Miracle-dz/UniFAR-FTUs huggingface dataset:
Probenecid treatment improves outcomes in a novel mouse model of peripartum cardiomyopathy

Probenecid has been used for decades in the treatment of gout but recently has also been found to improve outcomes in patients with heart failure via stimulation of the transient receptor potential vanilloid 2 (TRPV2) channel in cardiomyocytes. This study tested the use of probenecid on a novel mouse model of peripartum cardiomyopathy (PPCM) as a potential treatment option. A human mutation of the human heat shock protein 20 (Hsp20-S10F) in mice has been recently shown to result in cardiomyopathy, when exposed to pregnancies. Treatment with either probenecid or control sucrose water was initiated after the first pregnancy in both wild type and Hsp20-S10F mice. Serial echocardiography was performed during subsequent pregnancies and hearts were collected after the third pregnancies for staining and molecular analysis. Hsp20-S10F mice treated with probenecid had decreased mortality, hypertrophy, TRPV2 expression and molecular parameters of heart failure. Probenecid treatment also decreased apoptosis as evidenced by an increase in the level of Bcl-2/Bax. Probenecid improved survival in a novel mouse model of PPCM and may be an appropriate therapy for humans with PPCM as it has a proven safety and tolerability in patients with heart failure.
CHTF18 ensures the quantity and quality of the ovarian reserve†

Abstract The number and quality of oocytes, as well as the decline in both of these parameters with age, determines reproductive potential in women. However, the underlying mechanisms of this diminution are incompletely understood. Previously, we identified novel roles for CHTF18 (Chromosome Transmission Fidelity Factor 18), a component of the conserved Replication Factor C-like complex, in male fertility and gametogenesis. Currently, we reveal crucial roles for CHTF18 in female meiosis and oocyte development. Chtf18–/– female mice are subfertile and have fewer offspring beginning at 6 months of age. Consistent with age-dependent subfertility, Chtf18–/– ovaries contain fewer follicles at all stages of folliculogenesis than wild type ovaries, but the decreases are more significant at 3 and 6 months of age. By 6 months of age, both primordial and growing ovarian follicle pools are markedly reduced to near depletion. Chromosomal synapsis in Chtf18–/– oocytes is complete, but meiotic recombination is impaired resulting in persistent DNA double-strand breaks, fewer crossovers, and early homolog disjunction during meiosis I. Consistent with poor oocyte quality, the majority of Chtf18–/– oocytes fail to progress to metaphase II following meiotic resumption and a significant percentage of those that do progress are aneuploid. Collectively, our findings indicate critical functions for CHTF18 in ensuring both the quantity and quality of the mammalian oocyte pool. Summary sentence CHTF18 ensures both the quantity and quality of the mammalian oocyte pool and may play a role in delaying ovarian aging.
Use of Topical Tranexamic Acid to Reduce Blood Loss in Single-Level Transforaminal Lumbar Interbody Fusion

Study Design Nonrandomized, prospective, and case-controlled study. Purpose To evaluate the efficacy and cost-effectiveness of topically applied tranexamic acid (TXA) during different phases of spine surgery. Overview of Literature Perioperative blood loss is the leading cause of postoperative anemia associated with prolonged stays in hospital and long recovery times. The direct and indirect costs involved pose a significant economic challenge in developing countries. There is no consensus for topical use of tranexamic acid in spine surgery. Methods Patients requiring a single-level TLIF were divided into two groups. In the TXA group (n=75), the wound surface was soaked with TXA (1 g in 100 mL saline solution) for 3 minutes after exposure, after decompression, and before wound closure, and in the control group (n=175) using only saline. Intraoperative blood loss drain volume was recorded on each of the first 2 days immediately after surgery. An estimated cost analysis was made on the basis of the length of hospital stay and the blood transfusion. Results IBL for the control group was 783.33±332.71 mL and for intervention group 410.57±189.72 mL (p<0.001). The operative time for control group was 3.24±0.38 hours and for intervention group 2.99±0.79 hours (p<0.695). Hemovac drainage on days 1 and 2 for control group was 167.10±53.83 mL and 99.33±37.5 mL, respectively, and for intervention group 107.03±44.37 mL and 53.38±21.99 mL, respectively (p<0.001). The length of stay was significantly shorter in the intervention group (4.8±1.1 days) compared to control group (7.0±2.3 days). The cost of treatment in the intervention group was US dollar (USD) 4,552.57±1,222.6 compared with that in the control group USD 6,529.9±1,505.04. Conclusions Topical TXA is a viable, cost-effective method of decreasing perioperative blood loss in major spine surgery with fewer overall complications than other methods. Further studies are required to find the ideal dosage and timing.
Efficacy of Hyalase Hydrodissection in the Treatment of Carpal Tunnel Syndrome: A Randomized, Double-Blind, Controlled, Clinical Trial.

BACKGROUND Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy, which results from median nerve compression. A lot of nonsurgical modalities are available for the management of mild to moderate situations. Local Hyalase hydrodissection (HD) of the entrapped median nerve could offer a desirable sustained symptom alleviation. OBJECTIVES To evaluate the clinical efficacy of Hyalase/saline solution carpal tunnel HD on pain, functional status, and nerve conduction in patients with CTS. STUDY DESIGN A randomized, double-blinded trial. SETTING Anesthesia, pain, and rheumatology clinics in a university hospital. METHODS Patients: 60 patients with CTS (> 6 months' duration). INTERVENTION patients were allocated equally into either group 1 (HD with Hyalase + 10 mL saline solution injection), or group 2 (HD with 10 mL saline solution only). MEASUREMENTS assessment of pain using Visual Analog Scale (VAS), functional disability (FD) score, and nerve conduction studies before injection, and over 6 months after injection. Nerve conduction parameters before injection and postinjection by the end of 3 and 6 months were evaluated as well. RESULTS Statistically significant lower postinjection values of VAS (1 ± 1.8, 2 ± 1.1, 2 ± 1.2, 2 ± 1.1) in group 1 versus (2 ± 1.2, 3 ± 1.7, 4 ± 1.5, 5 ± 2.6) in group 2 by the end of the first week, and the first, third, and sixth months, and significantly lower FD scores (15.3 ± 1.2, 13 ± 1.3, 10.2 ± 1.3, 10.2 ± 1.3) in group 1 versus (17.5 ± 1.8, 16.6 ± 2.8, 19.4 ± 3.2, 21.2 ± 2.5) in group 2 during the same time intervals. Nerve conduction study parameters have shown significantly higher velocity and lower latency in the Hyalase group than in the saline solution group by the 3 and 6 month follow-up. LIMITATION We suggest a longer period could be reasonable. CONCLUSIONS Carpal tunnel HD with Hyalase with saline solution is considered as an efficient technique offering a rapid onset of pain relief and functional improvements, and better median nerve conduction in patients with CTS over 6 months follow-up duration. KEY WORDS Carpal tunnel syndrome, Hyalase, median nerve hydrodissection.
Principles and Applications of Multi-energy CT Report of AAPM Task Group 291.

In x-ray computed tomography (CT), materials with different elemental compositions can have identical CT number values, depending on the mass density of each material and the energy of the detected x-ray beam. Differentiating and classifying different tissue types and contrast agents can thus be extremely challenging. In multi-energy CT, one or more additional attenuation measurements are obtained at a second, third or more energy. This allows the differentiation of at least two materials. Commercial dual-energy CT systems (only two energy measurements) are now available either using sequential acquisitions of low- and high-tube potential scans, fast tube-potential switching, beam filtration combined with spiral scanning, dual-source, or dual-layer detector approaches. The use of energy-resolving, photon-counting detectors is now being evaluated on research systems. Irrespective of the technological approach to data acquisition, all commercial CT multi-energy systems today provide dual-energy data. Material decomposition algorithms are then used to identify specific materials according to their effective atomic number and/or to quantitate mass density. These algorithms are applied to either projection or image data. Since 2006, a number of clinical applications have been developed for commercial release, including those that automatically 1) remove the signal from bony anatomy and/or calcified plaque; 2) create iodine concentration maps from contrast-enhanced CT data and/or quantify absolute iodine concentration; 3) create virtual non-enhanced images from contrast-enhanced scans; 4) identify perfused blood volume in lung parenchyma or the myocardium; and 5) characterize materials according to their elemental compositions, which can allow in vivo differentiation between uric-acid and non-uric-acid urinary stones or uric acid (gout) or non-uric-acid (calcium pyrophosphate) deposits in articulating joints and surrounding tissues. In this report, the underlying physical principles of multi-energy CT are reviewed and each of the current technical approaches described. In addition, current and evolving clinical applications are introduced. Finally, the impact of multi-energy CT technology on patient radiation dose is summarized.
Strength Training Induces Greater Increase in Handgrip Strength than Wrestling Training per se

Abstract This study investigated the effectiveness of a specialized strength training program on maximal handgrip strength in young wrestlers. 72 young wrestlers (36 children: 8–10 years-old and 36 adolescents:13–15 years-old) participated in the present study. Both age-categories were assigned into a training group (18 children and 18 adolescents) and a control group (18 children and 18 adolescents). The training groups, in conjunction with the wrestling training performed a 4-month (2 sessions/week) specialized handgrip training program. Maximal handgrip strength was evaluated pre, at the intermediate (2 months) and at the completion of the program (4 months). Maximal handgrip strength values increased during the intermediate and post-training measurements compared to pre-training measurement in training and control groups (p<0.001). No significant differences were observed on pre-training and intermediate measurements between groups, while significant differences were observed during the post-training measurement. Training group exhibited significantly (p<0.01) greater maximal handgrip strength values than the control group irrespective of age-category and hand-preference. A 4-month handgrip strength training program, incorporated into the conventional wrestling training, provokes greater adaptations in maximal handgrip strength than the wrestling training per se. For greater handgrip training adaptations are required more than 14 specialized handgrip training-sessions.
Three-dimensional nasal septum and maxillary changes following rapid maxillary expansion in patients with cleft lip and palate: A case-series analysis.

OBJECTIVES To determine the three-dimensional changes of the nasal septum (NS), alveolar width, alveolar cleft volume, and maxillary basal bone following rapid maxillary expansion (RME) in consecutive patients with unilateral cleft lip and palate (UCLP). MATERIALS AND METHODS A retrospective investigation was conducted based on the analysis of cone-beam computed tomography (CBCT) data of 40 consecutive patients with UCLP (mean age 11.1 ± 2.2 years). Scans were acquired prior to RME (T0) and after removal of the expander (T1) before graft surgery. A three-dimensional analysis of the effects of RME on the nasal septum, alveolar width, alveolar cleft volume, and maxillary basal bone was performed. RESULTS No changes in the NS deviation were observed following RME (P > .05). Significant increases of the alveolar transverse dimension were found in the anterior (14.2%; P < .001) and posterior (7.7%; P < .001) regions as well as in the volume of the alveolar cleft (19.6%; P < .001). No changes in the basal bone dimensions and morphology were observed (P > .05). CONCLUSIONS Following RME, no changes were observed in the NS and maxillary basal bones of patients with UCLP despite the significant gain in the anterior and posterior alveolar width and the increase of the alveolar cleft defect. Clinicians should be aware that maxillary changes following RME in patients with UCLP are restricted to the dentoalveolar region.
Comparison of Somatic Mutation Profiles Between Formalin-Fixed Paraffin Embedded Tissues and Plasma Cell-Free DNA from Ovarian Cancer Patients Before and After Surgery

Ovarian carcinogenesis can be induced by a large number of somatic gene mutations. Circulating tumor DNA (ctDNA) released into peripheral blood can provide insights into the genomic landscape of cancer cells and monitor their dynamics. Our aim was to detect and compare the genetic profiles in tumor tissue and plasma before and after tumor resection in ovarian cancer patients. All three samples were collected from each patient. In this study, we used a commercial cancer panel to identify somatic mutations in 26 genes in seven selected patients through next-generation sequencing on the Illumina platform. Overall, 16 variants with pathogenic effect were identified in the TP53, PIK3CA, PTEN, APC, NRAS, KRAS, GNAS, and MET genes involved in important signaling pathways. The genetic alterations found in the presurgical plasma in six of seven ovarian cancer patients were no longer present in the plasma after tumor surgical removal. Identical variants in formalin-fixed paraffin embedded (FFPE) tissues and preoperative plasma specimens were observed in only two cases. These findings suggest that the detected presurgical pathogenic variants absent in postsurgery plasma are associated with the primary ovarian tumor. Finally, the low-identified concordance between FFPE and plasma can be due to various factors, but most likely to high tumor heterogeneity and low ctDNA level.
Non-consumptive predator effects on prey population size: a dearth of evidence.

There is a large and growing interest in non-consumptive effects of predators. Diverse and extensive evidence shows that predation risk directly influences prey traits, such as behaviour, morphology, and physiology, which in-turn, may cause a reduction in prey fitness components (i.e., growth rate, survival, and reproduction). An intuitive expectation is that non-consumptive effects that reduce prey fitness will extend to alter population growth rate and therefore population size. However, our intensive literature search yielded only 10 studies that examined how predator-induced changes in prey traits translate to changes in prey population size. Further, the scant evidence for risk-induced changes on prey population size have been generated from studies that were performed in very controlled systems (mesocosm and laboratory), which do not have the complexity and feedbacks of natural settings. Thus, although likely that predation risk alone can alter prey population size, there is little direct empirical evidence that demonstrates that it does. There are also clear reasons that risk effects on population size may be much smaller than the responses on phenotype and fitness components that are typically measured, magnifying the need to show, rather than infer, effects on population size. Herein we break down the process of how predation risk influences prey population size into a chain of events (predation risk affects prey traits, which affect prey fitness components and population growth rate, which affect prey population size), and highlight the complexity of each transition. We illustrate how the outcomes of these transitions are not straightforward, and how environmental context strongly dictates the direction and magnitude of effects. Indeed, the high variance in prey responses is reflected in the variance of results reported in the few studies that have empirically quantified risk effects on population size. It is therefore a major challenge to predict population effects given the complexity of how environmental context interacts with predation risk and prey responses. We highlight the critical need to appreciate risk effects at each level in the chain of events, and that changes at one level cannot be assumed to translate into changes in the next because of the interplay between risk, prey responses, and the environment. The gaps in knowledge we illuminate underscore the need for more evidence to substantiate the claim that predation risk effects extend to prey population size. The lacunae we identify should inspire future studies on the impact of predation risk on population-level responses in free-living animals.
Clustering with varying risks of false assignments in discrete latent variable model

Abstract In clustering problems, to model the intrinsic structure of unlabeled data, the latent variable models are frequently used. These model-based clustering methods often provide a clustering rule minimizing the total false assignment error. However, in many clustering applications, it is desirable to treat false assignment errors for a certain cluster differently. In this paper, we introduce the false assignment rate for clustering and estimate it by using the extended likelihood approach. We propose VRclust, a novel clustering rule that controls various errors differently across clusters. Real data examples illustrate the usage of estimation of false assignment rate and a simulation study shows that error controls are consistent as the sample size increases.
Prognostic significance of inflammatory indices in hepatocellular carcinoma treated with transarterial chemoembolization: A systematic review and meta-analysis

Objectives To investigate the association between inflammatory indices and clinical outcomes of hepatocellular carcinoma (HCC) patients treated with transarterial chemoembolization (TACE) by performing meta-analysis. Methods A systematic literature search for relevant studies published up to August 2019 was performed by using PubMed, Web of Science, EMBASE, China National Knowledge Internet (CNKI) and Wanfang databases. Pooled hazard ratios (HR) or odds ratio (OR) and 95% confidence intervals (95% CI) were calculated. Results A total of 5280 patients from 22 studies were finally enrolled in the meta-analysis. The results demonstrated that elevated preoperative NLR, PLR, and CRP was associated with poor OS in HCC patients treated by TACE (HR = 1.81, P<0.00001; HR = 1.56, P = 0.007; HR = 1.45, P<0.00001, respectively). In addition, high NLR was significantly correlated with the presence of tumor vascular invasion (OR = 1.49, P = 0.002). Elevated PLR tended to be correlated with higher incidence of tumor size>3 cm (OR = 2.42, P = 0.005). Conclusions Elevated preoperative NLR, PLR, and CRP are associated with poor prognosis in HCC patients treated with TACE. These inflammatory indices may be convenient, accessible, affordable and dependable biomarkers with prognostic potential for HCC patients treated by TACE.
Simultaneous Trajectory Generation and Volumetric Modulated Arc Therapy Optimization.

PURPOSE Trajectory-based treatment planning involves the combination of a gantry-couch trajectory with volumetric modulated arc therapy (VMAT) treatment plan optimization. This work presents the implementation of an optimization methodology that generates a trajectory simultaneous with treatment plan optimization (simTr-VMAT). METHODS The optimization algorithm is based on the column generation approach, in which a treatment plan is iteratively constructed through the solution of a subproblem called the "pricing problem". The property of the pricing problem to rank candidate apertures based on their associated price is leveraged to select an optimal aperture while simultaneously determining the trajectory path. A progressively increasing gantry-couch grid resolution is used to provide an initial coarse sampling of the angular solution space while maintaining fine control point spacing with the final treatment plan. The trajectory optimization was applied and compared to coplanar VMAT treatment plans for a lung patient, a glioblastoma patient, and a prostate patient. Algorithm validation was performed through the generation of 5000 random trajectories and optimization using column generation VMAT for each patient case, representing the solution space for the trajectory optimization problem. The simTr-VMAT trajectories were compared against these random trajectories based on a quality metric that prefers trajectories with few control points and low objective function value over long, inefficient trajectories. RESULTS For the lung patient, the simTr-VMAT plan resulted in a decrease of the mean dose of 1.5 Gy and 1.0 Gy to the heart and ipsilateral lung, respectively. For the glioblastoma patient, the simTr-VMAT plan resulted in improved PTV coverage with a decrease in mean dose to the eyes, lens, nose, and contralateral temporal lobe between 2 and 7 Gy. The prostate patient showed no clinically-relevant dosimetric improvement. The simTr-VMAT treatment plans ranked at the 99.6, 96.3, and 99.4 percentiles compared to the distribution of randomly generated trajectories for the lung, glioblastoma, and prostate patients, respectively. CONCLUSION The simTr-VMAT optimization methodology resulted in treatment plans with equivalent or improved dosimetric outcomes compared to coplanar VMAT treatment plans, with the trajectories resulting from the optimization ranking among the optimal trajectories for each patient case.
Main Patterns of Fetal Cardiac Remodeling

The heart is a central organ in the fetal adaptation to an adverse environment. Fetal cardiac changes may persist postnatally and increase the risk of cardiovascular disease in adulthood. Knowledge about fetal cardiac structural as well as functional remodeling has radically improved over the last few years. As it occurs in postnatal life, the fetal heart remodels – changing its structure and shape – to adapt to an insult. Several conditions have been reported to be associated with fetal cardiac remodeling including intrauterine growth restriction, diabetes, exposure to antiretroviral drugs, conception by assisted reproductive technologies, pulmonary stenosis, and other congenital heart diseases. Here we summarized the main observable patterns of cardiac remodeling, i.e., globular shape, hypertrophy without dilation, and hypertrophy with cardiomegaly. We discuss the potential pathophysiology behind different types of remodeling. Defining precisely the distinct patterns of fetal cardiac remodeling is critical for advancing in the understanding of fetal cardiovascular programming and its consequences on adult health, and potentially for the design of preventive strategies that might have an impact on long-term cardiovascular health.