Miracle-dz/UniFAR-FTUs huggingface dataset:
The Relationship between Neutrophil Lymphocyte Ratio and Platelet Lymphocyte Ratio to Degree of Activity in Systemic Lupus Erythematosus

Background: Systemic lupus erythematosus is a chronic autoimmune inflammatory disease with a wide spectrum of clinical and serological manifestations caused by autoantibody production, complement activation, and immune complex deposition. Several studies have shown that the neutrophil-lymphocyte ratio and the platelet-lymphocyte ratio are closely correlated with systemic lupus erythematosus and its disease activity so that they can be used as diagnostic indicators and monitoring of systemic lupus erythematosus. Objective: To determine the relationship between the ratio of neutrophil lymphocytes and the ratio of platelets to lymphocytes on the degree of activity of lupus disease in patients with systemic lupus erythematosus. Methods: This is an observational analytic study using medical record data from central installation patients at H. Adam Malik Hospital in the period January to December 2019. The sample was calculated using the unpaired comparative sample size formula for more than two groups of one measurement. Then the distribution test was carried out with the Shapiro Wilk test. Bivariate analysis was conducted to determine the relationship between the ratio of neutrophil lymphocytes and the ratio of platelets to lymphocytes with the MEX SLEDAI score using the ANOVA test if the data were normally distributed, or the Kruskal-Wallis test if the data was not normally distributed. Then proceed with the Mann-Whitney post hoc test to see which groups have differences. The sum of deviations (α) is 0.05, statistically significant if p<0.05. Results: 120 subjects participated in the study and 33 people (27.5%) had mild systemic lupus erythematosus, 47 (39.2%) moderate degrees, and 40 people (33.3%) severe degrees. Conclusion: The neutrophil-lymphocyte ratio and the platelet-lymphocyte ratio are associated with the degree of lupus activity in patients with systemic lupus erythematosus. Keywords: neutrophil-lymphocyte ratio, platelet lymphocyte ratio, systemic lupus erythematosus.
Comparison of Thyroid Imaging Reporting and Data Systems in Malignancy Risk Stratification of Indeterminate Thyroid Nodules

Corresponding author: Bo Hyun Kim Department of Internal Medicine, Pusan National University School of Medicine and Biomedical Research Institute, 179 Gudeok-ro, Seo-gu, Busan 49241, Korea Tel: +82-51-240-7678, Fax: +82-51-254-3237, E-mail: pons71@hanmail.net Copyright © 2021 Korean Endocrine Society This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/ licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Comparison of Thyroid Imaging Reporting and Data Systems in Malignancy Risk Stratification of Indeterminate Thyroid Nodules
Experiences of nursing students regarding clinical placement and support in primary healthcare clinics: Strengthening resilience

Background This research addressed the need to have a deeper understanding of nursing students’ experiences of clinical placement and support in primary healthcare (PHC) settings. Aim To explore and describe the experiences of nursing students’ clinical placement in PHC settings. Setting The study was conducted at PHC clinics in a specific province in South Africa. Method A qualitative, exploratory, descriptive and contextual research design was used. The population comprised fourth-year nursing students selected using purposive sampling. Five semi-structured focus group interviews were conducted. Data saturation determined the sample size which comprised 25 nursing students. Thematic data analysis produced four main themes. Results The main themes were (1) the meaning of placement, (2) experiences of clinical placement, (3) needs for support, and (4) resilience of nursing students. Conclusions Nursing students encountered negative and positive experiences. Both experiences confirmed that PHC settings can be valuable learning opportunities for nursing students. Nursing students appreciated the supervision of professional nurses who created an atmosphere conducive for teaching and learning by welcoming and encouraging nursing students’ independence. Recommendations include: appointing a professional nurse specifically for supervision of nursing students, tutor support before summative examinations, improvement of services, including the availability of resources. Contribution This article contributes to awareness of how nursing students manage to stay resilient irrespective of negative experiences during clinical placement and how tutors and professional nurses can support them. The study’s recommendations can guide professional nurses, nurse educators, nurse managers and other healthcare PHC workers to support nursing students.
Role of Deep Learning in Predicting Aging-Related Diseases: A Scoping Review

Aging refers to progressive physiological changes in a cell, an organ, or the whole body of an individual, over time. Aging-related diseases are highly prevalent and could impact an individual’s physical health. Recently, artificial intelligence (AI) methods have been used to predict aging-related diseases and issues, aiding clinical providers in decision-making based on patient’s medical records. Deep learning (DL), as one of the most recent generations of AI technologies, has embraced rapid progress in the early prediction and classification of aging-related issues. In this paper, a scoping review of publications using DL approaches to predict common aging-related diseases (such as age-related macular degeneration, cardiovascular and respiratory diseases, arthritis, Alzheimer’s and lifestyle patterns related to disease progression), was performed. Google Scholar, IEEE and PubMed are used to search DL papers on common aging-related issues published between January 2017 and August 2021. These papers were reviewed, evaluated, and the findings were summarized. Overall, 34 studies met the inclusion criteria. These studies indicate that DL could help clinicians in diagnosing disease at its early stages by mapping diagnostic predictions into observable clinical presentations; and achieving high predictive performance (e.g., more than 90% accurate predictions of diseases in aging).
Diabetes Mellitus and Its Impact on Patient-Profile and In-Hospital Outcomes in Peripheral Artery Disease

Background: In patients with peripheral artery disease (PAD), the impact of diabetes mellitus (DM) on patient-profile and adverse in-hospital events is not well investigated. Methods: The German nationwide inpatient sample 2005–2019 was used for this analysis. Hospitalized PAD patients were stratified for DM and the influence of DM on patient-profile and adverse in-hospital events was investigated. Results: Our study comprised 2,654,871 hospitalizations (54.3% aged ≥70 years, 36.7% females) of patients with PAD in Germany 2005–2019. Among these, 864,691 (32.6%) patients had DM and 76,716 (2.9%) died during hospitalization. Diabetic PAD patients revealed an aggravated cardiovascular profile (Charlson Comorbidity Index: 6.0 (5.0–8.0) vs. 4.0 (3.0–5.0), p < 0.001). PAD patients with DM showed a higher rate of in-hospital mortality (3.5% vs. 2.6%, p < 0.001), as well as major adverse cardiovascular and cerebrovascular events (MACCE, 4.7% vs. 3.3%, p < 0.001) and had more often operated with amputation surgery (16.4% vs. 9.1%, p < 0.001). DM was an independent predictor of in-hospital mortality (OR 1.077 (95%CI 1.060–1.093), p < 0.001) and MACCE (OR 1.118 (95%CI 1.103–1.133), p < 0.001). In addition, amputations were also associated with DM (OR 1.804 (95%CI 1.790–1.818)), p < 0.001). Conclusions: DM is associated with an unfavorable clinical patient-profile and higher risk for adverse events in PAD patients, including substantially increased in-hospital mortality as well as MACCE rate, and were more often associated with amputation surgeries.
Kinetics of Hydrothermal Furfural Production from Organosolv Hemicellulose and d-Xylose

Organosolv pulping processes are able to generate liquid hemicellulose fractions with a low cellulose and lignin content. Utilization of such streams is promising for production of high-value chemicals. In this study, on the basis of three reaction models, kinetics of an aqueous organosolv hemicellulose and d-xylose conversion into furfural was examined at temperatures between 160 and 200 °C using a continuous tube reactor. Furthermore, furfural degradation was investigated to consider the self-polymerization. Results were compared with previous studies and differences are discussed. Kinetic models showed slight differences for d-xylose conversion and stronger deviations for furfural formation. Overall, model 3, which includes the formation of a xylose intermediate, showed the best performance concerning the experimental results. Differences between d-xylose and organosolv hemicellulose conversion can be attributed mainly to sugar oligomers.
An ionic liquid as a potential multifunctional lubricating oil additive

Abstract Homopolymer of decyl acrylate was synthesized and blended with phosphonium based ionic liquid and their characterisation was carried out by spectral method (NMR, IR), thermogravimetric analysis and gel permeation chromatography (GPC). Performance of these blends were evaluated by standard ASTM method in base oil which clearly indicates that the blend effectively act as anti-wear agent and also pour point depressants and viscosity modifiers. A comparison of their performances with homopolymer has also been evaluated and reported.
USAGE PATTERNS OF SACROILIAC JOINT INJECTIONS - A COMPARATIVE
EVALUATION OF PRE AND POST AFFORDABLE CARE ACT IN MEDICARE
POPULATION

Background: The sacroiliac joints (SIJ) have been implicated as highly prevalent, pervasive, expensive, causes of chronic low back pain. The utilization of SIJ injections is escalating. A recent analysis demonstrated a reversal of growth of utilization patterns of interventional techniques post passage of the Affordable Care Act (ACA). Bearing that in mind, SIJ injections along with facet joint interventions seem to have increased modestly in that same period. Study Design: Analysis of growth patterns of SIJ injections from 2000 to 2016 with comparative analysis of pre- and post- ACA. Objectives: To assess utilization patterns of SIJ injections from 2000 to 2016. Methods: The Centers for Medicare and Medicaid Services (CMS) Physician/Supplier Procedure Summary (PSPS) Master dataset was utilized in this analysis. Results: The results of the evaluation from 2000 to 2016 showed, 11.7% increase from 2009 to 2016, with an annual increase of 1.6% per 100,000 Medicare population compared to an increase of 299.8% from 2000 to 2009 with annual increase of 16.6%. Limitations: The limitations of this study included a lack of inclusion of Medicare Advantage patients and the possibility that state claims data may include claims from other states. As with all claims based data analyses, this study is retrospective and thus potentially limited by bias. Finally, patients who are self or commercially insured are not part of the dataset. Conclusions: Study shows dampened increase in utilization patterns of SIJ injections from 2009 to 2016 as compared with a like time period prior. Key words: Chronic spinal pain, low back pain, sacroiliac joint arthritis, interventional techniques, interventional pain management, sacroiliac joint injections
The Role of Glucocorticoids in Inflammatory Diseases

For more than 70 years, glucocorticoids (GCs) have been a powerful and affordable treatment option for inflammatory diseases. However, their benefits do not come without a cost, since GCs also cause side effects. Therefore, strong efforts are being made to improve their therapeutic index. In this review, we illustrate the mechanisms and target cells of GCs in the pathogenesis and treatment of some of the most frequent inflammatory disorders affecting the central nervous system, the gastrointestinal tract, the lung, and the joints, as well as graft-versus-host disease, which often develops after hematopoietic stem cell transplantation. In addition, an overview is provided of novel approaches aimed at improving GC therapy based on chemical modifications or GC delivery using nanoformulations. GCs remain a topic of highly active scientific research despite being one of the oldest class of drugs in medical use.
The “Need for Chaos” and Motivations to Share Hostile Political Rumors

Why are some people motivated to circulate hostile political information? While prior studies have focused on partisan motivations, we demonstrate that some individuals circulate hostile rumors because they wish to unleash chaos to “burn down” the entire political order in the hope they gain status in the process. To understand this psychology, we theorize and measure a novel psychological state, the Need for Chaos, emerging in an interplay of social marginalization and status-oriented personalities. Across eight studies of individuals living in the United States, we show that this need is a strong predictor of motivations to share hostile political rumors, even after accounting for partisan motivations, and can help illuminate differences and commonalities in the frustrations of both historically privileged and marginalized groups. To stem the tide of hostility on social media, the present findings suggest that real-world policy solutions are needed to address social frustrations in the United States.
Growth and gas exchanges in soursop under irrigation with saline water and nitrogen sources

ABSTRACT Nitrogen (N) fertilization has been tested for the mitigation of salt stress in some species including fruit crops. However, special attention should be paid to the source of N, due to the different compositions and saline indices of the fertilizers, particularly when irrigation is conducted using waters with salinity levels that are restrictive to agriculture. Thus, this study evaluated the effect of fertilization with N sources on the growth and gas exchanges of soursop irrigated with saline water after transplanting. The experiment was carried out in greenhouse at the Center of Technology and Natural Resources of the Federal University of Campina Grande, and treatments were arranged in randomized blocks, in 4 x 4 factorial scheme, corresponding to electrical conductivity of water - 0.5, 1.1, 2.5 and 3.5 dS m-1, and the N sources urea, ammonia sulfate, calcium nitrate and potassium nitrate, with three replicates. Growth and gas exchanges of soursop at 110 days after transplanting were not influenced by either the interaction between water salinity and N sources or the individual action of N, but were inhibited by the increase in water salinity from 0.5 dS m-1. Increasing water salinity inhibited stomatal opening and carboxylation in the leaves.
Meal Patterns and Food Choices of Female Rats Fed a Cafeteria-Style Diet Are Altered by Gastric Bypass Surgery

After Roux-en-Y gastric bypass surgery (RYGB), rats tend to reduce consumption of high-sugar and/or high-fat foods over time. Here, we sought to investigate the behavioral mechanisms underlying these intake outcomes. Adult female rats were provided a cafeteria diet comprised of five palatable foodstuffs varying in sugar and fat content and intake was monitored continuously. Rats were then assigned to either RYGB, or one of two control (CTL) groups: sham surgery or a nonsurgical control group receiving the same prophylactic iron treatments as RYGB rats. Post-sur-gically, all rats consumed a large first meal of the cafeteria diet. After the first meal, RYGB rats reduced intake primarily by decreasing the meal sizes relative to CTL rats, ate meals more slowly, and displayed altered nycthemeral timing of intake yielding more daytime meals and fewer nighttime meals. Collectively, these meal patterns indicate that despite being motivated to consume a cafeteria diet after RYGB, rats rapidly learn to modify eating behaviors to consume foods more slowly across the entire day. RYGB rats also altered food preferences, but more slowly than the changes in meal patterns, and ate proportionally more energy from complex carbohydrates and protein and proportionally less fat. Overall, the pattern of results suggests that after RYGB rats quickly learn to adjust their size, eating rate, and distribution of meals without altering meal number and to shift their macronutrient intake away from fat; these changes appear to be more related to postingestive events than to a fundamental decline in the palatability of food choices.
Finny Merchandise: The Atlantic Cod (Gadus morhua) Trade in Gold Rush–Era San Francisco, California

During California’s Gold Rush of 1849–1855, thousands of miners rushed to San Francisco, Sacramento, and elsewhere throughout northern California, creating a significant demand for food. Here we investigate the role of Atlantic cod (Gadus morhua) and Pacific cod (G. macrocephalus) during the Gold Rush era using historical records, ancient DNA, and vertebral morphology in the cod assemblage recovered from Thompson’s Cove (CA-SFR-186H), a Gold Rush–era site in San Francisco. From the 18 cod bones recovered from Thompson’s Cove, our analysis of five specimens for ancient DNA indicates that Atlantic cod were imported during the 1850s, likely as a (largely) deboned, dried and salted product from the East Coast of the United States. Curiously, while locally available in very deep waters off the California coast, Pacific cod were minimally fished during the 1850s and became abundantly available in the 1860s after an Alaska-based fishery developed.
Machine Learning Prediction Models for Mortality in Intensive Care Unit Patients with Lactic Acidosis

Background: Lactic acidosis is the most common cause of anion gap metabolic acidosis in the intensive care unit (ICU), associated with poor outcomes including mortality. We sought to compare machine learning (ML) approaches versus logistic regression analysis for prediction of mortality in lactic acidosis patients admitted to the ICU. Methods: We used the Medical Information Mart for Intensive Care (MIMIC-III) database to identify ICU adult patients with lactic acidosis (serum lactate ≥4 mmol/L). The outcome of interest was hospital mortality. We developed prediction models using four ML approaches consisting of random forest (RF), decision tree (DT), extreme gradient boosting (XGBoost), artificial neural network (ANN), and statistical modeling with forward stepwise logistic regression using the testing dataset. We then assessed model performance using area under the receiver operating characteristic curve (AUROC), accuracy, precision, error rate, Matthews correlation coefficient (MCC), F1 score, and assessed model calibration using the Brier score, in the independent testing dataset. Results: Of 1919 lactic acidosis ICU patients, 1535 and 384 were included in the training and testing dataset, respectively. Hospital mortality was 30%. RF had the highest AUROC at 0.83, followed by logistic regression 0.81, XGBoost 0.81, ANN 0.79, and DT 0.71. In addition, RF also had the highest accuracy (0.79), MCC (0.45), F1 score (0.56), and lowest error rate (21.4%). The RF model was the most well-calibrated. The Brier score for RF, DT, XGBoost, ANN, and multivariable logistic regression was 0.15, 0.19, 0.18, 0.19, and 0.16, respectively. The RF model outperformed multivariable logistic regression model, SOFA score (AUROC 0.74), SAP II score (AUROC 0.77), and Charlson score (AUROC 0.69). Conclusion: The ML prediction model using RF algorithm provided the highest predictive performance for hospital mortality among ICU patient with lactic acidosis.
Comprehensive Diagnostic Criteria for MELAS Syndrome; a Case Study Involving an Elderly Patient With MT-TWm.5541C>T Mutation

Introduction: The mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) syndrome is a matrilineal hereditary multisystem disease caused by mutations in the mitochondrial DNA. Although the initial diagnostic criteria correlate with a range of clinical phenotypes, including clinical onset after the age of 40, there is still lack of a unified single diagnostic standard for MELAS. Case Report: A 71-year-old female patient with recurrent stroke was reported. Magnetic resonance imaging showed a cerebral gyrus-like diffusion weighted imaging high signal lesion in the parietal-occipital lobe and the area of this lesion expanded with disease progression. The MRS result showed significantly inverted Lac/Lip peaks. The nucleic acid sequencing result displayed a MT-TWm.5541C>T mutation, and a 12.86% mutation rate in the blood sample. The patient had a 6-year history of type 2 diabetes. Conclusion: Patients with the MELAS syndrome may present with a variety of clinical manifestations. Our data demonstrated that, for patients with atypical cerebral infarction and suspected MELAS syndrome, gene sequencing and muscle biopsy should be performed in time. This case provides a reference for the diagnostic criteria of MELAS syndrome.
INTERFERON-FREE THERAPY IS NOT A TRIGGER FOR HEPATOCELLULAR CARCINOMA IN PATIENTS WITH CHRONIC INFECTION WITH HEPATITIS C VIRUS

The literature focused on data regarding the occurrence of hepatocellular carcinoma (HCC) after interferon (IFN)-free therapy is ambiguous. Researchers are preoccupied to find if the risk of developing liver cancer is related only to the therapy per se or it is influenced by a multitude of factors. We aimed to develop a local analysis of risk factors associated with HCC occurrence in patients with liver cirrhosis due to HCV (hepatitis C virus) infection treated with IFN-free therapy. We made an observational, retrospective study, between 2016 2019, on 188 cirrhotic patients with HCV infection, diagnosed, treated and followed-up by screening for HCC occurrence, using the recordings from the patient’s charts available in the archive of the Gastroenterology Lab, “Aquamed” Clinic, Constanța County, Romania. We noted the demographic, lab, imagistic data and treatment procedures applied, comparing two groups of patients: the IFN-free therapy group – 89 patients and the standard IFN therapy group – 99 patients. As statistic method, we used the SAS Cox proportional hazards regression procedure, in order to calculate the HR (hazard ratio) and CI (confidence interval) 95% for each parameter studied as risk factor involved in HCC occurrence. In the unadjusted model, there was estimated an increased risk in HCC occurrence in IFN-free therapy group compared to standard IFN therapy group (p = 0.0341). After adjustment for age, gender, severity of the disease, (Child-Pugh classification) or complications, there was not a statistically significant difference between IFN-free therapy group or IFN therapy group in order to develop HCC (hazard ratio = 0.05, p = 0.5038). Our observational study, even if made on a small number of patients, confirms that IFN-free therapy is safe, the benefits obtained covering the risks. Our study results did not find a link between IFN-free therapy and HCC occurrence over the known risk of liver cirrhosis, when taking into account multiple features of disease prior to treatment onset.