight heparin (LMWH) in most patients. This study compared the effectiveness and safety of rivaroxaban versus LMWH for a broad CAT cohort. The cohort study used electronic health data from January 2012 to December 2020 to evaluate patients with active cancer experiencing acute venous thromboembolism (VTE) and treated with rivaroxaban or LMWH. Propensity score-overlap weighted hazard ratios (HRs) and 95% confidence intervals (CIs) for VTE, bleeding-related hospitalization, and all-cause mortality were calculated. In total, 4935 patients were identified (27.9% on rivaroxaban and 72.1% on LMWH). The cancer types included gastrointestinal (29.4%), genitourinary (26.2%), lung (24.0%), breast (19.7%), and hematologic (14.4%). Rivaroxaban was associated with a reduction in recurrent VTE versus LMWH among all patients with cancer (HR = 0.78; 95%CI = 0.61-0.99) at 3 months. No differences in bleeding-related hospitalization or all-cause mortality were observed. Directionally similar results to those at 3 months were observed at 6 months for all outcomes. In conclusion, we observed fewer recurrent VTE cases and no increase in bleeding-related hospitalizations with rivaroxaban versus LMWH at 3 months in this patient cohort with various cancer types.
Canagliflozin mediates tumor suppression alone and in combination with radiotherapy in non‐small cell lung cancer (NSCLC) through inhibition of HIF‐1α

Non‐small cell lung cancer (NSCLC) has a poor prognosis, and effective therapeutic strategies are lacking. The diabetes drug canagliflozin inhibits NSCLC cell proliferation and the mammalian target of rapamycin (mTOR) pathway, which mediates cell growth and survival, but it is unclear whether this drug can enhance response rates when combined with cytotoxic therapy. Here, we evaluated the effects of canagliflozin on human NSCLC response to cytotoxic therapy in tissue cultures and xenografts. Ribonucleic acid sequencing (RNA‐seq), real‐time quantitative PCR (RT‐qPCR), metabolic function, small interfering ribonucleic acid (siRNA) knockdown, and protein expression assays were used in mechanistic analyses. We found that canagliflozin inhibited proliferation and clonogenic survival of NSCLC cells and augmented the efficacy of radiotherapy to mediate these effects and inhibit NSCLC xenograft growth. Canagliflozin treatment alone moderately inhibited mitochondrial oxidative phosphorylation and exhibited greater antiproliferative capacity than specific mitochondrial complex‐I inhibitors. The treatment downregulated genes mediating hypoxia‐inducible factor (HIF)‐1α stability, metabolism and survival, activated adenosine monophosphate‐activated protein kinase (AMPK) and inhibited mTOR, a critical activator of hypoxia‐inducible factor‐1α (HIF‐1α) signaling. HIF‐1α knockdown and stabilization experiments suggested that canagliflozin mediates antiproliferative effects, in part, through suppression of HIF‐1α. Transcriptional regulatory network analysis pinpointed histone deacetylase 2 (HDAC2), a gene suppressed by canagliflozin, as a key mediator of canagliflozin's transcriptional reprogramming. HDAC2 knockdown eliminated HIF‐1α levels and enhanced the antiproliferative effects of canagliflozin. HDAC2‐regulated genes suppressed by canagliflozin are associated with poor prognosis in several clinical NSCLC datasets. In addition, we include evidence that canagliflozin also improves NSCLC response to chemotherapy. In summary, canagliflozin may be a promising therapy to develop in combination with cytotoxic therapy in NSCLC.
Multifaceted roles of T cells in obesity and obesity‐related complications: A narrative review

Obesity is characterized by chronic low‐grade inflammatory responses in the adipose tissue, accompanied by pronounced insulin resistance and metabolic anomalies. It affects almost all body organs and eventually leads to diseases such as fatty liver disease, type 2 diabetes mellitus, and atherosclerosis. Recently, T cells have emerged as interesting therapeutic targets because the dysfunction of T cells and their cytokines in the adipose tissue is implicated in obesity‐induced inflammation and their complicated onset. Although several recent narrative reviews have provided a brief overview of related evidence in this area, they have mainly focused on either obesity‐associated T cell metabolism or modulation of T cell activation in obesity. Moreover, at present, no published review has reported on the multifaceted roles of T cells in obesity and obesity‐related complications, even though there has been a significant increase in studies on this topic since 2019. Therefore, this narrative review aims to comprehensively summarize current advances in the mechanistic roles of T cells in the development of obesity and its related complications. Further, we aim to discuss relevant drugs for weight loss as well as the contradictory role of T cells in the same disease so as to highlight key findings regarding this topic and provide a valid basis for future treatment strategies.
Personal health behaviors and physical activity and nutrition counseling by nurse practitioners: An online survey

Supplemental Digital Content is Available in the Text. ABSTRACT Background: Healthy lifestyle counseling improves nutritional intake and participation in exercise, yet the rate of patient counseling varies and clinicians' personal behaviors can influence counseling practices. Purpose: This cross-sectional study evaluated lifestyle counseling by nurse practitioners (NPs) and the relationship between their personal behaviors and patient counseling. Methodology: Practicing NPs (N = 1,220) completed an online survey regarding personal behaviors and counseling for healthy body weight, moderate-vigorous physical activity, muscle strengthening, fruit and vegetable consumption, and dietary protein. Results: The majority reported counseling “usually” or “often” for healthy weight (54%), moderate-vigorous physical activity (53%), and fruits/vegetables (57%), whereas only 44% and 17% reported “usually” or “often” counseling for dietary protein and muscle strengthening. When NPs did not personally engage in the behavior, the odds for counseling were significantly reduced: NPs were 21% less likely to counsel for moderate-vigorous physical activity (odds ratio [OR] = 0.79 [0.65–0.97], p = .026), 27% less likely to counsel for muscle strengthening (OR = 0.73 [0.60–0.90], p = .004), 57% less likely to counsel for fruit/vegetable consumption (OR = 0.43 [0.35–0.54], p < .001), and 72% less likely to counsel for dietary protein (OR = 0.28 [0.18–0.45], p < .001). Personal body mass index did not predict counseling for a healthy weight. Conclusion: Although NPs report regular patient counseling regarding healthy lifestyle behaviors, the odds for counseling are increased approximately 20–75% when they engage in the behaviors themselves. Implications: Promotion of healthy behaviors during professional education may have long-term implications for preventive health counseling.
Hierarchies in the energy budget: Thyroid hormones and the evolution of human life history patterns

The evolution of human life history characteristics required dramatic shifts in energy allocation mechanisms compared with our primate ancestors. Thyroid hormones, such as thyroxine (T4) and triiodothyronine (T3), are sensitive to energy balance, and are significant determinants for both tissue‐specific and whole‐body metabolic rate. Thus, thyroid hormones are in part responsible for setting the body's overall energy budget and likely played an important role in the evolution of human life history patterns. We propose that the dynamics of mammalian T3 production, uptake, and action have evolved so that energy allocation prioritizes the high demands of brain development and functioning, often at the expense of growth and reproduction. This paper explores the role of thyroid hormone dynamics in the evolution of human encephalization, prolonged childhood and adolescence, long lifespans, reproduction, and human aging.