Miracle-dz/UniFAR-FTUs huggingface dataset:
Chronic venous disease, platelet and haemostatic abnormalities contribute to the pathogenesis of pigmented purpuric dermatoses

Background To investigate the aetiology of pigmented purpuric dermatoses (PPD). Methods 63 patients with a provisional diagnosis of PPD were assessed. Skin biopsies were performed to confirm the clinical diagnosis. Haemostasis was assessed using platelet function analyser-100 (PFA-100), light transmission aggregometry (LTA), impedance aggregometry (Multiplate) and measurement of clotting times and clotting factors. Chronic venous disease (CVD) was assessed by duplex ultrasound. When not contraindicated, patients were advised to discontinue haemostatic-modifying drugs or supplements for 4 weeks after which the laboratory measurements were repeated and the clinical resolution of PPD was assessed. Subsequently, a cohort of patients identified with CVD underwent endovenous interventions and further resolution of PPD was assessed. Results CVD was found in 48 patients (76.2%) while haemostatic abnormalities were found in 36 (57.1%). 30 patients (47.6%) had concurrent CVD and haemostatic abnormalities. Modifiable risk factors such as the intake of platelet inhibitors or other drugs and supplements such as fish oil were identified in 53 patients (84.1%). These could be ceased in 35 patients of whom 28 (80.0%) achieved either complete or partial resolution of PPD. Treatment of the underlying CVD was performed in 18 patients resulting in complete or partial resolution in 17 (94.4%). In seven patients (11.1%), no CVD or haemostatic abnormalities were identified, and the risk factors included dietary factors such as excessive caffeine or soft drink consumption. Conclusion Haemostatic abnormalities and CVD contribute to the pathogenesis of PPD. Resolution of PPD in the vast majority of patients may be achieved by cessation of modifiable risk factors and in particular platelet-modifying drugs or supplements and treatment of the underlying venous disease.
Correlates of Hospitalization for Methadone-Maintained Persons with Physical Health Problems

This cross-sectional study (n = 190) examined correlates of hospitalization for physical health problems among methadone maintenance therapy (MMT) clients with a history of alcohol abuse. The study was derived from baseline data collected for a longitudinal trial assessing the effect of motivational interviewing among alcohol-abusing adults undergoing MMT. The sample included clients who were 18–55 years of age, abusing alcohol, and receiving MMT from five large methadone maintenance clinics in the Los Angeles area. A structured questionnaire was used to collect the data. Correlates of hospitalization in logistic regression analysis included lack of social support, recent victimization, age of first alcohol use, chronic severe pain in the previous six months, not having children, and ethnicity. Identification of hospitalization risk factors among alcohol-abusing MMT clients is a first step to developing risk-reducing interventions designed to lower hospitalization rates in this population. this study is to examine the correlates of hospitalization among MMT clients. Identification of such correlates could lead to the development of interventions to promote health and treatment in community settings, such as MMT sites and thus reduce possibility of hospitalization. Potential correlates, which are theoretically based, include sociodemographic characteristics and health and health utilization factors.
Machine Learning for Predicting Discharge Disposition After Traumatic Brain Injury

BACKGROUND: Current traumatic brain injury (TBI) prognostic calculators are commonly used to predict the mortality and Glasgow Outcome Scale, but these outcomes are most relevant for severe TBI. Because mild and moderate TBI rarely reaches severe outcomes, there is a need for novel prognostic endpoints. OBJECTIVE: To generate machine learning (ML) models with a strong predictive capacity for trichotomized discharge disposition, an outcome not previously used in TBI prognostic models. The outcome can serve as a proxy for patients' functional status, even in mild and moderate patients with TBI. METHODS: Using a large data set (n = 5292) of patients with TBI from a quaternary care center and 84 predictors, including vitals, demographics, mechanism of injury, initial Glasgow Coma Scale, and comorbidities, we trained 6 different ML algorithms using a nested-stratified-cross-validation protocol. After optimizing hyperparameters and performing model selection, isotonic regression was applied to calibrate models. RESULTS: When maximizing the microaveraged area under the receiver operating characteristic curve during hyperparameter optimization, a random forest model exhibited top performance. A random forest model was also selected when maximizing the microaveraged area under the precision–recall curve. For both models, the weighted average area under the receiver operating characteristic curves was 0.84 (95% CI 0.81-0.87) and the weighted average area under the precision–recall curves was 0.85 (95% CI 0.82-0.88). CONCLUSION: Our group presents high-performing ML models to predict trichotomized discharge disposition. These models can assist in optimization of patient triage and treatment, especially in cases of mild and moderate TBI.
Georgia Southern University From the SelectedWorks of Yi Lin 2012 Log-Concavity and Symplectic Flows

Let (M,ω) be a compact, connected symplectic 2n-dimensional manifold on which an (n− 2)-dimensional torus T acts effectively and Hamiltonianly. Under the assumption that there is an effective complementary 2-torus acting on M with symplectic orbits, we show that the Duistermaat-Heckman measure of the T -action is log-concave. This verifies the logarithmic concavity conjecture for a class of inequivalent T -actions. Then we use this conjecture to prove the following: if there is an effective symplectic action of an (n − 2)-dimensional torus T on a compact, connected symplectic 2n-dimensional manifold that admits an effective complementary symplectic action of a 2-torus with symplectic orbits, then the existence of T -fixed points implies that the T -action is Hamiltonian. As a consequence of this, we give new proofs of a classical theorem by McDuff about S1-actions, and some of its recent extensions.
Components of interprofessional education programs in neonatal medicine: A focused BEME review: BEME Guide No. 73

Abstract Background Care delivery in neonatology is dependent on an interprofessional team. Collaborative learning and education amongst professionals can lead to successful management of critically ill patients. This focused BEME review synthesized the components, outcomes, and impact of such interprofessional education (IPE) programs in neonatal medicine. Methods The authors systematically searched four online databases and hand-searched MedEdPublish up to 10 September 2020. Two authors independently screened titles, abstracts, full-texts, performed data extraction and risk of bias assessment related to study methodology and reporting. Discrepancies were resolved by a third author. We reported our findings based on BEME guidance and the STORIES (STructured apprOach to the Reporting in health education of Evidence Synthesis) statement. Results We included 17 studies on IPE in neonatal medicine. Most studies were from North America with varying learners, objectives, instruction, and observed outcomes. Learners represented nurses, respiratory therapists, neonatal nurse practitioners, patient care technicians, parents, early interventionists, physicians, and medical trainees amongst others. Risk of bias assessment in reporting revealed poor reporting of resources and instructor training. Bias assessment for study methodology noted moderate quality evidence with validity evidence as the weakest domain. IPE instruction strategies included simulation with debriefing, didactics, and online instruction. Most studies reported level 1 Kirkpatrick outcomes (76%) and few reported level 3 or 4 outcomes (23%). Challenges include buy-in from leadership and the negative influence of hierarchy amongst learners. Conclusions This review highlights IPE program components within neonatal medicine and exemplary practices including a multimodal instructional approach, asynchronous instruction, an emphasis on teamwork, and elimination of hierarchy amongst learners. We identified a lack of reporting on program development and instructor training. Future work should address long term knowledge and skill retention and impact on patient outcomes and organizations.
Association Between Chronic Periodontal Disease and Erectile Dysfunction: A Case–Control Study

Erectile dysfunction (ED) and chronic periodontal disease (CPD) share mutual risk factors, and the incidence of ED is increasing among young adults. The relation of CPD and ED remains obscure due to inconsistent clinical evidence. This study aimed to further assess the relationship between CPD and ED using the Community Periodontal Index of Treatment Need (CPITN) and the International Index of Erectile Function (IIEF). Totally, 202 adult men were included, with 100 subjects with ED in the case group and 102 subjects without ED undergoing routine dental examinations in the control group. The IIEF questionnaire was used to assess the severity of ED, and CPD was assessed through the Community Periodontal Index (CPI) score. Periodontal assessments were performed by one single calibrated examiner. Logistic regression analysis was performed for the association between CPD and ED. After adjustment for age, smoking status, tooth brushing time, education level, monthly income, tooth brushing frequency, and gum bleeding, higher CPI score was identified to be associated with a greater risk of ED (odds ratio [OR] = 2.755, 95% confidence interval [CI] = [1.400, 5.423], p = .003), suggesting that CPD was positively associated with the odds of ED. CPD was getting more severe with the progress of ED (p < .05). Men with ED could be encouraged to receive routine dental examinations and appropriate preventive dental measures to maintain oral and periodontal health.
Utilizing the Analysis of Social Practices to Raise Critical Language Awareness in EFL Writing Courses

Language can be used as a means to control and influence people. EFL students need to realize that the language they interact with may contain ideological assumptions and propositional meanings. By increasing critical language awareness, students may come to recognize ideological assumptions within the language. Fairclough (2003) suggests that one of the ways to increase critical language awareness is to identify social practices, defined as rules and structures that limit human actions and interaction within a context. The elements of order of discourse– genre, discourse, and style—are the linguistic rules of social practices. The goal of this study was to provide a method for EFL teachers to increase students’ critical awareness through writing. The participants consisted of 16 teacher trainees and 10 university students who performed a journal-writing task over 10 sessions. Feedback, based on the elements of order of discourse, was provided after each session, and the participants were asked to consider the feedback for their next journal entry. After 10 sessions, the journals were quantified and regression analysis was used to calculate the slope polarity of the best fitting line. The results indicate that the scores of the majority of the participants increased.
Evaluation of cerebral cortex viscoelastic property estimation with nonlinear inversion magnetic resonance elastography

Objective. Magnetic resonance elastography (MRE) of the brain has shown promise as a sensitive neuroimaging biomarker for neurodegenerative disorders; however, the accuracy of performing MRE of the cerebral cortex warrants investigation due to the unique challenges of studying thinner and more complex geometries. Approach. A series of realistic, whole-brain simulation experiments are performed to examine the accuracy of MRE to measure the viscoelasticity (shear stiffness, μ, and damping ratio, ξ) of cortical structures predominantly effected in aging and neurodegeneration. Variations to MRE spatial resolution and the regularization of a nonlinear inversion (NLI) approach are examined. Main results. Higher-resolution MRE displacement data (1.25 mm isotropic resolution) and NLI with a low soft prior regularization weighting provided minimal measurement error compared to other studied protocols. With the optimized protocol, an average error in μ and ξ was 3% and 11%, respectively, when compared with the known ground truth. Mid-line structures, as opposed to those on the cortical surface, generally display greater error. Varying model boundary conditions and reducing the thickness of the cortex by up to 0.67 mm (which is a realistic portrayal of neurodegenerative pathology) results in no loss in reconstruction accuracy. Significance. These experiments establish quantitative guidelines for the accuracy expected of in vivo MRE of the cortex, with the proposed method providing valid MRE measures for future investigations into cortical viscoelasticity and relationships with health, cognition, and behavior.
Iron‐induced NCOA4 condensation regulates ferritin fate and iron homeostasis

Iron is not only essential but also a toxic trace element. Under iron repletion, ferritin maintains cellular iron homeostasis by storing iron to avoid iron toxicity. Under iron depletion, the ferritin‐specific autophagy adaptor NCOA4 delivers ferritin to lysosomes via macroautophagy to enable cells to use stored iron. Here, we show that NCOA4 also plays crucial roles in the regulation of ferritin fate under iron repletion. NCOA4 forms insoluble condensates via multivalent interactions generated by the binding of iron to its intrinsically disordered region. This sequesters NCOA4 away from ferritin and allows ferritin accumulation in the early phase of iron repletion. Under prolonged iron repletion, NCOA4 condensates can deliver ferritin to lysosomes via a TAX1BP1‐dependent non‐canonical autophagy pathway, thereby preventing relative iron deficiency due to excessive iron storage and reduced iron uptake. Together, these observations suggest that the NCOA4‐ferritin axis modulates intracellular iron homeostasis in accordance with cellular iron availability.
Minimally Invasive Esophagectomy Is Associated with Superior Survival Compared to Open Surgery

Introduction Minimally invasive esophagectomy (MIE) has not been associated with a long-term survival advantage compared to open esophagectomy (OE). We investigated survival differences between MIE, including laparoscopic and robotic, and OE. Methods Patients undergoing esophagectomy from 2010 to 2014 with T1-4N0-3M0, adenocarcinoma or squamous cell histology, in middle or lower esophagus were queried from the National Cancer Database and stratified into groups based on their surgical procedure: robotic, laparoscopic, or OE. Propensity matching (1:1) was done between robotic and laparoscopic to produce an MIE group. The MIE group was matched to OE yielding a 1:1:2 matching of robotic:laparoscopic:OE. Postoperative outcomes and survival (Kaplan-Meier) were compared between groups. Results Prior to matching, 7,163 patients met inclusion criteria and a greater portion underwent OE (67.7%) than MIE (laparoscopic 24.9% and robotic 7.4%). Matching yielded similar groups (robotic = 527, laparoscopic = 527, and OE =1054). Compared to OE, MIE patients had a significantly greater number of nodes sampled and trended toward increased R0 resections (96.1% vs 94.3%, P = .053). OE was associated with a longer median postoperative stay (10 vs 9 days, P = .001). Mortality at 30 and 90 days was similar. However, postoperative survival for MIE was significantly greater than OE (P < .001). No survival difference existed between robotic and laparoscopic (P = .723). Conclusions MIE is associated with increased number of nodes examined and a shorter postoperative length of stay. After propensity matching, patients undergoing MIE had better long but not short-term survival than OE. This benefit seems to be independent of the use of robotic technology.
Caregiver Distress in Home Palliative Care

Aim: This study aims to determine the symptom burden of caregivers who were following their loved ones at home and factors associated with this burden. Methods: From a consecutive number of patients followed at home by a specialistic palliative care team, a sample of 46 couples of patients-caregivers was screened. Epidemiological data of both patients and caregivers were collected, also including some variables, such as the level of religiousness, education, economic conditions, and financial distress. The Edmonton Symptom Assessment System (ESAS) was measured in both patients and caregivers. Caregivers were asked to provide a comment in a semi-structured interview, about “what do you think of your loved one’s suffering? ” They were also invited to release any further comment. Results: Caregivers’ symptom burden was relevant. Sleep disturbances were even more relevant in caregivers. Caregivers with a lower level of education and financial distress experienced more global symptom burden. Caregivers manifested a deep sense of injustice and gripes regarding previous hospitalizations. Conclusion: There is an association between patient-reported severity of symptoms and caregiver symptoms. These data suggest delivering support to those caregivers who express higher levels of symptoms. There is a need for further research to explore the possible interventions to mitigate caregivers’ symptom burden.
The Effects of Colchicine on the Histopathological Findings of Celiac Disease During Familial Mediterranean Fever Treatment

Familial mediterranean fever (FMF) and Celiac Disease (CD) are both autoinflammatory and autoimmune diseases with common clinical features affecting the gastrointestinal system. Familial mediterranean fever may coexist with CD. Inflammatory cells and cytokines are up-regulated within the intestinal mucosa of patients with CD. In this perspective, lymphocyte infiltration to the lamina propria of the small intestinal mucosa is a critical pathological sign. In the present study, we aimed to find out whether the treatment of an FMF patient with colchicine affects the pathological signs of concomitant developed CD on the same patient. We retrospectively reviewed the medical records of 147 patients with FMF who were followed up in our center between 2015 and 2020. Of the 147 patients with FMF, 3 patients also had CD. In this report, we presented these 3 cases. The findings obtained in this study suggest that pathological findings may be misinterpreted in autoimmune diseases, such as CD, when patients administer anti-inflammatory treatments, such as colchicine.
Selective recovery of nickel from stainless steel pickling sludge with NH3-(NH4)2CO3 leaching system

ABSTRACT The recovery of valuable metals from stainless steel pickling sludge(SSPS) has great economic and environmental benefits. In this study, a new method is proposed for selective recovery of nickel from SSPS by NH3-(NH4)2CO3 ammonia leaching system. The Eh-pH diagram was used to analyze Ni, Fe, Cr leaching behavior during the ammonia leaching process. Nickel can be leached as the complex [Ni(NH3)n]2+, whereas Fe and Cr remain as precipitates in the leaching slag. The effects of NH3·H2O concentration, liquid–solid ratio, reaction temperature, and reaction time on the leaching efficiency of nickel in the ammonia leaching system were analyzed and optimized by single-factor study and response surface analysis, and the kinetics were analyzed. The optimal conditions for Ni leaching were found to be 28.28 min, 54.07 °C, a liquid–solid ratio of 23.7:1, and NH3·H2O concentration of 5.10 mol/L. Each factor had a greater effect on the rate of Ni leaching in the following order: liquid–solid ratio > NH3·H2O concentration > leaching time > leaching temperature. The ammonia leaching recovery system was controlled by chemical reaction and the activation energy was 58.17 KJ/mol. The results of scanning electron microscopy-energy dispersion spectrum (SEM-EDS), x-ray diffraction (XRD), and X-ray photoelectron spectroscopy (XPS) show that the leaching slag was in granular form with agglomerated particles and particle size of approximately 2.8 μm The major components of the leaching slag were Fe(OH)3, Fe2O3, Fe(OH)2, Cr(OH)3, and Cr2O3. Therefore, this study provides a new and effective way of using the resources of SSPS. GRAPHICAL ABSTRACT
Many inspections are manipulable

A self-proclaimed expert uses past observations of a stochastic process to make probabilistic predictions about the process. An inspector applies a test function to the infinite sequence of predictions provided by the expert and the observed realization of the process in order to check the expert's reliability. If the test function is Borel and the inspection is such that a true expert always passes it, then it is also manipulable by an ignorant expert. The proof uses Martin's theorem about the determinacy of Blackwell games. Under the axiom of choice, there exist non-Borel test functions that are not manipulable.
Efficacy of Roxadustat on anemia and residual renal function in patients new to peritoneal dialysis

Abstract Background Both early correction of anemia and preserving residual renal function (RRF) are reported to improve patient survival. The aim of this study was to explore the efficacy and safety of Roxadustat for treatment of renal anemia in patients new to peritoneal dialysis (PD) and to assess its impact on RRF. Methods A retrospective analysis was performed on 60 initial peritoneal dialysis (PD) patients with renal anemia. Twenty-eight cases were treated with Roxadustat (Roxadustat group) and 32 with recombinant human erythropoietin (control group). Clinical characteristics, hemoglobin (Hb), C-reactive protein, blood lipids, iron metabolism, dialysis adequacy and RRF of the two groups were evaluated and adverse events were recorded. All patients were followed up for at least 40 weeks. Results After 40 weeks of treatment, mean Hb levels were significantly higher from baseline values in both groups, the mean Hb change in Roxadustat group was higher than control group (3.46 ± 1.59 g/dL vs. 2.28 ± 2.27 g/dL, p < 0.05). At 40 weeks, 92.9% patients met the target level of Hb in Roxadustat group and 84.4% in control group. Total iron binding was higher and ferritin was lower in Roxadustat group from baseline values and Roxadustat-induced Hb increases were independent of baseline C-reactive protein levels and history of rhuEPO administration. RRF decreased over time in both groups, the mean RRF change was lower in Roxadustat group than control group (1.15 ± 1.66 mL/min/1.73 m2 vs. 2.31 ± 1.46 mL/min/1.73 m2, p < 0.01). Compared with control group, patients in Roxadustat group had higher levels of total iron binding, 24 h urine volume, total weekly Ccr, and lower systolic pressure, ferritin, C-reactive protein, total cholesterol, LDL. No serious adverse reactions occurred in either group. Conclusion In patients new to PD, Roxadustat effectively and safely improved renal anemia and delay the decline of RRF.