Miracle-dz/UniFAR-FTUs huggingface dataset:
Total plaque area and plaque echogenicity are novel measures of subclinical atherosclerosis in patients with systemic lupus erythematosus.

OBJECTIVES Patients with systemic lupus erythematosus (SLE) have an increased risk of developing cardiovascular disease (CVD). Multiple studies have shown that these patients have increased numbers of carotid plaques and greater intima-media thickness (IMT) than healthy controls. Measures such as total plaque area (TPA) and plaque echogenicity may be more sensitive and more relevant to cardiovascular risk than presence of plaque and IMT alone. Our objective was to produce the first report of TPA and echogenicity in a population of. PATIENT s with SLE. METHODS One hundred patients with SLE and no history of clinical CVD were recruited. Clinical, serological and treatment variables were recorded and serum was tested for antibodies to apolipoprotein A-1 and high-density lipoprotein. Both carotid and both femoral artery bifurcations of each patient were scanned to determine IMT, TPA and echogenicity of plaques. Univariable and multivariable statistical analyses were carried out to define factors associated with each of these outcomes. RESULTS Thirty-six patients had carotid and/or femoral plaque. Increasing age was associated with presence of plaque and increased IMT. Triglyceride levels were associated with presence of plaque. Mean (SD) TPA was 60.8 (41. 6) mm2. Patients taking prednisolone had higher TPA. Most plaques were echolucent but increased echogenicity was associated with prednisolone therapy and persistent disease activity. CONCLUSION TPA and plaque echogenicity in patients with SLE are associated with different factors than those associated with presence of plaque and IMT. Longitudinal studies may show whether these outcome measures add value in the management of cardiovascular risk in SLE.
Impact of primary care involvement and setting on multidisciplinary heart failure management: a systematic review and meta‐analysis

Multidisciplinary disease management programmes (DMPs) are a cornerstone of modern guideline‐recommended care for heart failure (HF). Few programmes are community initiated or involve primary care professionals, despite the importance of home‐based care for HF. We compared the outcomes of different multidisciplinary HF DMPs in relation to their recruitment setting and involvement of primary care health professionals. We conducted a systematic review and meta‐analysis of randomized controlled trials published in MEDLINE, Embase, and Cochrane between 2000 and 2020 using Cochrane Collaboration methodology. Our meta‐analysis included 19 randomized controlled trials (7577 patients), classified according to recruitment setting and involvement of primary care professionals. Thirteen studies recruited in the hospital (n = 5243 patients) and six in the community (n = 2334 patients). Only six studies involved primary care professionals (n = 3427 patients), with two of these recruited in the community (n = 225 patients). Multidisciplinary HF DMPs that recruited in the community had no significant effect on all‐cause and HF readmissions nor on mortality, irrespective of primary care involvement. Studies that recruited in the hospital demonstrated a significant reduction in mortality (relative risk 0.87, 95% confidence interval [CI] [0.76, 0.98]), HF readmissions (0.70, 95% CI [0.54, 0.89]), and all‐cause readmissions (0.72, 95% CI [0.60, 0.87]). However, the difference in effect size between recruitment setting and involvement of primary care was not significant in a meta‐regression analysis. Multidisciplinary HF DMPs that recruit in the community have no significant effect on mortality or hospital readmissions, unlike DMPs that recruit in the hospital, although the difference in effect size was not significant in a meta‐regression analysis. Only six multidisciplinary studies involved primary care professionals. Given demographic evolutions and the importance of integrated home‐based care for patients with HF, future multidisciplinary HF DMPs should consider integrating primary care professionals and evaluating the effectiveness of this model.
Effect of Machine Learning on Dispatcher Recognition of Out-of-Hospital Cardiac Arrest During Calls to Emergency Medical Services

Key Points Question Can a machine learning model help medical dispatchers improve recognition of out-of-hospital cardiac arrest? Findings In this randomized clinical trial of 5242 emergency calls, a machine learning model listening to calls could alert the medical dispatchers in cases of suspected cardiac arrest. There was no significant improvement in recognition of out-of-hospital cardiac arrest during calls on which the model alerted dispatchers vs those on which it did not; however, the machine learning model had higher sensitivity that dispatchers alone. Meaning These findings suggest that while a machine learning model recognized a significantly greater number of out-of-hospital cardiac arrests than dispatchers alone, this did not translate into improved cardiac arrest recognition by dispatchers.
ResBCDU-Net: A Deep Learning Framework for Lung CT Image Segmentation

Lung CT image segmentation is a key process in many applications such as lung cancer detection. It is considered a challenging problem due to existing similar image densities in the pulmonary structures, different types of scanners, and scanning protocols. Most of the current semi-automatic segmentation methods rely on human factors therefore it might suffer from lack of accuracy. Another shortcoming of these methods is their high false-positive rate. In recent years, several approaches, based on a deep learning framework, have been effectively applied in medical image segmentation. Among existing deep neural networks, the U-Net has provided great success in this field. In this paper, we propose a deep neural network architecture to perform an automatic lung CT image segmentation process. In the proposed method, several extensive preprocessing techniques are applied to raw CT images. Then, ground truths corresponding to these images are extracted via some morphological operations and manual reforms. Finally, all the prepared images with the corresponding ground truth are fed into a modified U-Net in which the encoder is replaced with a pre-trained ResNet-34 network (referred to as Res BCDU-Net). In the architecture, we employ BConvLSTM (Bidirectional Convolutional Long Short-term Memory)as an advanced integrator module instead of simple traditional concatenators. This is to merge the extracted feature maps of the corresponding contracting path into the previous expansion of the up-convolutional layer. Finally, a densely connected convolutional layer is utilized for the contracting path. The results of our extensive experiments on lung CT images (LIDC-IDRI database) confirm the effectiveness of the proposed method where a dice coefficient index of 97.31% is achieved.
Undermining Credibility: The Limited Influence of Online Comments to Vaccine-related News Stories

State-sponsored disinformation campaigns increasingly use anti-vaccine comments to not only undermine public health but to also reduce confidence and participation in a democratic society. Despite these dangers, research has not fully explored whether anti-vaccine comments can achieve these effects. To address this gap, an online survey experiment was conducted using a national sample of 1010 U.S. adults. Participants read a mainstream news article discussing the flu vaccine that included random variations of user comments adapted from a documented state-sponsored disinformation campaign. While exposure to anti-vaccine comments did not affect participants’ views of vaccines or their willingness to discuss vaccines, participants holding pro-vaccine views reported lower confidence in news organizations and viewed the journalist who authored their article as less credible. These results suggest that anti-vaccine comments may produce effects that align with the goals of state-sponsored disinformation campaigns.
The Impact of Human Pressure and Climate Change on the Habitat Availability and Protection of Cypripedium (Orchidaceae) in Northeast China

Human pressure on the environment and climate change are two important factors contributing to species decline and overall loss of biodiversity. Orchids may be particularly vulnerable to human-induced losses of habitat and the pervasive impact of global climate change. In this study, we simulated the extent of the suitable habitat of three species of the terrestrial orchid genus Cypripedium in northeast China and assessed the impact of human pressure and climate change on the future distribution of these species. Cypripedium represents a genus of long-lived terrestrial orchids that contains several species with great ornamental value. Severe habitat destruction and overcollection have led to major population declines in recent decades. Our results showed that at present the most suitable habitats of the three species can be found in Da Xing’an Ling, Xiao Xing’an Ling and in the Changbai Mountains. Human activity was predicted to have the largest impact on species distributions in the Changbai Mountains. In addition, climate change was predicted to lead to a shift in distribution towards higher elevations and to an increased fragmentation of suitable habitats of the three investigated Cypripedium species in the study area. These results will be valuable for decision makers to identify areas that are likely to maintain viable Cypripedium populations in the future and to develop conservation strategies to protect the remaining populations of these enigmatic orchid species.
Psychometric properties of the Ryerson Social Anxiety Scales in individuals with social anxiety disorder

ABSTRACT Background Although numerous self-report measures of social anxiety exist, most instruments assess symptom severity by examining the range of social situations that provoke anxiety, rather than the distress and impairment associated with social anxiety. The Ryerson Social Anxiety Scales (RSAS; Lenton-Brym, A. P., Rogojanski, J., Hood, H. K., Vorstenbosch, V., McCabe, R. E., & Antony, M. M. (2020). Development and validation of the Ryerson Social Anxiety Scales (RSAS). Anxiety, Stress, & Coping, 33(6), 642–660), a measure assessing breadth of social anxiety inducing situations and severity of associated distress and impairment, was recently developed to fill this gap. The present study is the first to investigate the psychometric properties of the RSAS in a clinical sample. Method/Design Participants included 110 individuals with a principal diagnosis of social anxiety disorder (SAD). A subsample of participants (n = 23) completed cognitive–behavioural group treatment (CBGT) for SAD. Results The RSAS demonstrated excellent internal consistency. Examination of the correlations between the RSAS and other conceptually related and distinct measures supported the convergent and discriminant validity of the RSAS. The RSAS was also sensitive to changes in severity of social anxiety following CBGT. Conclusion The RSAS is a reliable and valid instrument for assessing the severity of SAD.
Significance of immediate dentin sealing and flowable resin coating reinforcement for unfilled/lightly filled adhesive systems.

BACKGROUND Immediate dentin sealing implies applying an adhesive system to dentin directly after tooth preparation, before impression. The technique is universal (inlays, onlays, veneers, crowns) and well documented clinically and experimentally. Different types of dentin bonding agents (DBAs) are available on the market. Major differences lie in the thickness of the hybrid layer and overlaying adhesive resin (filled vs. unfilled/lightly filled adhesives). OBJECTIVE The objective of this work is to provide precise clinical instructions and present new experimental data about the bond strength of five DBAs (Optibond FL, Scotchbond MP, Single Bond Plus, Clearfil SE Bond, and Scotchbond Universal) used conventionally (dentin sealed at the time of restoration delivery) or with immediate dentin sealing, as well as with an additional flowable resin coating. METHODS Seventy-five human molars were selected, restored/tested according the microtensile bond strength method. Fifteen groups (n=5) were obtained from the combination of the five DBAs and three application modes: delayed dentin sealing, immediate dentin sealing and immediate dentin sealing with flowable resin coating. RESULTS It appears that immediate dentin sealing was confirmed to significantly improve the bond strength of all tested adhesives. The use of a flowable resin coating reinforcement after immediate dentin sealing increased the microtensile bond strength of all unfilled/lightly filled adhesives (from 233% of increase for ScotchBond MP, up to 560% for Clearfil SE Bond) and maintained the performance of the 3-step golden standard adhesive. Optibond FL used with (52.51 MPa) or without (54.75 MPa) additional flowable resin coating and Clearfil SE Bond (45.64 MPa) used with flowable resin coating provided the best results. CLINICAL SIGNIFICANCE The original immediate dentin sealing (IDS) technique implies the use of a filled DBA. With unfilled/lightly filled adhesives, it is suggested to reinforce IDS with an additional flowable resin coating. This seems especially paramount to the performance of simplified adhesive systems to protect the thin bonding interface from oxygen inhibition and preserve IDS layer during predelivery cleaning of the preparation. The clinical reinforcement of unfilled/lightly filled IDS with flowable resin composite is encouraged for more predictable bonding.
Macrophage Migration Inhibitory Factor (MIF) and Its Homologue D-Dopachrome Tautomerase (DDT) Inversely Correlate with Inflammation in Discoid Lupus Erythematosus

Discoid Lupus Erythematosus (DLE) is a chronic cutaneous disease of unknown etiology and of immunoinflammatory origin that is characterized by inflammatory plaques and may lead to disfiguring scarring and skin atrophy. Current treatments are limited, with a large proportion of patients either poorly or not responsive, which makes DLE an unmet medical need. Macrophage migration inhibitory factor (MIF) is the prototype of a pleiotropic family of cytokine that also includes the recently discovered homologue D-dopachrome tautomerase (DDT) or MIF2. MIF and DDT/MIF-2 exert several biological properties, primarily, but not exclusively of a proinflammatory nature. MIF and DDT have been suggested to play a key role in the pathogenesis of several autoimmune diseases, such as multiple sclerosis and type 1 diabetes, as well as in the development and progression of certain forms of cancers. In the present study, we have performed an immunohistochemistry analysis for the evaluation of MIF in DLE lesions and normal skin. We found high levels of MIF in the basal layer of the epidermis as well as in the cutaneous appendage (eccrine glands and sebocytes) of normal skin. In DLE lesions, we observed a significant negative correlation between the expression of MIF and the severity of inflammation. In addition, we performed an analysis of MIF and DDT expression levels in the skin of DLE patients in a publicly available microarray dataset. Interestingly, while these in silico data only evidenced a trend toward reduced levels of MIF, they demonstrated a significant pattern of expression and correlation of DDT with inflammatory infiltrates in DLE skins. Overall, our data support a protective role for endogenous MIF and possibly DDT in the regulation of homeostasis and inflammation in the skin and open up novel avenues for the treatment of DLE.
Co-existing obstructive sleep apnea among patients with chronic obstructive pulmonary disease

Background and Objectives: Chronic obstructive pulmonary disease (COPD) is a common airway disease that is frequently associated with comorbidities. In this study, we assessed the co-existence of obstructive sleep apnea (OSA) among patients with stable COPD. Methodology: This cross-sectional study included patients with stable COPD who were screened with Epworth's Sleepiness Scale (ESS). Those with ESS score of >10 were subjected to in-lab polysomnography (PSG). PSG was manually analyzed and reported. Patients with apnea–hypopnea index of >5/h were diagnosed as OSA. Results: This study included 301 patients (78.1% male, 76.4% smokers, age 59.6 ± 10 years) with stable COPD. ESS score of >10 was observed in 47 (15.6%) patients. Among patients with ESS score of >10, OSA was observed in 34 (72.3%) patients. The overall prevalence of OSA among patients with COPD was 10.9%. Patients with co-existing OSA were older and had thicker neck and higher body mass index (BMI) as compared to COPD alone. In addition, patients with associated OSA had worse health-related quality of life (QOL) as shown by higher St. George's Respiratory Questionnaire score (42.42 ± 7.22 vs. 25.22 ± 8.66;P < 0.001). Conclusions: Co-existing OSA is common among patients with COPD and has a significant adverse effect on the QOL. Among COPD patients, older age, thick neck, and high BMI may predict co-existing OSA and require PSG for the confirmation.
Spread of Carbapenem-Resistant Gram-Negatives and Candida auris during the COVID-19 Pandemic in Critically Ill Patients: One Step Back in Antimicrobial Stewardship?

The possible negative impact of severe adult respiratory distress caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection (COVID-19) on antimicrobial stewardship and infection control has been postulated, but few real-life data are available. The aim of this study was to report our experience with colonization/infection of carbapenem-resistant Pseudomonas aeruginosa (CRPA), carbapenem-resistant Klebsiella pneumoniae (CR-Kp) and Candida auris among critically ill COVID-19 patients admitted to the intensive care unit (ICU). All COVID-19 patients admitted to the ICUs at San Martino Policlinico Hospital–IRCCS in Genoa, Italy, were screened from 28 February to 31 May 2020. One-hundred and eighteen patients admitted to COVID-19 ICUs were included in the study. Among them, 12 (10.2%) became colonized/infected with CRPA, 6 (5.1%) with C. auris and 2 (1.6%) with CR-Kp. All patients with CRPA received prior treatment with meropenem, and in 11 (91.7%) infection was not preceded by colonization. Four patients (66.7%) developed C. auris candidemia. A significant spread of resistant pathogens was observed among critically ill COVID-19 patients. Dedicated strategies are warranted to prevent horizontal spread and maintain effective antimicrobial stewardship programs in the setting of COVID-19 care.
Ral GTPases promote breast cancer metastasis by controlling biogenesis and organ targeting of exosomes

Cancer extracellular vesicles (EVs) shuttle at distance and fertilize pre-metastatic niches facilitating subsequent seeding by tumor cells. However, the link between EV secretion mechanisms and their capacity to form pre-metastatic niches remains obscure. Using mouse models, we show that GTPases of the Ral family control, through the phospholipase D1, multi-vesicular bodies homeostasis and tune the biogenesis and secretion of pro-metastatic EVs. Importantly, EVs from RalA or RalB depleted cells have limited organotropic capacities in vivoand are less efficient in promoting metastasis. RalA and RalB reduce the EV levels of the adhesion molecule MCAM/CD146, which favors EV-mediated metastasis by allowing EVs targeting to the lungs. Finally, RalA, RalB, and MCAM/CD146, are factors of poor prognosis in breast cancer patients. Altogether, our study identifies RalGTPases as central molecules linking the mechanisms of EVs secretion and cargo loading to their capacity to disseminate and induce pre-metastatic niches in a CD146-dependent manner.
Role of Melatonin on Virus-Induced Neuropathogenesis—A Concomitant Therapeutic Strategy to Understand SARS-CoV-2 Infection

Viral infections may cause neurological disorders by directly inducing oxidative stress and interrupting immune system function, both of which contribute to neuronal death. Several reports have described the neurological manifestations in Covid-19 patients where, in severe cases of the infection, brain inflammation and encephalitis are common. Recently, extensive research-based studies have revealed and acknowledged the clinical and preventive roles of melatonin in some viral diseases. Melatonin has been shown to have antiviral properties against several viral infections which are accompanied by neurological symptoms. The beneficial properties of melatonin relate to its properties as a potent antioxidant, anti-inflammatory, and immunoregulatory molecule and its neuroprotective effects. In this review, what is known about the therapeutic role of melatonin in virus-induced neuropathogenesis is summarized and discussed.
Three-Dimensional Planes of Reference for Orbital Fractures

Supplemental Digital Content is available in the text Introduction: Three-dimensional planes of reference for orbital fractures (3D-PROF) is a technique for isolating segments of the orbital cavity for 3D analyses. Method: Using 3D-PROF, the orbital floor, and medial wall were isolated on Meshlab (National Research Council, Pisa, Italy). (1) Hemi-facial segmentation: Removal of contralateral skull using the mid-sagittal plane(2) Caudal-facial segmentation: Removal of facial bones below the plane across the infraorbital foramen and external acoustic meatus(3) Superolateral segmentation: Removal of orbital roof and lateral wall using a plane across the inferior orbital fissure, external acoustic meatus, and posterior clinoid process(4) Posterior skull segmentation: Removal of skull segment posterior to the orbital cavity using the orbital apex as reference point A pilot study was conducted to evaluate the interobserver variability of 3D-PROF. Facial computed tomography scans of 20 patients with normal unilateral orbit were randomly selected. Four observers performed 3D-PROF to isolate the orbital floor. The isolated orbital segments are evaluated for:(1) Total surface area(2) Preservation of 3 critical landmarks (infraorbital rim, posteromedial bulge, inferior orbital fissure) Results: The intraclass correlation coefficient for the total surface area of the resultant bony segment was excellent (0.85, confidence interval 0.707–0.934, P < 0.01). All landmarks achieved a rate of preservation of at least 90% (18/20) for the observers, except for the infra-orbital rim where 1 observer achieved 85% (17/20). Conclusion: Three-dimensional planes of reference for orbital fractures, is an easy and reproducible technique for isolating regions of interest of the orbital cavity for preoperative planning.
Gender Stereotypes in Natural Language: Word Embeddings Show Robust Consistency Across Child and Adult Language Corpora of More Than 65 Million Words

Stereotypes are associations between social groups and semantic attributes that are widely shared within societies. The spoken and written language of a society affords a unique way to measure the magnitude and prevalence of these widely shared collective representations. Here, we used word embeddings to systematically quantify gender stereotypes in language corpora that are unprecedented in size (65+ million words) and scope (child and adult conversations, books, movies, TV). Across corpora, gender stereotypes emerged consistently and robustly for both theoretically selected stereotypes (e.g., work–home) and comprehensive lists of more than 600 personality traits and more than 300 occupations. Despite underlying differences across language corpora (e.g., time periods, formats, age groups), results revealed the pervasiveness of gender stereotypes in every corpus. Using gender stereotypes as the focal issue, we unite 19th-century theories of collective representations and 21st-century evidence on implicit social cognition to understand the subtle yet persistent presence of collective representations in language.